Search results for: post prison life

Authors: Sakkaphat T. Ngamake, Arunya Tuicomepee, Panrapee Suttiwan, Rewadee Watakakosol, Sompoch Iamsupasit

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Generally, 'positive' emotion regulation strategies such as cognitive reappraisal have linked to desirable outcomes while 'negative' strategies such as behavioral suppression have linked to undesirable outcomes. These trends have been found in both the elderly and professional practitioners. Hence, this study sought to investigate these trends further by examining the relationship between two dominant emotion regulation strategies in the literature (i.e., cognitive reappraisal and behavioral suppression) and well-being outcomes among the elderly (i.e., successful aging) and their caregivers (i.e., satisfaction with life), using the actor-partner interdependence model. A total of 150 elderly-caregiver dyads participated in the study. The elderly responded to two measures assessing the two emotion regulation strategies and successful aging while their caregivers responded to the same emotion regulation measure and a measure of satisfaction with life. Two criterion variables (i.e., successful aging and satisfaction with life) were specified as latent variables whereas four predictors (i.e., two strategies for the elderly and two strategies for their caregivers) were specified as observed variables in the model. Results have shown that, for the actor effect, the cognitive reappraisal strategy yielded positive relationships with the well-being outcomes for both the elderly and their caregivers. For the partner effect, a positive relationship between caregivers’ cognitive reappraisal strategy and the elderly’s successful aging was observed. The behavioral suppression strategy has not related to any well-being outcomes, within and across individual agents. This study has contributed to the literature by empirically showing that the mental activity of the elderly’s immediate environment such as their family members or close friends could affect their quality of life.

Keywords: emotion regulation, caregiver, older adult, well-being

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Authors: Hanee Ryu

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The former president Lee Myung-bak's administration of Korea presented “green growth” as a catchphrase from 2008. He declared “low-carbon, green growth” the nation's vision for the next decade according to United Nation Framework on Climate Change. The government designed omnidirectional policy for low-carbon and green growth with concentrating all effort of departments. The structural change was expected because this slogan is the identity of the government, which is strongly driven with the whole department. After his administration ends, the purpose of this paper is to quantify the policy effect and to compare with the value of the other OECD countries. The major target values under direct policy objectives were suggested, but it could not capture the entire landscape on which the policy makes changes. This paper figures out the policy impacts through comparing the value of ex-ante between the one of ex-post. Furthermore, each index level of Korea’s low-carbon and green growth comparing with the value of the other OECD countries. To measure the policy effect, indicators international organizations have developed are considered. Environmental Sustainable Index (ESI) and Environmental Performance Index (EPI) have been developed by Yale University’s Center for Environmental Law and Policy and Columbia University’s Center for International Earth Science Information Network in collaboration with the World Economic Forum and Joint Research Center of European Commission. It has been widely used to assess the level of natural resource endowments, pollution level, environmental management efforts and society’s capacity to improve its environmental performance over time. Recently OCED publish the Green Growth Indicator for monitoring progress towards green growth based on internationally comparable data. They build up the conceptual framework and select indicators according to well specified criteria: economic activities, natural asset base, environmental dimension of quality of life and economic opportunities and policy response. It considers the socio-economic context and reflects the characteristic of growth. Some selected indicators are used for measuring the level of changes the green growth policies have induced in this paper. As results, the CO2 productivity and energy productivity show trends of declination. It means that policy intended industry structure shift for achieving carbon emission target affects weakly in the short-term. Increasing green technologies patents might result from the investment of previous period. The increasing of official development aids which can be immediately embarked by political decision with no time lag present only in 2008-2009. It means international collaboration and investment to developing countries via ODA has not succeeded since the initial stage of his administration. The green growth framework makes the public expect structural change, but it shows sporadic effect. It needs organization to manage it in terms of the long-range perspectives. Energy, climate change and green growth are not the issue to be handled in the one period of the administration. The policy mechanism to transfer cost problem to value creation should be developed consistently.

Keywords: comparing ex-ante between ex-post indicator, green growth indicator, implication for green growth policy, measuring policy effect

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Authors: Yanqing Yi, Maria Cristina Lavagnolo, Alessandro Manzardo

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Construction and demolition waste (C&DW) is a major challenge in the European Union, emphasizing the urgent need for appropriate waste management processes. Selecting these solutions is challenging, as it requires identifying efficient C&DW management techniques that balance acceptable practices, regulatory compliance, resource conservation, economic viability, and environmental concerns. Techniques for analyzing many kinds of criteria allow for the use of multi-criteria analysis in life cycle assessment (LCA). Although LCA is commonly used to analyze environmental effects, the economic factor has not been fully integrated into the LCA approach in C&DW management. The life cycle costing (LCC) approach was designed to assess economic performance in the C&DW management process. The choice of an effective multi-criteria decision-making (MCDM) technique is critical for the C&DW system. This study seeks to propose a model that employs MCDM by considering LCA and LCC results, thereby augmenting both environmental and economic sustainability. A widely used compensatory MCDM technique, TOPSIS, has been chosen to identify the most effective C&DW management scheme by comparing and ranking various scenarios. Four waste management alternatives were examined in the Lombardy region of Italy, namely, (i) landfill; (ii) recycling for concrete production and road construction, incineration with energy recovery; (iii) recycling for road construction; (iv) recycling for concrete production and road construction. We determine that, with the implementation of various scenarios, the most suitable scenario emerges to be recycled for concrete production and road construction, with a score of 0.711/1; recycling for road construction, with a final score of 0.291/1, ranks second; recycling for concrete production and road construction, incineration with energy recovery scores 0.002/1, ranks third; and landfill (scores: 0/1) is the worst choice, indicating it has the highest environmental impact. Finally, suggestions were developed to improve the system's environmental performance.

Keywords: life cycle assessment, life cycle costing, construction and demolition waste, multi-criteria decision making

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Authors: Murat Zencirkıran, Elvan Ender

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Climate change, which has become effective on a global scale, is accompanied by an increase in negative conditions for human, plant and animal life. Especially these negative conditions (drought, warming, glowing, etc.) are felt more rapidly in urban life and affect the sustainability of green areas which are of great importance in terms of life comfort. In this context, the choice of woody taxa used in the design and design of green spaces in the city increase one more time. Within the scope of this study, two of four urban parks located in the city center of Bursa province were selected and evaluated for woody taxa. Urban parks have been identified as the oldest and newest urban park in Bursa, and it has been tried to emphasize the differences that may exist over time. It was determined that 54 woody taxa took place in Resat Oyal Kulturpark and 76 woody taxa in Hudavendigar Urban Park. These taxa have been evaluated in terms of water consumption and ecological tolerances by taking into account climate change, and suggestions have been developed against possible problems.

Keywords: ecological hardiness, urban park, water consumption, woody plants

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Authors: Michael Daly

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Background/Aims: The interplay of childhood self-control and early life social background in predicting adult health is currently unclear. We drew on rich data from two large nationally representative cohort studies to test whether individual differences in childhood self-control may: (i) buffer the health impact of social disadvantage, (ii) act as a mediating pathway underlying the emergence of health disparities, or (iii) compensate for the health consequences of socioeconomic disadvantage across the lifespan. Methods: We examined data from over 25,000 participants from the British Cohort Study (BCS) and the National Child Development Study (NCDS). Child self-control was teacher-rated at age 10 in the BCS and ages 7/11 in the NCDS. The Early life social disadvantage was indexed using measures of parental education, occupational prestige, and housing characteristics (i.e. housing tenure, home crowding). A range of health outcomes was examined: the presence of chronic conditions, whether illnesses were limiting, physiological dysregulation (gauged by clinical indicators), mortality, and perceptions of pain, psychological distress, and general health. Results: Childhood self-control and social disadvantage predicted each measure of adult health, with similar strength on average. An examination of mediating factors showed that adult smoking, obesity, and socioeconomic status explained the majority of these linkages. There was no systematic evidence that self-control moderated the health consequences of early social disadvantage and limited evidence that self-control acted as a key pathway from disadvantage to later health. Conclusions: Childhood self-control predicts adult health and may compensate for early life social disadvantage by shaping adult health behaviour and social status.

Keywords: personality and health, social disadvantage, health psychology, life-course development

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Authors: Nazanin Forouz

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The textile industry faces increasing criticism due to its resource-intensive nature and the negative environmental and societal impacts associated with the manufacturing, use, and disposal of clothes. To address these concerns, there is a growing desire to transition towards a circular economy for textiles, implementing recycling concepts and technologies to protect resources, the environment, and people. While existing recycling processes have focused on chemical and mechanical reuse of textile fibers, bio-based processes have received limited attention beyond end-of-life composting. However, bio-based technologies hold great promise for circularizing the textile life cycle and reducing environmental impacts.

Keywords: textile industry, circular economy, bio-based processes, recycling, environmental impacts

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Authors: Amir Shouri, Fereshteh Tabe

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Master planning and urban infrastructure’s thoughtful and sequential design strategies will play the major role in reducing the damages of natural disasters, war and or social/population related conflicts for cities. Defensive strategies have been revised during the history of mankind after having damages from natural depressions, war experiences and terrorist attacks on cities. Lessons learnt from Earthquakes, from 2 world war casualties in 20th century and terrorist activities of all times. Particularly, after Hurricane Sandy of New York in 2012 and September 11th attack on New York’s World Trade Centre (WTC) in 21st century, there have been series of serious collaborations between law making authorities, urban planners and architects and defence related organizations to firstly, getting prepared and/or prevent such activities and secondly, reduce the human loss and economic damages to minimum. This study will work on developing a model of planning for New York City, where its citizens will get minimum impacts in threat-full time with minimum economic damages to the city after the stress is passed. The main discussion in this proposal will focus on pre-hazard, hazard-time and post-hazard transformative policies and strategies that will reduce the “Life casualties” and will ease “Economic Recovery” in post-hazard conditions. This proposal is going to scrutinize that one of the key solutions in this path might be focusing on all overlaying possibilities on architectural platforms of three fundamental infrastructures, the transportation, the power related sources and defensive abilities on a dynamic-transformative framework that will provide maximum safety, high level of flexibility and fastest action-reaction opportunities in stressful periods of time. “Planning Fore Stress” is going to be done in an analytical, qualitative and quantitative work frame, where it will study cases from all over the world. Technology, Organic Design, Materiality, Urban forms, city politics and sustainability will be discussed in deferent cases in international scale. From the modern strategies of Copenhagen for living friendly with nature to traditional approaches of Indonesian old urban planning patterns, the “Iron Dome” of Israel to “Tunnels” in Gaza, from “Ultra-high-performance quartz-infused concrete” of Iran to peaceful and nature-friendly strategies of Switzerland, from “Urban Geopolitics” in cities, war and terrorism to “Design of Sustainable Cities” in the world, will all be studied with references and detailed look to analysis of each case in order to propose the most resourceful, practical and realistic solutions to questions on “New City Divisions”, “New City Planning and social activities” and “New Strategic Architecture for Safe Cities”. This study is a developed version of a proposal that was announced as winner at MoMA in 2013 in call for ideas for Rockaway after Sandy Hurricane took place.

Keywords: urban scale, city safety, natural disaster, war and terrorism, city divisions, architecture for safe cities

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Authors: Malathi Iyer, Jayesh Vaidya

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The demographic dividend of India will last for thirty years from now. However, reduction in birth rate, an increase in working population, improvements in medicine and better health practices lead to an ever-expanding elderly population, bringing additional burden to the economy and putting an end to the demographic dividend. To reap the dividend India needs to train the youth for employability. The need of the hour is to improve their life skills which lead the youth to become industrious and have continuous employment. The study will be conducted in perceiving the skill gaps that exist in commerce students for employability. The analysis results indicate the relation between the core study and the right skills for the workforce, with the steps that are taken to open the window for the demographic dividend.

Keywords: demographic dividend, life skills, employability, workforce

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Authors: Al. Harshan, Hazamah Ali Mahdi

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The Big House literature embodies Irish history. It requires a special dimension of moral and social significance in relation to its owners. The Big House is a metaphor for the decline of the protestant Ascendancy that ruled in a catholic country and oppressed a native people. In the tradition of the Big House fiction, Maria Edgeworth's Castle Rackrent and the Absentee explore the effect of the Anglo-Irish protestant Ascendancy as it governed and misgoverned Ireland. Edgeworth illustrates the tradition of the Big House as a symbol of both a personal and historical theme. This paper provides a reading of Castle Rackrent and The Absentee from a post-colonial perspective. The paper maintains that Edgeworth's novel contain elements of a radical critique of the colonialist enterprise. In our postcolonial reading of Maria Edgeworth's novels, one that goes beyond considering works as those of Sir Walter Scoot, regional evidence has been found of Edgeworth's colonial ideology. The significance of Castle Rackrent lies mainly in the fact that is the first English novel to speak in the voice of the colonized Irish. What is more important is that the irony and the comic aspect of the novel comes from its Irish narrator (Thady Quirk) and its Irish setting Ireland. Edgeworth reveals the geographical 'other' to her English reader, by placing her colonized Irish narrator and his son, Jason Quirk, in a position of inferiority to emphasize the gap between Englishness and Irishness. Furthermore, this satirical aspect is a political one. It works to create and protect the superiority of the domestic English reader over the Irish subject. In other words, the implication of the colonial system of the novel and of its structure of dominance and subordination is overlooked by its comic dimension. The matrimonial plot in the Absentee functions as an imperial plot, constructing Ireland as a complementary but ever unequal partner in the family of Great Britain. This imperial marriage works hegemonically to produce the domestic stability considered so crucial to national and colonial stability. Moreover, in order to achieve her proper imperial plot, Edgeworth reconciliation of England and Ireland is seen in the marriage of the Anglo-Irish (hero/Colambre) with the Irish (heroine/Grace Nugent), and the happy bourgeois family; consequently, it becomes the model for colonizer-colonized relationships. Edgeworth must establish modes of legitimate behavior for women and men. The Absentee explains more purposely how familial reorganization is dependent on the restitution of masculine authority and advantage, particularly for Irish community.

Keywords: Maria Edgeworth, post-colonial, reading, Irish

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Authors: Salima Bijapuri, Shweta Bhatbolan, Sejalben Patel

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Ergonomics concerns the fitting of the environment and the equipment to the worker. Ergonomic principles can be employed in different dimensions of the industrial sector. Participation of all the stakeholders is the key to the formulation of a multifaceted and comprehensive approach to lessen the burden of occupational hazards. Taking responsibility for one’s own work activities by acquiring sufficient knowledge and potential to influence the practices and outcomes is the basis of participatory ergonomics and even hastens the process to identify workplace hazards. The study was aimed to check how participatory ergonomics can be effective in the management of work-related musculoskeletal disorders. Method: A mega kitchen was identified in a twin city of Karnataka, India. Consent was taken, and the screening of workers was done using observation methods. Kitchen work was structured to include different tasks, which included preparation, cooking, distributing, and serving food, packing food to be delivered to schools, dishwashing, cleaning and maintenance of kitchen and equipment, and receiving and storing raw material. Total 100 workers attended the education session on participatory ergonomics and its role in implementing the correct ergonomic practices, thus preventing WRMSDs. Demographic details and baseline data on related musculoskeletal pain and discomfort were collected using the Nordic pain questionnaire and VAS score pre- and post-study. Monthly visits were made, and the education sessions were reiterated on each visit, thus reminding, correcting, and problem-solving of each worker. After 9 months with a total of 4 such education session, the post education data was collected. The software SPSS 20 was used to analyse the collected data. Results: The majority of them (78%), depending on the availability and feasibility, participated in the intervention workshops were arranged four times. The average age of the participants was 39 years. The percentage of female participants was 79.49%, and 20.51% of participants comprised of males. The Nordic Musculoskeletal Questionnaire (NMQ) showed that knee pain was the most commonly reported complaint (62%) from the last 12 months with a mean VAS of 6.27, followed by low back pain. Post intervention, the mean VAS Score was reduced significantly to 2.38. The comparison of pre-post scores was made using Wilcoxon matched pairs test. Upon enquiring, it was found that, the participants learned the importance of applying ergonomics at their workplace which inturn was beneficial for them to handle any problems arising at their workplace on their own with self confidence. Conclusion: The participatory ergonomics proved effective with workers of mega kitchen, and it is a feasible and practical approach. The advantage of the given study area was that it had a sophisticated and ergonomically designed workstation; thus it was the lack of education and practical knowledge to use these stations was of utmost need. There was a significant reduction in VAS scores with the implementation of changes in the working style, and the knowledge of ergonomics helped to decrease physical load and improve musculoskeletal health.

Keywords: ergonomic awareness session, mega kitchen, participatory ergonomics, work related musculoskeletal disorders

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Authors: Radovan Čobanović, Milica Rankov Šicar

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In the modern bakery various supplements are used to attract more customers. Analyzed sample decorative toppings are consisted of flax seeds, corn grits, oatmeal, wheat flakes, sesame seeds, sunflower seeds, soybean sprouts are used as decoration for the bread. Our goal was to extend the product shelf life based on the analysis. According to the plan of sustainability it was defined that sample which already had expired shelf life had to be stored for 5 months at 25°C and analyzed every month from the day of reception until spoilage occurs. Samples were subjected to sensory analysis (appearance, odor, taste, color, and consistency), microbiological analysis (Salmonella spp., Bacillus cereus, Enterobacteriaceae and moulds) and chemistry analysis (free fatty acids (as oleic), peroxide number, water content and degree of acidity). All analyses were tested according: sensory analysis ISO 6658, Salmonella spp ISO 6579, Bacillus cereus ISO 7932, Enterobacteriaceae ISO 21528-2 and moulds ISO 21527-1, free fatty acids (as oleic) ISO 660, peroxide number ISO 3960, water content and degree of acidity Serbian ordinance on the methods of chemical analysis. After five months of storage, there had been the first changes concerning of sensory properties of the product. In the sample were visible worms and creations which look like spider nets linking seeds and cereal. The sample had smell on rancid and pungent. The results of microbiological analysis showed that Salmonella spp was not detected, Enterobacteriaceae were < 10 cfu/g during all 5 months but in fifth month Bacillus cereus and moulds occurred 700 cfu/g and 1500 cfu/g respectively. Chemical analyzes showed that the water content did not exceed a maximum of 14%. The content of free fatty acids ranged from 3.06 to 3.26%, degree of acidity from 3.69 to 4.9. With increasing degree of acidity the degradation of the sample and the activity of microorganisms was increased which led to the formation of acid reaction which is accompanied by the appearance of unpleasant odor and taste. Based on the obtained results it can be concluded that this product can have longer shelf life for four months than shelf life which is already defined because there are no changes that could have influence on decision of customers when purchase of this product is concerned.

Keywords: bakery products, extension of shelf life, sensory and chemical and microbiological analyses, sustainability

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Authors: Hae Jeong Park, Joo-Ho Chung

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In this study, the effect of essential oil from Chamaecyparis obtuse (EOCO) on early life stress using maternal separation (MS) rats was investigated. Anxiety-related behaviors were examined in MS rats using the elevated plus-maze (EPM) test. The changes of gene expressions by EOCO in the hippocampus of MS rats were analyzed using a microarray method. Rats in the MS groups were separated from their respective mothers from postnatal day (pnd) 14 to 28. Rats in the EOCO-treated groups were exposed to EOCO for 1 h or 2 h by inhalation from pnd 21 to 28. The EOCO-treated MS rats showed decreased anxiety-related behaviors compared to the MS rats in the EPM test. In the microarray analysis, EOCO downregulated the expressions of cytokine genes such as Ccl2, Il6, Cxcl10, Ccl19, and Il1rl in the hippocampus of MS rats, and it was also confirmed through RT-PCR. In particular, the expressions of Ccl2 and Il6 were predominantly decreased by EOCO in the hippocampus of MS rats. Interestingly, their protein expressions were also reduced by EOCO in MS rats. These results indicate that EOCO decreases MS-induced anxiety-related behaviors, and modulate cytokines, particularly Ccl2 and Il6, in the hippocampus of MS rats.

Keywords: anxiety-related behavior, Chamaecyparis obtuse, cytokine gene, early-life stress, maternal separation

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Authors: Anirban Dey, Sukanta Kumar Dash, Bishnupada Mandal

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Carbondioxide (CO2) is a major greenhouse gas responsible for global warming and fossil fuel power plants are the main emitting sources. Therefore the capture of CO2 is essential to maintain the emission levels according to the standards. Carbon capture and storage (CCS) is considered as an important option for stabilization of atmospheric greenhouse gases and minimizing global warming effects. There are three approaches towards CCS: Pre combustion capture where carbon is removed from the fuel prior to combustion, Oxy-fuel combustion, where coal is combusted with oxygen instead of air and Post combustion capture where the fossil fuel is combusted to produce energy and CO2 is removed from the flue gases left after the combustion process. Post combustion technology offers some advantage as existing combustion technologies can still be used without adopting major changes on them. A number of separation processes could be utilized part of post –combustion capture technology. These include (a) Physical absorption (b) Chemical absorption (c) Membrane separation (d) Adsorption. Chemical absorption is one of the most extensively used technologies for large scale CO2 capture systems. The industrially important solvents used are primary amines like Monoethanolamine (MEA) and Diglycolamine (DGA), secondary amines like diethanolamine (DEA) and Diisopropanolamine (DIPA) and tertiary amines like methyldiethanolamine (MDEA) and Triethanolamine (TEA). Primary and secondary amines react fast and directly with CO2 to form stable carbamates while Tertiary amines do not react directly with CO2 as in aqueous solution they catalyzes the hydrolysis of CO2 to form a bicarbonate ion and a protonated amine. Concentrated Piperazine (PZ) has been proposed as a better solvent as well as activator for CO2 capture from flue gas with a 10 % energy benefit compared to conventional amines such as MEA. However, the application of concentrated PZ is limited due to its low solubility in water at low temperature and lean CO2 loading. So following the performance of PZ its derivative 2-Aminoethyl piperazine (AEP) which is a cyclic amine can be explored as an activator towards the absorption of CO2. Vapour liquid equilibrium (VLE) in CO2 capture systems is an important factor for the design of separation equipment and gas treating processes. For proper thermodynamic modeling accurate equilibrium data for the solvent system over a wide range of temperatures, pressure and composition is essential. The present work focuses on the determination of VLE data for (AEP + H2O) system at 40 °C for various composition range.

Keywords: absorption, aminoethyl piperazine, carbondioxide, vapour liquid equilibrium

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Authors: Ezgiamn Abraha Hagos

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Higher education is important for college students to develop their authentic identity by means of getting exposure to diverse ideas and experiences. However, current college students are not successfully achieving a satisfying sense of meaning and purpose in their lives, which often places them in a state of existential vacuum. Thus, this study uncovers the existential concerns of youth in higher education by means of assessing their view on meaningful life and integration of it as a guide into their lives and challenges faced in doing so. Data were procured from thirty undergraduate students of Addis Ababa University, Ethiopia via interview, naïve sketch method, and content analysis of selected magazines and newspapers. Data were analyzed using organization, immersion, generating themes, coding, offering interpretation as well as checking the data. Relationship, education, and belief were found to be main sources of meaning. But, many of the study participants failed to articulate their meaning in life explicitly and identified to be in a state of drifting. Moreover, hopelessness, economic problems and quality of training impinge their sense of meaning in life negatively. The content analysis principally embodied the youth in higher education as a group of people confronted with rafts of challenges such as debauchery, moral crisis, self-destructive behaviors and hankering for support and direction. Thus, crafting the asset-based approach and counseling services that will prepare the youth for the future and develop holistically in terms of body and mind are tremendously vital.

Keywords: higher education institutions; meaning in life; youth

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Authors: Sudkhanoung Ritruechai, Somrak Choovanichwong, Kruawon Tiengtom, Peanchanan Leeudomwong

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The purposes of this qualitative research were to study the recovery experience of people with bipolar disorder and also to propose a development approach to the Bipolar Friends Club. The participants were eight people with bipolar disorder for six to twenty years (four women and four men). They have been members of the Bipolar Friends Club for two to ten years. They have no mental symptoms in order to provide sufficient information about their recovery experiences and have returned to everyday life with their family, community, and work. The data were collected by doing an in-depth interview. Two interviews were done, each from 45-90 minutes and four to five weeks apart. The researcher sent the results of the preliminary data analysis to the participants two to three days beforehand. Confirmation of the results of the preliminary data analysis from the first interview was done at the second interview. The research study found that the participants had a positive experience of being a Bipolar Club member. The club continued its activities following Recovery Oriented Service: ROS to the participants. As a result, they recovered in eight areas as follows. 1) Intellectual: The wisdom of joining the group has brought knowledge and experiences from an exchange with others in self-care as well as a positive thinking in life. 2) Social: The participants have set up a group to take care of each other and to do activities which have brought warmth. Their social network which was normally little has also been increased. 3) Spiritual: The concept of religion has been used to lead the life of the participants. 4) Occupational: One participant is a student while the others do work. All of them have done well. 5) Environmental: The participants would be able to adapt to the environment and cope with their problems better. 6) Physical: Most female participants have difficulties with losing weight which leads them saying that they are ‘not fully recovered’. 7) Emotional: The participants feel calmer than before entering the club. They have also developed more tolerance to problems. 8) Financial: The participants would be able to control their spending by themselves and with the help of their family members. The people with bipolar disorder have suggested that the services of the club are perfect and should be continued. The results of the study encourage the Bipolar Friends Club, as well as other clubs/associations that support the recovery of patients. Consideration of the recovery has highlighted the need for ongoing and various life-enhancing programs for the caregivers and their loved ones with bipolar disorder. Then, they would be able to choose the program that suits their needs to improve their life.

Keywords: people with bipolar disorder, recovery, club, experience

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Authors: Lugean K. Alomari, Rahaf K. Sharif, Basil K. Alomari, Hind M. Aljabri, Faisal F. Aljahdali, Amal A. Alomari, Saeed A. Alghamdi

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Background: The thermal pulsation system is a therapy that uses heat and massage to treat dry eye disease; thus, some trials have been published to compare it with the conventional treatment. The aim of this study is to conduct a systematic review and meta-analysis comparing the efficacy of thermal pulsation systems with conventional treatment in patients undergoing cataract surgery. Methods: Medline, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched for eligible trials. We included three randomized controlled trials (RCTs) that compared the thermal pulsation system with the conventional treatment in patients undergoing cataract surgery. A table of characteristics was plotted, and the Quality of the studies was assessed using the Cochrane risk-of-bias tool for randomized trials (RoB 2). Forest plots were plotted using the Random-effect Inverse Variance method. χ2 test and the Higgins-I-squared (I2) model were used to assess heterogeneity. A total of 201 cataract surgery patients were included, with 105 undergoing preoperative pulsation therapy and 96 receiving conventional treatment. Demographic analysis revealed comparable distributions across groups. Results: All the studies in our analysis are of good quality with a low risk of bias. A total of 201 patients were included in the analysis, out of which 105 underwent pulsation therapy, and 95 were in the control group. Tear Break-up Time (TBUT) analysis revealed no significant baseline differences, except pulsation therapy being better at 1 month. (SMD 0.42 [95%CI 0.14 - 0.70] p=0.004). This positive trend continued at three months (SMD 0.52 [95% CI (0.20 – 0.84)] p=0.002). Corneal fluorescein staining scores and Meibomian gland-yielding secretion scores showed no significant differences at baseline. However, at one month, pulsation therapy significantly improved Meibomian gland function (SMD -0.86 [95% CI (-1.20 - -0.53)] p<0.00001), indicating a reduced risk of dry eye syndrome. Conclusion: Preoperative pulsation therapy appears to enhance post-cataract surgery outcomes, particularly in terms of tear film stability and Meibomian gland secretory function. The sustained positive effects observed at one and three months post-surgery suggest the potential for long-term benefits.

Keywords: lipiflow, cataract, thermal pulsation, dry eye

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Authors: Jose Gay D. Gallego

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This study examined the learning performance in General Psychology of 297 freshmen of the CPSU-Main through the Pre and Post Tests. The instructional intervention via Universal Design for Learning (UDL) was applied to 33% (97 out of 297) of these freshmen as the Treatment Group while the 67% (200) belonged to the Control Group for traditional instructions. Statistical inferences utilized one-way Analysis of Variance for mean differences; Pearson R Correlations for bivariate relationships, and; Factor Analysis for significant components that contributed most to the Universal Design for Learning instructions. Findings showed very high levels of students’ acquired UDL skills. Results in the pre test in General Psychology, respectively, were low and average when grouped into low and high achievers. There was no significant mean difference in the acquired nine UDL components when categorized into seven colleges to generalize that between colleges they were on the same very high levels. Significant differences were found in three test areas in General Psychology in eight colleges whose students in College of teacher education taking the lead in the learning performance. Significant differences were also traced in the post test in favor of the students in the treatment group. This proved that UDL really impacted the learning performance of the low achieving students. Significant correlations were revealed between the components of UDL and General Psychology. There were twenty four significant itemized components that contributed most to UDL instructional interventions. Implications were emphasized to maximizing the principles of UDL with the contention of thoughtful planning related to the four curricular pillars of UDL: (a) instructional goals, (b) instructional delivery methods, (c) instructional materials, and (d) student assessments.

Keywords: universal design for learning, enhanced performance, teaching innovation, technology in education, social science area

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Authors: Jhemson C. Elis, Alvin S. Magadia

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Our world is full of numbers, shapes, and figures that illustrate the wholeness of a thing. Indeed, this statement signifies that mathematics is everywhere. Mathematics in its broadest sense helps people in their everyday life that is why in education it is a must to be taken by the students as a subject. The study aims to determine the profile of the respondents in terms of gender and age, performance of the control and experimental groups in the pretest and posttest, impact of the instructional game used as instructional intervention in teaching algebra for high school students, significant difference between the level of performance of the two groups of respondents in their pre–test and post–test results, and the instructional intervention can be proposed. The descriptive method was also utilized in this study. The use of the certain approach was to that it corresponds to the main objective of this research that is to determine the effectiveness of the instructional game used as an instructional intervention in teaching algebra for high school students. There were 30 students served as respondents, having an equal size of the sample of 15 each while a greater number of female teacher respondents which totaled 7 or 70 percent and male were 3 or 30 percent. The study recommended that mathematics teacher should conceptualize instructional games for the students to learn mathematics with fun and enjoyment while learning. Mathematics education program supervisor should give training for teachers on how to conceptualize mathematics intervention for the students learning. Meaningful activities must be provided to sustain the student’s interest in learning. Students must be given time to have fun at the classroom through playing while learning since mathematics for them was considered as difficult. Future researcher must continue conceptualizing some mathematics intervention to suffice the needs of the students, and teachers should inculcate more educational games so that the discussion will be successful and joyful.

Keywords: instructional game in algebra, mathematical intervention, joyful, successful

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Authors: Nina Kaufmans

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Traditional therapies, utilizing spoken narratives as a primary source of intervention, are proven to be limited in effectively treating post traumatic stress disorder. Following the effects of the global pandemic of COVID-19, an increasing number of mental health consumers are beginning to experience somatically-based distress in addition to existing mental health symptoms. Moreover, the aftermath of the rapid increase in demand for mental health services has caused significant burnout in mental health professionals. This paper explores the ramifications of recent changes and challenges in the mental health demands and subsequent response and its consequences for mental health workers. We will begin by investigating the neurobiological mechanisms involved in traumatic experiences, then discuss the premises for "bottom-up" or somatically oriented psychotherapy approaches, and finally offer clinical skills and interventions for clients diagnosed with post traumatic stress disorder. In addition, we will discuss how somatically-based psychotherapy interventions implemented in sessions may decrease burnout and improve the well-being of clinicians. We will discuss how the integration of somatically-based interventions into counseling would increase the effectiveness of mental health recovery and sustain remission while simultaneously providing opportunities for self-care for mental health professionals.

Keywords: somatic psychotherapy interventions, trauma counseling, preventing and treating burnout, adults with PTSD, bottom-up skills, the effectiveness of trauma treatment

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Authors: Nanyombi Lubimbi, Josette Niyokindi

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Background: As in many other developing countries in Africa, Rwanda suffers from a chronic shortage of skilled Health Care professionals including Clinical Instructors. This shortage negatively affects the clinical instruction quality therefore impacting student-learning outcomes. Due to poor clinical supervision, it is often noted that students have no structure or consistent guidance in their learning process. The Clinical Educators and the Rwandan counterparts identified the need to create a favorable environment for learning. Description: During orientation the expectations of the student learning process, collaboration of the clinical instructors with the nurses and Clinical Educators is outlined. The ward managers facilitate structured learning by helping the students identify a maximum of two patients using the school’s objectives to guide the appropriate selection of patients. Throughout the day, Clinical Educators with collaboration of Clinical Instructors when present conduct an ongoing assessment of learning and provide feedback to the students. Post-conference is provided once or twice a week to practice critical thinking skills of patient cases that they have been taking care of during the day. Lessons Learned: The students are found to be more confident with knowledge and skills gained during rotations. Clinical facility evaluations completed by students at the end of their rotations highlight the student’s satisfaction and recommendation for continuation of structured learning. Conclusion: Based on the satisfaction of both students and Clinical Instructors, we have identified need for structured learning during clinical rotations. We acknowledge that more evidence-based practice is necessary to effectively address the needs of nursing and midwifery students throughout the country.

Keywords: Rwanda, clinical rotation, structured learning, critical thinking skills, post-conference

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Authors: Nazma Sultana

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Social media has become an important part of our daily life. It has a significance influences on the people who use them in their daily life frequently. The number of people using social network sites has been increasing continuously. For this frequent utilization has started to affect our social life. This study examine whether the use of social network sites affects the psychosocial interaction between children and their parents. At first parents introduce their children to the internet and different type of device in their early childhood. Many parents use device for feeding their children by watching rhyme or cartoon. As a result children are habituate with it. In Bangladesh 70% people are heavy internet users. About 23 percent of them spend more than five hours on the social networking sites a day. Media are increasing pervasive in the lives of children-roughly the average child today spends nearly about 45 hours per week with media, compared with 17 hours with parents and 30 hours in school. According to a social learning theory, children & adolescents learn by observing & imitating what they see on screen particularly when these behaviors are realistic or are rewarded. The influence of the media on the psychosocial development of children is profound. Thus it is important for parents to provide guidance on age-appropriate use of all media, including television, radio, music, video games and the internet.

Keywords: social media, psychosocial, Technology, Parent, Social Relationship, Adolescents, Teenage, Youth

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Authors: Mahnaz Poorshahidi

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This article is a psychological reading of Shakespeare’s Hamlet applying Lacan’s ideas to work with a new look. Lacan entitled Hamlet ‘tragedy of desire’. He believes that Hamlet is caught up in the desire of his mother. So he is the universal symbol of all human beings, regardless of their sex, who desire their mother, but based on the rules of Nature and Father, this unity is impossible. Hamlet hesitates in fulfilling the task of revenge and the text says nothing about the reasons and motives behind it. However, this essay tries to answer the question and justify Hamlet’s hesitation. There is one question for the readers, which is why Hamlet appears to delay in killing his uncle, despite the fact that this is precisely what he seems to want to do. In 1958-59 Lacan delivered a series of lectures on Hamlet entitled ‘Desire and Its Interpretations’ and called it ‘tragedy of desire’. However, this article will have a new representation of Hamlet’s decision not to take revenge. The research demonstrates that Hamlet has passed through imaginary, symbolic and real stages, which are the natural process of life. Eliminating father means disturbing this natural process. This essay is going to conclude that killing Claudius can break the natural order of life. On the other hand, Claudius has also disturbed nature and is regretful about his deed. Hamlet’s ever-present speech ‘To be or not to be’ reflects his mental turmoil and disturbance of the natural life cycle: Nature.

Keywords: desire, father figure, lacan, nature

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Authors: A. M. Ferrari, L. Volpi, M. Pini, C. Siligardi, F. E. Garcia Muina, D. Settembre Blundo

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A long tradition in the ceramic manufacturing since the 18th century, primarily due to the availability of raw materials and an efficient transport system, let to the birth and development of the Italian ceramic tiles district that nowadays represents a reference point for this sector even at global level. This economic growth has been coupled to attention towards environmental sustainability issues throughout various initiatives undertaken over the years at the level of the production sector, such as certification activities and sustainability policies. In this way, starting from an evaluation of the sustainability in all its aspects, the present work aims to develop a benchmarking helping both producers and consumers. In the present study, throughout the Life Cycle Sustainability Assessment (LCSA) framework, the sustainability has been assessed in all its dimensions: environmental with the Life Cycle Assessment (LCA), economic with the Life Cycle Costing (LCC) and social with the Social Life Cycle Assessment (S-LCA). The annual district production of stoneware tiles during the 2016 reference year has been taken as reference flow for all the three assessments, and the system boundaries cover the entire life cycle of the tiles, except for the LCC for which only the production costs have been considered at the moment. In addition, a preliminary method for the evaluation of local and indoor emissions has been introduced in order to assess the impact due to atmospheric emissions on both people living in the area surrounding the factories and workers. The Life Cycle Assessment results, obtained from IMPACT 2002+ modified assessment method, highlight that the manufacturing process is responsible for the main impact, especially because of atmospheric emissions at a local scale, followed by the distribution to end users, the installation and the ordinary maintenance of the tiles. With regard to the economic evaluation, both the internal and external costs have been considered. For the LCC, primary data from the analysis of the financial statements of Italian ceramic companies show that the higher cost items refer to expenses for goods and services and costs of human resources. The analysis of externalities with the EPS 2015dx method attributes the main damages to the distribution and installation of the tiles. The social dimension has been investigated with a preliminary approach by using the Social Hotspots Database, and the results indicate that the most affected damage categories are health and safety and labor rights and decent work. This study shows the potential of the LCSA framework applied to an industrial sector; in particular, it can be a useful tool for building a comprehensive benchmark for the sustainability of the ceramic industry, and it can help companies to actively integrate sustainability principles into their business models.

Keywords: benchmarking, Italian ceramic industry, life cycle sustainability assessment, porcelain stoneware tiles

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Authors: Rana Eijaz Ahmad

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This paper is going to explain about the Fifth Political Theory that challenges all existing three plus one (Capitalism, Marxism and Fascism + Fourth Political Theory) theories. It says, ‘it is human ambiance evolve any political system to survive instead of borrowing other imported thoughts to live in a specific environment, in which Legitimacy leads to authority and promotes humanism.’ According to this theory, no other state is allowed to dictate or install any political system upon other states. It is the born right of individuals to choose a political system or a set of values that are going to make their structures and functions efficient enough to support the system harmony and counter the negative forces successfully. In the post 9/11 era, it is observed that all existing theories like Capitalism, Marxism, Fascism and Fourth Political Theory remained unsuccessful in resolving the global crisis. The so-called war against terrorism is proved as a war for terrorism and creates a vacuum on the global stage, worsening the crisis. The fifth political theory is an answer to counter terrorism in the twenty-first century. It calls for accountability of the United Nations for its failure in sustaining peace at global level. Therefore, the UN charter is supposed to be implemented in its true letter and spirit. All independent sovereign states have right to evolve their own system to carry out a political system that suits them best for sustaining harmony at home. This is the only way to counter terrorism. This paper is comprised of mixed method. Qualitative, quantitative and comparative methods will be used along with secondary sources. The objective of this paper is to create knowledge for the benefit of human beings with a logical and rational argument. It will help political scientists and scholars in conflict management and countering terrorism on pragmatic grounds.

Keywords: capitalism, fourth political theory, fifth political theory, Marxism, fascism

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Authors: Rajlakshmi Banerjee, Sujoy Banerjee

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The prevalence of malnutrition, as the most common cause of morbidity and mortality increases with old age, especially in developing countries like India, because of many factors out of which dentate status is one. It affects diet, nutritional status and general health due to reduced chewing ability and poor food choices. Aim and Objective: This study aimed to evaluate the effect of nutritional status, dietary intake on the Oral Health-related Quality of life (OHRQoL) of elderly edentulous complete denture wearing patients and to know whether they are at a higher risk of malnutrition. The objective was to assess the need to include dietary and nutritional counselling during Prosthodontic rehabilitation of elderly edentulous patients. Materials and method: A cross-sectional study was conducted among 200 elderly denture wearing patients above 60 yrs of age from Nagpur, Maharashtra. The majority of study subjects (60%) were between the age group 60 and 75 years. Mini-Nutritional Assessment (MNA) Questionnaire was used to assess nutritional status and General Oral Health Assessment Index (GOHAI) questionnaire was used to determine the Oral health related Quality of life of these patients.Descriptive statistics was used to analyze data using SPSS version 21. Results: Among the assessed subjects, nearly 80% of them had total scores of GOHAI between 12 and 57 which require ‘needed dental care.’ As per MNA, 10.5% had adequate nutrition, 70 % were at risk of malnutrition, and remaining 19.5 % of subjects were malnourished. There was a significant correlation between GOHAI and MNA scores. A strong association was found between mean GOHAI and MNA scores and thereby nutritional status and OHRQOL.Conclusion: The use of conventional dentures increases the risk of malnutrition in the elderly due to inability to eat and chew food properly and therefore severely affecting the quality of life. Dietary analysis and counselling should be strictly incorporated into geriatric treatment planning during Prosthetic rehabilitation.

Keywords: general oral health assessment index, General Oral Health Assessment Index (GOHAI), nutritional assessment, mini-nutritional assessment, Mini-Nutritional Assessment (MNA), quality of life

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Authors: I. Gupta, N. Setia

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Introduction. Buyer conduct is a progression of practices or examples that buyers pursue before making a buy. It begins when the shopper ends up mindful of a need or wish for an item, at that point finishes up with the buying exchange. Business visionaries can't generally simply shake hands with their intended interest group people and become more acquainted with them. Research is often necessary, so every organization primarily involves doing continuous research to understand and satisfy consumer needs pattern. Aims and Objectives: The aim of the present study is to examine the different behaviors of the consumer, including pre-purchase, purchase, and post-purchase behavior. Materials and Methods: In order to get results, face to face interview held with 80 people which comprise a larger part of female individuals having upper as well as middle-class status. The prime source of data collection was primary. However, the study has also used the theoretical contribution of many researchers in their respective field. Results: Majority of the respondents were females (70%) from the age group of 20-50. The collected data was analyzed through hypothesis testing statistical techniques such as correlation analysis, single regression analysis, and ANOVA which has rejected the null hypothesis that there is no relation between researching the consumer behavior at different stages and organizational performance. The real finding of this study is that simply focusing on the buying part isn't enough to gain profits and fame, however, understanding the pre, buy and post-buy behavior of consumer performs a huge role in organization success. The outcomes demonstrated that the organization, which deals with the three phases of research of purchasing conduct is able to establish a great brand image as compare to their competitors. Alongside, enterprises can observe customer conduct in a considerably more proficient manner. Conclusion: The analyses of consumer behavior presented in this study is an attempt to understand the factors affecting consumer purchasing behavior. This study has revealed that those corporations are more successful, which work on understanding buying behavior instead to just focus on the selling products. As a result, organizations perform good and grow rapidly because consumers are the one who can make or break the company. The interviews that were conducted face to face, clearly revealed that those organizations become at top-notch whom consumers are satisfied, not just with product but also with services of the company. The study is not targeting the particular class of audience; however, it brings out benefits to the masses, in particular to business organizations.

Keywords: consumer behavior, pre purchase, post purchase, consumer satisfaction

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Authors: Bonnie R. Brammall, Rhonda M. Garad, Helena J. Teede, Cheryce L. Harrison

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Introduction: Reproductive aged women are at high-risk for accelerated weight gain and obesity development, with pregnancy recognised as a critical contributory life phase. Healthy lifestyle interventions during the preconception and antenatal period improve maternal and infant health outcomes. Yet, interventions from preconception through to postpartum and translation and implementation into real-world healthcare settings remain limited. OptimalMe is a randomised, hybrid implementation effectiveness study of evidence-based healthy lifestyle intervention. Here, we report engagement, acceptability of the intervention during preconception, and self-reported behaviour change outcomes as a result of the preconception phase of the intervention. Methods: Reproductive aged women who upgraded their private health insurance to include pregnancy and birth cover, signalling a pregnancy intention, were invited to participate. Women received access to an online portal with preconception health and lifestyle modules, goal-setting and behaviour change tools, monthly SMS messages, and two coaching sessions (randomised to video or phone) prior to pregnancy. Results: Overall n=527 expressed interest in participating. Of these, n=33 did not meet inclusion criteria, n=8 were not contactable for eligibility screening, and n=177 failed to engage after the screening, leaving n=309 who were enrolled in OptimalMe and randomised to intervention delivery method. Engagement with coaching sessions dropped by 25% for session two, with no difference between intervention groups. Women had a mean (SD) age of 31.7 (4.3) years and, at baseline, a self-reported mean BMI of 25.7 (6.1) kg/m², with 55.8% (n=172) of a healthy BMI. Behaviour was sub-optimal with infrequent self-weighing (38.1%), alcohol consumption prevalent (57.1%), sub-optimal pre-pregnancy supplementation (61.5%), and incomplete medical screening. Post-intervention 73.2% of women reported engagement with a GP for preconception care and improved lifestyle behaviour (85.5%), since starting OptimalMe. Direct pre-and-post comparison of individual participant data showed that of 322 points of potential change (up-to-date cervical screening, elimination of high-risk behaviours [alcohol, drugs, smoking], uptake of preconception supplements and improved weighing habits) 158 (49.1%) points of change were achieved. Health coaching sessions were found to improve accountability and confidence, yet further personalisation and support were desired. Engagement with video and phone sessions was comparable, having similar impacts on behaviour change, and both methods were well accepted and increased women's accountability. Conclusion: A low-intensity digital health and lifestyle program with embedded health coaching can improve the uptake of preconception care and lead to self-reported behaviour change. This is the first program of its kind to reach an otherwise healthy population of women planning a pregnancy. Women who were otherwise healthy showed divergence from preconception health and lifestyle objectives and benefited from the intervention. OptimalMe shows promising results for population-based behaviour change interventions that can improve preconception lifestyle habits and increase engagement with clinical health care for pregnancy preparation.

Keywords: preconception, pregnancy, preventative health, weight gain prevention, self-management, behaviour change, digital health, telehealth, intervention, women's health

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Authors: Josephine Muchiri, Makena Muriithi

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Adverse mental health consequences are experienced by those that have been touched by Intimate Partner Violence (IPV), whether directly or indirectly. These negative effects are felt not only in the short term but in years to come. It is important to examine the prevalence and co-occurrence of mental disorders in order to provide strategic interventions for women who have experienced IPV. The aim of this study was to examine the prevalence and comorbidity of post-traumatic stress disorder (PTSD), Depression, and Anxiety among women who had experienced intimate Partner violence in two selected informal settlements in Nairobi County, Kenya. Participants were 116 women (15-60 years) selected through purposive and snowball sampling from the low social, economic settlements (Kawangware and Kibera) in Nairobi, Kenya. A social demographic questionnaire and the Woman Abuse Screening Tool (WAST) were used to collect data on intimate partner violence experiences. The PTSD Checklist for DSM-5 (PCL-5), Beck’s Depression Inventory, and the Beck’s Anxiety Inventory assessed for post-traumatic stress disorder, depression, and anxiety, respectively. Data analysis was conducted using the Statistical Package for Social Sciences (SPSS) version 29, utilizing descriptive and correlation analyses. Findings indicated that the women had undergone various forms of abuse from their intimate partners, which were physical abuse 111(92.5%), sexual abuse 70(88.6%), and verbal abuse 92(93.9%). The prevalence of the mental disorders was PTSD 47(32.4%); M= 44.11, S.D =14.67, depression was the highest at n=131(90.3%; M=33.37±9.98) with the levels of depression having varying prevalence rates where severe depression had the highest representation [moderate: n= 35; 24.1%, severe: n=69 (47.6%) and extremely severe: n=27(18.6%)]. Anxiety had the second highest prevalence of n=99 (68.8%; M= 28.55±13.63) with differing prevalence rates in the levels of anxiety which were normal anxiety: 45(31.3%), moderate anxiety n=62(43.1%) and severe anxiety: n=37(25.7%). Regarding comorbidities, the Pearson correlation test showed that there was a significant (p=0.000) positive relationship between PTSD and depression (r=0.379; p=.000), PTSD and anxiety (r=0.624; p=.000), and depression and anxiety (r=0.386; p=.000) such that increase in one disorder concomitantly led to increase of the other two disorders; hence comorbidity of the three disorders was ascertained. Conclusion: The study asserted the adverse impacts of IPV on women’s mental well-being, where the prevalence of PTSD, depression, and anxiety was established. Almost all the women had depressive symptoms; whereas more than half had anxiety and slightly more than a third had PTSD. Regarding the severity levels of anxiety and depression, almost half of the women with depression had severe depression whereas moderate anxiety was more prevalent for those with anxiety. The three disorders were found to co-occur where comorbidities of PTSD and anxiety had the highest probability of co-occurrence. It is thus recommended that mental health interventions with a focus on the three disorders be offered for women undergoing IPV.

Keywords: anxiety, comorbidity, depression, intimate partner violence, post-traumatic stress disorder

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Authors: Ahmad Saad, Shuja Abbas, Breanna Marine

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Introduction: This study explores the potential applications of autologous pedal fat pad grafting as a minimally invasive therapeutic strategy for addressing pedal fat pad loss. Without adequate shock absorbing tissue, a patient can experience functional deficits, ulcerations, loss of quality of life, and significant limitations with ambulation. This study details a novel technique involving autologous adipose grafting from the abdomen to enhance plantar fat pad thickness in a patient involved in a severe motor vehicle accident which resulted in total fat pad loss of the heel. Autologous adipose grafting (AAG) was used following adipose allografting in an effort to recreate a normal shock absorbing surface to allow return to activities of daily living and painless ambulation. Methods: A 46-year-old male sustained multiple open pedal fractures and necrosis to the heel fat pad after a motorcycle accident, which resulted in complete loss of the calcaneal fat pad. The patient underwent serial debridement’s, utilization of wound vac therapy and split thickness skin grafting to accomplish complete closure, despite complete loss of adipose to area. Patient presented with complaints of pain on ambulation, inability to bear weight on the heel, recurrent ulcerations, admitted had not been ambulating for two years. Clinical exam demonstrated complete loss of the plantar fat pad with a thin layer of epithelial tissue overlying the calcaneal bone, allowing visibility of the osseous contour of the calcaneus. Scar tissue had formed in place of the fat pad, with thickened epithelial tissue extending from the midfoot to the calcaneus. After conservative measures were exhausted, the patient opted for initial management by adipose allograft matrix (AAM) injections. Post operative X-ray imaging revealed noticeable improvement in calcaneal fat pad thickness. At 1 year follow up, the patient was able to ambulate without assistive devices. The fat pad at this point was significantly thicker than it was pre-operatively, but the thickness did not restore to pre-accident thickness. In order to compare the take of allograft versus autografting of adipose tissue, the decision to use adipose autograft through abdominal liposuction harvesting was deemed suitable. A general surgeon completed harvesting of adipose cells from the patient’s abdomen via liposuction, and a podiatric surgeon performed the AAG injection into the heel. Total of 15 cc’s of autologous adipose tissue injected to the calcaneus. Results: There was a visual increase in the calcaneal fat pad thickness both clinically and radiographically. At the 6-week follow up, imaging revealed retention of the calcaneal fat pad thickness. Three months postop, patient returned to activities of daily living and increased quality of life due to their increased ability to ambulate. Discussion: AAG is a novel treatment for pedal fat pad loss. These treatments may be viable and reproducible therapeutic choices for patients suffering from fat pad atrophy, fat pad loss, and/or plantar ulcerations. Both treatments of AAM and AAG exhibited similar therapeutic results by providing pain relief for ambulation and allowing for patients to return to their quality of life.

Keywords: podiatry, wound, adipose, allograft, autograft, wound care, limb reconstruction, injection, limb salvage

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Authors: Parastou Kharazmi

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Degradation of building materials particularly pipelines causes environmental damage during renovation or replacement and is a time consuming and costly process. Rehabilitation by polymer composites is a solution for renovation of degraded pipeline in heritage buildings and other structures which are less costly, faster and causes less damage to the environment; however, it is still not clear for how long these materials can perform as expected in the field and working condition. To study their service life, two types of composites based on Epoxy and Polyester resins have been evaluated by accelerated exposure and field exposure. The primary degradation agent used in accelerated exposure has been cycling temperature with half of the tests performed in presence of water. Thin films of materials used in accelerated testing were prepared in laboratory by using the same amount of material as well as technique of multi-layers application used in majority of the field installations. Extreme intensity levels of degradation agents have been used only to evaluate materials properties and as also mentioned in ISO 15686, are not directly correlated with degradation mechanisms that would be experienced in service. In the field exposure study, the focus has been to identify possible failure modes, causes, and effects. In field exposure, it has been observed that there are other degradation agents present which can be investigated further such as presence of contaminants and rust before application which prevents formation of a uniform layer of polymer or incompatibility between dissimilar materials. This part of the study also highlighted the importance of application’s quality of the materials in the field for providing the expected performance and service life. Results from extended accelerated exposure and field exposure can help in choosing inspection techniques, establishing the primary degradation agents and can be used for ageing exposure programs with clarifying relationship between different exposure periods and sites.

Keywords: building, renovation, service life, pipelines

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