Search results for: Caribbean history

Authors: Anjelika Kremer, Irina Nachimov, Dan Justo

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Background: C-reactive protein (CRP) serum levels are commonly measured in hospitalized patients. Elevated admission CRP serum levels and in-hospital mortality has been seldom studied in the general population of elderly patients admitted to the acute Geriatrics department. Methods: A retrospective cross-sectional study was conducted at a tertiary medical center. Included were all elderly patients (age 65 years or more) admitted to a single acute Geriatrics department from the emergency room between April 2014 and January 2015. CRP serum levels were measured routinely in all patients upon the first 24 hours of admission. A logistic regression analysis was used to study if admission CRP serum levels were associated with in-hospital mortality independent of age, gender, functional status, and co-morbidities. Results: Overall, 498 elderly patients were included in the analysis: 306 (61.4%) female patients and 192 (38.6%) male patients. The mean age was 84.8±7.0 years (median: 85 years; IQR: 80-90 years). The mean admission CRP serum levels was 43.2±67.1 mg/l (median: 13.1 mg/l; IQR: 2.8-51.7 mg/l). Overall, 33 (6.6%) elderly patients died during the hospitalization. A logistic regression analysis showed that in-hospital mortality was independently associated with history of stroke (p < 0.0001), heart failure (p < 0.0001), and admission CRP serum levels (p < 0.0001) – and to a lesser extent with age (p = 0.042), collagen vascular disease (p=0.011), and recent venous thromboembolism (p=0.037). Receiver operating characteristic (ROC) curve showed that admission CRP serum levels predict in-hospital mortality fairly with an area under the curve (AUC) of 0.694 (p < 0.0001). Cut-off value with maximal sensitivity and specificity was 19.7 mg/L. Conclusions: Admission CRP serum levels may be used to predict in-hospital mortality in the general population of elderly patients admitted to the acute Geriatrics department.

Keywords: c-reactive protein, elderly, mortality, prediction

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Authors: Mahzad Yousefi, Azin Tavakoli

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Periodontal disease is an inflammatory reaction; therefore, it is predicted that changes may occur in some inflammatory parameters that can be detected in routine blood tests. The objective of this study was to evaluate the hematological and biochemistry changes that occur in dogs affected with advanced stages of periodontal disease. 87 dogs were diagnosed with periodontal disease (PD group), and 76 healthy dogs entered the study. The PD dogs had been affected with periodontitis stage 3 or 4 and were candidates for any dental extractions. The healthy dogs were either referred for annual checkups or for issuing health travel certificates that their owners asked for complete lab tests. Neither the diseased nor healthy subjects had a history of infectious, or other general health problems or surgery in the past 3 months. Age, as well as all hematologic including PCV, WBC and RBC count, Hb, MCV, MCH, MCHC, PLT, CBC, NLR, and biochemistry data, including total protein, albumin, glucose, BUN, Creatinine, ALT, AST, and ALP, were recorded and analyzed statistically. Results confirmed that aging has a significant direct relationship with the advanced stages of periodontal disease. Mild leukocytosis occurred in the diseased group; however, it was not significant. Also, the mean total protein of the PD group was lower than that of the healthy dogs, and serum levels of albumin were found to be lower significantly in the diseased group (P<0.05). Mean ±SD amount of Platelet, MCH, and ALT were significantly higher in the diseased group in comparison to the healthy dogs (P<0.05). No significant differences were reported in other evaluated parameters. It is concluded that CBC indices of PD dogs are not systemic inflammatory; however, only a decrease in albumin showed inflammatory responses. Some indices in routine laboratory tests can be changed significantly during advanced stages of the periodontal disease dogs.

Keywords: periodontal disease, dogs, hematological factors, advanced stages, blood tests

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Authors: Tek Nath Subedi

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Violent activities used previously to erupt in specific societies owing to unequal, oppressive and unjust social practices have crossed out of their usual place of occurrence and entered the peace-zones such as schools and universities. The recent history of Universities in Nepal is marked with violent activities of students targeting to professors and other university officials. A student in a university is supposed to involve in scholarly activities and cooperate the teacher so as to achieve the academic degree and to enhance knowledge. Besides, the relationship between a teacher and a student is supposed to be the most sacred, which, in other words, is explained as the relationship between deity and devotee in a spiritual ground, carer and the kid in a moral ground, and mutually dependent in a functionalist view. Above all, the interdependence between teacher and student is illustrated as the two sides of the same coin. But the targeted attack on teachers and the degrading relationship between university and students raises serious questions on what makes a student violent and why the academia is terrorized. Therefore, this research aims to find the nexus of deviant activities of students to other social, political, economic and cultural areas of their life. To find possible answer of a few analytical questions, this paper takes an in-depth interview into consideration based on a snowball sampling and inquires some professors and officials how and why they are terrorized. It also reaches to some students who have witnessed or been part of any terror, following the same research method and ask them why violence has become recurring in the university and how university can be converted into a peace-zone. This research has simply hypothesized that the terror-inspired activities carried out by students in the university are the extended version of their deviant activities out of the university premises. But, it was found that the deviant activities of students were connected in particular to their culture and political identity.

Keywords: deviance, relationship, student, teacher, terror, university

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Authors: Ian N. Robertson

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Alkali Silica Reaction (ASR) occurs in concrete when the alkali hydroxides (Na, K and OH) from the cement react with unstable silica, SiO2, in some types of aggregate. The gel that forms during this reaction will expand when it absorbs water, potentially leading to cracking and overall expansion of the concrete. ASR has resulted in accelerated deterioration of concrete highways, dams and other structures that are exposed to moisture during their service life. Concrete aggregates available in Hawaii have not demonstrated a history of ASR, however, accelerated laboratory tests using ASTM 1260 indicated a potential for ASR with some aggregates. Certain clients are now requiring import of aggregates from the US mainland at great expense. In order to assess the accuracy of the laboratory test results, a long-term field study of the potential for ASR in concretes made with Hawaiian aggregates was initiated in 2011 with funding from the US Federal Highway Administration and Hawaii Department of Transportation. Thirty concrete specimens were constructed of various concrete mixtures using aggregates from all Hawaiian aggregate sources, and some US mainland aggregates known to exhibit ASR expansion. The specimens are located in an open field site in Manoa valley on the Hawaiian Island of Oahu, exposed to relatively high humidity and frequent rainfall. A weather station at the site records the ambient conditions on a continual basis. After two years of monitoring, only one of the Hawaiian aggregates showed any sign of expansion. Ten additional specimens were fabricated with this aggregate to confirm the earlier observations. Admixtures known to mitigate ASR, such as fly ash and lithium, were included in some specimens to evaluate their effect on the concrete expansion. This paper describes the field evaluation program and presents the results for all forty specimens after four years of monitoring.

Keywords: aggregate, alkali silica reaction, concrete durability, field exposure

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Authors: Collins Nkapnwo Formella

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The democratic wave of the 1980s and 1990s brought a lot of hopes to the politics of African states as many nation-states adopted ‘democracy.’ The end of the Cold War ushered in, with a lot of rush, pro-democracy movements, which led to multi-party politics, following constitutional reviews. For the very first time since independence, Africans revolted against personalized dictatorship and adopted the idea of limited office terms for the presidents. This paper dives deep into the history of Africa post-independence with the aim of allowing the readers to understand the nature of the differences in the political setups that currently govern the continent and the central region in particular. Time has proven the euphoria that characterized post-Cold War African politics at least for many countries short-lived, as their leaders were unable to re-design the institutions of governance from the compromise and interest-oriented structures handed down after independence. The result has been that politics in many of the countries have been tailored down along the lines of winner takes all approach, with the accumulation of state power being the sole objective of the leaders. The paper contends that 21ˢᵗ Century African politics is exactly the politics of inclusion/exclusion based on ethnic and interest groups, leading to the flourishing of patrimonial authoritarian regimes. It also puts to the test, whether authoritarian responses to delivering growth (economic, political, social) and peace as has been the model adopted by many leaders is superior compared to democracy. This paper then concludes by adding that the practice of democracy in the Central African region in its current form is inherently flawed from its foundations, thus incapable of rooting out the crises faced in the region.

Keywords: authoritarianism, democracy, development, power, institutions

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Authors: Quirijn Menken

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Menken, Q. Author  Constellating Images Abstract—We live in a predominantly visual era. Vastly expanded quantities of imagery influence us on a daily basis, in contrast to earlier days where the textual prevailed. The increasing producing and reproducing of images continuously compete for our attention. As such, how we perceive images and in what way images are framed or mediate our beliefs, has become of even greater importance than ever before. Especially in art education a critical awareness and approach of images as part of visual culture is of utmost importance. The Bilderatlas operates as a mediation, and offers new Ways of Seeing and knowing. It is mainly known as result of the ground-breaking work of the cultural theorist Aby Warburg, who intended to present an art history without words. His Mnemosyne Bilderatlas shows how the arrangement of images - and the interstices between them, offers new perspectives and ways of seeing. The Atlas as a medium to critically address Visual Culture is also practiced by the German artist Gerhard Richter, and it is in written form used in the Passagen Werk of Walter Benjamin. In order to examine the use of the Bilderatlas as a tool in art education, several experiments with art students have been conducted. These experiments have lead to an exploration of different Pedagogies, which help to offer new perspectives and trajectories of learning. To use the Bilderatlas as a tool to develop criticality towards Visual Culture, I developed and tested a new pedagogy; a Pedagogy of Difference and Repetition, based on the philosophy of Gilles Deleuze. Furthermore, in offering a new pedagogy - based on the rhizomatic work of Gilles Deleuze – the Bilderatlas as a tool to develop criticality has found a firm basis. Keywords—Art Education, Walter Benjamin, Bilderatlas, Gilles Deleuze, Difference and Repetition, Pedagogy, Rhizomes, Visual Culture,

Keywords: Art Education, Bilderatlas, Pedagogy, Aby Warburg

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Authors: Sandhya Rao

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Kevin Lynch’s Theory on Imeageability, let on explore a city in terms of five elements, Nodes, Paths, Edges, landmarks and Districts. What happens when we try to record the same data in an Indian context? What happens when we apply the same theory of Imageability to a complex shifting urban pattern of the Indian cities and how can we as Urban Designers demonstrate our role in the image building ordeal of these cities? The organizational patterns formed through mental images, of an Indian city is often diverse and intangible. It is also multi layered and temporary in terms of the spirit of the place. The pattern of images formed is loaded with associative meaning and intrinsically linked with the history and socio-cultural dominance of the place. The embedded memory of a place in one’s mind often plays an even more important role while formulating these images. Thus while deriving an image of a city one is often confused or finds the result chaotic. The images formed due to its complexity are further difficult to represent using a single medium. Under such a scenario it’s difficult to derive an output of an image constructed as well as make design interventions to enhance the legibility of a place. However, there can be a combination of tools and methods that allows one to record the key elements of a place through time, space and one’s user interface with the place. There has to be a clear understanding of the participant groups of a place and their time and period of engagement with the place as well. How we can translate the result obtained into a design intervention at the end, is the main of the research. Could a multi-faceted cognitive mapping be an answer to this or could it be a very transient mapping method which can change over time, place and person. How does the context influence the process of image building in one’s mind? These are the key questions that this research will aim to answer.

Keywords: imageability, organizational patterns, legibility, cognitive mapping

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Authors: Zeynep Tanrıverdi

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The Bosphorus is an international waterway in Istanbul city of Turkey connecting the Sea of Marmara and the Black Sea. The Bosphorus, which has formed an important part of the silhouette of Istanbul throughout history, has also influenced the design of the coastal structures built around it. The waterfront mansions, which are located on both sides of the Bosphorus by the sea, and can be generally of two or three storeys, are called “yalı”. The yalı buildings with their architectural characteristics of the traditional Turkish House are the most grandiose examples of Ottoman residential architecture. However, the classical Ottoman yalı architecture of the 18th century can only be seen in engravings, and today only the modest and smaller yalı examples from the 19th century can be seen because of their disappearance over time. The study aims to reveal the architectural conservation and restoration problems of waterfront mansions and propose solutions for them. Firstly, the development of the waterfront mansion architecture in Bosphorus was evaluated in its historical process. Secondly, the waterfront mansions and their architectural features were explained. Thirdly, the architectural conservation and restoration problems that caused the disappearance of waterfront mansions were discussed. These problems include disruptions in legal regulations and practices about the Bosphorus, dramatic changes in Turkey’s socio-cultural life from the Ottoman Empire to the present, inadequacies in economic resources, negative environmental effects, and errors in restoration works. Finally, solution suggestions were proposed for the problems that threaten the protection of waterfront mansions. In the study, literature on waterfront mansions was reviewed using historical reports, photographs, maps, and drawings in archival documents. It is hoped that this study will contribute the conservation of the “Yalı” waterfront mansions, which occupy a particular role in the cultural heritage of Turkey, and to their transmission with their authentic values to the next generation.

Keywords: bosphorus architecture, conservation, heritage, Istanbul, waterfront mansions (yalı)

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Authors: Chun-Hao Lai, Yu-Fang Huang, Pei-Wei Wang, Meng-Han Lin, Mei-Lien Chen

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Nonylphenol (NP) is a degradation product of nonylphenol ethoxylates (NPEOs). It is a well-known endocrine disruptor which may cause estrogenic effects. The growing fetus and infants are more vulnerable to exposure to NP than adults. It is important to know the levels and influences of prenatal exposure to NP. The aims of this study were (1) to determine the levels of prenatal exposure among Taiwanese, (2) to evaluate the potential risk for the infants who were breastfed and exposed to NP through the milk. (3) To investigate the correlation between birth outcomes and prenatal exposure to NP. We analyzed thirty one pairs of maternal urines, placentas, first month’ breast milk by high-performance liquid chromatography coupling with fluorescence detector. The questionnaire included socio- demographics, lifestyle, delivery method, dietary and work history. Information about the birth outcomes were obtained from medical records. The daily intake of NP from breast milk was calculated using deterministic and probabilistic risk assessment methods. The geometric means and geometric standard deviation of NP levels in placenta, and breast milk in the first month were 31.2 (1.8) ng/g, 17.2 (1.6) ng/g, respectively. The medium of daily intake NP in breast milk was 1.33 μg/kg-bw/day in the first month. We found negative association between NP levels of placenta and birth height. And we observed negative correlation between maternal urine NP levels and birth weight. In this study, we could provide the NP exposure profile among Taiwan pregnant women and the daily intake of NP in Taiwan infants. Prenatal exposure to higher levels of NP may increase the risk of lower birth weight and shorter birth height.

Keywords: nonylphenol, mother, fetus, placenta, breast milk, urine

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Authors: Cabangile Ncengeni Ngwane, Gerald Mills

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Anthropogenic climate change is exacerbating natural hazards such as droughts, heat waves and sea-level rise. The associated risks are the greatest in places where socio-ecological systems are exposed to these changes and the populations and infrastructure are vulnerable. Identifying the communities at risk and enhancing local resilience are key issues in responding to the current and project climate changes. This paper explores the types of risks associated with multiple overlapping hazards in Durban, South Africa where the social, cultural and economic dimensions that contribute to exposure and vulnerability are compounded by its history of apartheid. As a result, climate change risks are highly concentrated in marginalized communities that have the least adaptive capacity. In this research, a Geographic Information System is to explore the spatial correspondence among geographic layers representing hazards, exposure and vulnerability across Durban. This quantitative analysis will allow authors to identify communities at high risk and focus our study on the nature of the current human-environment relationships that result in risk inequalities. This work will employ qualitative methods to critically examine policies (including educational practices and financial support systems) and on-the-ground actions that are designed to improve the adaptive capacity of these communities and meet UN Sustainable Development Goals. This work will contribute to a growing body of literature on disaster risk management, especially as it relates to developing economies where socio-economic inequalities are correlated with ethnicity and race.

Keywords: adaptive capacity, disaster risk reduction, exposure, resilience, South Africa

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Authors: Oleg Redkin, Olga Bernikova

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It is commonly accepted that every language is both pure linguistic phenomenon as well as socially significant communicative system, which exists on the basis of certain society - its collective 'native speaker'. Therefore the language evolution and features besides its own linguistic rules and regulations are also defined by the influence of a number of extra-linguistic factors. The above mentioned statement may be illustrated by the example of the Arabic language which may be characterized by the following peculiarities: - the inner logic of the Arabic language - the 'algebraicity' of its morphological paradigms and grammar rules; - association of the Arabic language with the sacred texts of Islam, its close ties with the pre-Islamic and Islamic cultural heritage - the pre-Islamic poetry and Islamic literature and science; - territorial distribution, which in recent years went far beyond the boundaries of its traditional realm due to the development of new technologies and the spread of mass media, and what is more important, migration processes; - association of the Arabic language with the so called 'Renaissance of Islam'. These peculiarities should be remembered while considering the status of the Modern Standard Arabic (MSA) language or the Classical Arabic (CA) language as well as the Modern Arabic (MA) dialects in synchrony or from the diachronic point of view. Continuity of any system in diachrony on the one hand depends on the level of its ability to adapt itself to changing environment and by its internal ties on the other. Structural durability of language is characterized by its inner logic, hierarchy of paradigms and its grammar rules, as well as continuity of their implementation in acts of everyday communication. Since the Arabic language is both linguistic and social phenomenon the process of the Arabic language acquisition and study should not be focused only on the knowledge about linguistic features or development of communicative skills alone, but must be supplied with the information related to culture, history and religion of peoples of certain region that will expand and enrich competences of the target audience.

Keywords: Arabic, culture, Islam, language

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Authors: Angeliki Vassila, Dimitrios Kalogeropoulos, Rania Rawashdeh, Nigel Hall, Najiha Rahman, Mark Fabian, Suresh Thulasidharan, Hossain Parwez

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Introduction: Necrotising scleritis is a severe form of scleritis and poses a significant threat to vision. It can manifest in various systemic autoimmune disorders, systemic vasculitis, or as a consequence of microbial infections. The objective of this study is to present a case of necrotizing scleritis associated with scleroderma, which was further complicated by a secondary Staphylococcus epidermidis infection. Methods: This is a retrospective analysis that examines the medical records of a patient who was hospitalised in the Eye Unit at University Hospital Southampton. Results: A 78-year-old woman presented at the eye casualty department of our unit with a two-week history of progressively worsening pain in her left eye. She received a diagnosis of necrotising scleritis and was admitted to the hospital for further treatment. It was decided to commence a three-day course of intravenous methylprednisolone followed by a tapering regimen of oral steroids. Additionally, a conjunctival swab was taken, and two days later, it revealed the presence of S. epidermidis, indicating a potential secondary infection. Given this finding, she was also prescribed topical (Ofloxacin 0.3% - four times daily) and oral (Ciprofloxacin 750mg – twice daily) antibiotics. The inflammation and symptoms gradually improved, leading to the patient being scheduled for a scleral graft and applying an amniotic membrane to cover the area of scleral thinning. Conclusions: Rheumatoid arthritis and granulomatosis with polyangiitis are the most commonly identifiable systemic diseases associated with necrotising scleritis. Although association with scleroderma is extremely rare, early identification and treatment are necessary to prevent scleritis-related complications.

Keywords: scleritis, necrotizing scleritis, scleroderma, autoimmune disease

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Authors: Awangku Hassanal Bahar Pengiran Bagul, Fauziahton Ag. Samad

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The focus of this study is to outline the development of Community-Based Ecotourism (CBET) in order to achieve sustainability. The CBET in Desa Cinta Kobuni is a result of a collaboration between Kampung Kobuni, Kota Kinabalu City Hall or DBKK (Dewan Bandaraya Kota Kinabalu), and Universiti Malaysia Sabah (UMS). It is located in Inanam, a sub-district of Kota Kinabalu city. The current ecotourism activities are still in the growth stage and mainly focused on cultural tourism products and activities that showcase their traditional food, clothing, language, history, values, beliefs, dance, arts, and crafts. The study’s methodological approach is qualitative with narrative inquiry, also known as storytelling. This enables the study to access valuable insight with rich data into the complexity of developing community-based ecotourism. The results show that there are three major impacts on the Desa Cinta Kobuni, which are, 1) the increment of secondary income, 2) the advancement of women’s empowerment, and 3) the enhanced sustainability initiatives of the villagers. The experience in developing their first CBET has resulted in the Kota Kinabalu City Hall producing the Framework for Sustainable Community Based Ecotourism that integrates Sustainable Development Goals and the Global Code of Ethics for Tourism (GCET) for future CBET development in other parts of the city. The paper concludes that there is a significant positive transformation of the village and the villagers while reaffirming that Community-Based ecotourism (CBET) is a sustainable form of tourism that improves the quality of life of hosts at the tourist destination.

Keywords: community, ecotourism, cultural tourism, sustainability, sustainable development

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Authors: Rithika Sriram, Kiran M. Bhojwani

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Introduction : Tuberculosis of the head and neck has proved to be a diagnostic challenge for otorhinolarynologists around the world. These lesions are often misdiagnosed as cancer. So in order to contribute to a better understanding of these lesions, we have conducted our study among patients affected by TB in the head and neck region with the objective of assessing the various manifestations, presentations, diagnostic techniques, risk factors such as smoking and alcohol consumption, coexisting illnesses and treatment modalities. Materials and Methods: This was a retrospective study conducted over a three year period (2012-2014) in 2 hospitals affliated to Kasturba Medical College in Mangalore, South India. A semi structured proforma was used to capture information from the medical records pertaining to the various objectives of the study such as clinical features and history of smoking. Data was analysed using SPSS version 16.0 and results obtained were depicted as percentages. Chi square test was used to find association between the variables and p<0.05 was considered statistically significant. Results: 104 patients were found to have TB of the head and neck and among them,the most common manifestation was found to be Tubercular Lymphadenitis (86.53%), followed by laryngeal TB (4.8%), submandibular gland TB (3.8%), deep neck space abscess(3.8%) and adenotonsillar TB. FNAC was found to be the gold standard for the diagnosis of TB disease of the lymph node.26% of the patients had coexisting HIV infection and 16.3% of the patients had associated pulmonary TB. More than 20% of the patients were smokers. Most patients were treated using ATT. Conclusion: Tuberculosis affecting regions of head and neck is no longer uncommon. Sufficient knowledge and appropriate diagnostic means is required while dealing with these lesions and must be included in the differential diagnosis of pathological lesions of head and neck.

Keywords: FNAC, Mangalore, smoking, tuberculosis

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Authors: R. Chinyakata, N. R. Raselekoane

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Migration has always been part of human history. Migration is spurred by globalisation which connects nations by encouraging the flow of goods, services, ideas and people across borders. Migration does not only involve movement of adults from one country to another. It also affects and involves the youth as they are the most mobile group. Musina area, like many other border areas, experiences a variety of challenges as a result of the influx of people from the neighbouring Zimbabwe and other African countries. Of great concern about this migration is the fact that the host country or area may become unsafe and unstable as a result of huge influx of migrants. There may also be tensions between local people and migrants over the resources. The study sought to investigate the effects of the Zimbabwean youth migration on Musina area. The study was undertaken in Musina area which is situated 18km from the Beit-Bridge border post. A qualitative research approach was used. Semi-structured interviews were used to collect data. Non-probability quota sampling technique was used to select the respondents. The study sample consisted of sixteen female and male respondents. Thematic coding was used to analyse the data. Ethical considerations such as informed consent, confidentiality, anonymity and voluntary participation were taken into account to protect the participants. The study found that the effects of the Zimbabwean youth migration on the Musina area include, among others, tensions between locals and the Zimbabwean youth migrants over resources, job and business opportunities, overcrowding and crime. Multi-pronged strategies which involve different stakeholders should be applied to address tensions over job and business opportunities, overcrowding and crime in the Musina area.

Keywords: host country, effects, migrant, migration, Musina, youth, Zimbabwe

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Authors: Sidi Ahmed Berrabah

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English as a Medium of Instruction (EMI) is expanding rapidly in the world. A growing volume of research has been dedicated to investigating its introduction, with findings that describe a complex picture and suggest that the practicality and effectiveness of EMI are still the subjects of debate. However, considerably less attention has been given to understanding EMI in a context where its introduction has been discussed but not yet put into practice. One such context is Algeria, where discourses about a potential introduction of EMI have been going on for some time. It is likely that the first courses where EMI is introduced are Business degree programmes. This study aims to examine the current discourses and attitudes towards the potential implementation of EMI and the language practices in Business degree programmes in three Algerian universities. The research is conducted in three different universities in three different regions in Algeria with the aim of including both ‘centre’ and ‘periphery’ Algerian universities. In order to achieve the previous aims, a mixed research paradigm is used. Questionnaires, semi structured interviews, and classroom observations are used to gather data from three participant cohorts: university students of Business, lecturers of Business, and lecturers of English for specific purposes. The findings showed that students and lecturers of Business are found in favour of the introduction of English instead of French or standard Arabic as a medium of instruction. The reason is that English is seen as having internationalisation and instrumental benefits, while French was too closely linked to the colonial history of the country. The favourable attitudes towards EMI, however, seem to contrast with the daily classroom practices at the departments of Business studies, where students and lecturers make practical choices of using their language repertoire based on their linguistic background and skills. Classrooms in the three Algerian universities featured fluid and translanguaging practices that cannot be reduced to a monolingual EMI policy.

Keywords: EMI, Algerian universities, business degree programmes, translanguaging

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Authors: Gregory Michael McMahon

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Risk management for the purposes of minimizing the damages from the operations of dams has met with opposition emerging from organisations and authorities, and their practitioners. It appears that the cause may be a misunderstanding of risk management arising from exchanges that mix deterministic thinking with risk-centric thinking and that do not separate uncertainty from reliability and accuracy from probability. This paper sets out those misunderstandings that arose from dam operations at Wivenhoe in 2011, using a comparison of outcomes that have been based on the methodology and its rules and those that have been operated by applying misunderstandings of the rules. The paper addresses the performance of one risk-centric Flood Manual for Wivenhoe Dam in achieving a risk management outcome. A mixture of engineering, administrative, and legal factors appear to have combined to reduce the outcomes from the risk approach. These are described. The findings are that a risk-centric Manual may need to assist administrations in the conduct of scenario training regimes, in responding to healthy audit reporting, and in the development of decision-support systems. The principal assistance needed from the Manual, however, is to assist engineering and the law to a good understanding of how risks are managed – do not assume that risk management is understood. The wider findings are that the critical profession for decision-making downstream of the meteorologist is not dam engineering or hydrology, or hydraulics; it is risk management. Risk management will provide the minimum flood damage outcome where actual rainfalls match or exceed forecasts of rainfalls, that therefore risk management will provide the best approach for the likely history of flooding in the life of a dam, and provisions made for worst cases may be state of the art in risk management. The principal conclusion is the need for training in both risk management as a discipline and also in the application of risk management rules to particular dam operational scenarios.

Keywords: risk management, flood control, dam operations, deterministic thinking

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Authors: T. Jivita, M. S. Salmiah

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The aims of this study were to determine the prevalence of smoking, reasons for tried smoking, factors that influence smoking, and knowledge level on health risk among male Tamil primary school students. Seven urban Tamil primary schools in Kuala Lumpur were identified based on cluster sampling. A cross-sectional study was conducted in May 2014 and a total of 380 male children in standard 4 and 5 were selected. Survey included information on history of ever smoking even a puff, smoking a whole cigarette, smoking every day at least for 7 days, reasons for tried smoking, potential factors of smoking and knowledge related to smoking and health. Fifty seven had previously smoked, with a prevalence of 15.0% (95% CI = 11.4, 18.6) and 17 had smoked a whole cigarette (4.5%, 95% CI = 2.42, 6.58) while 8 had at least smoked 7 days continuously (2.1%, 95% CI = 0.66, 3.54). The reasons for tried smoking were because of curiosity (63.2%), it is not allowed (42.6%), it is relaxing (35.2%), it is cool (33.3%), to lose weight (20.4%), style (1.8%), by mistake (0.5%), for prayers purpose (0.3%), given by uncle (0.3%), and introduced by elder brother (0.3%). None of these reasons were associated with age factors (p > 0.05). Of those who had smoked a whole cigarette, 42.9% were significantly influenced by father (χ2 (1) = 6.42, p = 0.040) and 47.8% were significantly influenced by friends (χ2 (2) = 6.27, p = 0.043). Overall 91.5% had good level of knowledge about smoking, where the majority knew that smoking was dangerous to their health. However only 61.7% and 63.1% of them knew that smoking can cause high blood pressure and stroke, respectively. There is no significant different in mean rank between 10 years old and 11 years old students (p=0.987 < 0.05) for level of knowledge, tested by Mann-Whitney U Test. Odds of smoking increased 1.37 times having seen actors smoking (95% CI= 1.01, 1.86), 1.55 times having a father who smokes (95% CI= 1.26, 1.92), 1.64 times having siblings who smokes (95% CI= 1.32, 2.04), and 10.55 times having friends who offered cigarette (95% CI= 4.17, 26.68). As a conclusion, cessation of smoking in family members, who are role models, so as to reduce rates to taking up smoking among children.

Keywords: factors influence, knowledge on smoking, prevalence on smoking, reasons

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Authors: Papazafeiropoulou Olga

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The “Athens Dramatic Company” was one of the longest-running and most widely traveled troupes in the history of modern Greek theatre. The theatre company had been established since 1887, and the following: Euthychios Vonaseras, Eleni Kotopoulis, etc., like the founder of the troupe Theodoros Pofantis, referred to the distribution of the works presented in Patras: The price of a crime, The niece of her uncle, Agathopoulos, Amphitryon, The Two Sergeants, Lawyer and Actors, The Crusaders, The Daughter of Pantopolos, He Will Kill Himself, Macbeth, The Two Orphans, The Auction, Pistis Hope and Mercy, Love Attempt, The Crusaders, The lady is in Loutra, Markos Votsaris. In 1921, after peregrinations in Cyprus, Constantinople, Romania, Crete, Thessaloniki, Volos, Smyrna, the “Athens Dramatic Company” toured in Africa, where the Greek communities flourished. In 1923, the collaborations of troupe’s members and the repertoire varied several times, such as in Johannesburg, from where they traveled via Cape Town to Australia, where they presented the works: Dikaioma o Eros, Enochos, Psychokori, Kolokotronis. Atimoi, Voskopoula, Golfo, etc., while they impressed with the tragedy Oedipus Tyrannus, which was watched by Australians. Alongside the “Athens Dramatic Company” was also touring “Vrysoula’s Pantopoulos Troupe” and most of the members of the two troupes went to America, uniting their formation. In 1927, the old leader of “Athens Dramatic Company” (Theodoros Pofantis) decided to re-establish his troupe, but after unpleasant adventures, he passed away. In the year 1934, the Greek Dramatic Troupe of Athens revived with works including: The Man of the Day, A Dying Heart, A Dream Was and Gone, An Inspection, The Two Sergeants, The Mother, the Father-in-Law and the Non-existent Son-in-law, before finally expiring in 1935, after nearly 40 years of historical passage.

Keywords: athens, dramatic, company, universal, troupe

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Authors: Mohammad Jahangeer Warsi

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This is, perhaps, the first linguistic study of Maithili Urdu, a dialect of Urdu language of Indo-Aryan family, spoken by around four million speakers in Darbhanga, Samastipur, Begusarai, Madhubani, and Muzafarpur districts of Bihar. It has the subject–verb–object (SOV) word order and it lacks script and literature. Needless to say, this work is an attempt to document this dialect so that it should contribute to the field of descriptive linguistics. Besides, it is also spoken by majority of Maithili diaspora community. Maithili Urdu does not have its own script or literature, yet it has maintained an oral history of over many centuries. It has contributed to enriching the Maithili, Hindi and Urdu languages and literature very profoundly. Dialects are the contact languages of particular regions, and they have a deep impact on their cultural heritage. Slowly with time, these dialects begin to take shape of languages. The convergence of a dialect into a language is a symbol and pride of the people who speak it. Although, confined to the five districts of northern Bihar, yet highly popular among the natives, it is the primary mode of communication of the local Muslims. The paper will focus on the structure of expressions about Maithili Urdu that include the structure of words, phrases, clauses, and sentences. There are clear differences in linguistic features of Maithili Urdu vis-à-vis Urdu, Maithili and Hindi. Though being a dialect of Urdu, interestingly, there is only one second person pronoun tu and lack of agentive marker –ne. Although being spoken in the vicinity of Hindi, Urdu and Maithili, it undoubtedly has its own linguistic features, of them, verb conjugation is remarkably unique. Because of the oral tradition of this link language, intonation has become significantly prominent. This paper will discuss the morpho-syntactic pattern of Maithili Urdu and will go through a sample text to authenticate the findings.

Keywords: cultural heritage, morpho-syntactic pattern, Maithili Urdu, verb conjugation

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Authors: Ebru Nergiz

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The world is facing one of the biggest refugee crisis’ in history as hundred thousands of refugees who run away from the battle and genocide in the Middle East are travelling illegally to reach Europe over the Mediterranean and Aegean Sea. The number of refugees has reached huge numbers due to the civil war that was caused by the Arab Spring. The number of asylum applications to the European Union has also increased in parallel with the increase in the number of refugees. The conflict in Syria between the government of Bashar Al-Assad and various other forces, which started in the spring of 2011, continues to cause displacement within the country and across the region. The refugee situation caused by the Syrian conflict has placed enormous strain on neighboring countries Lebanon, Jordan, Iraq, Egypt, and especially Turkey. Turkey hosts massive numbers of Syrian refugees, almost 3 million and Syrians have been seeking protection in increasing numbers. The refugee crisis has affected the relationships between Turkey and the European Union deeply. President of the European Council Donald Tusk chaired a meeting of EU heads of state or government with Turkey on 29 November 2015. The meeting opened a new era in the relationships between Turkey and the European Union in terms of the migration crisis. The EU and Turkey agreed to negotiate Turkey's accession process to the European Union and to hold regular summits on Turkey-EU relations and discuss these issues. This paper looks at the reasons and consequences of the European refugee crisis and its effects on Turkey- European Union relationships. This paper also argues that the European Union has not sufficiently contributed toward alleviating the burden caused by the refugee influx, in terms of both financial assistance and refugee resettlement. The European Union’s priority is to guarantee that the lowest possible number of refugees reach Europe rather than to ensure the security of the refugees.

Keywords: European Union, human rights, refugee crisis, Turkey-European union relationships

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Authors: Fatma Koksal Çakirlar, Si̇nem Ozdemir, Selcan Akyol, Revazi̇ye Gulesen, Murat Gunaydin, Nevri̇ye Gonullu, Belkis Levent, Nuri̇ Kiraz

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Vibrio cholerae O1 and O139 are the causative agent of epidemic or pandemic cholera. V. cholerae O1 is generally accepted as a non-invasive enterotoxigenic organism causing gastroenteritis of various severities. Non-O1 V. cholerae can cause small outbreaks of diarrhea due to consumption of contaminated food and water. Particularly, the patients with achlorydria have a risk for vibrio infections. There are numerous case reports of bacteremia caused by vibrio in patients with predisposing conditions like cirrhosis, nephrotic syndrome, diabetes, hematologic malignancy, gastrectomy, and AIDS. We described in this study the first case of nontoxigenic, non-01/non-O139 V. cholerae isolated from the blood culture of a 77-year-old female patient with hipertension, diabetes, coronary artery disease, gout and about 9 years ago migrated breast cancer history. The patient with complaints of shortness of breath, fever and malaise admitted to our emergency clinic were evaluated. There was no diarrhea or abdominal symptoms in the patient. No growth in her urine culture, but blood culture (BACTEC 9120 system, Becton Dickinson, USA) was positive for non-01/non-O139 V. cholerae that was identified by conventional methods and Phoenix automated system (BD Diagnostic Systems, Sparks, MD). It does not secrete the cholera toxin. The agglutination test was negative with polyvalent O1 antisera and O139 antiserum. Empirically ceftriaxone was administered to the patient and she was discharged with improvement in general condition. In this study we report bacteremia by non-01/non-O139 V. cholerae that is rare in the worldwide and first in Turkey.

Keywords: bacteremia, blood culture, immunocompromised patient, Non-O1 vibrio cholerae

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Authors: Mukunda Upadhyay, Rakesh Mishra, Rajni Singh

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This paper is an attempt to understand the abstract concept of space, citizenship and migration in the north-eastern region. In the twentieth century, researchers and thinkers related citizenship and migration on national models. The national models of jus sulis and jus sangunis provide scope of space and rights to only those who are either born in the territory or either share the common descent. Space ensures rights and citizenship ensures space and for many migrants, citizenship is the ultimate goal in the host country. Migrants with the intention of settling down in the destination region, begin to adapt and assimilate in their new homes. In many cases, migrants may also retain the culture and values of the place of origin. In such cases the difference in the degree of retention and assimilation may determine the chances of conflict between the host society and migrants. Such conflicts are fueled by political aspirations of few individuals on both the sides. The North-Eastern part of India is a mixed community with many linguistic and religious groups sharing a common Geo-political space. Every community has its own unique history, culture and identity. Since the last half of the nineteenth century, this region has been experiencing both internal migration from other states and immigration from the neighboring countries which has resulted in the interactions of various cultures and ethnicities. With the span of time, migration has taken bitter form with problems concentrated around acquiring rights through space and citizenship. Political tensions resulted by host hostility and migrants resistance has ruined the social order in few areas. In order to resolve these issues in this area proper intervention has to be carried out by the involvement of the National and International community.

Keywords: space, citizenship, assimilation, migration, rights

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Authors: Matthew T. McCarthy, Sarah Janse, Natalie M. Pizzimenti, Anthony K. Savino, Brian Crosser, Sean C. Rose

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Concussion is diagnosed clinically using a comprehensive history and exam, supported by ancillary testing. Frequently, symptom checklists are used as part of the evaluation of concussion. Existing symptom scales are based on a subjective Likert scale, without relation of symptoms to clinical or functional impairment. This is a retrospective review of 133 patients under age 30 seen in an outpatient neurology practice within 30 days of a probable or definite concussion. Each patient completed 2 symptom checklists at the initial visit – the SCAT-3 symptom evaluation (22 symptoms, 0-6 scale) and a scale based on the degree of clinical impairment for each symptom (22 symptoms, 0-3 scale related to functional impact of the symptom). Final clearance date was determined by the treating physician. 60.9% of patients were male with mean age 15.7 years (SD 2.3). Mean time from concussion to first visit was 6.9 days (SD 6.2), and 101 patients had definite concussions (75.9%), while 32 were diagnosed as probable (24.1%). 94 patients had a known clearance date (70.7%) with mean clearance time of 20.6 days (SD 18.6) and median clearance time of 19 days (95% CI 16-21). Mean total symptom score was 27.2 (SD 22.9) on the SCAT-3 and 14.7 (SD 11.9) for the functional impairment scale. Pearson’s correlation between the two scales was 0.98 (p < 0.001). After adjusting for patient and injury characteristics, an equivalent increase in score on each scale was associated with longer time to clearance (SCAT-3 hazard ratio 0.885, 95%CI 0.835-0.938, p < 0.001; functional impairment scale hazard ratio 0.851, 95%CI 0.802-0.902, p < 0.001). A concussion symptom scale based on degree of functional impairment correlates strongly with the SCAT-3 scale and demonstrates a similar association with time to clearance. By assessing the degree of impact on clinical functioning, this symptom scale reflects a more intuitive approach to rating symptoms and can be used in the management of concussion.

Keywords: checklist, concussion, neurology, scale, sports, symptoms

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Authors: Min Bae

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Hygiene had traditionally meant ways of healthy and right living. However, the nineteenth century was the time when a gradual shift in medical and hygienic paradigms took place from holism to reductionism. Against this medical and social background, E. W. Lane (MD, Edinburgh, 1853) formulated his own medical philosophies in his book Hydropathy: Or Hygienic Medicine (1859). Until the 1880s when he published his last book on the hygienic medicine, he consistently intended to raise the importance of hygienic holism in medicine, while adopting hydropathy as his main therapeutic measure. Lane’s case reflects the mid-nineteenth century trend in which since the 1840s, the rational and holistic facets in medicine had significantly transferred to hydropathy, which was the most naturalistic healing system in the medical market. Hygiene for Lane was no longer the ancient form of ‘six non-naturals’. He emphasised physiology as the rational grounds for his project of the medicalisation of hygiene. His medical philosophy was profoundly naturalistic and holistic against the opposite trend of the contemporary hygiene and medicine. Conflicting aspects may often be best embodied in persons who stood on the boundaries between inside and outside. Lane’s theories on hygienic medicine did not develop into a new medical system which he believed would reconciliate orthodox medicine and hydropathy of his time had also adopted increasingly reductionist approaches since 1860s. Nevertheless, the naturalistic philosophies and approaches in Lane’s hygienic medicine demonstrates a continuous effort for a theoretical reformulation of hydropathy during its stagnant and declining period to constantly fit into the holistic paradigm of medicine and hygiene. Considering the fact that the nature cure concept in hydropathy and its individualistic approach were succeeded by naturopathy at the end of the century, analysis of Lane’s medical thoughts reveals part of a ‘thin red line’ of naturalism in the battleground between reductionism and holism during the nineteenth century in the history of medicine and hygiene.

Keywords: E. W. Lane, hygienic medicine, hydropathy, naturopath

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Authors: Satyajit Kalita

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Assam from an early period has gone through various religious transformations and has witnessed its impact in different period. One of such epoch is the epoch of Srimanta Shankardeva. Srimanta Shankareva is regarded, as the greatest religious preacher and social reformer in the history of Assam. It was Shankardeva, who brought the faith of vaisnavite movement that prevailed in other parts of India. Before and during his time, the people of Assam were followers of Sakta worship, the worshipping of different gods and goddesses. People worshiped idols and offered sacrifices. Srimanta Shankardeva under the faith neo-vaishnavism and propagated the Eka-Saran-Naam-Dharm, through which spread the splendor of one and only Lord Vishnu or Krishna and abolished offering sacrifices. With the help of Eka-Saran-Naam-Dharma, Srimanta Shankardeva tries to vanish the superstitious beliefs and irrational practices of Assamese society. The NeoVaishnavite faith developed a democratic outlook which permeates the entire teachings and practices in Assamese people. His contributions not only made the foundations of Assamese literature, culture, and social structure but also established the super structures the upon. It is understood that all contributions of Srimanta Shankardeva bear his marks distinctively. Religion is said to be biggest and the most influential aspect in bringing about change in the society. In Assam, with the essence of neo-vaishnavism by Shankardeva and the emergence of the Eka-Saran-Naam-Dharma came into a huge Change to the region. The movement of religion brought about a social mobility to all sections of society. This paper is a mere initiative to look into the organizational structure of Srimanta Shankardeva Sangha and its maintenance of the ideology and principles without failure. It is aimed to examine the assimilation of different groups and communities of people under the fold of Srimanta Shankardeva Sangha.

Keywords: Neo-Vaishnavism, Srimanta Shankardeva, Srimanta Shankardeva Shangha, Eka-Saran-Naam-Dharma

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Authors: Nouira Mariem, Ennigrou Samir

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Background and aims: Healthcare-associated infections (HAI) represent a major public health problem worldwide. They represent one of the most serious adverse events in health care. The objectives of our study were to estimate the prevalence of HAI at the Charles Nicolle Hospital (CNH) and to identify the main associated factors as well as to estimate the frequency of antibiotic use. Methods: It was a cross-sectional study at the CNH with a unique passage per department (October-December 2018). All patients present at the wards for more than 48 hours were included. All patients from outpatient consultations, emergency, and dialysis departments were not included. The site definitions of infections proposed by the Centers for Disease Control and Prevention (CDC) were used. Only clinically and/or microbiologically confirmed active HAIs were included. Results: A total of 318 patients were included, with a mean age of 52 years and a sex ratio (female/male) of 1.05. A total of 41 patients had one or more active HAIs, corresponding to a prevalence of 13.1% (95% CI: 9.3%-16.9%). The most frequent site infections were urinary tract infections and pneumonia. Multivariate analysis among adult patients (>=18 years) (n=261) revealed that infection on admission (p=0.01), alcoholism (p=0.01), high blood pressure (p=0.008), having at least one invasive device inserted (p=0.004), and history of recent surgery (p=0.03), increased the risk of HAIs significantly. More than 1 of 3 patients (35.4%) were under antibiotics on the day of the survey, of which more than half (57.4%) were under two or more types of antibiotics. Conclusion: The prevalence of HAIs and antibiotic prescriptions at the CNH were considerably high. An infection prevention and control committee, as well as the development of an antibiotic stewardship program with continuous monitoring using repeated prevalence surveys, must be implemented to limit the frequency of these infections effectively.

Keywords: prevalence, healthcare associated infection, antibiotic, Tunisia

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Authors: Gwendy Darras, Mattias Desmet

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Previous research showed that psychological distress has a negative impact on the disease course of viral infections. For COVID-19, the same association was observed in small samples of specific segments of the population (e.g. health care workers). The present study presents a more refined analysis of this association, measuring a broader spectrum of psychological distress in a large sample (n=3084) of the general Flemish population. Several types of psychological distress (state, trait and health anxiety, depression, intra-, and interpersonal stress) are registered throughout three periods: one year before the contamination, one week before the contamination, and during the contamination. In doing so, validated scales such as DASS-21, IIP-32, and FCV-19S are used. Furthermore, the course of COVID-19 is registered in several ways: number of symptoms, number of days sick leave due to COVID-19, and number of days the symptoms have lasted. Also, different control variables such as vaccination status, medical and psychological history are taken into account. Statistical analysis shows that all types of psychological distress are positively correlated with the severity of the COVID-19 disease course. Anxiety during the contamination shows the strongest correlation, but psychological distress one year before the onset of COVID-19 was still significantly associated with the worsening of the disease course. As the assessment of the latter type of distress happened before the onset of the COVID-19 disease course, retrospective bias resulting in artificial associations between self-reported stress and COVID-19 severity is unlikely to have impacted the observations. In view of possible future pandemics, it is important to focus on general stress and anxiety reduction in the general population as soon as possible. It is also advisable to minimize the use of stress-inducing messages to encourage the population to adhere to the measures issued during a pandemic.

Keywords: anxiety, COVID-19, depression, psychoneuroimmunology, psychological distress, stress

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Authors: Eun Hui Bae, Sang Yeob Lim, Bongseong Kim, Tae Ryom Oh, Su Hyun Song, Sang Heon Suh, Hong Sang Choi, Eun Mi Yang, Chang Seong Kim, Seong Kwon Ma, Kyung-Do Han, Soo Wan Kim

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Background: Recent hypertension guidelines have recommended lower blood pressure (BP) targets in high-risk patients. However, there are no specific guidelines based on age or systolic and diastolic blood pressure (SBP and DBP, respectively). We aimed to assess the effects of age-related BP on the development of end-stage renal disease (ESRD) in patients with diabetes. Methods: A total of 2,563,870 patients with DM aged >20 years were selected from the Korean National Health Screening Program from 2009 to 2012 and followed up until the end of 2019. Participants were categorized into age and BP groups, and the hazard ratios (HRs) for ESRD were calculated. Results: During a median follow-up of 7.15 years, the incidence rates of ESRD increased with increasing SBP and DBP. The HR for ESRD was the highest in patients younger than 40 years of age with DBP ≥ 100 mmHg. The effect of SBP and DBP on ESRD development was attenuated with age (interaction p-value was <0.0001 for age and SBP and 0.0022 for age and DBP). The subgroup analysis for sex, anti-hypertension medication, and history of chronic kidney disease (CKD) showed higher HRs for ESRD among males younger than 40 years, not taking anti-hypertension medications and CKD compared to those among females older than 40 years, anti-hypertension medication and non-CKD groups. Conclusions: Higher SBP and DBP increase the risk of developing ESRD in patients with diabetes, and in particular, younger individuals face greater risk. Therefore, intensive BP management is warranted in younger patients to prevent ESRD.

Keywords: hypertension, young adult, end-stage renal disease, diabetes mellitus, chronic kidney disease, blood pressure

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Authors: Edoardo Lomi

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A problem of central interest in anthropology concerns the ethnographic displacement of modernity’s conceptual sovereignty over that of native collectives worldwide. Part of this critical project has been the association of Western modernity with a dualist, naturalist ontology. Despite its demonstrated value for comparative work, this association often comes at the cost of reproducing ideas that lack an empirical ethnographic basis. This paper proposes a way forward by bringing to bear some of the results produced by an ethnographic study of a village in Wiltshire, South England. Due to its picturesque qualities, this village has served for decades as a ready-made set for fantasy movies and a backdrop to fictional stories. These forms of mediation have in turn generated some apparent paradoxes, such as fictitious characters that affect actual material changes, films that become more real than history, and animated stories that, while requiring material grounds to unfold, inhabit a time and space in other respects distinct from that of material processes. Drawing on ongoing fieldwork and interviews with locals and tourists, this paper considers the ways villagers engage with fiction as part of their everyday lives. The resulting image is one of convergence, in the same landscape, of people and things having different ontological status. This study invites reflection on the implications of this image for diversifying our imagery of Western lifeworlds. To this end, the notion of ‘real fictions’ is put forth, connecting the ethnographic blurring of modernist distinctions–such as sign and signified, mind and matter, materiality and immateriality–with discussions on anthropology’s own reliance on fictions for critical comparative work.

Keywords: England, ethnography, landscape, modernity, mediation, ontology, post-structural theory

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