Search results for: malignant middle cerebral artery (MCA) infarct

Authors: Yi Huang

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Background: For the development of children, it is important for parents to encourage children not only on academic competence but also on children’s social competence. In the western cultural context, parents emphasize more heavily on female children’s social-behavioral development. However, whether the conclusion is correct in eastern culture and whether the parent’s gender affects such an emphasis remains unclear. And, more valuably, from the perspective of intervention, except for the nature factors - child’s gender and parent’s gender, it is also worth to probe whether the improvable factors, such as parent’s perspective taking, influence parent’s emphasis on child’s social competence. Aim: This study was aimed to investigate the impact of parent’s gender, child’s gender, and parent’s perspective-taking on parent’s attitudes of encouragement of the child’s social competence under the Chinese cultural context. Method: 461 Chinese parents whose children were in the first year of middle school during the research time participated in this study. Among all participants, there were 155 fathers and 306 mothers. The research adopted the self-report of perspective-taking, which is the sub-scale of the Interpersonal Reactivity Index and the self-report of the encouragement on a child’s social communication, which is the sub-scale of the Chinese version of The Children Rearing Practice Report. In this study, 291 parents reported regarding male children, and 170 parents reported regarding female children. Results: Contrary to the traditional western theory, which usually suggests parent puts more attention on social development and competence to girl the instead of the boy, in the Chinese context, parent emphasizes social competence more on the male child. Analogically, in China, compared to mother, father underscores the child’s social competence more heavily. By constructing the hierarchical regression model, the result indicated that after controlling the variables of the gender of child and the gender of parent, parent’s perspective-taking still explains for the variance of parent’s encouragement on child’s social competence, which means, parent’s perspective-taking predicts parent’s encouragement on child’s social competence after excluding the impact of the gender of parent and child. Conclusion: For Chinese parents, the ability of perspective-taking is beneficial to enhance their awareness of encouraging children’s social competence.

Keywords: parent; child, gender differences, perspective-taking, social development

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Authors: Rhodine Hickman, Craig Wylie, Michael G. McCaul

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Introduction: The World Health Organisation has called on governments around the world to recognise emergency conditions as a global public health problem and respond with appropriate steps for effective preventative strategies. However, to understand the magnitude of the problem, good quality epidemiological data is required. This is especially challenging in low and middle-income countries, where routine data is scarce, specifically within the prehospital setting. Methods: We conducted a retrospective cross-sectional study of a national prehospital private sector EMS database. The database being the property of ER24 (private Emergency Medical Services (EMS) company in South Africa) contains claims submitted by the majority of ambulance services in South Africa during the period between 1 January 2008 to 28 March 2017. We used descriptive statistics and control charts to describe the data using STATA 14. Results: 299,257 calls were included in the analysis. The top clinical conditions requiring ambulance transport were transport accidents (10% of total call volume) and ischaemic heart disease (4.4%). The number of transport accidents consistently increased between 2009 and 2014 and reached beyond the limit for normal variation in 2015. Victims of transport accidents required basic life support services 60% of the time with 80% of injuries being minor to moderate. The frequency of ischaemic heart disease had a steady incline from 2011 to 2016. Advanced life support services were required about 50% of the time, with 60% of patients needing urgent care. Conclusion: Transport accidents, followed by ischaemic heart disease, are the most prevalent conditions in South African private EMS. There is a potential to address these conditions by developing the capacity of low and mid-level providers in trauma and advanced EMS providers in ischaemic heart disease.

Keywords: emergency care, emergency medicine, prehospital providers, South Africa

Procedia PDF Downloads 154

Authors: Magdy Danial Riad

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Introduction: The ability of our world to support the expanding population after 2050 is at risk due to the food system's global role in poor health, climate change, and resource depletion. Healthy, equitable, and sustainable food systems must be achieved from the point of production through consumption in order to meet several of the sustainable development goals (SDG) targets. There is evidence that changing the local food environment can effectively change dietary habits in a community. The purpose of this article is to outline the policy initiatives taken by local governments to support environmentally friendly eating habits. Methods: Five databases were searched for peer-reviewed articles that described local government authorities' implementation of environmentally sustainable eating habits, were located in cities that had signed the Milan Urban Food Policy Pact, were published after 2015, were available in English, and described policy interventions. Data extraction was a two-step approach that started with extracting information from the included study and ended with locating information unique to policies in the grey literature. Results: 45 papers that described a variety of policy initiatives from low-, middle-, and high-income countries met the inclusion criteria. A variety of desired dietary behaviors were the focus of policy action, including reducing food waste, procuring food locally and in season, boosting breastfeeding, avoiding overconsumption, and consuming more plant-based meals and fewer items derived from animals. Conclusions: In order to achieve SDG targets, local governments are under pressure to implement evidence-based interventions. This study can help direct local governments toward evidence-based policy measures to improve regional food systems and support ecologically friendly eating habits.

Keywords: meals, planet, poor health, eating habits

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Authors: Fatima Alkhayat, Abu Hassan Ahmed

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Qatar as the one of Middle East and Gulf country is growing rapidly due to urbanization. Urbanization, population’s movement and goods transportation in addition to climatic change all together create suitable environments for remerging and/or introduction of new disease vectors species. Unfortunately, knowledge on mosquito species composition and their geographical distribution in Qatar is extremely limited. The objective of present study is to provide update information on species composition and distribution. Mosquito larval survey carried out in six sentinel sites in Qatar. The collection was made on monthly basis in period from October 2013 to May 2015 using dipping techniques and identified to species level using appropriate pictorial keys. In total about 3,085 mosquito larvae were collected and identified to species compromising three mosquito genera, Culex 87.4% (n=2697), Ochlerotatus 9.9% (n= 305) and Anopheles 2.6% (n= 81). Among Culex genera; Culex quinquefasciatus represent 87.8% (n= 2369), Cx. pipiens 8.7% (n=237), and Cx. mattinglyi 3.4% (n=91). Culex quinquefasciatus was the most commonly collected species, representing 93.5% in Alwakra (n= 2216) which was observed in November, December, March, April and May when reached the peak. 6.4% in Nuaija (n= 151) was found in February and March and reached the peak in March. 0.1% in Alkaraana (n=2) only observed in April. Cx. pipiens was observed 50.2% in Rwdat Alfaras (n=120) and 48.9% in Hazm Almurkhiya (n=117). While in Rowdat Alfaras it was observed in Oct-May and in Hazm Almurkhiya from Oct-April. Cx. mattinglyi (n= 91) was only found in Nuaija from October to December. Ochlerotatus genera account 1 species Oc. dorsalis (n=305). The majority of Oc. dorsalis were observed in March and May, 98% in Nuaija (n= 299), followed by 2% in Alkhor (n=6) which was observed in January and February. Anopheles was only represented by An. stephensi which was found 69% in Alwakra (n= 56) in November, December, April and May, while 25.9% in Hazm Almurkhiya (n=21) and found in May and November. 6.2% in Rwadat Alfaras and was observed only in November and 1.2% in Nuaija (n=1) and observed in October. Further investigation is required on the composition and distribution of mosquito for implementing a surveillance program and control of mosquito-borne diseases in Qatar.

Keywords: composition, distribution, mosquito, Qatar

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Authors: Rudra Prasad Khanal

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Introduction: Non-communicable disease, such as cancer, has spread all over the world for some last decades. However, every nation has experienced a burden from the development of technology. In the context of Nepal, 10 to 15 thousand new cancer incidences are being registered in different hospitals for treatment. Since the date of starting nuclear medicine at Bir Hospital in 1998, cancer patients have been getting treatment regularly. According to the data of the population-based cancer registry, approximately 60% of the population having a middle-class income is being affected by cancer in Nepal. Methods and Materials: The study is aimed to find out the particular place where the population density of new cancer incidence is highest in Nepal and to inform the concerned regulatory body that is working on cancer screening and early detection for the proper treatment from the beginning. In order to identify the areas with the highest population density of new cancer incidence, all the data of cancer patients were collected from five different renowned hospitals and also from the population-based cancer registry center and then analyzed the data. The history of cancer patients was studied from 2003 to 2020, but here the data are analyzed from 2015 to 2020 only to find the latest trend in cancer incidence. Results: In the five major hospitals in Nepal, the total new cancer incidence was 61783 from 2015 to 2020. Out of those, 34617 were female, and 27176 were male. This research shows that female cancer patients were more every year. In the male, lung cancer patients more than cancer of other organs, but in females, the number of breast cancer patients was greatest. The age-adjusted mortality rate for males in Kathmandu valley was 36.3, and for females was 27.0 per 100,000 population. The cancer incidence and mortality rate were slightly lesser in other districts of Nepal. This rate increased with the increase in the age of people. Over 60 years, cancer incidence and mortality rates have been found to increase rapidly. Conclusion: This research supports conducting the program of cancer screening and early detection at Kathmandu valley with high priority and then Morang, Rukum, SSDM, etc., to control cancer.

Keywords: cancer incidence, research scholar, Tribhuvan University, Bhaktapur Cancer Hospital, Nepal

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Authors: May Al Sahib

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This paper draws together an analysis of two autobiographical writings; Ahdaf Soueif’s Cairo: My City, Our Revolution (2012), Radwa Ashour’s Heavier than Radwa (2013), and Revolution is My Name: An Egyptian Woman’s Diary from Eighteen Days in Tahrir (2015). Soueif, Ashour, and Prince are Egyptian authors, activists, and cultural commentators who are fully aware that being a ‘third world’ citizen constrains the writer into taking a specific pattern in writing. However, this paper will analyze the choice of literary form in writing the 2011 January revolution. All texts give factual accounts of the revolution with all its contesting powers lingering with mixed references of anxiety and merriment that accentuates their sense of communal solidarity against social corruption and political positioning. Through shifting between the pronouns ‘I’ and ‘we’, these narratives do not solely engage with the personal life of the memorialist; but rather give an account of the collective. Both writers take us to the heart of high-spirited Tahrir Square in 2011 while millions are ranting to oust Hosni Mubarak, the 30 years ruling dictator. By utilizing the instrumentality of collective memory for expressing textual collectivity in their non-fictional writings, these writers are depicting the people power of Egyptians and the historical civil-resistance against governmental unfairness and establishing a certain type of patriotism that elevates and priorities itself from minor conflicts. Their de-individualizing type of life narrative represents the Arabic nation through vital socio-political situations that perpetuate the politics of resistance and collectivity with a constant fear of betraying it and erupts historical moments aiming for an improved future. The texts incorporate an explicit set of reported political series of thought that shape an overall public argument and representational ideas.

Keywords: resistance narrative, life-writing, Tahrir memoir, Middle Eastern literature

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Authors: Avijit Mahala

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Present study is primarily concerned with the physical processes and status of land degradation in a tropical plateau fringe. Chotanagpur plateau is one of the most water erosion related degraded areas of India. The granite gneiss geological formation, low to medium developed soil cover, undulating lateritic uplands, high drainage density, low to medium rainfall (100-140cm), dry tropical deciduous forest cover makes the Silabati River basin a truly representative of the tropical environment. The different physical factors have been taken for land degradation study includes- physiographic formations, hydrologic characteristics, and vegetation cover. Water erosion, vegetal degradation, soil quality decline are the major processes of land degradation in study area. Granite-gneiss geological formation is responsible for developing undulating landforms. Less developed soil profile, low organic matter, poor structure of soil causes high soil erosion. High relief and sloppy areas cause unstable environment. The dissected highland causes topographic hindrance in productivity. High drainage density and frequency in rugged upland and intense erosion in sloppy areas causes high soil erosion of the basin. Decreasing rainfall and increasing aridity (low P/PET) threats water stress condition. Green biomass cover area is also continuously declining. Through overlaying the different physical factors (geological formation, soil characteristics, geomorphological characteristics, etc.) of considerable importance in GIS environment the varying intensities of land degradation areas has been identified. Middle reaches of Silabati basin with highly eroded laterite soil cover areas are more prone to land degradation.

Keywords: land degradation, tropical environment, lateritic upland, undulating landform, aridity, GIS environment

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Authors: Sarchil H. Qader, Andrew Harfoot, Mathias Kuepie, Sabrina Juran, Attila Lazar, Andrew J. Tatem

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The need for high-quality, reliable, and timely population data, including demographic information, to support the achievement of the sustainable development goals (SDGs) in all countries was recognized by the United Nations' 2030 Agenda for sustainable development. However, many low and middle-income countries lack reliable and recent census data. To achieve reliable and accurate census and survey outputs, up-to-date census enumeration areas and digital national sampling frames are critical. Census enumeration areas (EAs) are the smallest geographic units for collection, disseminating, and analyzing census data and are often used as a national sampling frame to serve various socio-economic surveys. Even for countries that are wealthy and stable, creating and updating EAs is a difficult yet crucial step in preparing for a national census. Such a process is commonly done manually, either by digitizing small geographic units on high-resolution satellite imagery or walking the boundaries of units, both of which are extremely expensive. We have developed a user-friendly tool that could be employed to generate draft EA boundaries automatically. The tool is based on high-resolution gridded population and settlement datasets, GPS household locations, building footprints and uses publicly available natural, man-made and administrative boundaries. Initial outputs were produced in Burkina Faso, Paraguay, Somalia, Togo, Niger, Guinea, and Zimbabwe. The results indicate that the EAs are in line with international standards, including boundaries that are easily identifiable and follow ground features, have no overlaps, are compact and free of pockets and disjoints, and the boundaries are nested within administrative boundaries.

Keywords: enumeration areas, national sampling frame, gridded population data, preEA tool

Procedia PDF Downloads 117

Authors: Keshari Shrestha, Philip Vatterott

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Introduction: Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare and potentially fatal drug-related syndrome. DRESS classically presents with a diffuse maculopapular rash, fevers, and eosinophilia more than three weeks after drug exposure. DRESS can present with multi-organ involvement, with liver damage being the most common and severe. Pulmonary involvement is a less common manifestation and is associated with poor clinical outcomes. Chest imaging is often nonspecific, and symptoms can range from mild cough to acute respiratory distress syndrome (ARDS) . This is a case of a 49-year-old female with a history of recent clostridium difficile colitis status post treatment with oral vancomycin who presented with rash, acute liver and kidney failure, as well as diffuse nodular alveolar lung opacities concerning for DRESS syndrome with multi-organ involvement. Clinical Course: This patient initially presented to an outside hospital with clostridium difficile colitis, acute liver injury, and acute kidney injury. She developed a desquamating maculopapular rash in the setting of recent oral vancomycin, meloxicam, and furosemide initiation. She was hospitalized on two additional occasions with worsening altered mental status, liver injury, and acute kidney injury and was initiated on intermittent hemodialysis. Notably, she was found to have systemic eosinophilia (4100 cells/microliter) several weeks prior. She was transferred to this institution for further management where she was found to have encephalopathy, jaundice, lower extremity edema, and diffuse bilateral rhonchorous breath sounds on pulmonary examination. The patient was started on methylprednisolone for suspected DRESS syndrome. She underwent an evaluation for alternative causes of her organ failure. Her workup included a negative infectious, autoimmune, metabolic, toxic, and malignant work-up. Abdominal computed tomography (CT) and ultrasound were remarkable for evidence of hepatic steatosis and possible cirrhotic morphology. Additionally, a chest CT demonstrated diffuse and symmetric nodular alveolar lung opacities with peripheral sparing not consistent with acute respiratory distress syndrome or edema. Ultimately, her condition continued to decline, and she required intubation on several occasions. On hospital day 25 she succumbed to distributive shock in the setting of probable sepsis and multi-organ failure. Discussion: DRESS syndrome occurs in 1 in 1,000 to 10,000 patients with a mortality rate of around 10%. Anti-convulsant, anti-bacterial, anti-viral, and sulfonamide drugs are the most common drugs implicated in the development of DRESS syndrome; however, the list of offending agents is extensive . The diagnosis of DRESS syndrome is made after excluding other causes of disease such as infectious and autoimmune etiologies. The RegiSCAR scoring system is used to diagnose DRESS syndrome with 2-3 points indicating possible disease, 4-5 probable disease, and >5 definite disease. This patient scored a 7 on the RegiSCAR scale for eosinophilia, rash, organ involvement, and exclusion of other causes (infectious and autoimmune). While the pharmacologic trigger in this case is unknown, it is speculated to be caused by vancomycin, meloxicam, or furosemide due to the favorable timeline of initiation. Despite aggressive treatment, DRESS syndrome can often be fatal. Because of this, early diagnosis and treatment of patients with suspected DRESS syndrome is imperative.

Keywords: drug reaction with eosinophilia and systemic symptoms, multi-organ failure, pulmonary involvement, renal failure

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Authors: Michael R. Shurin, Galina Shurin, Vladimir A. Kirichenko

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Background. Visibility of hepatic malignancies is poor on non-contrast imaging for daily verification of liver malignancies prior to radiation therapy on MRI-guided Linear Accelerators (MR-Linac). Ferumoxytol® (Feraheme, AMAG Pharmaceuticals, Waltham, MA) is a SPION agent that is increasingly utilized off-label as hepatic MRI contrast. This agent has the advantage of providing a functional assessment of the liver based upon its uptake by hepatic Kupffer cells proportionate to vascular perfusion, resulting in strong T1, T2 and T2* relaxation effects and enhanced contrast of malignant tumors, which lack Kupffer cells. The latter characteristic has been recently utilized for MRI-guided radiotherapy planning with precision targeting of liver malignancies. However potential radiotoxicity of SPION has never been addressed for its safe use as an MRI-contrast agent during liver radiotherapy on MRI-Linac. This study defines the radiomodulating properties of SPIONs in vitro on human monocyte and macrophage cell lines exposed to 60Go gamma-rays within clinical radiotherapy dose range. Methods. Human monocyte and macrophages cell line in cultures were loaded with a clinically relevant concentration of Ferumoxytol (30µg/ml) for 2 and 24 h and irradiated to 3Gy, 5Gy and 10Gy. Cells were washed and cultured for additional 24 and 48 h prior to assessing their phenotypic activation by flow cytometry and function, including viability (Annexin V/PI assay), proliferation (MTT assay) and cytokine expression (Luminex assay). Results. Our results reveled that SPION affected both human monocytes and macrophages in vitro. Specifically, iron oxide nanoparticles decreased radiation-induced apoptosis and prevented radiation-induced inhibition of human monocyte proliferative activity. Furthermore, Ferumoxytol protected monocytes from radiation-induced modulation of phenotype. For instance, while irradiation decreased polarization of monocytes to CD11b+CD14+ and CD11bnegCD14neg phenotype, Ferumoxytol prevented these effects. In macrophages, Ferumoxytol counteracted the ability of radiation to up-regulate cell polarization to CD11b+CD14+ phenotype and prevented radiation-induced down-regulation of expression of HLA-DR and CD86 molecules. Finally, Ferumoxytol uptake by human monocytes down-regulated expression of pro-inflammatory chemokines MIP-1α (Macrophage inflammatory protein 1α), MIP-1β (CCL4) and RANTES (CCL5). In macrophages, Ferumoxytol reversed the expression of IL-1RA, IL-8, IP-10 (CXCL10) and TNF-α, and up-regulates expression of MCP-1 (CCL2) and MIP-1α in irradiated macrophages. Conclusion. SPION agent Ferumoxytol increases resistance of human monocytes to radiation-induced cell death in vitro and supports anti-inflammatory phenotype of human macrophages under radiation. The effect is radiation dose-dependent and depends on the duration of Feraheme uptake. This study also finds strong evidence that SPIONs reversed the effect of radiation on the expression of pro-inflammatory cytokines involved in initiation and development of radiation-induced liver damage. Correlative translational work at our institution will directly assess the cyto-protective effects of Ferumoxytol on human Kupfer cells in vitro and ex vivo analysis of explanted liver specimens in a subset of patients receiving Feraheme-enhanced MRI-guided radiotherapy to the primary liver tumors as a bridge to liver transplant.

Keywords: superparamagnetic iron oxide nanoparticles, radioprotection, magnetic resonance imaging, liver

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Authors: Shreya Saxena, Felix Miller-Molloy, Phillipa Bowen, Greg Fellows, Elizabeth Bowen

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Background: Complex fluid balance abnormalities are well-established post-neurosurgery and traumatic brain injury (TBI). The triple-phase response requires fluid management strategies reactive to urine output and sodium homeostasis as patients shift between Diabetes Insipidus (DI) and Syndrome of Inappropriate ADH (SIADH). It was observed, at a tertiary paediatric center, a relatively high prevalence of the above complications within a cohort of paediatric post-neurosurgical and TBI patients. An audit of the clinical practice against set institutional guidelines was undertaken and analyzed to understand why this was occurring. Based on those results, new guidelines were developed with structured educational packages for the specialist teams involved. This was then reaudited, and the findings were compared. Methods: Two independent audits were conducted across two time periods, pre and post guideline change. Primary data was collected retrospectively, including both qualitative and quantitative data sets from the CQUIN neurosurgical database and electronic medical records. All paediatric patients post posterior fossa (PFT) or supratentorial surgery or with a TBI were included. A literature review of evidence-based practice, initial audit data, and stakeholder feedback was used to develop new clinical guidelines and nursing standard operation procedures. Compliance against these newly developed guidelines was re-assessed and a thematic, trend-based analysis of the two sets of results was conducted. Results: Audit-1 January2017-June2018, n=80; Audit-2 January2020-June2021, n=30 (reduced operative capacity due to COVID-19 pandemic). Overall, improvements in the monitoring of both fluid balance and electrolyte trends were demonstrated; 51% vs. 77% and 78% vs. 94%, respectively. The number of clear fluid management plans documented postoperatively also increased (odds ratio of 4), leading to earlier recognition and management of evolving fluid-balance abnormalities. The local paediatric endocrine team was involved in the care of all complex cases and notified sooner for those considered to be developing DI or SIADH (14% to 35%). However, significant Na fluctuations (>12mmol in 24 hours) remained similar – 5 vs six patients – found to be due to complex pituitary hypothalamic pathology – and the recommended adaptive fluid management strategy was still not always used. Qualitative data regarding useability and understanding of fluid-balance abnormalities and the revised guidelines were obtained from health professionals via surveys and discussion in the specialist teams providing care. The feedback highlighted the new guidelines provided a more consistent approach to the post-operative care of these patients and was a better platform for communication amongst the different specialist teams involved. The potential limitation to our study would be the small sample size on which to conduct formal analyses; however, this reflects the population that we were investigating, which we cannot control. Conclusion: The revised clinical guidelines, based on audited data, evidence-based literature review and stakeholder consultations, have demonstrated an improvement in understanding of the neuro-endocrine complications that are possible, as well as increased compliance to post-operative monitoring of fluid balance and electrolytes in this cohort of patients. Emphasis has been placed on preventative rather than treatment of DI and SIADH. Consequently, this has positively impacted patient safety for the center and highlighted the importance of educational awareness and multi-disciplinary team working.

Keywords: post-operative, fluid-balance management, neuro-endocrine complications, paediatric

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Authors: Ejaz Ashraf, Raheel Babar, Muhammad Yaseen, Hafiz Khurram Shurjeel, Nosheen Fatima

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Main purpose of this study was to assess adoption level of farmers for quinoa cultivation after they had been taught through training and visit extension approach. At this time of the 21^st century, population structure, climate change, food requirements and eating habits of people are changing rapidly. In this scenario, farmers must play their key role in sustainable crop development and production through adoption of new crops that may also be helpful to overcome the issue of food insecurity as well as reducing poverty in rural areas. Its cultivation in Pakistan is at the early stages and there is a need to raise awareness among farmers to grow quinoa crops. In the middle of the 2015, a training and visit extension approach was used to raise awareness and convince farmers to grow quinoa in the area. During training and visit extension program, 80 farmers were randomly selected for the training of quinoa cultivation. Later on, these farmers trained 60 more farmers living into their neighborhood. After six months, a survey was conducted with all 140 farmers to assess the impact of the training and visit program on adoption level of respondents for the quinoa crop. The survey instrument was developed with the help of literature review and other experts of the crop. Validity and reliability of the instrument were checked before complete data collection. The data were analyzed by using SPSS. Multiple regression analysis was used for interpretation of the results from the survey, which indicated that factors like information/ training, change in agronomic and plant protection practices play a key role in the adoption of quinoa cultivation by respondents. In addition, the model explains more than 50% of variation in the adoption level of respondents. It is concluded that farmers need timely information for improved knowledge of agronomic and plant protection practices to adopt cultivation of the quinoa crop in the area.

Keywords: farmers, quinoa, adoption, contact, training and visit

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Authors: Akhigbe Mark, Abang Roger, Mwoltu Nanaribet, Edet Blessing

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Introduction.: The introduction of pre- exposure prophylaxis (PrEP) as a biomedical prevention method for HIV/AIDS has been around for more than a decade since the first confirmed evidence of its effectiveness when used daily as an oral pill. It is now a very valuable addition for people who are at higher risk of contracting HIV. Although globalacceptanceof PrEP hasincreased, PrEP is still highly concentrated in a small number of countries and within a small sub-population, with Kenya and South Africa accounting for only 19% of people who have received PrEP in Africa region, there is still a significant regionGap in PrEP availability and use, with only 28% of the target of 3 million in low-and middle countries currently using PrEP. Description: The purpose of this study is to find out if serum creatinine could be used as an incentive to improve PrEP uptake among Key population.Numerous approaches to increasing the uptake ofPrEP as a prevention mechanism for HIV in KPs has beenemployed, and one of them is serum creatinine. This approach is a biomarker of renal function, which was used in study as an incentive to increase PrEP uptake among key population groups (female sex workers, men who have sex with men, persons who inject drugs, transgender) in 3 states from South-South Nigeria. Whole blood samples are collected from clients, analysis of the samples is done using the clinical chemistry analyzer before they are initiated onto PrEP. Lessons learned and Recommendations: Secondary data was extracted from 3 states of HALG Implementing facilities in Southern part of Nigeria, PrEP uptake before and afterthe introduction of serum creatinine between March 2020 and August 2020 among key populationsin Nigeria. A total of 5664 patients were initiated on PrEP before, and after the introduction of serum creatinine, the PrEP uptake rate before (March 2020 to May 2020) introduction of serum creatinine accounted for only 5% of the total onset, and after (June 2020 to August 2020) introduction of serum creatinine, the uptake rate accounted for 95% of the total onset. These finding shows that increased uptake of PrEP before/after serum creatineindicates that serum creatine may be an effective stimulus for promoting PrEP in key populations.

Keywords: serum creatinine, incentives, PrEP, key populations, Nigeria

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Authors: Canan Duzan

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For most language learners, mastery of the speaking skill is the proof of the mastery of the foreign language. On the other hand, the speaking skill is considered as the most difficult aspect of language learning to develop for both learners and teachers. Especially in countries like Turkey where exposure to the target language is minimum and resources and opportunities provided for language practice are scarce, teaching and learning to speak the language become a real struggle for teachers and learners alike. Data collected from students, instructors, faculty members and the business sector in needs analysis studies conducted previously at Middle East Technical University (METU) consistently revealed the need for addressing the problem of lack of confidence in speaking English. Action was taken during the design of the only EAP speaking course offered in Modern Languages Department since lack of confidence is considered to be a serious barrier for effective communication and causes learners to suffer from insecurity, uncertainty and fear. “Confidence building” served as the guiding principle in the syllabus design, nature of the tasks created for the course and the assessment procedures to help learners become more confident speakers of English. In order to see the effectiveness of the decisions made during the design phase of the course and whether students become more confident speakers upon completion of the course, a case study was carried out with 100 students at METU. A questionnaire including both Likert-Scale and open-ended items were administered to students to collect data and this data were analyzed using the SPSS program. Group interviews were also carried out to gain more insight into the effectiveness of the course in terms of building speaking confidence. This presentation will explore the specific actions taken to develop students’ confidence based on the findings of program evaluation studies and to what extent the students believe these actions to be effective in improving their confidence. The unique design of this course and strategies adopted for confidence building are highly applicable in other EAP contexts and may yield similar positive results.

Keywords: confidence, EAP, speaking, strategy

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Authors: Mindaugas Zavalis

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Analysis of experimental tests data of bending one-way reinforced concrete slabs from various articles of science revealed that voided slabs with a grid of hollow plastic inserts inside have smaller mechani-cal and physical parameters compared to continuous cross-section slabs (solid slabs). The negative influence of a reinforced concrete slab is impacted by hollow plastic inserts, which make a grid of voids in the middle of the cross-sectional area of the reinforced concrete slab. A formed grid of voids reduces the slab’s stiffness, which influences the slab’s parameters of serviceability, like deflection and cracking. Prima-ry investigation of data established during experiments illustrates that cracks occur faster in the tensile surface of the voided slab under bend-ing compared to bending solid slab. It means that the crack bending moment force for the voided slab is smaller than the solid slab and the reduction can variate in the range of 14 – 40 %. Reduce of resistance to cracking can be controlled by changing a lot of factors: the shape of the plastic hallow insert, plastic insert height, steps between plastic in-serts, usage of prestressed reinforcement, the diameter of reinforcement bar, slab effective depth, the bottom cover thickness of concrete, effec-tive cross-section of the concrete area about reinforcement and etc. Mentioned parameters are used to evaluate crack width and step of cracking, but existing analytical calculation methods for cracking eval-uation of voided slab with plastic inserts are not so exact and the re-sults of cracking evaluation in this paper are higher than the results of analyzed experiments. Therefore, it was made analytically calculations according to experimental bending tests of voided reinforced concrete slabs with hollow plastic inserts to find and propose corrections for the evaluation of cracking for reinforced concrete voided slabs with hollow plastic inserts.

Keywords: voided slab, cracking, hallow plastic insert, bending, one-way reinforced concrete, serviceability

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Authors: Anand Malik

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The Himalayas with high tectonic activities poses a great threat to human life and property. Climate change is another reason which triggering extreme events multiple fold effect on high mountain glacial environment, rock falls, landslides, debris flows, flash flood and snow avalanches. One such extreme event of cloud burst along with breach of moraine dammed Chorabri Lake occurred from June 14 to June 17, 2013, triggered flooding of Saraswati and Mandakini rivers in the Kedarnath Valley of Rudraprayag district of Uttrakhand state of India. As a result, huge volume of water with its high velocity created a catastrophe of the century, which resulted into loss of large number of human/animals, pilgrimage, tourism, agriculture and property. Thus a comprehensive assessment of debris flow hazards requires GIS-based modeling using numerical methods. The aim of present study is to focus on analysis and mapping of debris flow movements using geospatial data with flow-r (developed by team at IGAR, University of Lausanne). The model is based on combined probabilistic and energetic algorithms for the assessment of spreading of flow with maximum run out distances. Aster Digital Elevation Model (DEM) with 30m x 30m cell size (resolution) is used as main geospatial data for preparing the run out assessment, while Landsat data is used to analyze land use land cover change in the study area. The results of the study area show that model can be applied with great accuracy as the model is very useful in determining debris flow areas. The results are compared with existing available landslides/debris flow maps. ArcGIS software is used in preparing run out susceptibility maps which can be used in debris flow mitigation and future land use planning.

Keywords: debris flow, geospatial data, GIS based modeling, flow-R

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Authors: Mojo Mengistu Gelasso

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The tropical forest is considered the most important forest ecosystem for mitigating climate change by sequestering a high amount of carbon. The potential carbon stock of the forest can be influenced by many factors. Therefore, studying these factors is crucial for understanding the determinants that affect the potential for woody carbon storage in the forest. This study was conducted to evaluate the potential for woody carbon stock and how it varies based on plant community types, as well as along altitudinal, slope, and aspect gradients in the Munessa dry Afromontane forest. Vegetation data was collected using systematic sampling. Five line transects were established at 100 m intervals along the altitudinal gradient between two consecutive transect lines. On each transect, 10 quadrats (20 x 20 m), separated by 200 m, were established. The woody carbon was estimated using an appropriate allometric equation formulated for tropical forests. The data was analyzed using one-way ANOVA in R software. The results showed that the total woody carbon stock of the Munessa forest was 210.43 ton/ha. The analysis of variance revealed that woody carbon density varied significantly based on environmental factors, while community types had no significant effect. The highest mean carbon stock was found at middle altitudes (2367-2533 m.a.s.l), lower slopes (0-13%), and west-facing aspects. The Podocarpus falcatus-Croton macrostachyus community type also contributed a higher woody carbon stock, as larger tree size classes and older trees dominated it. Overall, the potential for woody carbon sequestration in this study was strongly associated with environmental variables. Additionally, the uneven distribution of species with larger diameter at breast height (DBH) in the study area might be linked to anthropogenic factors, as the current forest growth indicates characteristics of a secondary forest. Therefore, our study suggests that the development and implementation of a sustainable forest management plan is necessary to increase the carbon sequestration potential of this forest and mitigate climate change.

Keywords: munessa forest, woody carbon stock, environmental factors, climate mitigation

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Authors: Mengistu Gelasso Mojo

Abstract:

The tropical forest is considered the most important forest ecosystem for mitigating climate change by sequestering a high amount of carbon. The potential carbon stock of the forest can be influenced by many factors. Therefore, studying these factors is crucial for understanding the determinants that affect the potential for woody carbon storage in the forest. This study was conducted to evaluate the potential for woody carbon stock and how it varies based on plant community types, as well as along altitudinal, slope, and aspect gradients in the Munessa dry Afromontane forest. Vegetation data was collected using systematic sampling. Five line transects were established at 100 m intervals along the altitudinal gradient between two consecutive transect lines. On each transect, 10 quadrats (20 x 20 m), separated by 200 m, were established. The woody carbon was estimated using an appropriate allometric equation formulated for tropical forests. The data was analyzed using one-way ANOVA in R software. The results showed that the total woody carbon stock of the Munessa forest was 210.43 ton/ha. The analysis of variance revealed that woody carbon density varied significantly based on environmental factors, while community types had no significant effect. The highest mean carbon stock was found at middle altitudes (2367-2533 m.a.s.l), lower slopes (0-13%), and west-facing aspects. The Podocarpus falcatus-Croton macrostachyus community type also contributed a higher woody carbon stock, as larger tree size classes and older trees dominated it. Overall, the potential for woody carbon sequestration in this study was strongly associated with environmental variables. Additionally, the uneven distribution of species with larger diameter at breast height (DBH) in the study area might be linked to anthropogenic factors, as the current forest growth indicates characteristics of a secondary forest. Therefore, our study suggests that the development and implementation of a sustainable forest management plan is necessary to increase the carbon sequestration potential of this forest and mitigate climate change.

Keywords: munessa forest, woody carbon stock, environmental factors, climate mitigation

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Authors: Mikael Soini, Kari Björn

Abstract:

Metropolia University of Applied Sciences (MUAS) Information and Communication Technology (ICT) Degree Programme provides full-time Bachelor-level undergraduate studies. ICT Degree Programme has seven different major options; this paper focuses on Health Technology. In Health Technology, a significant curriculum change in 2014 enabled transition from fragmented curriculum including dozens of courses to a new integrated curriculum built around three 30 ECTS themes. This paper focuses especially on the second theme called Customer Oriented Software Applications. From students’ point of view, the goal of this theme is to get familiar with existing health related ICT solutions and systems, understand business around health technology, recognize social and healthcare operating principles and services, and identify customers and users and their special needs and perspectives. This also acts as a background for health related web application development. Built web application is tested, developed and evaluated with real users utilizing versatile user centred development methods. This paper presents experiences obtained from the first implementation of Customer Oriented Software Applications theme. Student feedback was gathered with two questionnaires, one in the middle of the theme and other at the end of the theme. Questionnaires had qualitative and quantitative parts. Similar questionnaire was implemented in the first theme; this paper evaluates how the theme-based integrated curriculum has progressed in Health Technology major by comparing results between theme 1 and 2. In general, students were satisfied for the implementation, timing and synchronization of the courses, and the amount of work. However there is still room for development. Student feedback and teachers’ observations have been and will be used to develop the content and operating principles of the themes and whole curriculum.

Keywords: engineering education, integrated curriculum, learning and teaching methods, learning experience

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Authors: Munaza Mubeen

Abstract:

The colonial Urdu literature has played a significant role in uplifting the overall status of the Indians. Taking example of the Bhopal State, the contribution of the Royal ladies holds no match in the contemporary age. Similarly, the efforts of the Begamat-e-Bhopal in the field of education had been acknowledged across the Sub-continent. It had been noticed that with the downfall of the Mughal Empire at the hands of the British Raj, the local culture in the Indian sub-continent in general and in Bhopal State in proper got deteriorated. This led to uncertainty, chaos and an anti-British sentiment which created hatred against them in the entire sub-continent. Likely, in Bhopal State, the role of women in field of education also vanished. However, this change was felt by the ladies in the Royal Household where they struggled for restoration of the status quo with their personal efforts. The prominent contributors from the Royal household included Qudseya Begum, Nawab Sikander Begum, Nawab Shah Jahan Begum and Nawab Sultan Johan-they are known as Begamat-i-Bhopal. They established schools, colleges and universities to impart formal and non-formal education respectively. Their systematic approach and continued efforts constituted a dynamic aspect of women’ empowerment. Focused on the female education, however, one of the by-products of their efforts was an introduction of socio-cultural and politico-religious awareness among the middle class womenfolk. Unfortunately, the role of these Bagamat-i-Bhopal has been left untouched or ignored by the academic scholars. This study critically analyzed the role of Beghamat-i-Bhopal regarding female education in Hindustan in general and in Bhopal in particular. Similarly, the contribution of the contemporary writers in development of female education in Bhopal has also been discussed in this paper. This paper is based on the 'historico-textual' approach following structural reason which has established a justifiable argument. The researcher, therefore, has taken into consideration all the chronological nuances in order to accord greater visibility to the contents. The data has been described, analyzed and interpreted inclusively and in generalized manner.

Keywords: colonialism, Begamaat e Bhopal, female education, State of Bhopal

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Authors: Adam M. Yates, Julie E. Byles

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Hypertension has been identified as a prominent co-morbidity of obesity. To improve clinical intervention of hypertension, it is critical to identify metrics that most accurately reflect risk for increased morbidity. Two of the most relevant and accurate measures for increased risk of hypertension due to excess adipose tissue are Body Mass Index (BMI) and Waist-Height Ratio (WHtR). Previous research has examined these measures in cross-national and cross-ethnic studies, but has most often relied on secondary means such as meta-analysis to identify and evaluate the efficacy of individual body mass measures. In this study, we instead use cross-sectional analysis to assess the cross-ethnic discriminative power of BMI and WHtR to predict risk of hypertension. Using the WHO SAGE survey, which collected anthropometric and biometric data from respondents in six middle-income countries (China, Ghana, India, Mexico, Russia, South Africa), we implement logistic regression to examine the discriminative power of measured BMI and WHtR with a known population of hypertensive and non-hypertensive respondents. We control for gender and age to identify whether optimum cut-off points that are adequately sensitive as tests for risk of hypertension may be different between groups. We report results for OR, RR, and ROC curves for each of the six SAGE countries. As seen in existing literature, results demonstrate that both WHtR and BMI are significant predictors of hypertension (p < .01). For these six countries, we find that cut-off points for WHtR may be dependent upon gender, age and ethnicity. While an optimum omnibus cut-point for WHtR may be 0.55, results also suggest that the gender and age relationship with WHtR may warrant the development of individual cut-offs to optimize health outcomes. Trends through multiple countries show that the optimum cut-point for WHtR increases with age while the area under the curve (AUROC) decreases for both men and women. Comparison between BMI and WHtR indicate that BMI may remain more robust than WHtR. Implications for public health policy are discussed.

Keywords: hypertension, obesity, Waist-Height ratio, SAGE

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Authors: Rai Friedman

Abstract:

The recent migrant crisis has revealed an unmet demand for increased international protection and promotion of migrant rights. Europe has found itself at the centre of the migration crisis, being the recipient to the largest number of asylum-seekers since the conclusion of the second World War. Rather than impart a unified humanitarian lens of offering legal protections, the Schengen territory is devising new, preventative measures to confront the influx of asylum-seekers. This paper will focus on the refugee crisis in Europe as it relates to the Central Mediterranean route. To do so, it will outline the increased need for international protection for migrant rights through analyzing historic human rights treaties and conventions; the formation of the current composition of the Schengen area; the evolutionary changes in policies and legal landscapes throughout Europe and the Central Mediterranean route; the vernacular transformation surrounding refugees, migrants, and asylum-seekers; and expose the gaps in international protection. It will also discuss Europe’s critical position, both geographically and conceptually, critiquing the notion of European victimization. Lastly, it will discuss the increased harm of preventative border measures and argue for tangible sustainability solutions through economic programming models in highly vulnerable countries. To do so, this paper will observe a case study in Algeria that has conceded to an economic programming model for forced migrants. In 2017 amid worker shortages, Algeria announced it would grant African migrants’ legal status to become agriculturalists and construction workers. Algeria is one of the few countries along the Central Mediterranean route that has adopted a law to govern foreign nationals’ conditions of entry, stay and circulation. Thereafter, it will provide recommendations for solutions for forced migration along the Central Mediterranean route and advocate for strengthened protections under international law.

Keywords: refugees, migrants, human rights, middle east, Africa, mediterranean, international humanitarian law, policy

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Authors: Violeta Kapageorgiadou

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Over the past decade, millions of individuals from middle-eastern and African countries have migrated to Europe to seek refuge. The majority of these refugees emigrate from Muslim majority countries and seek to integrate into European societies. Notably, Greece has hosted thousands of individuals seeking asylum since 2015. Many of these individuals have applied for asylum. They have sought to integrate into the Greek society and to navigate their way through the national and European legal systems with regard to their status. This paper, drawn from a PhD thesis project, focuses on the legal consciousness of migrants and the processes open to asylum seekers to assert their rights, notably with regard to incidents of hate crime and including their interactions with the legal authorities in Greece. The research seeks to capture the factors that influence the views and behaviors of migrants towards the law and their legal rights, using legal consciousness as a theoretical framework. The research findings indicate that asylum seekers have developed a multidimensional legal consciousness influenced by their religious and political background, legal knowledge, previous (negative) experiences with the legal system and their socio-economic status in Greece. Asylum seekers, while aware of the rights essential for their survival in the host country (such as applying for asylum to obtain a secure status, claiming for benefits and housing), were unaware of, and less willing to engage with, legal authorities and rights which they did not find essential for their survival. They viewed hate incidents against them as less important, not worth reporting and sometimes did not even consider these incidents as crimes. The research suggests that asylum seekers in Greece are a vulnerable population who need mechanisms to support them and raise their legal consciousness around their rights in order to better integrate, develop and thrive in the host society. Moving forwards, a better understanding of refugees' and asylum seekers’ reactions towards hate crime will help to create future policies and support mechanisms that could improve the lives of these individuals.

Keywords: hate crime, legal consciousness, legal rights, migrations

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Authors: Nagendra P. Luitel, Mark J. D. Jordans

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Globally, there is a significant gap between the number of individuals in need of mental health care and those who actually receive treatment. The evidence is accumulating that mental health services can be delivered effectively by primary health care workers through community-based programs and task-sharing approaches. Changing the role of specialist mental health workers from service delivery to building clinical capacity of the primary health care (PHC) workers could help in reducing treatment gap in low and middle-income countries (LMICs). We developed a comprehensive mental health care plan in 2012 and evaluated its feasibility and effectiveness over the past three years. Initially, a mixed method formative study was conducted for the development of mental health care plan (MHCP). Routine monitoring and evaluation data, including client flow and reports of satisfaction, were obtained from beneficiaries (n=135) during the pilot-testing phase. Repeated community survey (N=2040); facility detection survey (N=4704) and the cohort study (N=576) were conducted for evaluation of the MHCP. The resulting MHCP consists of twelve packages divided over the community, health facility, and healthcare organization platforms. Detection of mental health problems increased significantly after introducing MHCP. Service implementation data support the real-life applicability of the MHCP, with reasonable treatment uptake. Currently, MHCP has been implemented in the entire Chitwan district where over 1400 people (438 people with depression, 406 people with psychosis, 181 people with epilepsy, 360 people with alcohol use disorder and 51 others) have received mental health services from trained health workers. Key barriers were identified and addressed, namely dissatisfaction with privacy, perceived burden among health workers, high drop-out rates and continue the supply of medicines. The results indicated that involvement of PHC workers in detection and management of mental health problems is an effective strategy to minimize treatment gap on mental health care in Nepal.

Keywords: mental health, Nepal, primary care, treatment gap

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Authors: Khanday Pervaiz Ahmad

Abstract:

It was in 19th century when the Indian educated class started to reform their socio-religious set up as an imperative to respond to the challenges put forward by the colonial empire. The colonial discourse on India from the very beginning was gendered, as the colonized society was feminized and its ‘effeminate’ character, as opposed to ‘colonial masculinity’ was held to be a justification for its loss of independence. The ‘women health figure’ is prominently in these gender discourses. The women’s health received a much place in the colonial discourse. Lack of health consciousness, illiteracy, and belief in myths, rituals and superstitions were deemed the main factors taken as an indicator of miserable condition of Indian women’s health. As the low position of women caused shame to the natives, reforming the condition of women, its health occupied a major place in their intellectual as well as activist engagements. Magazines (journals) for women began to appear in various Indian languages in the mid to late 19th century with Bengal leading the front. These sources (Magazines) like Harm, Tehzib un Niswan, Saheli, Khatoon etc. are essential for the study of the emergence of an ideology of respectable domesticity in Indian Muslim upper middle class. Similarly for the study of development of Women’s health consciousness, women’s magazines are very essential. These earliest women Urdu magazines were first started by men, and then followed by the women’s own magazines. Various health issues, like pregnancy, child-rearing, menstruation, midwives training, Pardah, and health etc. were discussed at a time when it was impossible to discuss them in public sphere. These women magazines were brave pioneers, expanding the frontiers of women’s roles, and consciousness at a time when those frontiers were severely limited. This paper will try to focus on how women responded to the question of colonial discourse about their bodies. How health consciousness developed among Indian Muslim women and in what way it contributed in the development of feminist consciousness in South Asian Muslim Women community.

Keywords: Ashraf class, khatoon, haram women, feminism

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Authors: A. A. Md. Ryhan Uddin, Swarup Das, Rajesh Barua, Joheb Hasan, Rashedul Islam

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Background: The herbicide has toxicological importance because some of them are associated with high mortality rates due to respiratory failure. Organophosphate poisoning (OPC) & Paraquat self-poisoning is a major clinical and public health problems in low and middle-income countries across much of South Asia. Paraquat was not used as a common suicidal agent previously in Bangladesh. We report a case of 15 years old female admitted to the ER with a history of nausea & vomiting after ingestion of an unknown substance in a suicidal attempt, later identified as mixed poisoning- OPC & Paraquat. She was initially asymptomatic but later developed renal shutdown & lung injuries as well as pneumothorax, referred to as Daisley Barton Syndrome. Objective: This case report aims to alert spontaneous pneumothorax in mixed poisoning on uncommon forms of presentation. Pneumothorax in a patient with paraquat poisoning is a less unusual but underdiagnosed finding. It has a high index of early mortality. Case history: The patient's attendant complained about nausea followed by vomiting, which was nonprojectile & contains undigested food materials first, then gastric juice later. After a few hours, she also complains of urinary retention. Her family members treated her with some home remedies for her initial symptoms, but all attempts failed. After admission, the patient was initially asymptomatic. Through repeated history taking, her attendant showed a bottle of OPC in liquid form, which they suspected that she may have ingested some of the liquid from that bottle accidentally or attempted Suicide. So, management started for OPC poisoning. She responded well initially, but on 4th day of admission, the patient's condition became deteriorating. After the workout with the family member, 2nd bottle of Pesticide was discovered, which was Paraquat. Conclusion: Physicians should be aware of the symptoms of mixed poisoning and the timely use of urine dithionate testing for early detection and treatment. Pneumothorax is an early predictor of mortality in patients with paraquat poisoning.

Keywords: pneumothorax, suicide, dithionate, OPC, herbicide

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Authors: Yelba Maria Carrillo

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The focus of this research study was to explore barriers, if any, faced by parents or legal guardians who are of Latinx background and speak Spanish as a primary language or are bilingual speakers of Spanish and English; barriers that limit their understanding of and involvement in their gifted child’s academic life. This study was guided by a qualitative case study design. The primary investigator hosted focus group interviews at a Magnet Middle School in Southern California. The groups consisted of 25 parents, or legal guardians of bilingual (English/Spanish) or former English learner students enrolled in a school serving 6th-8th grades. The primary investigator interviewed Latinx Spanish-speaking parents or legal guardians of gifted students regarding their perception of their child’s giftedness, parental involvement in schools, and fostering their child’s exceptional abilities. Parents and legal guardians described children as creative, intellectual, and highly intelligent. Key themes such as student performance, language proficiency, socio-emotional, and general intellectual ability were strong indicators of giftedness. Barriers such as language and education inhibited parent and legal guardian ability to understand their child’s giftedness, which resulted in their inability to adequately contribute to the development of their children’s talents and advocate for the appropriate services for their children. However, they recognized the importance of being involved in their child’s academic life and the importance of nurturing their ‘dón’ or ‘gift.’ La Familia is the foundation and core of Latinx culture; and, without a strong foundation, children lack guidance, confidence, and awareness to tap into their gifted abilities. Providing Latinx parents with the proper tools and resources to appropriately identify gifted characteristics and traits could lead to early identification and intervention for students in schools and at home.

Keywords: gifted education, gifted Latino students, Latino parent involvement, high ability students

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Authors: Elise Machline

Abstract:

Policy instruments have been developed worldwide to reduce the energy demand of buildings. Two types of such instruments have been green building rating systems and energy efficiency standards for buildings -such as Green Star (Australia), LEED (United States, Leadership in Energy and Environmental Design), Energy Star (United States), and BREEAM (United Kingdom, Building Research Establishment Environmental Assessment Method). The popularity of the idea of sustainable development has allowed the actors to consider the potential value generated by the environmental performance of buildings, labeled “green value” in the literature. Sustainable performances of buildings are expected to improve their attractiveness, increasing their value. A growing number of empirical studies demonstrate that green buildings yield rental/sale premia, as well as higher occupancy rates and thus higher asset values. The results suggest that green buildings are not affordable to all and that their construction tends to have a gentrifying effect. An increasing number of countries are institutionalizing green strategies for affordable housing. In that sense, making green buildings affordable to all will depend on government policies. That research aims to investigate whether green building fosters inequality in Israel, under the banner of sustainability. The method is comparison (of the market value). This method involves comparing the green buildings sale prices with non-certified buildings of the same type that have undergone recent transactions. The “market value” is deduced from those sources by analogy. The results show that, in Israel, green building projects are usually addressed to the middle to upper classes. The green apartment’s sale premium is about 19% (comparing to non-certified dwelling). There is a link between energy and/or environmental performance and the financial value of the dwellings. Moreover, price differential is much higher than the value of energy savings. This perpetuates socio-spatial and socio-economic inequality as well as ecological vulnerability for the poor and other socially marginal groups. Moreover, there are no green affordable housings and the authorities do not subsidy green building or retrofitting.

Keywords: green building, gentrification, social housing, green value, green building certification

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Authors: Sathvika Reddy, Devi Revathi

Abstract:

Background: In India, deliberate self-harm (DSH) with poisoning agents carries a significant impact on morbidity and mortality. Changes in the patterns of poisoning vary across various geographical locations. It is important to know the patterns in a given region in order to facilitate rapid clinical diagnosis, appropriate treatment to reduce associated morbidity and mortality. Aim and Objective: To study the patterns, treatment outcomes of acute poisoning in patients admitted to emergency wards in a tertiary care hospital and to provide poison information services. Materials and Methods: This study was conducted at M.S Ramaiah Memorial and Teaching Hospital from November 2016 to March 2017. The patient’s data was obtained from patient case sheet, interaction with health care professionals, interviewing patients and their caretakers (if possible), and were documented in a suitably designed form. Results: The study involved 131 patients with a mean age of 27.76 ± 15.5 years. Majority of the patients were in the age group 21-30 years, literates (n=53) dwelling in urban (n=113) areas belonging to upper middle class (n=50). Analgesics and antipyretics were commonly utilized in intentional drug overdosage (n=49). Envenomation constituted n=21(16.03%). Furthermore, a significant relationship was observed between marital status and self-poisoning (n=64) (P < 0.001) which commonly occurred through oral ingestion. The outcomes were correlated with the GCS and PSS system and n=85 recovered, n=17 were discharged against medical advice, and n=4 died, and n=4 were lost to follow up respectively. The poison information queries include drug overdose (n=29) and management related queries (n=22) provided majorly by residents (n=45) to update knowledge (n=11) and for better patient care (n=40). Conclusion: The trend in poisoning is dynamic. Medications were identified as the main cause of poisoning in urban areas of India. Educational programs with more emphasis on preventive measures are necessary to create awareness among the general public.

Keywords: poisoning, suicides, clinical pharmacist, envenomation, poison information services

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Authors: Howaida I. Abd-Alla, Omnia Kutkat, Yassmin Moatasim, Magda T. Ibrahim, Marwa A. Mostafa, Mohamed GabAllah, Mounir M. El-Safty

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Artemisia judaica (known shih-balady), Azadirachta indica and Sophora tomentosa (known yellow necklace pod) are members of available medicinal plants well-known for their traditional medical use in Egypt which suggests that they probably harbor broad-spectrum antiviral, immunostimulatory and anti-inflammatory functions. Their ethyl acetate-dichloromethane (1:1, v/v) extracts were evaluated for the potential anti-Middle East respiratory syndrome-related coronavirus (anti-MERS-CoV) activity. Their cytotoxic activity was tested in Vero-E6 cells using 3-(4,-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) method with minor modification. The plot of percentage cytotoxicity for each extract concentration has calculated the concentration which exhibited 50% cytotoxic concentration (TC50). A plaque reduction assay was employed using safe dose of extract to evaluate its effect on virus propagation. The highest inhibition percentage was recorded for the yellow necklace pod, followed by Shih-balady. The possible mode of action of virus inhibition was studied at three different levels viral replication, viral adsorption and virucidal activity. The necklace pod leaves have induced virucidal effects and direct effects on the replication of virus. Phytochemical investigation of the promising necklace pod led to the isolation and structure determination of nine compounds. The structure of each compound was determined by a variety of spectroscopic methods. Compounds 4-O-methyl sorbitol 1, 8-methoxy daidzin 6 and 6-methoxy apigenin-7-O-β-D-glucopyranoside 8 were isolated for the first time from the Sophora genus and the other six compounds were the first time that they were isolated from this species according to available works of literature. Generally, the highest anti-CoV 2 activity of S. tomentosa was associated with the crude ethanolic extract, indicating the possibility of synergy among the antiviral phytochemical constituents (1-9).

Keywords: coronavirus, MERS-CoV, mode of action, necklace pod, shih-balady

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