Search results for: regional hospital

Authors: Abdulrahman Al Lily

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This article spans the domains of education, technology and geo-politics. It uses as an instance the Arab scholarship of education and technology, viewing its scholarly community through the geographical lens of regionalism. It enquires into the power relations among scholars in the Arab region and between scholars in the Arab region and their fellows from outside the region. It addresses the research question: to what extent have region-informed factors affected the scholarly community of education and technology in the Arab region? This question was answered by both qualitative and numerical enquiry, analysing documents, interviews and a survey of native Arabic-speaking scholars. Having analysed the data using the grounded theory approach, two categories of power relations among scholars were identified: power relations within a particular region and power relations across regions. Considering these two categories, a theoretical proposition could be posited that there could be power relationships among scholars that exist on a regional basis. The recommendation is therefore that research should further shed light upon the regionalistic (and thus geographically informed political) dynamics of scholarly communities.

Keywords: education, technology, politics, geography, regionalism, Arab

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Authors: H. Nur Görkemli, Mehmet Fidan

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After the first acquaintance with internet in April 1993, number of internet users increased rapidly in Turkey. According to Turkish Statistical Institute’s 2013 data, internet usage in Turkey between 16-74 age group is 48,9%. Hospitals are one of the areas where internet is being intensively used like many other businesses. As a part of public relations application, websites are important tools for hospitals to reach a wide range of target audience within and outside the organization. With their websites, hospitals have opportunities to give information about their organization, strengthen their image, compete with their rivals, interact with shareholders, reflect their transparency and meet with new audiences. This study examines web sites of totally 31 hospitals which are located in Konya. Institutions are categorized as public and private hospitals and then three main research categories are determined: content, visual and technical. Main and sub categories are examined by using content analysis method. Results are interpreted in terms of public and private institutions.

Keywords: websites, hospital, health communication, internet, webpages

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Authors: Emrah Yildirim, Veli Ortacesme

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Manavgat region, located in Antalya province at South Turkey, has hosted many civilizations throughout the centuries. All of these civilizations cultivated the land in their surroundings by engaging in agriculture, livestock production and hunting. In the last 50 years, there have been dramatic changes in the region. The economy of the region switched from the agriculture to tourism. Due to the increase in the irrigable agricultural lands, several dams were built on Manavgat River. Developments in the agricultural mechanization and new product needs have changed the pattern of agriculture and regional landscape. Coastal zone of the region has transformed to tourism areas, Manavgat Town Center has grown up and the urbanization in general has increased. The population and urbanization have increased by 257 % and 276 %, respectively. The tourism and commercial areas cover 561,8 hectares today. All these developments had some negative effects on the environment. In this study, land use/land cover transformations were studied in Manavgat region by using aerial photos. The reasons and consequences of the land use transformations were discussed, and some recommendations regarding the sustainable use of this region’s landscape will be shared.

Keywords: land use, Manavgat region, south Turkey, transformation

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Authors: Donald Kushon, Jyoti Pillai

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Psychogenic Non-epileptic Seizure Disorder (PNES) is a challenging clinical problem for the neurologist. This study explores the benefits of on-site collaboration between psychiatry and neurology in the management of PNES. A 3 month period at a university hospital seizure clinic is described detailing specific management approaches taken as a result of this collaboration. This study describes four areas of interest: (1. After the video EEG results confirm the diagnosis of PNES, the presentation of the diagnosis of PNES to the patient. (2. The identification of co-morbid psychiatric illness (3. Treatment with specific psychotherapeutic interventions (including Cognitive Behavioral Therapy) and psychopharmacologic interventions (primarily SSRIs) and (4. Preliminary treatment outcomes.

Keywords: cognitive behavioral therapy (CBT), psychogenic non-epileptic seizure disorder (PNES), selective serotonin reuptake inhibitors (SSRIs), video electroencephalogram (VEEG)

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Authors: Jaana Sepp, Ulvi Kõrgemaa, Kristi Puusepp, Õie Tähtla

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COVID-19 was officially recognized as a pandemic in late 2019 by the WHO, and it has led to changes in the education sector. Educational institutions were closed, and most schools adopted distance learning. Estonia is known as a digitally well-developed country. Based on that, in the pandemic time, nursing education continued, and new technological solutions were implemented. To provide nursing education, special focus was paid on quality and flexibility. The aim of this paper is to present administrative, digital, and technological solutions which support Estonian nursing educators to continue the study process in the pandemic time and to develop a sustainable solution for nursing education for the future. This paper includes the authors’ analysis of the documents and decisions implemented in the institutions through the pandemic time. It is a case study of Estonian nursing educators. Results of the analysis show that the implementation of distance learning principles challenges the development of innovative strategies and technics for the assessment of student performance and educational outcomes and implement new strategies to encourage student engagement in the virtual classroom. Additionally, hospital internships were canceled, and the simulation approach was deeply implemented as a new opportunity to develop and assess students’ practical skills. There are many other technical and administrative changes that have also been carried out, such as students’ support and assessment systems, the designing and conducting of hybrid and blended studies, etc. All services were redesigned and made more available, individual, and flexible. Hence, the feedback system was changed, the information was collected in parallel with educational activities. Experiences of nursing education during the pandemic time are widely presented in scientific literature. However, to conclude our study, authors have found evidence that solutions implemented in Estonian nursing education allowed the students to graduate within the nominal study period without any decline in education quality. Operative information system and flexibility provided the minimum distance between the students, support, and academic staff, and likewise, the changes were implemented quickly and efficiently. Institution memberships were updated with the appropriate information, and it positively affected their satisfaction, motivation, and commitment. We recommend that the feedback process and the system should be permanently changed in the future to place all members in the same information area, redefine the hospital internship process, implement hybrid learning, as well as to improve the communication system between stakeholders inside and outside the organization. The main limitation of this study relates to the size of Estonia. Nursing education is provided by two institutions only, and similarly, the number of students is low. The result could be generated to the institutions with a similar size and administrative system. In the future, the relationship between nurses’ performance and organizational outcomes should be deeply investigated and influences of the pandemic time education analyzed at workplaces.

Keywords: hybrid learning, nursing education, nursing, COVID-19

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Authors: Anatoly V. Stepanov, Maria Y. Ilyushkina, Alexander S. Burnasov

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Expansion of tourism, especially after WWII, has led to significant improvements in the regional infrastructure. The present study has revealed a lot of progress in the advancement of industrial heritage narrative in the Central Urals. The evidence comes from the general public’s increased fascination with some of Europe’s oldest mining and industrial sites, and the agreement of many stakeholders that the Urals industrial heritage should be preserved. The development of tourist sites in Nizhny Tagil and Nevyansk, gold-digging in Beryosovsky, gemstone search in Murzinka, and the progress with the Urals Gemstone Ring project are the examples showing the immense opportunities of industrial heritage tourism development in the region that are still to be realized. Regardless of the economic future of the Central Urals, whether it will remain an industrial region or experience a deeper deindustrialization, the sprouts of the industrial heritage tourism should be advanced and amplified for the benefit of local communities and the tourist community at large as it is hard to imagine a more suitable site for the discovery of industrial and mining heritage than the Central Urals Region of Russia.

Keywords: industrial heritage, mining heritage, Central Urals, Russia

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Authors: J. Junk, M. Eickermann

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The Small Hive Beetle, Aethina tumida (Coleoptera: Nitidulidae) is a parasite for honey bee colonies, Apis mellifera, and was recently introduced to the European continent, accidentally. Based on the literature, a model was developed by using regional meteorological variables (daily values of minimum, maximum and mean air temperature as well as mean soil temperature at 50 mm depth) to calculate the time-point of hive invasion by A. tumida in springtime, the development duration of pupae as well as the number of generations of A. tumida per year. Luxembourg was used as a test region for our model for 2005 to 2013. The model output indicates a successful surviving of the Small Hive Beetle in Luxembourg with two up to three generations per year. Additionally, based on our meteorological data sets a first migration of SHB to apiaries can be expected from mid of March up to April. Our approach can be transferred easily to other countries to estimate the risk potential for a successful introduction and spreading of A. tumida in Western Europe.

Keywords: Aethina tumida, air temperature, larval development, soil temperature

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Authors: Shawn Baker-Garcia, Janna O. Schaeffer

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As the global and national communities and governments strive to address ongoing and evolving threats to humanity and pervasive or emerging “shared” global priorities on environmental, economic, political, and security, it is more urgent than ever before to understand each other, communicate effectively with one another, identify models of cooperation that yield improved, mutually reinforcing outcomes across and within cultures. It is within the backdrop of this reality that the presentation examines whether cultural training as we have approached it in recent decades is sufficiently meeting our current needs and what changes may be applied to foster better and more productive and sustainable intercultural interactions. Domestic and global relations face multiple challenges to peaceable cooperation. The last two years, in particular, have been defined by a travel-restricted COVID-19 pandemic yielding increased intercultural interactions over virtual platforms, polarized politics dividing nations and regions, and the commensurate rise in weaponized social and traditional media communication. These societal and cultural fissures are noticeably challenging our collective and individual abilities to constructively interact both at home and abroad. It is within this pressure cooker environment that the authors believe it is time to reexamine existing and broadly accepted inter- and cross- cultural training approaches and concepts to determine their level of effectiveness in setting conditions for optimal human understanding and relationships both in the national and international context. In order to better understand the amount and the type of intercultural training practitioners professionally engaging in international partnership building have received throughout their careers and its perceived effectiveness, a survey was designed and distributed to US and international professionals presently engaged in the fields of diplomacy, military, academia, and international business. The survey questions were deigned to address the two primary research questions investigators posed in this exploratory study. Research questions aimed to examine practitioners’ view of the role and effectiveness of current and traditional cultural training and education as a means to fostering improved communication, interactions, understanding, and cooperation among inter, cross, or multi-cultural communities or efforts.Responses were then collected and analyzed for themes present in the participants’ reflections. In their responses, the practitioners identified the areas of improvement and desired outcomes in regards to intercultural training and awareness raising curricular approaches. They also raised issues directly and indirectly pertaining to the role of foreign language proficiency in intercultural interactions and a need for a solid grasp on cultural and regional issues (regional expertise) to facilitate such an interaction. Respondents indicated knowledge, skills, abilities, and capabilities that the participants were not trained on but learned through ad hoc personal and professional intercultural interactions, which they found most valuable and wished they had acquired prior to the intercultural experience.

Keywords: cultural training, improved communication, intercultural competence, international cooperation

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Authors: Moumita Chanda, Md. Fazlul Karim Patwary

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Smoking is one of the most popular recreational drug use behaviors, and it contributes to birth defects, COPD, heart attacks, and erectile dysfunction. To completely eradicate this disease, it is imperative that it be identified and treated. Numerous smoking cessation programs have been created, and they demonstrate how beneficial it may be to help someone stop smoking at the ideal time. A tomography meter is an effective smoking detector. Other wearables, such as RF-based proximity sensors worn on the collar and wrist to detect when the hand is close to the mouth, have been proposed in the past, but they are not impervious to deceptive variables. In this study, we create a machine that can discriminate between smokers and non-smokers in real-time with high sensitivity and specificity by watching and collecting the human lung and analyzing the X-ray data using machine learning. If it has the highest accuracy, this machine could be utilized in a hospital, in the selection of candidates for the army or police, or in university entrance.

Keywords: CNN, smoker detection, non-smoker detection, OpenCV, artificial Intelligence, X-ray Image detection

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Authors: Dereje Moges Azbite

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Laboratory analysis of igneous rocks is performed with the help of the main oxide plots. The lithology of the two wells was identified using the main oxides obtained using the XRF method. Twenty-four (24) cutting samples with different degrees of alteration were analyzed to determine and identify the rock types by plotting these well samples on special diagrams and correlating with the regional rocks. The results for the analysis of the main oxides and trace elements of 24 samples are presented. Alteration analysis in the two well samples was conducted for 21 samples from two wells for identifying clay minerals. Bulk sample analysis indicated quartz, illite & micas, calcite, cristobalite, smectite, pyrite, epidote, alunite, chlorite, wairakite, diaspore and kaolin minerals present in both wells. Hydrothermal clay minerals such as illite, chlorite, smectite and kaoline minerals were identified in both wells by X-ray diffraction.

Keywords: auto geothermal field, igneous rocks, major oxides, tracer elements, XRF, XRD, alteration minerals

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Authors: Anita Bajpai, Sarah Duan, Ashlee Erskine, Shehzein Khan, Raymond Kramer

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Introduction: This research focuses on exploring the beneficial effects if any, of Vitamin-D in reducing the need for supplemental oxygen among hospitalized COVID-19 patients. Two questions are investigated – Q1)Doeshaving a healthy level of baselineVitamin-D 25-OH (≥ 30ng/ml) help,andQ2) does administering Vitamin-D therapy after-the-factduring inpatient hospitalization help? Methods/Study Design: This is a comprehensive, retrospective, observational study of all inpatients at RUHS from March through December 2020 who tested positive for COVID-19 based on real-time reverse transcriptase–polymerase chain reaction assay of nasal and pharyngeal swabs and rapid assay antigen test. To address Q1, we looked atall N1=182 patients whose baseline plasma Vitamin-D 25-OH was known and who needed supplemental oxygen. Of this, a total of 121 patients had a healthy Vitamin-D level of ≥30 ng/mlwhile the remaining 61 patients had low or borderline (≤ 29.9ng/ml)level. Similarly, for Q2, we looked at a total of N2=893 patients who were given supplemental oxygen, of which713 were not given Vitamin-D and 180 were given Vitamin-D therapy. The numerical value of the maximum amount of oxygen flow rate(dependent variable) administered was recorded for each patient. The mean values and associated standard deviations for each group were calculated. Thesetwo sets of independent data served as the basis for independent, two-sample t-Test statistical analysis. To be accommodative of any reasonable benefitof Vitamin-D, ap-value of 0.10(α< 10%) was set as the cutoff point for statistical significance. Results: Given the large sample sizes, the calculated statistical power for both our studies exceeded the customary norm of 80% or better (β< 0.2). For Q1, the mean value for maximumoxygen flow rate for the group with healthybaseline level of Vitamin-D was 8.6 L/min vs.12.6L/min for those with low or borderline levels, yielding a p-value of 0.07 (p < 0.10) with the conclusion that those with a healthy level of baseline Vitamin-D needed statistically significant lower levels of supplemental oxygen. ForQ2, the mean value for a maximum oxygen flow rate for those not administered Vitamin-Dwas 12.5 L/min vs.12.8L/min for those given Vitamin-D, yielding a p-valueof 0.87 (p > 0.10). We thereforeconcludedthat there was no statistically significant difference in the use of oxygen therapy between those who were or were not administered Vitamin-D after-the-fact in the hospital. Discussion/Conclusion: We found that patients who had healthy levels of Vitamin-D at baseline needed statistically significant lower levels of supplemental oxygen. Vitamin-D is well documented, including in a recent article in the Lancet, for its anti-inflammatory role as an adjuvant in the regulation of cytokines and immune cells. Interestingly, we found no statistically significant advantage for giving Vitamin-D to hospitalized patients. It may be a case of “too little too late”. A randomized clinical trial reported in JAMA also did not find any reduction in hospital stay of patients given Vitamin-D. Such conclusions come with a caveat that any delayed marginal benefits may not have materialized promptly in the presence of a significant inflammatory condition. Since Vitamin-D is a low-cost, low-risk option, it may still be useful on an inpatient basis until more definitive findings are established.

Keywords: COVID-19, vitamin-D, supplemental oxygen, vitamin-D in primary care

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Authors: Badrun Taman

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This study aims to review the use of the Bengkulu Provincial Government Mess as the location of rukyatul hilal because its determination has not been carried out scientifically. There are three things that will be analyzed, namely geographical-astronomical conditions, the suitability of the location with ideal criteria, and the determination of the location of rukyatul hilal in accordance with regional conditions based on the results of the study. The research method used is qualitative with an astronomical geographical approach. The results showed that the factor that strengthened the disturbance from the weather aspect was the western sky horizon in the form of the Indian Ocean sea level. The potential for geographical disturbances on this horizon is high sea waves, relatively high sea breezes, and more seawater vapor due to sea surface temperatures and high air humidity. This study found new criteria for determining the location of the observation crescent. The criteria is the western horizon is not sea level (especially the Indian Ocean).

Keywords: criteria, location, Rukyatul Hilal, tropics, Indian ocean

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Authors: Alice Sanwald, Thomas Schober

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We analyze mortality and follow-up costs of heart attack patients using administrative data from Austria (2002-2011). As treatment intensity in a hospital largely depends on whether it has a catheterization laboratory, we focus on the effects of patients' initial admission to these specialized hospitals. To account for the nonrandom selection of patients into hospitals, we exploit individuals' place of residence as a source of exogenous variation in an instrumental variable framework. We find that the initial admission to specialized hospitals increases patients' survival chances substantially. The effect on 3-year mortality is -9.5 percentage points. A separation of the sample into subgroups shows the strongest effects in relative terms for patients below the age of 65. We do not find significant effects on longterm inpatient costs and find only marginal increases in outpatient costs.

Keywords: acute myocardial infarction, mortality, costs, instrumental variables, heart attack

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Authors: Ruth Mandujano Lopez

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During the second half of the 19th century, in the transition from sail to steam navigation, the transpacific space underwent major transformation. This paper examines the role that the steamship companies between Mexico, the rest of North America and Asia played in that process. Based on primary sources found in Mexico, California, London and Hong Kong, it argues that these companies actively participated in the redefining of the Pacific space as they opened new routes, transported thousands of people and had an impact on regional geopolitics. In order to prove this, the text will present the cases of a handful of companies that emerged between 1867 and 1910 and of some of their passengers. By looking at the way the Mexican ports incorporated to the transpacific steam maritime network, this work contributes to have a better understanding of the role that Latin American ports have played in the formation of a global order. From a theoretical point of view, it proposes the conceptualization of space in the form of transnational networks as a point of departure to conceive a history that is truly global.

Keywords: mexico, steamships, transpacific, maritime companies

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Authors: Sergei Kosarev

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Wrong treatment tactics for hand and wrist sport-related injuries can lead to the inability to play sports in the future. It is especially important for professional athletes. The members of the Russian Olympic Team are treated in our hospital -Federal Clinical Research Center (Moscow). For their treatment, we use minimally invasive methods such as wrist arthroscopy and also orthobiologics procedures. In 2022 we had cases with scaphoid fracture and TFCC injuries. In all the cases, we were using the arthroscopy technic for treatment. The scaphoid fracture was fixed by K-wires with free bone grafting. For TFCC injures we used transossal sutures. Rehabilitation started the next day after surgery. Rehabilitation included hand therapy and physiotherapy. All athletes returned to the sport after 8-12 weeks after surgery. One of them had pain in the wrist after 12 weeks after surgery, not more than 4 point VAS. Pain syndrome was blocked after 2 PRP injections in the ulnar side of the wrist.

Keywords: sport trauma, wrist arthroscopy, wrist pain, scaphoid fracture

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Authors: Grace Omowunmi Soyebi

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A computerized medical record system is a collection of medical information about a person that is stored on a computer. One principal problem of most hospitals in rural areas is using the file management system for keeping records. A lot of time is wasted when a patient visits the hospital, probably in an emergency, and the nurse or attendant has to search through voluminous files before the patient's file can be retrieved, this may cause an unexpected to happen to the patient. This Data Mining application is to be designed using a Structured System Analysis and design method which will help in a well-articulated analysis of the existing file management system, feasibility study, and proper documentation of the Design and Implementation of a Computerized medical record system. This Computerized system will replace the file management system and help to quickly retrieve a patient's record with increased data security, access clinical records for decision-making, and reduce the time range at which a patient gets attended to.

Keywords: programming, computing, data, innovation

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Authors: Yael Dubinsky, Orit Hazzan

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There is a constant need for hi-tech innovation to be decentralized to peripheral regions. This work describes how we applied design science research (DSR) principles to define what we refer to as the Sea of Galilee (SoG) method. The goal of the SoG method is to harness existing and new technological initiatives in peripheral regions to create a socio-technological network that can initiate and maintain hi-tech activities. The SoG method consists of a set of principles, a stakeholder network, and actual hi-tech business initiatives, including their infrastructure and practices. The three cycles of DSR, the Relevance, Design, and Rigor cycles, layout a research framework to sharpen the requirements, collect data from case studies, and iteratively refine the SoG method based on the existing knowledge base. We propose that the SoG method can be deployed by regional authorities that wish to be considered smart regions (an extension of the notion of smart cities).

Keywords: design science research, socio-technological initiatives, Sea of Galilee method, periphery stakeholder network, hi-tech initiatieves

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Authors: Shamill Amedot Udonwa, Phyllis S. Y. Chong, Lim S. L. Julia, Wee-Joo Chng

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In this paper, we investigated how PRL-3 expression in H929 and U266 cells affects the efficacy of drug treatment. H929 and U266 cells were treated with Bortezomib (BTZ) of different concentrations, and it was observed that H929 cells were resistant to BTZ, while U266 cells were not viable. Investigations into how BTZ targets these cells were conducted, and it was observed that BTZ affects the PARP-Caspase3 pathway as well as PRL-3-Leo1 pathways. These pathways regulate cell proliferation and cell cycle, respectively. Hence, we are able to show the mechanism of how BTZ affects cells and also the role PRL-3 plays on downstream oncogenes such as cyclin-D1 and c-MYC. More importantly, this investigation into PRL-3 in BTZ resistance will be highly applicable in the future as the first clinical trials of PRL-3 antibody (PRL3-zumab) are ongoing at the National University Hospital, Singapore (NUHS). This would mean that understanding the mechanism of resistance through PRL-3, which has yet to be studied, will demonstrate the potential of PRL-3 in developing novel strategies to improve the treatment of MM.

Keywords: drug resistance, hematology, multiple myeloma, oncogene

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Authors: Etibar Guliyev

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The breakdown of the Soviet Union in 1991 has led to a considerable rise in the religious self-consciousness of Muslim population of the Central Asia. Additionally, huge amount of money spent by various states further facilitated the spread of religious ideas. According to some sources, Saudi Arabia spent 87 billion dollars to propagate Wahhabism abroad during two decades, whereas the Communist Party of the Soviet Union spent just over 7 billion dollars to spread its ideology worldwide between 1921 and 1991. As the result, today once a remote area from international politics has turned into third major source of recruitment of fighters for global terrorist organizations. In order to illustrate to scope of the involvement of the Central Asian residents in international terrorist networks it is enough to mention the name of Colonel Gulmorod Khalimov, the former head of the Tajik special police forces who served as ISIS war minister between 2016 and 2017. The importance of the topic stems from the fact that the above-mentioned republics with a territory of 4 million square km and the population of around 80 million people borders Russia, Iran Afghanistan and China. Moreover, the fact that political and military activities motivated with religious feelings in those countries have implications not only for domestic but also for regional and global political relations and all of them has root in politics of religions adds value to the research. This research aims to provide an in-depth analyses of the marked features of the state policies to regulate religious activities and approach this question both from individual, domestic, regional and global levels of analyses. The research will enable us to better understand what implications have the state of religious freedom in post-Soviet Muslim republics for international relations and the rise of global jihadi terrorism. The paper tries to find a linkage between the mentioned terror attacks and underground rise of religious extremism in Central Asia. This research is based on multiple research methods, mainly on qualitative one. The process tracing method is also employed to review religious policies implemented from 1918-1991 and after the collapse of the Soviet Union in a chronological way. In terms of the quantitative method, it chiefly will be used in a bid to process various statistics disseminated in academic and official sources. The research mostly explored constructivist, securitization and social movement theories. Findings of the research suggests that the endemic problems peculiar to authoritarian regimes of Central Asia such as crackdown on the expression of religious believe and any kind of opposition, economic decline, instrumental use of religion and corruption and tribalism further accelerated the recruitment problem. Paper also concludes that the Central Asian states in some cases misused counter-terrorism campaign as a pretext to further restrict freedom of faith in their respective countries.

Keywords: identity, political Islam, religious extremism, security, terrorism

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Authors: Yiqi Wu, Simon Tait, Andrew Nichols

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Management of UK railway drainage assets is challenging due to the large amounts of historical assets with long asset life cycles. A major concern for asset managers is to maintain the required performance economically and efficiently while complying with the relevant regulation and legislation. As the majority of the drainage assets are buried underground and are often difficult or costly to examine, it is important for asset managers to understand and model the degradation process in order to foresee the upcoming reduction in asset performance and conduct proactive maintenance accordingly. In this research, a Markov chain approach is used to model the deterioration process of rail drainage assets. The study is based on historical condition scores and characteristics of drainage assets across the whole railway network in England, Scotland, and Wales. The model is used to examine the effect of various characteristics on the probabilities of degradation, for example, the regional difference in probabilities of degradation, and how material and shape can influence the deterioration process for chambers, channels, and pipes.

Keywords: deterioration, degradation, markov models, probability, railway drainage

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Authors: Wen Liu, Errol Haarhoff, Lee Beattie

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In 2010, New Zealand’s central government re-organise the local governments arrangements in Auckland, New Zealand by amalgamating its previous regional council and seven supporting local government units into a single unitary council, the Auckland Council. The Auckland Council is charged with providing local government services to approximately 1.5 million people (a third of New Zealand’s total population). This includes addressing Auckland’s strategic urban growth management and setting its urban planning policy directions for the next 40 years. This is expressed in the first ever spatial plan in the region – the Auckland Plan (2012). The Auckland plan supports implementing a compact city model by concentrating the larger part of future urban growth and development in, and around, existing and proposed transit centres, with the intention of Auckland to become globally competitive city and achieving ‘the most liveable city in the world’. Turning that vision into reality is operatized through the statutory land use plan, the Auckland Unitary Plan. The Unitary plan replaced the previous regional and local statutory plans when it became operative in 2016, becoming the ‘rule book’ on how to manage and develop the natural and built environment, using land use zones and zone standards. Common to the broad range of literature on urban growth management, one significant issue stands out about intensification. The ‘gap’ between strategic planning and what has been achieved is evident in the argument for the ‘compact’ urban form. Although the compact city model may have a wide range of merits, the extent to which these are actualized largely rely on how intensification actually is delivered. The transformation of the rhetoric of the residential intensification model into reality is of profound influence, yet has enjoyed limited empirical analysis. In Auckland, the establishment of the Auckland Plan set up the strategies to deliver intensification into diversified arenas. Nonetheless, planning policy itself does not necessarily achieve the envisaged objectives, delivering the planning system and high capacity to enhance and sustain plan implementation is another demanding agenda. Though the Auckland Plan provides a wide ranging strategic context, its actual delivery is beholden on the Unitary Plan. However, questions have been asked if the Unitary Plan has the necessary statutory tools to deliver the Auckland Plan’s policy outcomes. In Auckland, there is likely to be continuing tension between the strategies for intensification and their envisaged objectives, and made it doubtful whether the main principles of the intensification strategies could be realized. This raises questions over whether the Auckland Plan’s policy goals can be achieved in practice, including delivering ‘quality compact city’ and residential intensification. Taking Auckland as an example of traditionally sprawl cities, this article intends to investigate the efficacy plan making and implementation directed towards higher density development. This article explores the process of plan development, plan making and implementation frameworks of the first ever spatial plan in Auckland, so as to explicate the objectives and processes involved, and consider whether this will facilitate decision making processes to realize the anticipated intensive urban development.

Keywords: urban intensification, sustainable development, plan making, governance and implementation

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Authors: Soheila Sadeghi

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Infrastructure projects often encounter contract variations that can significantly deviate from the original tender estimates, leading to cost overruns, schedule delays, and financial implications. This research aims to quantitatively assess the impact of changes in contract variations on project performance by conducting an in-depth analysis of a comprehensive dataset from the Regional Airport Car Park project. The dataset includes tender budget, contract quantities, rates, claims, and revenue data, providing a unique opportunity to investigate the effects of variations on project outcomes. The study focuses on 21 specific variations identified in the dataset, which represent changes or additions to the project scope. The research methodology involves establishing a baseline for the project's planned cost and scope by examining the tender budget and contract quantities. Each variation is then analyzed in detail, comparing the actual quantities and rates against the tender estimates to determine their impact on project cost and schedule. The claims data is utilized to track the progress of work and identify deviations from the planned schedule. The study employs statistical analysis using R to examine the dataset, including tender budget, contract quantities, rates, claims, and revenue data. Time series analysis is applied to the claims data to track progress and detect variations from the planned schedule. Regression analysis is utilized to investigate the relationship between variations and project performance indicators, such as cost overruns and schedule delays. The research findings highlight the significance of effective variation management in construction projects. The analysis reveals that variations can have a substantial impact on project cost, schedule, and financial outcomes. The study identifies specific variations that had the most significant influence on the Regional Airport Car Park project's performance, such as PV03 (additional fill, road base gravel, spray seal, and asphalt), PV06 (extension to the commercial car park), and PV07 (additional box out and general fill). These variations contributed to increased costs, schedule delays, and changes in the project's revenue profile. The study also examines the effectiveness of project management practices in managing variations and mitigating their impact. The research suggests that proactive risk management, thorough scope definition, and effective communication among project stakeholders can help minimize the negative consequences of variations. The findings emphasize the importance of establishing clear procedures for identifying, assessing, and managing variations throughout the project lifecycle. The outcomes of this research contribute to the body of knowledge in construction project management by demonstrating the value of analyzing tender, contract, claims, and revenue data in variation impact assessment. However, the research acknowledges the limitations imposed by the dataset, particularly the absence of detailed contract and tender documents. This constraint restricts the depth of analysis possible in investigating the root causes and full extent of variations' impact on the project. Future research could build upon this study by incorporating more comprehensive data sources to further explore the dynamics of variations in construction projects.

Keywords: contract variation impact, quantitative analysis, project performance, claims analysis

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Authors: Mouhoubi Nedjima, Sassi Boudemagh Souad, Chouabbia Khedidja

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Cities grow, large or small; they seek to gain a place in the market competition, which talks to sell a product that is the city itself. The metropolis are large cities enjoying a legal status and assets providing their dominions elements on a territory larger than their range, do not escape this situation. Thus, the search for promising tool metropolises better development and durability meet the challenges as economic, social and environmental is timely. The urban project is a new way to build the city; it is involved in the metropolises of two ways, either to manage the crisis and to meet the internal needs of the metropolis, or by creating a regional attractiveness with their potential. This communication will address the issue of urban project as a tool that has and should find a place in the panoply of existing institutional tools. Based on the example of the modernization project of the metropolis of eastern Algeria "Constantine", we will examine what the urban project can bring to a city, the extent of its impact but also the relationship between the visions actors so metropolization a success.

Keywords: urban project, metropolis, institutional tools, Constantine

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Authors: Lamia Bouzgarrou, Amira Omrane, Leila Mrabet, Taoufik Khalfallah

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Background and aims: School accidents are one of the leading causes of morbidity and mortality among pupils and students. Indeed, they may induce an elevated number of lost school days, heavy emotional and physical disabilities, and financial costs on the victims and their families. This study aims to evaluate the annual incidence of school accidents in the central Tunisian governorate of Mahdia and to identify the epidemiological profile of victims and risk factors of these accidents. Methods: A retrospective study was conducted over the period of 5 school years, focusing on school accidents that occurred in public educational institutions (primary, basic, secondary and university) in the governorate of Mahdia (area = 2 966 km² and number of inhabitants in 2014 = 410 812). All accidents declared near the only official insurance of this type of injuries (MASU: Mutual School and University Accidents), and initially taken in charge at the University Hospital of Mahdia were included. Data was collected from the MASU reporting forms and the medical records of emergency and other specialized hospital departments. Results: With 3248 identified victims, the annual incidence of school accidents was equal to 0.69 per 100 pupils and students per year. The average age of victims was 14.51 ± 0.059 years and the sex ratio was 1.58. Pupils aged between 12 and 15 years, were concerned by 46.7% of the identified accidents. The practice of sports was the most relevant circumstances of these accidents (76.2 %). In 56.58 % of cases, falls were the leading mechanism. Bruises and fractures were the most frequent lesions (32.43 % and 30.51 %). Serious school accidents were noted in 28% of cases with hospitalization in 2.27 % of them. The average lost school days, was 12.23±1.73 days. Accidents occurring during sports or leisure activities were significantly more serious (p= 0.021). Furthermore, the frequency of hospitalization was significantly higher among boys (2.81% vs. 1.43%; p= 0.035), students ≤11 years (p= 0.008), and following crush trauma (p= 0.000). In addition, the surgical interventions were statistically more frequent among male victims (p=0.00), accidents occurring during physical education sessions (p=0.000); those associated to falls (p=0.000) and to crushes mechanisms (p=0.002), and injuries affecting lower limbs (p=0.000). Following this Multi-varied analysis concluded that the severity of school accident is correlated to the activity practiced during the trauma and the geographical location of the school. Conclusion: Children and adolescents are one of the most vulnerable groups against incidents with the risk of permanent disability, mainly related to the perturbation of the growth process and physiological limitations. Our five-year study, objectified a real elevate incidence of school accident among children and adolescents, with a considerable rate of severe injuries. In any community, the promotion of adolescents and children’s health is an important indicator of the public health level. Thus, it’s important to develop a multidisciplinary prevention strategy of school accident, based on safety and security rules and adapted to the specificity of our context.

Keywords: children and adolescents, children health, injuries and disability, school accident

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Authors: N. Gigauri, A. Surmava, L. Intskirveli, V. Kukhalashvili, S. Mdivani

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The subject of our study is atmospheric air pollution with numerical modeling. In the presented article, as the object of research, there is chosen city Tbilisi, the capital of Georgia, with a population of one and a half million and a difficult terrain. The main source of pollution in Tbilisi is currently vehicles and construction dust. The concentrations of dust and PM (Particulate Matter) were determined in the air of Tbilisi and in its vicinity. There are estimated their monthly maximum, minimum, and average concentrations. Processes of dust propagation in the atmosphere of the city and its surrounding territory are modelled using a 3D regional model of atmospheric processes and an admixture transfer-diffusion equation. There were taken figures of distribution of the polluted cloud and dust concentrations in different areas of the city at different heights and at different time intervals with the background stationary westward and eastward wind. It is accepted that the difficult terrain and mountain-bar circulation affect the deformation of the cloud and its spread, there are determined time periods when the dust concentration in the city is greater than MAC (Maximum Allowable Concentration, MAC=0.5 mg/m³).

Keywords: air pollution, dust, numerical modeling, PM-particles

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Authors: Chastiti Mediafira Wulolo, Tri Legionosuko, Suhirwan, Yusuf

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Terrorism and radicalization have become a common threat to every nation in this world. As a part of the asymmetric warfare threat, terrorism and radicalization need a complex strategy as the problem solver. One such way is by collaborating with the international community. The Our Eyes Initiative (OEI), for example, is a cooperation pact in the field of intelligence information exchanges related to terrorism and radicalization initiated by the Indonesian Ministry of Defence. The pact has been signed by Indonesia, Philippines, Malaysia, Brunei Darussalam, Thailand, and Singapore. This cooperation mostly engages military acts as a central role, but it still requires the involvement of various parties such as the police, intelligence agencies and other government institutions. This paper will use a qualitative content analysis method to address the opportunity and enhance the optimization of OEI. As the result, it will explain how OEI takes the opportunities as the strategy for counter-terrorism by building it up as the regional cooperation, building the legitimacy of government and creating the legal framework of the information sharing system.

Keywords: our eyes initiative, terrorism, counter-terrorism, ASEAN, cooperation, strategy

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Authors: Sanjaya Humagain, Rajendra Koju

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Background: Rheumatic heart disease (RHD) is the most common cardiovascular disease in children and young adults. Though declined and almost non-existent in developed nations, RHD is still one of the leading cause for premature death and disability in developing countries. Prevalence of RHD is high in both rural as well as urban area of Nepal. Present study is designed to look at the pattern of valvular involvement and demographic features in RHD. Methods: 326 patients indicated for inj. Benzathine penicillin were selected and echocardiograph performed to see the pattern of vavular involvement. Data analysis was done using SPSS 17. Result: The most common type of lesion was mixed type with mitral valve involvement. MR was the most common isolated lesion. MS was more commonly seen in females whereas AS was more common in males. Secondary prophylaxis was more common than primary prophylaxis. Conclusion: RHD still being a major problem and a preventable disease so extensive screening program is required to identify them early and prevent the complication.

Keywords: acute rheumatic fever, RHD, MS, MR, AS, AR, Inj benzathine penicillin

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Authors: G. M. Vlasceanu, H. Iovu, E. Vasile, M. Ionita

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Herein, the synthesis and characterization of chitosan-gelatin highly porous scaffold reinforced with graphene oxide, and hydroxyapatite (HAp), crosslinked with genipin was targeted. In tissue engineering, chitosan and gelatin are two of the most robust biopolymers with wide applicability due to intrinsic biocompatibility, biodegradability, low antigenicity properties, affordability, and ease of processing. HAp, per its exceptional activity in tuning cell-matrix interactions, is acknowledged for its capability of sustaining cellular proliferation by promoting bone-like native micro-media for cell adjustment. Genipin is regarded as a top class cross-linker, while graphene oxide (GO) is viewed as one of the most performant and versatile fillers. The composites with natural bone HAp/biopolymer ratio were obtained by cascading sonochemical treatments, followed by uncomplicated casting methods and by freeze-drying. Their structure was characterized by Fourier Transform Infrared Spectroscopy and X-ray Diffraction, while overall morphology was investigated by Scanning Electron Microscopy (SEM) and micro-Computer Tomography (µ-CT). Ensuing that, in vitro enzyme degradation was performed to detect the most promising compositions for the development of in vivo assays. Suitable GO dispersion was ascertained within the biopolymer mix as nanolayers specific signals lack in both FTIR and XRD spectra, and the specific spectral features of the polymers persisted with GO load enhancement. Overall, correlations between the GO induced material structuration, crystallinity variations, and chemical interaction of the compounds can be correlated with the physical features and bioactivity of each composite formulation. Moreover, the HAp distribution within follows an auspicious density gradient tuned for hybrid osseous/cartilage matter architectures, which were mirrored in the mice model tests. Hence, the synthesis route of a natural polymer blend/hydroxyapatite-graphene oxide composite material is anticipated to emerge as influential formulation in bone tissue engineering. Acknowledgement: This work was supported by the project 'Work-based learning systems using entrepreneurship grants for doctoral and post-doctoral students' (Sisteme de invatare bazate pe munca prin burse antreprenor pentru doctoranzi si postdoctoranzi) - SIMBA, SMIS code 124705 and by a grant of the National Authority for Scientific Research and Innovation, Operational Program Competitiveness Axis 1 - Section E, Program co-financed from European Regional Development Fund 'Investments for your future' under the project number 154/25.11.2016, P_37_221/2015. The nano-CT experiments were possible due to European Regional Development Fund through Competitiveness Operational Program 2014-2020, Priority axis 1, ID P_36_611, MySMIS code 107066, INOVABIOMED.

Keywords: biopolymer blend, ectopic osteoinduction, graphene oxide composite, hydroxyapatite

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Authors: András Medve, Katalin Szabad, István Patkó

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According to the International Energy Association the previous principles of the energy sector should be reassessed, in which renewable energy sources have a significant role. We might witness the exchange of roles of countries from importer to exporter, which look for the main resources of market needs. According to the World Energy Outlook 2013, the duration of high oil prices is exceptionally long in the history of the energy market. Forecasts also point at the expected great differences between the regional prices of gas and electric energy. The energy need of the world will grow by its third. two thirds of which will appear in China, India, and South-East Asia, while only 4 per cent of which will be related to OECD countries. Current trends also forecast the growth of the price of energy sources and the emission of glasshouse gases. As a reflection of these forecasts alternative energy sources will gain value, of which geothermic energy is one of the cheapest and most economical. Hungary possesses outstanding resources of geothermic energy. The aim of the study is to research the environmental effects of geothermic energy and the opportunities of its exploitation in Hungary, related to „Horizon 2020” project.

Keywords: sustainable energy, renewable energy, development of geothermic energy in Hungary

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Authors: Ashleigh Medina

Abstract:

Chronic conditions account for the majority of total health care spending both in the United States and globally. Encouraging self-management to improve chronic conditions, which in turn could decrease the strain placed on hospitals, requires resources to address the patient’s social concerns in addition to their medical concerns. Transitional care has been identified as a possible bridge between acutely managing conditions at the hospital to chronically managing conditions in a community setting. The aim of this integrative review was to examine the impact of transitional care on self-management outcomes of chronic conditions in un/underinsured populations. Both transitional care, by assisting with resources such as funding sources for healthcare and medications or identifying a healthcare provider for continued care, and self-management, by increasing responsibility for one’s care through goal setting and taking action, can impact health outcomes while providing health care cost-savings.

Keywords: chronic conditions, self-management, transitional care, uninsured

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