Search results for: nursing department

Authors: Alvarado M. Lady G., Ortiz V. Yaylenne, Quintero B. Quelbis R.

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The oil palm sector has seen significant growth in Colombia after the insertion of policies to stimulate the use of biofuels, which eventually contributes to the reduction of greenhouse gases (GHG) that deteriorate not only the environment but the health of people. However, the policy of using biofuels has been strongly questioned by the impacts that can generate; an example is the increase of other more harmful GHGs like the CH₄ that underlies the amount of solid waste generated. Casanare's department is estimated be one of the major producers of palm oil of the country given that has recently expanded its sowed area, which implies an increase in waste generated primarily in the industrial stage. For this reason, the following study evaluated the agronomic potential of the biochar obtained from empty fruit bunches and its nutritional contribution in cultivated soils with Elaeis guineensis in Casanare, Colombia. The biochar was obtained by slow pyrolysis of the clusters in a retort oven at an average temperature of 190 °C and a residence time of 8 hours. The final product was taken to the laboratory for its physical and chemical analysis as well as a soil sample from a cultivation of Elaeis guineensis located in Tauramena-Casanare. With the results obtained plus the bibliographical reports of the nutrient demand in this cultivation, the possible nutritional contribution of the biochar was determined. It is estimated that the cultivation requirements of nitrogen is 12.1 kg.ha⁻¹, potassium is 59.3 kg.ha⁻¹, magnesium is -31.5 kg.ha⁻¹ and phosphorus is 5.6 kg.ha⁻¹ obtaining a biochar contribution of 143.1 kg.ha⁻¹, 1204.5 kg.ha⁻¹, 39.2 kg.ha⁻¹ and 71.6 kg.ha⁻¹ respectively. The incorporation of biochar into the soil would significantly improve the concentrations of N, P, K and Mg, nutrients considered important in the yield of palm oil, coupled with the importance of nutrient recycling in agricultural production systems sustainable. The biochar application improves the physical properties of soils, mainly in the humidity retention. On the other hand, it regulates the availability of nutrients for plants absorption, with economic savings in the application of synthetic fertilizers and water by irrigation. It also becomes an alternative to manage agricultural waste, reducing the involuntary emissions of greenhouse gases to the environment by decomposition in the field, reducing the CO₂ content in the atmosphere.

Keywords: biochar, nutrient recycling, oil palm, pyrolysis

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Authors: Nuruddin Mohammod Zahangir, Syed Tanvir Ahmady, Firoz Ahmed, Mainul Kabir, Tamjid Mohammad Najmus Sakib Khan, Nazmul Hossain, Niaz Ahmed, Madhava Janardhan Naik

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The management of combined Coronary Artery Disease and Peripheral Vascular Disease is a challenge and brings with it numerous clinical dilemmas.The 56 year old gentleman presented to our department with significant triple vessel disease with occluded lower end of aorta just before bifurcation and bilateral superficial femoral arteries. Operation was done on 11.03.14. The The Left Internal Mammary Artery (LIMA) and the Right Internal Mammary Artery (RIMA) were harvested in skeletonized manner. The free RIMA was then anastomosed with LIMA to make LIMA-RIMA Y. Cardio Pulmonary Bypass was then established and coronary artery bypass grafts performed. LIMA was anastomosed to the Left Anterior Descending artery. RIMA was anastomosed to Posterior Descending Artery, 1st and 2nd Obtuse Marginal arteries in a sequential manner. Abdomen was opened by midline incision. The infrarenal aorta exposed and was found to be severely diseased. A Vascular Clamp was applied infrarenally, aortotomy done and limited endarterectomy performed. An end-to-side anastomosis was done with upper end of PTFE synthetic Y-graft (14/7 mm) to the infarenal Aorta and the Clamp released. Good flow noted in both limbs of the graft. Patient was then slowly weaned off from Cardio Pulmonary Bypass without difficulty. The distal two limbs of the Y graft were passed to the groin through retroperitoneal tunnels and anastomosed end-to-side with the common femoral arteries. Saphenous vein was interposed between common femoral and popliteal arteries bilaterally through subfascial tunnels in both thigh. On 12th postoperative day he was discharged from hospital in good general condition. Follow up after 3 months of operation the patient is doing good and free of chest pain and claudication pain.

Keywords: total arterial, coronary revascularization, aorto-bifemoral bypass, bifemoro-bipopliteal bypass

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Authors: Adedeji S. Adegoke, Olakunle N. Popoola

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Promotion is indispensible and inestimable property of marketing through which different organizations persuade their prospective customers. The idea of passing information about a product to the consumer at outside the world is known as promotional activities. A study was determined whether there was relationship between promotional mix and consumer buying decision, that is may be customers were influenced by promotion. It was investigated to determine whether promotion can be used to influence competitors’ activities in the market and also research was conducted to determine if there was any problem encountered by Nigeria bottling company plc, in promoting its beverages products. The various forms of promotional mix available for an organization were examined and recommended the appropriate promotional mix that company can adopt to boost the company sales. The research design was depended on the primary and secondary data. The primary data were information collected from the subjects using methods of data collection, that is through the use of questionnaire, interview, direct observation, etc. The secondary data consist of information that already exists having been collected for another purpose by some researchers. These include internal and external sources. The questionnaire was designed and administered to the staff of production and marketing department of Nigeria bottling company plc., which served as the population of this study, out of which sample was drawn randomly from the population, using sample random technique. It was deduced that 90% of the respondents opined that advertising influenced competition in the market and that there was a good sale after they started advert while 10% of them were not sure. At advertising level, 85% of the respondents chose 81-100% as the increase in the percentage recorded in their sales level, while 10% of them agreed that increase in the percentage recorded in their sales was within 61-80% and 5% of them chose 45-60% as the percentage increase in their sales record. Due to unstable economic condition of the Nigeria, many business organizations adopted the promotional strategies. Apart from advertising, it was discovered through research that sales promotion served as an incentive to consumers of Nigeria bottling company plc at a time offer gifts and prizes to consumers which drastically increased their level of sales. Since advertising and sales promotion increased the level of sales, more money should be allocated for this purpose to maintain market share and thereby increase profit.

Keywords: consumer, marketing, organization, promotional mix

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Authors: Liaquat Ali, Khurshid Natasha

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Low resource countries are not usually equipped with the organizational tools to implement health care for chronic diseases, and thus, providing effective diabetes care in such countries is a challenging task. Diabetic Association of Bangladesh (BADAS in Bengali acronym) has created a stimulating example to meet this challenge. Starting its journey in 1956 with 39 patients in a small tin shed clinic BADAS, and its affiliated associations now operate 90 hospitals and health centres all over the country. Together, these facilities provide integrated health care to about 1.5 million registered diabetic patients which constitute about 20% of the estimated diabetic population in the country. BADAS has also become a pioneer in health manpower generation in Bangladesh. Along with its affiliates, it now runs 3 Medical Colleges (to generate graduate physicians), 2 Nursing Institutes, and 2 Postgraduate Institutes which conduct 25 postgraduate courses (under the University of Dhaka) in various basic, clinical and public health disciplines. BADAS gives great emphasis on research, which encompasses basic, clinical as well as public health areas. BADAS is an ideal example of public-private partnership in health as most of its infrastructure has been created through government support but it is almost self-reliant in managing its revenue budget which approached approximately 40 million US dollar during 2010. BADAS raises resources by providing high-quality services to the people, both diabetic and non-diabetic. At the same time, BADAS has developed a cross financing model, to support diabetic patients in general and poor diabetic patients (identified through a social welfare network) in particular, through redistribution of the resources. Along with financial sustainability BADAS ensure organizational sustainability through a process of decentralization, community ownership, and democratic management. Presently a large scale pilot project (named as a Health Care Development Project or HCDP) is under implementation under BADAS umbrella with an objective to transform the diabetes care model to a health care model in general. It is expected to create further evidence on providing sustainable (with social safety net) health care delivery for diabetes, and other chronic illnesses as an integral part of general health care delivery in a resource constrained setting.

Keywords: Bangladesh, self sustain, health care, constrain

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Authors: Maria Medeiros, Suren Surenthiran, Abitha Muralithar, Soushma Seeburuth, Mohammed Mohammed

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Introduction: Appendicitis is the most common surgical emergency globally and can have devastating consequences. Diagnostic imaging in acute appendicitis has become increasingly common in aiding the diagnosis of acute appendicitis. Computerized tomography (CT) and ultrasound (US) are the most commonly used imaging modalities for diagnosing acute appendicitis. Pre-operative imaging has contributed to a reduction of negative appendicectomy rates from between 10-29% to 5%. Literature report CT scan has a diagnostic sensitivity of 94% in acute appendicitis. This clinical audit was conducted to establish if the CT scan's diagnostic yield for acute appendicitis matches the literature. CT scan has a high sensitivity and specificity for diagnosing acute appendicitis and its use can result in a lower negative appendicectomy rate. The aim of this study is to compare the pre-operative imaging findings from CT scans to the histopathology results post-operatively and establish the accuracy of CT scans in aiding the diagnosis of acute appendicitis. Methods: This was a retrospective study focusing on adult presentations to the general surgery department in a district general hospital in central London with an impression of acute appendicitis. We analyzed all patients from July 2022 to December 2022 who underwent a CT scan preceding appendicectomy. Pre-operative CT findings and post-operative histopathology findings were compared to establish the efficacy of CT scans in diagnosing acute appendicitis. Our results were also cross-referenced with pre-existing literature. Data was collected and anonymized using CERNER and analyzed in Microsoft Excel. Exclusion criteria: Children, age <16. Results: 65 patients had CT scans in which the report stated acute appendicitis. Of those 65 patients, 62 patients underwent diagnostic laparoscopies. 100% of patients who underwent an appendicectomy with a pre-operative CT scan showing acute appendicitis had acute appendicitis in histopathology analysis. 3 of the 65 patients who had a CT scan showing appendicitis received conservative treatment. Conclusion: CT scans positive for acute appendicitis had 100% sensitivity and a positive predictive value, which matches published research studies (sensitivity of 94%). The use of CT scans in the diagnostic work-up for acute appendicitis can be extremely helpful in a) confirming the diagnosis and b) reducing the rates of negative appendicectomies and consequently reducing unnecessary operative-associated risks for patients, reducing costs and reducing pressure on emergency theatre lists.

Keywords: acute apendicitis, CT scan, general surgery, imaging

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Authors: Nnodi Chinweikpe Akelachi, Adebayo Oladini Kachollom Ifeoma

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Insecurity and the possession of nuclear weapons for non-peaceful purposes constitute a major threat to global peace and security, and this undermines the capacity for sustainable development. In Nigeria, the threat of terrorism is a challenge to national stability. For over a decade, Nigeria has been faced with insecurity ranging from Boko-Haram terrorist groups, kidnapping and banditry. The threat exhibited by this non-state actor poses a huge challenge to nuclear and radiological high risks facilities in Nigeria. This challenge has resulted in the regulatory authority and International stakeholders formulating policies for a good mitigation strategy. This strategy is enshrined in formulated laws, regulations and guides like the repealed Nuclear Safety and Radiation Protection Act 19 of 1995 (Nuclear safety, Physical Security and Safeguards Bill), the Nigerian Physical Protection of Nuclear Material and Nuclear Facilities, and Nigerian Nuclear Safeguards Regulations of 2021. All this will help Nigeria’s effort to meet its national nuclear security and safeguards obligations. To further enhance the implementation of nuclear security and safeguards system, Nigeria has signed the Non-Proliferation Treaty (NPT) in 1970, the Comprehensive Safeguards Agreement (INFCIRC/358) in 1988, Additional Protocol in 2007 as well as the Convention on Physical Protection of Nuclear Material and its amendment in 2005. In view of the evolving threats by non-state actors in Nigeria, physical protection security upgrades are being implemented in nuclear and all high-risk radiological facilities through the support of the United States Department of Energy (US-DOE). Also, the IAEA has helped strengthen nuclear security and safeguard systems through the provision of technical assistance and capacity development. Efforts are being made to address some of the challenges identified in the cause of implementing the measures for effective nuclear security and safeguards systems in Nigeria. However, there are eminent challenges in the implementation of the measures within the security and systems in Nigeria. These challenges need to be addressed for an effective security and safeguard regime in Nigeria. This paper seeks to address the challenges encountered in implementing the regulatory and stakeholder measures for effective security and safeguards regime in Nigeria, amongst others.

Keywords: nuclear regulatory body, nuclear facilities and activities, international stakeholders, security and safeguards measures

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Authors: Raphael C. Zero, Thiago A. S. S. Rocha, Marita V. Cardozo, Caio C. C. Santos, Alisson D. S. Fechis, Antonio C. Shimano, FabríCio S. Oliveira

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Biomechanical analysis is an important factor in tissue studies. The objective of this study was to determine the feasibility of a new anatomical technique and quantify the changes in skin and the jejunum resistance of cats’ corpses throughout the process. Eight adult cat cadavers were used. For every kilogram of weight, 120ml of fixative solution (95% 96GL ethyl alcohol and 5% pure glycerin) was applied via the external common carotid artery. Next, the carcasses were placed in a container with 96 GL ethyl alcohol for 60 days. After fixing, all carcasses were preserved in a 30% sodium chloride solution for 60 days. Before fixation, control samples were collected from fresh cadavers and after fixation, three skin and jejunum fragments from each cadaver were tested monthly for strength and displacement until complete rupture in a universal testing machine. All results were analyzed by F-test (P <0.05). In the jejunum, the force required to rupture the fresh samples and the samples fixed in alcohol for 60 days was 31.27±19.14N and 29.25±11.69N, respectively. For the samples preserved in the sodium chloride solution for 30 and 60 days, the strength was 26.17±16.18N and 30.57±13.77N, respectively. In relation to the displacement required for the rupture of the samples, the values of fresh specimens and those fixed in alcohol for 60 days was 2.79±0.73mm and 2.80±1.13mm, respectively. For the samples preserved for 30 and 60 days with sodium chloride solution, the displacement was 2.53±1.03mm and 2.83±1.27mm, respectively. There was no statistical difference between the samples (P=0.68 with respect to strength, and P=0.75 with respect to displacement). In the skin, the force needed to rupture the fresh samples and the samples fixed for 60 days in alcohol was 223.86±131.5N and 211.86±137.53N respectively. For the samples preserved in sodium chloride solution for 30 and 60 days, the force was 227.73±129.06 and 224.78±143.83N, respectively. In relation to the displacement required for the rupture of the samples, the values of fresh specimens and those fixed in alcohol for 60 days were 3.67±1.03mm and 4.11±0.87mm, respectively. For the samples preserved for 30 and 60 days with sodium chloride solution, the displacement was 4.21±0.93mm and 3.93±0.71mm, respectively. There was no statistical difference between the samples (P=0.65 with respect to strength, and P=0.98 with respect to displacement). The resistance of the skin and intestines of the cat carcasses suffered little change when subjected to alcohol fixation and preservation in sodium chloride solution, each for 60 days, which is promising for use in surgery training. All experimental procedures were approved by the Municipal Legal Department (protocol 02.2014.000027-1). The project was funded by FAPESP (protocol 2015-08259-9).

Keywords: anatomy, conservation, fixation, small animal

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Authors: Laura A. Rodriguez-Villamizar, Alvaro Osornio-Vargas, Brian H. Rowe, Rhonda J. Rosychuk

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Introduction/Objectives: The Census Metropolitan Area of Edmonton (CMAE) has important industrial emissions to the air from the Industrial Heartland Alberta (IHA) at the Northeast and the coal-fired power plants (CFPP) at the West. The objective of the study was to explore the presence of clusters of children asthma ED visits in the areas around the IHA and the CFPP. Methods: Retrospective data on children asthma ED visits was collected at the dissemination area (DA) level for children between 2 and 14 years of age, living in the CMAE between April 1, 2004, and March 31, 2010. We conducted a spatial analysis of disease clusters around putative sources with count (ecological) data using descriptive, hypothesis testing, and multivariable modeling analysis. Results: The mean crude rate of asthma ED visits was 9.3/1,000 children population per year during the study period. Circular spatial scan test for cases and events identified a cluster of children asthma ED visits in the DA where the CFPP are located in the Wabamum area. No clusters were identified around the IHA area. The multivariable models suggest that there is a significant decline in risk for children asthma ED visits as distance increases around the CFPP area this effect is modified at the SE direction with mean angle 125.58 degrees, where the risk increases with distance. In contrast, the regression models for IHA suggest that there is a significant increase in risk for children asthma ED visits as distance increases around the IHA area and this effect is modified at SW direction with mean angle 216.52 degrees, where the risk increases at shorter distances. Conclusions: Different methods for detecting clusters of disease consistently suggested the existence of a cluster of children asthma ED visits around the CFPP but not around the IHA within the CMAE. These results are probably explained by the direction of the air pollutants dispersion caused by the predominant and subdominant wind direction at each point. The use of different approaches to detect clusters of disease is valuable to have a better understanding of the presence, shape, direction and size of clusters of disease around pollution sources.

Keywords: air pollution, asthma, disease cluster, industry

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Authors: Rabindra K. Panda, Gurjeet Singh

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The major objective of this study was to analyze the trend and variability of rainfall in the middle Mahandi river basin located in eastern India. The trend of variation of extreme rainfall events has predominant effect on agricultural water management and extreme hydrological events such as floods and droughts. Mahanadi river basin is one of the major river basins of India having an area of 1,41,589 km² and divided into three regions: Upper, middle and delta region. The middle region of Mahanadi river basin has an area of 48,700 km² and it is mostly dominated by agricultural land, where agriculture is mostly rainfed. The study region has five Agro-climatic zones namely: East and South Eastern Coastal Plain, North Eastern Ghat, Western Undulating Zone, Western Central Table Land and Mid Central Table Land, which were numbered as zones 1 to 5 respectively for convenience in reporting. In the present study, analysis of variability and trends of annual, seasonal, and monthly rainfall was carried out, using the daily rainfall data collected from the Indian Meteorological Department (IMD) for 35 years (1979-2013) for the 5 agro-climatic zones. The long term variability of rainfall was investigated by evaluating the mean, standard deviation and coefficient of variation. The long term trend of rainfall was analyzed using the Mann-Kendall test on monthly, seasonal and annual time scales. It was found that there is a decreasing trend in the rainfall during the winter and pre monsoon seasons for zones 2, 3 and 4; whereas in the monsoon (rainy) season there is an increasing trend for zones 1, 4 and 5 with a level of significance ranging between 90-95%. On the other hand, the mean annual rainfall has an increasing trend at 99% significance level. The estimated seasonality index showed that the rainfall distribution is asymmetric and distributed over 3-4 months period. The study will help to understand the spatio-temporal variation of rainfall and to determine the correlation between the current rainfall trend and climate change scenario of the study region for multifarious use.

Keywords: Eastern India, long-term variability and trends, Mann-Kendall test, seasonality index, spatio-temporal variation

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Authors: Chiou-Shiue Ko

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As is explicitly stipulated in Article 7 of the Enforcement Rules of the Special Education Act as amended in 1998, "in principle, children with disabilities should be integrated with normal children for preschool education". Since then, all cities and counties have been committed to promoting preschool inclusive education. The Education Department, New Taipei City Government, has been actively recruiting advisory groups of professors to assist in the implementation of inclusive education in preschools since 2001. Since 2011, the author of this study has been guiding Preschool Rainbow to implement inclusive education. Through field observations, meetings, and teaching demonstration seminars, this study explored the process of how inclusive education has been successfully implemented in collaboration with teachers of special education classes and regular classes in Preschool Rainbow. The implementation phases for inclusive education in a single academic year include the following: 1) Preparatory stage. Prior to implementation, teachers in special education and regular classes discuss ways of conducting inclusive education and organize reading clubs to read books related to curriculum modifications that integrate the eight education strategies, early treatment and education, and early childhood education programs to enhance their capacity to implement and compose teaching plans for inclusive education. In addition to the general objectives of inclusive education, the objective of inclusive education for special children is also embedded into the Individualized Education Program (IEP). 2) Implementation stage. Initially, a promotional program for special education is implemented for the children to allow all the children in the preschool to understand their own special qualities and those of special children. After the implementation of three weeks of reverse inclusion, the children in the special education classes are put into groups and enter the regular classes twice a week to implement adjustments to their inclusion in the learning area and the curriculum. In 2013, further cooperation was carried out with adjacent hospitals to perform development screening activities for the early detection of children with developmental delays. 3) Review and reflection stage. After the implementation of inclusive education, all teachers in the preschool are divided into two groups to record their teaching plans and the lessons learned during implementation. The effectiveness of implementing the objective of inclusive education is also reviewed. With the collaboration of all teachers, in 2015, Preschool Rainbow won New Taipei City’s “Preschool Light” award as an exceptional model for inclusive education. Its model of implementing inclusive education can be used as a reference for other preschools.

Keywords: collaboration, inclusive education, preschool, teachers, special education classes, regular classes

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Authors: Muhammad Umar Usman

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This study investigates the entrepreneurial intentions, drivers and challenges of starting a business among final year students in Jigawa State polytechnic. Nigeria. Final year students of Jigawa State Polytechnic from the department of accounting, business administration and management and public administration were used as a case study. The study became necessary due to the alarming rate of graduate unemployment in Nigeria. The study adopted a holistic case study approach involving a multiple methods of questionnaires involving (182) Higher National Diploma (HND) and National Diploma (ND) final year students and a telephone interview with two lecturers teaching entrepreneurship in the college. The findings clearly indicate that exposer to entrepreneurship education increases students’ entrepreneurial intentions. The result found that desire for independence, confidence and strong intention are the most important factors that influence students’ entrepreneurial intention. The study identified 3 key drivers of students’ entrepreneurial intentions. These are to earn a living, to seek job security and provision of employment. The result again identified 4 factors namely lack of support, finance, insecurity and erratic power supply as the major challenges in starting a business in Nigeria. It was also revealed that the current entrepreneurship education programme prepares students on how to open up a business not becoming an entrepreneur. The study concluded entrepreneurship helps students toward building and driving their intention to venture into business. However, the challenges of entrepreneurship in Nigeria need to be addressed in order to enable individuals to become an entrepreneur and create employment opportunities that will lead to the development of Nigerian economy. Thus, the government should provide adequate support particularly the issue of infrastructures. The Federal Government of Nigeria in collaboration with the National Board for Technical Education should fashion out the curriculum thereby making it more practically-oriented so that students may become more interested. Polytechnics should develop an internship programme for students to work in firms so as to put theory learnt in the class to practice. Students should try to align the theory learnt in college with the practical application in dynamic economic environment. Hence, this will help in building their capabilities toward entrepreneurship development in Nigeria.

Keywords: entrepreneurial intention, entrepreneurial drivers, challenges, entrepreneurial education

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Authors: Hamid Oumer Seid

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Piled raft foundation (PRF) is a union of pile and raft working together through the interaction of soil-pile, pile-raft, soil-raft and pile-pile to provide adequate bearing capacity and controlled settlement. A uniform pile positioning is used in PRF; however, there is a wide room for optimization through parametric study under vertical load to result in a safer and economical foundation. Addis Ababa is found in seismic zone 3 with a peak ground acceleration (PGA) above the threshold of damage, which makes investigating the performance of PRF under seismic load considering the dynamic kinematic soil structure interaction (SSI) vital. The study area is located in Addis Ababa around Mexico (commercial bank) and Kirkos (Nib, Zemen and United Bank) in which input parameters (pile length, pile diameter, pile spacing, raft area, raft thickness and load) are taken. A finite difference-based numerical software, FLAC3D V6, was used for the analysis. The Kobe (1995) and Northridge (1994) earthquakes were selected, and deconvolution analysis was done. A close load sharing between pile and raft was achieved at a spacing of 7D with different pile lengths and diameters. The maximum settlement reduction achieved is 9% for a pile of 2m diameter by increasing length from 10m to 20m, which shows pile length is not effective in reducing settlement. The installation of piles results in an increase in the negative bending moment of the raft compared with an unpiled raft. Hence, the optimized design depends on pile spacing and the raft edge length, while pile length and diameter are not significant parameters. An optimized piled raft configuration (𝐴𝐺/𝐴𝑅 = 0.25 at the center and piles provided around the edge) has reduced pile number by 40% and differential settlement by 95%. The dynamic analysis shows acceleration plot at the top of the piled raft has PGA of 0.25𝑚2/𝑠𝑒𝑐 and 0.63𝑚2/𝑠𝑒𝑐 for Northridge (1994) and Kobe (1995) earthquakes, respectively, due to attenuation of seismic waves. Pile head displacement (maximum is 2mm, and it is under the allowable limit) is affected by the PGA rather than the duration of an earthquake. End bearing and friction PRF performed similarly under two different earthquakes except for their vertical settlement considering SSI. Hence, PRF has shown adequate resistance to seismic loads.

Keywords: FLAC3D V6, earthquake, optimized piled raft foundation, pile head department

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Authors: Pampita Chakraborty, Sukumar Mukherjee

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Diabetes Mellitus (DM) is commonly encountered metabolic disorder in clinical practice. An estimated 25 percent of DM patients develop foot problems. Foot ulceration and infection are one of the major causes of morbidity, hospitalization or even amputation. Objective: To isolate and identify bacterial pathogens in Diabetic Foot Ulcer (DFU) and to observe its antimicrobial sensitivity pattern. Methodology: A prospective study was conducted for a period of 9 months at the Department of Microbiology, GD Hospital & Diabetes Institute, Kolkata. 75 DFU patients were recruited in the study. Specimens for microbiological studies obtained from ulcer base were examined as gram stained smear and was cultured aerobically on Nutrient agar, Blood agar and MacConkey agar plates. Antimicrobial sensitivity test was performed by disc diffusion techniques according to CLSI guidelines. Result: In this study out of 75cases, 73% (55/75) were male and 27% (20/75) were females with mean (SD) age of 51.11(±10) years. Out of 75 pus cultures, 63(84%) showed growth of microorganism making total of 81 bacterial isolates with 71.42% of monomicrobial infection and 28.57% of polymicrobial infection. Out of 81 isolates 53(65.43%) were gram negative and 21(25.92%) were gram positive. E.coli was relatively common isolate 21(26%) followed by Staphylococcus aureus 15(18.5%), Klebsiella pneumonia 14(17.28%), Pseudomonas aeruginosa 12 (14.81%), Proteus spp. 3 (3.70%), and Enterococcus faecalis 6 (7.40%). 75% of Gram-negative microorganism were extended Beta-lactamase enzyme (ESBL) producer and around 20 % of Klebsiella and Proteus spp. were carbapenemase enzyme producer. Among Gram positive, around 50% of S.aureus was MRSA, sensitive only to Vancomycin, Teicoplanin & Linezolid. Conclusion: More prevalence of monomicrobial gram-negative bacteria than gram-positive bacteria in DFU was observed. This study emphasizes that Beta-Lactam group of antibiotics should not be the empirical treatment of choice for Gram-negative isolates; instead alternatives like Carbapenems, Amikacin could be a better option. On the other hand, Vancomycin and Linezolid are preferred for most of the infection with gram-positive aerobes. Continuous surveillance of resistant bacteria is required for empiric therapy.

Keywords: antibiotic resistant, antimicrobial susceptibility, diabetic foot ulcer, surveillance

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Authors: Michael Howard

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The growing popularity of electric vehicles in the United States requires an ever-expanding infrastructure of commercial DC fast charging stations. The U.S. Department of Energy estimates 33,355 publicly available DC fast charging stations as of September 2023. In 2017, 115,370 gasoline stations were operating in the United States, much more ubiquitous than DC fast chargers. Range anxiety is an important impediment to the adoption of electric vehicles and is even more relevant in underserved regions in the country. The peer-to-peer energy marketplace helps fill the demand by allowing private home and small business owners to rent their 240 Volt, level-2 charging facilities. The existing, publicly accessible outlets are wrapped with a Cloud-connected microcontroller managing security and charging sessions. These microcontrollers act as Edge devices communicating with a Cloud message broker, while both buyer and seller users interact with the framework via a web-based user interface. The database storage used by the marketplace framework is a key component in both the cost of development and the performance that contributes to the user experience. A traditional storage solution is the SQL database. The architecture and query language have been in existence since the 1970s and are well understood and documented. The Structured Query Language supported by the query engine provides fine granularity with user query conditions. However, difficulty in scaling across multiple nodes and cost of its server-based compute have resulted in a trend in the last 20 years towards other NoSQL, serverless approaches. In this study, we evaluate the NoSQL vs. SQL solutions through a comparison of Google Cloud Firestore and Cloud SQL MySQL offerings. The comparison pits Google's serverless, document-model, non-relational, NoSQL against the server-base, table-model, relational, SQL service. The evaluation is based on query latency, flexibility/scalability, and cost criteria. Through benchmarking and analysis of the architecture, we determine whether Firestore can support the energy marketplace storage needs and if the introduction of a GraphQL middleware layer can overcome its deficiencies.

Keywords: non-relational, relational, MySQL, mitigate, Firestore, SQL, NoSQL, serverless, database, GraphQL

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Authors: C. Scurr, J. Jeans, S. Srivastava

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Introduction: Acute type two respiratory failure (T2RF) has become a common presentation over the last two decades primarily due to an increase in the prevalence of chronic lung disease. Acute exacerbations can be managed either medically or in combination with non-invasive ventilation (NIV) which should be monitored with regular arterial blood gas samples (ABG). Arterial lines allow more frequent arterial blood sampling with less patient discomfort. We present the experience from a teaching hospital emergency department (ED) and level 2 medical high-dependency unit (HDU) that together form the pathway for management of acute type 2 respiratory failure. Methods: Patients acutely presenting to Charing Cross Hospital, London, with T2RF requiring non-invasive ventilation (NIV) over 14 months (2011 to 2012) were identified from clinical coding. Retrospective data collection included: demographics, co-morbidities, blood gas numbers and timing, if arterial lines were used and who performed this. Analysis was undertaken using Microsoft Excel. Results: Coding identified 107 possible patients. 69 notes were available, of which 41 required NIV for type 2 respiratory failure. 53.6% of patients had an arterial line inserted. Patients with arterial lines had 22.4 ABG in total on average compared to 8.2 for those without. These patients had a similar average time to normalizing pH of (23.7 with arterial line vs 25.6 hours without), and no statistically significant difference in mortality. Arterial lines were inserted by Foundation year doctors, Core trainees, Medical registrars as well as the ICU registrar. 63% of these were performed by the medical registrar rather than ICU, ED or a junior doctor. This is reflected in that the average time until an arterial line was inserted was 462 minutes. The average number of ABGs taken before an arterial line was 2 with a range of 0 – 6. The average number of gases taken if no arterial line was ever used was 7.79 (range of 2-34) – on average 4 times as many arterial punctures for each patient. Discussion: Arterial line use was associated with more frequent arterial blood sampling during each inpatient admission. Additionally, patients with an arterial line have less individual arterial punctures in total and this is likely more comfortable for the patient. Arterial lines are normally sited by medical registrars, however this is normally after some delay. ED clinicians could improve patient comfort and monitoring thus allowing faster titration of NIV if arteral lines were regularly inserted in the ED. We recommend that ED doctors insert arterial lines when indicated in order improve the patient experience and facilitate medical management.

Keywords: non invasive ventilation, arterial blood gas, acute type, arterial line

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Authors: F. O Anugom

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The general functions of the university amongst other things include teaching, research and community service. Universities are recognized as the apex of learning, accumulating and imparting knowledge and skills of all kinds to students to enable them to be productive, earn their living and to make optimum contributions to national development. This is equivalent to the production of human capital in the form of high level manpower needed to administer the educational society, be useful to the society and manage the economy. Quality has become a matter of major importance for university education in Nigeria. Accreditation is the systematic review of educational programs to ensure that acceptable standards of education, scholarship and infrastructure are being maintained. Accreditation ensures that institution maintain quality. The process is designed to determine whether or not an institution has met or exceeded the published standards for accreditation, and whether it is achieving its mission and stated purposes. Ensuring quality assurance in accreditation process falls in the hands of university management which justified the need for this study. This study examined accreditation and quality assurance: the management imperative. Three research questions and three hypotheses guided the study. The design was a correlation survey with a population of 2,893 university administrators out of which 578 Heads of department and Dean of faculties were sampled. The instrument for data collection was titled Programme Accreditation Exercise scale with high levels of reliability. The research questions were answered with Pearson ‘r’ statistics. T-test statistics was used to test the hypotheses. It was found among others that the quality of accredited programme depends on the level of funding of universities in Nigeria. It was also indicated that quality of programme accreditation and physical facilities of universities in Nigeria have high relationship. But it was also revealed that programme accreditation is positively related to staffing in Nigerian universities. Based on the findings of the study, the researcher recommend that academic administrators should be included in the team of those who ensure quality programs in the universities. Private sector partnership should be encouraged to fund programs to ensure quality of programme in the universities. Independent agencies should be engaged to monitor the activities of accreditation teams to avoid bias.

Keywords: accreditation, quality assurance, national universities commission , physical facilities, staffing

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Authors: Melek Göregenli, Işık Gürşimşek

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There has been a great deal of research in the past few decades examining attitudes toward homosexuals.Theoretic research has demonstrated that antihomosexual attitudes are expressed in cognitive, affective, behavioral and cultural components. Homophobia is generally defined as hostility towards or fear of LGBTI people, but can also refer to social and cultural ideologies which stigmatize homosexuality. Negative feelings or attitudes towards non-heterosexual behavior, identity, relationships and community can lead to homophobic behavior and is the root of the discrimination experienced by many lesbian, gay, bisexual and transgender (LGBTI) people. Since the increase in number of hate crimes during the last decade, there has been a sense of urgency to respond to the problem of hate violence in Turkey. The LGBTI Rights Association KAOS-GL indicated that the most of lesbian, gay, bisexual, travesty and transsexuals reported some form of victimization in their lifetimes based on their sexual orientation in Turkey. This study explored the relations between homophobia, right-wing authoritarianism, social dominance orientation and just world belief attitudes towards LGBTI individuals in a sample of 393 Turkish college students from Ege University in Izmir, Turkey. Data were collected with a questionnaire including the Homosexism Scale, the Right-Wing Authoritarianism Scale, Social Dominance Orientation Scale and Just World Belief Scale. Participants completed a questionnaire containing the attitude measures and other several questions related with the socio-demographic variables. Consistent with the previous finding males were more homophobic than females. Contrary to this finding the main effects of other demographic variables (age, income, place of birth, class) were not statistically significant except the department of participants. These findings imply that efforts to garner wide-ranging support for policies designed to change negative attitudes to LGBT people and to enhance the given awareness on homophobia. The results of the study were discussed in cross-cultural and social psychological perspective considering cultural and social values of Turkey and current political circumstances of the country.

Keywords: homophobia, just world belief, right-wing authoritarianism, social dominance orientation, Turkey

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Authors: Dianne Lyneth Alavado

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At the turn of the millennium, development paradigms in the international scene revolved around one goal: elimination of global poverty without comprising human rights. One measure which achieved high endorsement and visibility in the world of work is the Decent Work Agenda (DWA) championed by the United Nation’s (UN) specialized agency for work, the International Labour Organization (ILO). The DWA has been thoroughly promoted and recommended as an ingredient of development planning and a poverty reduction strategy, particularly in developing countries such as the Philippines. The global imperative of economic growth is measurable not only in the numbers raked in by countries in terms of expanding economy but also by the development and realization of the full capacities of their people. Decent work (DW), as an outcome and not just a development approach, promises poverty eradication by means of providing both quantity and quality work that is accompanied by rights, representation, and protection. As a party to these international pacts, the Philippines is expected to heed the call towards a world free from poverty through well-endorsed measures such as the DWA with the aid of multilateral and donor organizations such as the ILO. This study aims to assess the capacity and readiness of the Philippines to achieve the goals of the DWA. This is a qualitative research using the sociological and juridical lens in the desk analysis of existing Philippine laws, policies, and programs vis-à-vis decent work indicators set forth by the ILO. Interview with experts on the Philippine labor situation is conducted for further validation. The paper identifies gaps within the Philippine legal system and its collection of laws, acts, presidential decrees, department orders and other policy instruments aimed towards achieving the goals of the DWA. Among the major findings of this paper are: the predisposition of Philippine labor laws towards the formal sector; the need for alternative solutions for the informal sector veering away from the usual dole-outs and livelihood projects; the needs for evaluation of policies and programs that are usually self-evaluated; the minimal reach of the labour inspectorate which ensures decent work; and the lack of substantial penalty for non-compliance with labor laws. The paper concludes with policy implications and recommendations towards addressing the potholes on the road to Decent Work.

Keywords: decent work agenda, labor laws, millennium development goals, poverty eradication, sustainable development goal

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Authors: Sabyasachi Behera, Shiv Kumar, Pramod Gautam, Anisur Rahman, Pawan Pathak, Rahul Bhadouria

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Background: The increasing proportion of population especially urban poor and vulnerable groups or groups with specific needs, with health indicators worse than their rural counterparts in India face various issues related with availability and quality of health care. The reasons are myriad, starting from information and awareness of the community, especially, in a scenario wherein the needs and challenges of floating and migrant urban populations remain poorly understood. Weak linkages between health care facilities and slum dwellers and vulnerable populations hinder the improvement of health services for urban poor. Method: To address this issue, TCIHC program is helping health department of Indore city of Madhya Pradesh to establish a referral mechanism with a dual approach: at both community and facility level. The former is based on the premise of ‘building social capital’, i.e. norms and networks within a community facilitating collective action, helps improve the demand and supply of health services at appropriate levels of care (Minus 2: Accredited Social Health Activist and Community Health Groups; Minus 1: Urban Health Nutrition Days; Zero: Urban Primary Health Center; Plus 1: secondary facility with BEmONC services; Plus 2: secondary facilities with CEmONC services; Plus 3: tertiary level facility) for the urban poor. The latter focuses on encouraging the provision of all services at various levels of service delivery points and stakeholders to function in a coordinated manner to ensure better health service availability and coverage in underserved slum areas. Results: This initiative has enhanced the utilization of community based, primary and secondary level services through defined referral pathways that are clearly known to a community dweller. Conclusion: An ideal referral mechanism should begin with referral at the community level wherein services of a frontline health care provider are accessed by them at their door-step, causing no delay in both understanding and decision on the health issues faced by them.

Keywords: levels of care, linkages, referral mechanism, service delivery

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Authors: Mariola Głowacka

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Aim: The aim of this study was to present the assessment of dyspnea and anxiety in seniors staying in the hospice in the context of the nurse's tasks. Materials and methods: The presented research was carried out at the "Hospicjum Płockie" Association of St. Urszula Ledóchowska in Płock, in a stationary ward, for adults. The research group consisted of 100 people, women, and men. In the study described in this paper, the method of diagnostic survey, the method of estimation and analysis of patient records were used, and the research tools were the numerical scale of the NRS assessment, the modified Borg scale to assess dyspnea, the Trait Anxiety scale to test the intensity of anxiety and the sociodemographic assessment of the respondent. Results: Among the patients, the greatest number were people without dyspnoea (38 people) and with average levels of dyspnoea (26 people). People with lung cancer had a higher level of breathlessness than people with other cancers. Half of the patients included in the study felt anxiety at a low level. On average, men had a higher level of anxiety than women. Conclusion: 1) Patients staying in the hospice require comprehensive nursing care due to the underlying disease, comorbidities, and a wide range of medications taken, which aggravate the feeling of dyspnea and anxiety. 2) The study showed that in patients staying in the hospice, the level of dyspnea was of varying severity. The greatest number of people were without dyspnea (38) and patients with a low level of dyspnea (34). There were 12 people experiencing an average level of dyspnea and a high level of dyspnea 15. 3) The main factor influencing the severity of dyspnea in patients was the location of cancer. There was no significant relationship between the intensity of dyspnea and the age, gender of the patient, and time from diagnosis. 4) The study showed that in patients staying in the hospice, the level of anxiety was of varying severity. Most people experience a low level of anxiety (51). There were 16 people with a high level of anxiety, while there were 33 people experiencing anxiety at an average level. 5) The patient's gender was the main factor influencing the increase in anxiety intensity. Men had higher levels of anxiety than women. There was no significant correlation between the intensity of anxiety and the age of the respondents, as well as the type of cancer and time since diagnosis. 6) The intensity of dyspnea depended on the type of cancer the subjects had. People with lung cancer had a higher level of breathlessness than those with breast cancer and bowel cancer. It was not found that the anxiety increased depending on the type of cancer and comorbidities of the examined person.

Keywords: cancer, shortness of breath, anxiety, senior, hospice

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Authors: Jui Hsuan Hung, Jeng Yi Tzeng

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Engineering education in the higher education is always male dominated. Therefore, women learning in this environment is an important research topic for feminists, gender researchers and engineering education researchers, especially in the era of gender mainstreaming. The research topics are from the dialectical discussion of feminism and science development history, gender issues of science education, to the subject choice of female students. These researches enrich the field of gender study in engineering education but lack of describing the detailed images of women in engineering education, including their learning, obstacles, needs or feelings. Otherwise, in order to keep up with the industrial trends of emphasizing group collaboration, engineering education turns from traditional lecture to creative group inquiry pedagogy in recent years. Creative project based learning is one of the creative group inquiry pedagogy which the engineering education in higher education adopts often, and it is seen as a gender-inclusive pedagogy in engineering education. Therefore, in order to understand the real situation of women learning in engineering education, this study took place in a course (Introduction to Engineering) offered by the school of engineering of a university in Taiwan. This course is designed for freshman students to establish basic understanding engineering from four departments (Chemical Engineering, Power Mechanical Engineering, Materials Science, Industrial Engineering and Engineering Management). One section of this course is to build a Hydraulic Robot designed by the Department of Power Mechanical Engineering. 321 students in the school of engineering took this course and all had the reflection questionnaire. These students are divided into groups of 5 members to work on this project. The videos of process of discussion of five volunteered groups with different gender composition are analyzed, and six women of these five groups are interviewed. We are still on the process of coding and analyzing videos and the qualitative data, but several tentative findings have already emerged. (1) The activity models of groups of both genders are gender segregation, and not like women; men never be the ‘assistants’. (2) The culture of the group is developed by the major gender, but men always dominate the process of practice in all kinds of gender composition groups. (3) Project based learning is supposed to be a gender-inclusive learning model in creative engineering education, but communication obstacles between men and women make it less women friendly. (4) Gender identity, not professional identity, is adopted by these women while they interact with men in their groups. (5) Gender composition and project-based learning pedagogy are not the key factors for women learning in engineering education, but the gender conscience awareness is.

Keywords: engineering education, gender education, creative project based learning, women learning

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Authors: Maria Consuelo Doble

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For decades, basic public education in the Philippines has been beleaguered by a governance scenario of multi-layered decision-making and the lack of collaboration between sectors in addressing issues on poor access to schools, high dropout rates, low survival rates, and poor student performance. These chronic problems persisted despite multiple efforts making it appear that the education system is incapable of reforming itself. In the mountainous rural towns of La Trinidad and Tuba, in the province of Benguet in Northern Philippines, collaborative education governance was catalyzed by the intervention of Synergeia Foundation, a coalition made up of individuals, institutions and organizations that aim to improve the quality of education in the Philippines. Its major thrust is to empower the major stakeholders at the community level to make education work by building the capacities of School Governing Councils (SGCs). Although mandated by the Department of Education in 2006, the SGCs in Philippine public elementary schools remained dysfunctional. After one year of capacity-building by Synergeia Foundation, some SGCs are already exhibiting active community-based multi-sectoral collaboration, while there are many that are not. With the myriad of factors hindering collaboration, Synergeia Foundation is now confronted with the pressing question: What are the factors that promote collaborative governance in the SGCs so that they can address the education-related issues that they are facing? Using Emerson’s (2011) framework on collaborative governance, this study analyzes the application of collaborative governance by highly-functioning SGCs in the public elementary schools of Tuba and La Trinidad. Findings of this action research indicate how the dynamics of collaboration composed of three interactive and iterative components – principled engagement, shared motivation and capacity for joint action – have resulted in meaningful short-term impact such as stakeholder engagement and decreased a number of dropouts. The change in the behavior of stakeholders is indicative of adaptation to a more collaborative approach in governing education in Benguet highland settings such as Tuba and La Trinidad.

Keywords: basic public education, Benguet highlands, collaborative governance, School Governing Council

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Authors: Hebah M. Musalem, Jeylan El-Mansoury, Lin M. Tuleimat, Selwa Alhazza, Abdul-Aziz A. Al Zoba

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Background: Amblyopia is a condition that affects the visual system triggering a decrease in visual acuity without a known underlying pathology. It is due to abnormal vision development in childhood or infancy. Most importantly, vision loss is preventable or reversible with the right kind of intervention in most of the cases. Strabismus, sensory defects, and anisometropia are all well-known causes of amblyopia. However, ocular misalignment in Strabismus is considered the most common form of amblyopia worldwide. The risk of developing amblyopia increases in premature children, developmentally delayed or children who had brain lesions affecting the visual pathway. The prevalence of amblyopia varies between 2 to 5 % in the world according to the literature. Objective: To determine the different causes of Amblyopia in pediatric patients seen in ophthalmology clinic of a tertiary care center, i.e. King Faisal Specialist Hospital and Research Center (KFSH&RC). Methods: This is a hospital based, random retrospective, based on reviewing patient’s files in the Ophthalmology Department of KFSH&RC in Riyadh city, Kingdom of Saudi Arabia. Inclusion criteria: amblyopic pediatric patients who attended the clinic from 2015 to 2016, who are between 6 months and 18 years old. Exclusion Criteria: patients above 18 years of age and any patient who is uncooperative to obtain an accurate vision or a proper refraction. Detailed ocular and medical history are recorded. The examination protocol includes a full ocular exam, full cycloplegic refraction, visual acuity measurement, ocular motility and strabismus evaluation. All data were organized in tables and graphs and analyzed by statistician. Results: Our preliminary results will be discussed on spot by our corresponding author. Conclusions: We focused on this study on utilizing various examination techniques which enhanced our results and highlighted a distinguished correlation between amblyopia and its’ causes. This paper recommendation emphasizes on critical testing protocols to be followed among amblyopic patient, especially in tertiary care centers.

Keywords: amblyopia, amblyopia causes, amblyopia diagnostic criterion, amblyopia prevalence, Saudi Arabia

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Authors: Dewan Ali Ahsan

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Hilsa (Tenualosa ilisha) is one of the most important anadromous fish species of the trans-boundary ecosystem of Bangladesh, India and Myanmar. Hilsa is not only an economically important species specially for Bangladesh and India, but also for the integral part of the culture of the Bangladesh and India. This flag-ship species in Bangladesh contributed alone of 10.82% of the total fish production of the country and about 75% of world’s total catch of hilsa comes from Bangladesh alone. As hilsa is an anadromous fish, it migrates from the Bay of Bengal to rivers for spawning, nursing and growing and for all of these purposes hilsa needs freshwaters. Ripe broods prefer turbid, fast flowing freshwater for spawning but young prefer clear and slow flowing freshwater. Climate change (salinity intrusion, sea level rise, temperature rise, impact of fresh water flow), unplanned developmental activities and other anthropogenic activities all together are severely damaging the hilsa stock and its habitats. So, climate change and human interferences are predicted to have a range of direct and indirect impacts on marine and freshwater hilsa fishery, with implications for fisheries-dependent economies, coastal communities and fisherfolk. The present study identified that salinity intrusion, siltation in river bed, decrease water flow from upstream, fragmentation of river in dry season, over exploitation, use of small mesh nets are the major reasons to affect the upstream migration of hilsa and its sustainable management. It has been also noticed that Bangladesh government has taken some actions for hilsa management. Government is trying to increase hilsa production not only by conserving jatka (juvenile hilsa) but also protecting the brood hilsa during the breeding seasons by imposing seasonal ban on fishing, restricted mesh size etc. Unfortunately, no such management plans are available for Indian and Myanmar territory. As hilsa is a highly migratory trans-boundary fish in the Bay of Bengal (and all of these countries share the same stock), it is essential to adopt a joint management policy (by Bangladesh-India-Myanmar) for the sustainable management for the hilsa stock.

Keywords: hilsa, climate change, south-east Asia, fishery management

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Authors: Ewelina Zdebska

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A social worker is an integral part of an interdisciplinary team working with the child and his family in a terminal state. Social support is an integral part of the medical procedure in the care of hospice. This is the basis and prerequisite of full treatment and good care of the child - patient, whose illness often finds at least the expected period of his life when his personal and legal issues are not regulated, and the family burdened with the problem requires care and support specialists - professionals. Hospice for Children in Krakow: a palliative care team operating in the province of Krakow and Malopolska, conducts specialized care for terminally ill children in place of their residence from the time when parents and doctors decided to end of treatment in hospital, allows parents to carry out medical care at home, provides parents social and legal assistance and provides care, psychological support and friendship to families throughout the life of the child's illness and after his death, as long as it is needed. The social worker in a hospice does not bear the burden of solving social problems, which is the responsibility of other authorities, but provides support possible and necessary at the moment. The most common form of assistance is to provide information on benefits, which for the child and his family may be subject to any treatment and fight for the life and health of a child. Employee assists in the preparation and completion of documents, requests to increase the degree of disability because of progressive disease or Allowance care because of the inability to live independently. It works in settling all the issues with the Department of Social Security, as well as with the Municipal and District Team Affairs of disability. Seeking help and support using multi-faceted childcare. With the Centres for Social Welfare contacts are also often on the organization of additional respite care for the sick at home (care), especially in the work of the other members of the family or if the family can not cope with the care and needs extra help. Hospice for Children in Cracow completing construction of Poland's first Respite Care Centre for chronically and terminally ill children, will be an open house where children suffering from chronic and incurable diseases and their families can get professional help, whenever - when they need it. The social worker has to pick up a very important role in caring for a terminally ill child. His presence gives a little patient and family the opportunity to be at this difficult time together while organizing assistance and support.

Keywords: social worker, care, terminal care, hospice

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Authors: Sultan Samah A. Alenezi

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Many EFL teachers are eager to look into the best way to suit the needs of their students in EFL writing courses. Numerous studies suggest that online blogging may present a social interaction opportunity for EFL writing students. Additionally, it can foster peer collaboration and social support in the form of scaffolding, which, when viewed from the perspective of socio-cultural theory, can boost social support and foster the development of students' writing abilities. This idea is based on Vygotsky's theories, which emphasize how collaboration and social interaction facilitate effective learning. In Saudi Arabia, students are taught to write using conventional methods that are totally under the teacher's control. Without any peer contact or cooperation, students are spoon-fed in a passive environment. This study included the cognitive processes of the genre-process approach into the EFL writing classroom to facilitate the use of internet blogging in EFL writing education. Thirty second-year undergraduate students from the Department of Languages and Translation at a Saudi college participated in this study. This study employed an action research project that blended qualitative and quantitative methodologies to comprehend Saudi students' perceptions and experiences with internet blogging in an EFL process-genre writing classroom. It also looked at the advantages and challenges people faced when blogging. They included a poll, interviews, and blog postings made by students. The intervention's outcomes showed that merging genre-process procedures with blogging was a successful tactic, and the Saudi students' perceptions of this method of online blogging for EFL writing were quite positive. The socio-cultural theory constructs that Vygotsky advocates, such as scaffolding, collaboration, and social interaction, were also improved by blogging. These elements demonstrated the improvement in the students' written, reading, social, and collaborative thinking skills, as well as their positive attitudes toward English-language writing. But the students encountered a variety of problems that made blogging difficult for them. These problems ranged from technological ones, such sluggish internet connections, to learner inadequacies, like a lack of computer know-how and ineffective time management.

Keywords: blogging, process-gnere approach, saudi learenrs, writing quality

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Authors: Shahid Mahmood, Ghulam Mueen-Ud-Din, Farah Naz Akbar, Yousaf Quddoos, Syeda Mahvish Zahra, Wajiha Saeed, Tayyaba Sami Ullah

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Obesity is an epidemic across the globe that affects all the segments of the population. Physical inactivity, passionate consumption of junk food, inadequate water intake and an unhealthy lifestyle are evident among university girls that are ruining their health gravely especially fat accumulation. The study was carried out to investigate the potential etiological factors of obesity development in university girls. The cross sectional study was carried out after approval of the Departmental Review Committee for Ethics (DRCE) as the par Declaration of Helsinki at Institute of Food Science and Nutrition (IFSN), University of Sargodha, Sargodha-Pakistan and Department of Food Science and Home Economics, G. C. Women University, Faisalabad-Pakistan. 400 girls were selected randomly from different departments of both universities. Nutritional status of the volunteers was assessed through approved protocols for demographics, anthropometrics, body composition, energetics, vital signs, clinical signs and symptoms, medical/family history, and dietary intake assessment (FFQ), water intake and physical activity level. The obesity was determined on body fat (%). Alarming and unheeded etiological factors for the development of obesity in girls were explored by the study. About 93 % girls had a sedentary level of physical activity, zealous consumption of junk food (5.31±1.23 servings), drank little water (1.09±0.26 L/day) that consequent high heaps of fat (35.06±3.02 %), measly body water (52.38±3.4 %), poor bone mass (05.14±0.31 Kg), and high BMI (26.68±1.14 Kg/m²) in 34% girls. The malnutrition also depicted by poor vital signs i.e. low body temperature (97.11±0.93 °F), slightly higher blood pressure (124.19±4.08 / 85.25±2.97 mmHg), rapid pulse rate (99.2 ± 6.85 beats/min), reduced blood O₂ saturation (96.53±0.96 %), scanty peak expiratory flow rate (297 ± 15.7 L /min). The outcomes of the research articulated that physical inactivity; extreme intakes of junk food, insufficient water consumption are etiological factors for obesity development among girls which are usually overlooked in Pakistan.

Keywords: informed consent, junk food, obesity, physical inactivity

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Authors: Malika Turganova, Aigul Abduldayeva

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Modern conditions require nursing innovations at the primary ambulatory stage in the health system of Kazakhstan. There is a growing need for nurses involved in before-doctor attendance for preventive interview with a female population about reproductive health. We conducted questionnaire survey of the population of Astana in 2015. Questionnaires were drawn up according to the criteria of sexual health of World Health Organization. 3593 respondents out of 8000 questionnaires agreed to answer the questions anonymously, mM=±2,1. The average age of women comprised 37,4±11,2, Ме=31,7 years of age. Analysis of awareness about marriage hygiene revealed that 72,7% of respondents did not receive information about marriage hygiene and 89,1% respondents consider it more advisable before marriage. 45,9% of respondents specified the internet as a source of information on marriage hygiene issues, 24,5% of respondents pointed out friends, and 21,5% specified doctor. Comparing female age groups under and after 40 years old we see that proportion of cases when parents provide information about marriage hygiene issues comprises 4.3% (χ2 =9.8, p<0.05). The most important factor of preservation of women reproductive health is handling a problem of unwanted pregnancy. The responsibility lies equally in men and women. Data analysis of contraceptive methods by ranking showed three most frequently used methods: contraception sheath – 29.3%, then coitus interruptus – 18.7% and hormonal preparations – 16.9%. The most important factor of women's reproductive health preservation is a solving of the problem of unwanted pregnancy, and in this respect, the responsibility lies equally in men and women. Analyzing obtained data on contraceptive methods by ranking three of the most frequently used methods are condoms – 29,3%, then coitus interruptus – 18,7% and hormonal preparations – 16,9%. Additional oral survey of the population showed a low level of informational support of female population by family physicians, health care professionals of educational organizations (schools, universities, and colleges) about hormonal contraceptive. Females of both age groups used to think that hormonal contraceptives cause collateral damage such as blastoma, cancer, increased body weight, varix dilatation of lower limbs. Satisfaction with the frequency of sexual relations of the respondents comprised 57,6%. At that, women under 40 years of age are the most satisfied women among age groups (χ2 =5,8, p<0,05).

Keywords: nurse, public health service of Kazakhstan, reproductive and sexual health, trust of population

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Authors: Tadele Araya, Tsehaye Asmelash, Girmatsion Fiseha

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Background: Hepatitis B virus (HBV), Hepatitis C virus (HCV) and Human Immunodeficiency Virus (HIV) constitute serious healthcare problems worldwide. Blood-borne pathogens HBV, HCV and HIV are commonly associated with infections among substance or Injection Drug Users (IDUs). The objective of this study was to determine the prevalence of HBV, HCV, and HIV infections among substance users in Mekelle Substance users Treatment and Rehabilitation Centers. Methods: A cross-sectional study design was used from Dec 2020 to Sep / 2021 to conduct the study. A total of 600 substance users were included. Data regarding the socio-demographic, clinical and sexual behaviors of the substance users were collected using a structured questionnaire. For laboratory analysis, 5-10 ml of venous blood was taken from the substance users. The laboratory analysis was performed by Enzyme-Linked Immunosorbent Assay (ELISA) at Mekelle University, Department of Medical Microbiology and Immunology Research Laboratory. The Data was analyzed using SPSS and Epi-data. The association of variables with HBV, HCV and HIV infections was determined using multivariate analysis and a P value < 0.05 was considered statistically significant. Result: The overall prevalence rate of HBV, HCV and HIV infections were 10%, 6.6%, and 7.5%, respectively. The mean age of the study participants was 28.12 ± 6.9. A higher prevalence of HBV infection was seen in participants who were users of drug injections and in those who were infected with HIV. HCV was comparatively higher in those who had a previous history of unsafe surgical procedures than their counterparts. Homeless participants were highly exposed to HCV and HIV infections than their counterparts. The HBV/HIV Co-infection prevalence was 3.5%. Those doing unprotected sexual practices [P= 0.03], Injection Drug users [P= 0.03], those who had an HBV-infected person in their family [P=0.02], infected with HIV [P= 0.025] were statistically associated with HBV infection. HCV was significantly associated with Substance users and previous history of unsafe surgical procedures [p=0.03, p=0.04), respectively. HIV was significantly associated with unprotected sexual practices and being homeless [p=0.045, p=0.05) respectively. Conclusion-The highly prevalent viral infection was HBV compared to others. There was a High prevalence of HBV/HIV co-infection. The presence of HBV-infected persons in a family, unprotected sexual practices and sharing of needles for drug injection were the risk factors associated with HBV, HIV, and HCV. Continuous health education and screening of the viral infection coupled with medical and psychological treatment is mandatory for the prevention and control of the infections.

Keywords: hepatitis b virus, hepatitis c virus, HIV, substance users

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Authors: Anindita Patra, Prasad K. Bhaskaran

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The atmosphere-ocean is a dynamically linked system that influences the exchange of energy, mass, and gas at the air-sea interface. The exchange of energy takes place in the form of sensible heat, latent heat, and momentum commonly referred to as fluxes along the atmosphere-ocean boundary. The large scale features such as El Nino and Southern Oscillation (ENSO) is a classic example on the interaction mechanism that occurs along the air-sea interface that deals with the inter-annual variability of the Earth’s Climate System. Most importantly the ocean and atmosphere as a coupled system acts in tandem thereby maintaining the energy balance of the climate system, a manifestation of the coupled air-sea interaction process. The present work is an attempt to understand the long-term variability in atmospheric parameters (from surface to upper levels) and investigate their role in influencing the surface ocean variables. More specifically the influence of atmospheric circulation and its variability influencing the mean Sea Level Pressure (SLP) has been explored. The study reports on a critical examination of both ocean-atmosphere parameters during a monsoon season over the head Bay of Bengal region. A trend analysis has been carried out for several atmospheric parameters such as the air temperature, geo-potential height, and omega (vertical velocity) for different vertical levels in the atmosphere (from surface to the troposphere) covering a period from 1992 to 2012. The Reanalysis 2 dataset from the National Centers for Environmental Prediction-Department of Energy (NCEP-DOE) was used in this study. The study signifies that the variability in air temperature and omega corroborates with the variation noticed in geo-potential height. Further, the study advocates that for the lower atmosphere the geo-potential heights depict a typical east-west contrast exhibiting a zonal dipole behavior over the study domain. In addition, the study clearly brings to light that the variations over different levels in the atmosphere plays a pivotal role in supporting the observed dipole pattern as clearly evidenced from the trends in SLP, associated surface wind speed and significant wave height over the study domain.

Keywords: air temperature, geopotential height, head Bay of Bengal, long-term variability, NCEP reanalysis 2, omega, wind-waves

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