Search results for: diversity and tirunesh beijing hospital

Authors: A. Bouzabata, A. Boukhari

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Curcuma longa L. (Zingiberaceae), commonly known as turmeric, has a long history of traditional uses for culinary purposes as a spice and a food colorant. The present study aimed to document the ethnobotanical knowledge about Curcuma longa and to assess the variation in the herbalists’ experience in Northeastern Algeria. Data were collected by semi-structured questionnaires and direct interviews with 30 herbalists. Ethnobotanical indices, including the fidelity level (FL%), the relative frequency citation (RFC) and use value (UV) were determined by quantitative methods. Diversity in the knowledge was analyzed using univariate, non-parametric and multivariate statistical methods. Three main categories of uses were recorded for C. longa: for food, for medicine and for cosmetic purposes. As a medicine, turmeric was used for the treatment of gastrointestinal, dermatological and hepatic diseases. Medicinal and food uses were correlated with both forms of use (rhizome and powder). The age group did not influence the use. Multivariate analyses showed a significant variation in traditional knowledge, associated with the use value, origin, quality and efficacy of the drug. These findings suggested that the geographical origin of C. longa affected the use in Algeria.

Keywords: curcuma, indices, knowledge, variation

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Authors: Nurtazin Sabir, Begon Michael, Yeszhanov Aidyn, Alexander Belyaev, Hughes Nelika, Bethany Levick, Salmurzauly Ruslan

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This paper describes the features of the distribution of the most abundant species of fleas that are carriers of the most dangerous infections in the Balkhash-Alakol depression of Kazakhstan. We show that of 153 species of fleas described in the territory of the great gerbil (Rhombomys opimus Licht.), 35 species are parasitic. 21 of them are specific to gerbils species, and four species of fleas from the Xenopsylla genus are dominant in number and value of epizootic. We also describe the modern features of habitats of these species and their relationship with the great gerbil populations found in the South Balkhash region. It indicates the need for research on the population structure of the most abundant fleas species and their relationship with the structure of the populations of main carrier of transmission infections in the region-great gerbil.

Keywords: Balkhash-Alakol depression, natural foci of plague, species diversity and distribution of fleas, flea and great gerbil population structure, epizootic activity, mass species of fleas

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Authors: Dibyendu Rakshit, Santosh K. Sarkar

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The study illustrates a comprehensive account of large-scale changes plankton community structure in relevance to water quality characteristics due to anthropogenic stresses, mainly concerned for Annual Gangasagar Festival (AGF) at the southern tip of Sagar Island of Indian Sundarban wetland for 3-year duration (2012-2014; n=36). This prograding, vulnerable and tide-dominated megadelta has been formed in the estuarine phase of the Hooghly Estuary infested by largest continuous tract of luxurious mangrove forest, enriched with high native flora and fauna. The sampling strategy was designed to characterize the changes in plankton community and water quality considering three diverse phases, namely during festival period (January) and its pre - (December) as well as post (February) events. Surface water samples were collected for estimation of different environmental variables as well as for phytoplankton and microzooplankton biodiversity measurement. The preservation and identification techniques of both biotic and abiotic parameters were carried out by standard chemical and biological methods. The intensive human activities lead to sharp ecological changes in the context of poor water quality index (WQI) due to high turbidity (14.02±2.34 NTU) coupled with low chlorophyll a (1.02±0.21 mg m-3) and dissolved oxygen (3.94±1.1 mg l-1), comparing to pre- and post-festival periods. Sharp reduction in abundance (4140 to 2997 cells l-1) and diversity (H′=2.72 to 1.33) of phytoplankton and microzooplankton tintinnids (450 to 328 ind l-1; H′=4.31 to 2.21) was very much pronounced. The small size tintinnid (average lorica length=29.4 µm; average LOD=10.5 µm) composed of Tintinnopsis minuta, T. lobiancoi, T. nucula, T. gracilis are predominant and reached some of the greatest abundances during the festival period. Results of ANOVA revealed a significant variation in different festival periods with phytoplankton (F= 1.77; p=0.006) and tintinnid abundance (F= 2.41; P=0.022). RELATE analyses revealed a significant correlation between the variations of planktonic communities with the environmental data (R= 0.107; p= 0.005). Three distinct groups were delineated from principal component analysis, in which a set of hydrological parameters acted as the causative factor(s) for maintaining diversity and distribution of the planktonic organisms. The pronounced adverse impact of anthropogenic stresses on plankton community could lead to environmental deterioration, disrupting the productivity of benthic and pelagic ecosystems as well as fishery potentialities which directly related to livelihood services. The festival can be considered as multiple drivers of changes in relevance to beach erosion, shoreline changes, pollution from discarded plastic and electronic wastes and destruction of natural habitats resulting loss of biodiversity. In addition, deterioration in water quality was also evident from immersion of idols, causing detrimental effects on aquatic biota. The authors strongly recommend for adopting integrated scientific and administrative strategies for resilience, sustainability and conservation of this megadelta.

Keywords: Gangasagar festival, phytoplankton, Sundarban megadelta, tintinnid

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Authors: Lip Vui Tshin

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Sabah, one of the thirteen Malaysian states, is located in the northern part of Malaysian Borneo. It is a melting pot of many different cultures and traditions, being home to about 2.9 million people with more than 30 ethic groups. It is also known as one of the twelve mega-diversity sites in the world with its rich living heritage; ethnic makes it ideal for the ecotourism industry. Sabah enjoys a steady flow of eco tourists from domestic and international markets with a gradual increase in the number of visitor arrival each year. Sabah’s ecotourism is categorized by its natural attraction, wildlife and wilderness habitats. This paper sets out to interpret and develop the indicators for success ecotourism sites in Sabah and measures its development stage. The long-term viability of tourism can be assured only when the limitations and favorable opportunities of the overall environment for tourism development are understood and ways to measure changes induced by tourism are identified and applied. This is a literature review of ecotourism site success indicators, and the outcome of this review is the identification of existing clusters and categorization of indicators and charting the way forward to develop a better understanding in ecotourism site success.

Keywords: ecotourism, ecotourism indicators, ecotourism success, Sabah

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Authors: Ashok Kumar, Parveen Parveen

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India is bestowed with an extremely high population of plant species with medicinal value and even has two biodiversity hotspots. Indian systems of medicine including Ayurveda, Siddha and Unani have historically been serving humankind across the world since time immemorial. About 1500 plant species have well been documented in Ayurvedic Nighantus as official medicinal plants. Additionally, several hundred species of plants are being routinely used as medicines by local people especially tribes living in and around forests. The natural resources for medicinal plants have unscientifically been over-exploited forcing rapid depletion in their genetic diversity. Moreover, renewed global interest in herbal medicines may even lead to additional depletion of medicinal plant wealth of the country, as about 95% collection of medicinal plants for pharmaceutical preparation is being carried out from natural forests. On the other hand, huge export market of medicinal and aromatic plants needs to be seriously tapped for enhancing inflow of foreign currency. Asparagus racemosus Willd., a member of family Liliaceae, is one of thirty-two plant species that have been identified as priority species for cultivation and conservation by the National Medicinal Plant Board (NMPB), Government of India. Though attention is being focused on standardization of agro-techniques and extraction methods, little has been designed on genetic improvement and selection of desired types with higher root production and saponin content, a basic ingredient of medicinal value. The saponin not only improves defense mechanisms and controls diabetes but the roots of this species promote secretion of breast milk, improved lost body weight and considered as an aphrodisiac. There is ample scope for genetic improvement of this species for enhancing productivity substantially, qualitatively and quantitatively. It is emphasized to select desired genotypes with sufficient genetic diversity for important economic traits. Hybridization between two genetically divergent genotypes could result in the synthesis of new F1 hybrids consisting of useful traits of both the parents. The evaluation of twenty seed sources of Asparagus racemosus assembled different geographical locations of India revelled high degree of variability for traits of economic importance. The maximum genotypic and phenotypic variance was observed for shoot height among shoot related traits and for root length among root related traits. The shoot height, genotypic variance, phenotypic variance, genotypic coefficient of variance, the phenotypic coefficient of variance was recorded to be 231.80, 3924.80, 61.26 and 1037.32, respectively, where those of the root length were 9.55, 16.80, 23.46 and 41.27, respectively. The maximum genetic advance and genetic gain were obtained for shoot height among shoot-related traits and root length among root-related traits. Index values were developed for all seed sources based on the four most important traits, and Panthnagar (Uttrakhand), Jodhpur (Rajasthan), Dehradun (Uttarakhand), Chandigarh (Punjab), Jammu (Jammu & Kashmir) and Solan (Himachal Pradesh) were found to be promising seed sources.

Keywords: asparagus, genetic, genotypes, variance

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Authors: Hakan Bozdoğan

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The goal of this paper is to evaluate the species richness, diversity and structure of in different habitats in the Kahramanmaraş Province in Turkey by using a mathematical program called as Geo-Gebra Software. The Ascalaphidae family comprises the most visually remarkable members of the order Neuroptera due to large dimensions, aerial predatory behaviour and dragonfly-like (or even butterfly-like) habits, allowing an immediate recognition also for occasional observers. Otherwise, they are one of the more poorly known families of the order in respect to biology, ecology and especially larval morphology. This discrepancy appears particularly noteworthy considering that it is a fairly large family (ca. 430 species) widely distributed in tropical and temperate areas of the World. The use of Dynamic Geometry, Analytical Softwares provides researchers a great way of visualising mathematical objects and encourage them to carry out tasks to interact with such objects and add to support of their researching. In this study we implemented; Circle with Center Through Point, Perpendicular Line, Vectors and Rays, Segments and Locus to elucidate the ecological and habitat behaviours of Butterfly-like lacewings in an analytical plane by using Geo-Gebra.

Keywords: neuroptera, Ascalaphidae, geo-gebra software, habitat selectivity

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Authors: Zain Khan, Steve Ahn, Kathy Monypenny, James Fink

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In Australian public hospitals, there were approximately 34,000 reported inpatient falls between 2015 to 2016. The gold standard for diagnosing intracranial injury is non-contrast enhanced brain computed tomography (CTB). Over a three-month timeframe, a total of one hundred and eighty (180) falls were documented between the hours of 4pm and 8am at a large metro hospital. Only three (3) of these scans demonstrated a positive intra-cranial finding. The rationale for scanning varied. The common indications included a fall with head strike, the presence of blood thinning medication, loss of consciousness, reduced Glasgow Coma Scale (GCS), vomiting and new neurological findings. There are several validated tools to aid in decision-making around ordering CTB scans in the acute setting, but no such accepted tool exists for the inpatient space. With further data collection, spanning a greater length of time and through involving multiple centres, work can be done towards generating such a tool that can be utilized for inpatient falls.

Keywords: computed tomography, falls, inpatient, intracranial hemorrhage

Procedia PDF Downloads 172

Authors: Boma Nellie S, Nambiar Ritu, K. Kanchanmala, T. Rashida, Israell Imelda, Moul Khusnud, Michael Marina

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Gestational diabetes (GDM) imparts an increased life long risk of developing Type 2 Diabetes Mellitus (T2DM) and cardiovascular disease in women. Once diagnosed with GDM women have up to 74% increased cumulative risk developing T2DM in 10-15 years. Identifying women at increased risk of developing T2DM and offering them pharmacological and lifestyle management interventions will delay or eliminate the development of diabetes in this population. While ADA recommends that all gestational diabetics be offered postnatal screening, worldwide the screening rates from 35-75% and Al Rahba Hospital with a robust universal antenatal screening program for GDM was at a dismal 9% in 2011. A multidisciplinary team was put together involving OB/Gyn Physicians, Midwives, Nurses (ward and OPD) Diabetic Educators, Dietitians, Medical Records, Laboratory & IT with the implementation of multiple strategies to increase the uptake of postpartum screening of the gestational diabetic.

Keywords: GDM, postnatal screening, preventing type 2 diabetes, lifestyle management

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Authors: Michaela Chovancova, Jakub Elcner

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Real bronchial tree is very complicated piping system. Analysis of flow and pressure losses in this system is very difficult. Due to the complex geometry and the very small size in the lower generations is examination by CFD possible only in the central part of bronchial tree. For specify the pressure losses of lower generations is necessary to provide a mathematical equation. Determination of mathematical formulas for calculating the pressure losses in the real lungs is due to its complexity and diversity lengthy and inefficient process. For these calculations is necessary the lungs to slightly simplify (same cross-section over the length of individual generation) or use one of the models of lungs. The simplification could cause deviations from real values. The article compares the values of pressure losses obtained from CFD simulation of air flow in the central part of the real bronchial tree with the values calculated in a slightly simplified real lungs by using a mathematical relationship derived from the Bernoulli equation and continuity equation. Then, evaluate the desirability of using this formula to determine the pressure loss across the bronchial tree.

Keywords: pressure gradient, airways resistance, real geometry of bronchial tree, breathing

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Authors: Marref C., Bezzalla A., Marref S., Houhamdi M.

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Wetlands represent ecosystems of great importance through their ecological and socio-economic functions and biological diversity, even if they are most threatened by anthropization. This study aimed to contribute to the creation of an inventory of bird species in Batna, on Algeria from 2020 to 2022. Counts were carried out from 8:00 to 19:00 using a telescope (20 × 60) and a pair of binoculars (10 × 50) and by employing absolute and relative methods. Birds were categorized by phenology, habitat, biogeography, and diet. A total of 80 species in 58 genera and 19 families were observed. Migratory birds were dominant (38%) phenologically, and the birds of Palearctic origin dominated (26.25%) biogeographically. Invertivorous and carnivorous species were most common (35%). Ecologically, the majority of species were waterbirds (73.75%), which are protected in Algeria. This study highlights the need for the preservation of ecosystem components and enhancement of biological resources of protected, rare, and key species. it observed 43797 individuals of Marmaronetta angustirostris during our study and reported the nesting of Podiceps nigricollis, Porphyrio porphyrio, and Tadorna ferruginea. For this reason, it is recommended to propose the area as a Ramsar site.

Keywords: biodiversity, avifauna, ecologicat status, zone humide, algerie

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Authors: Amir Ikram, Qin Su, Muhammad Fiaz, Muhammad Waqas Shabbir

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Women entrepreneurship witnessed a healthy rise in the last decade or so, and the scenario in Pakistan is not different. However female leaders are facing various, cultural, career oriented, and professional challenges. The study investigates the impact of social and industry-specific challenges on female entrepreneurship; social challenges was evaluated in terms of culture, and industry-specific challenges was measured in terms of team management and career growth. Purposive sampling was employed to collect data from 75 multicultural organizations operating in the culturally diverse and historic city of Lahore, Pakistan. Cronbach’s alpha was conducted to endorse the reliability of survey questionnaire, while correlation and regression analysis were used to test hypotheses. Industry-specific challenges were found to be more significant as compared to cultural factors. The paper also highlights the importance of female entrepreneurship for emerging economies, and suggests that bringing women to mainstream professions can lead to economic success.

Keywords: cultural challenges, emerging economy, female entrepreneurship, leadership

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Authors: Lauren G. Coggins

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Catheter-associated urinary tract infections (CAUTI) and central line-associated bloodstream infections (CLABSI) are among the most common healthcare-associated infections (HAI), contributing to prolonged lengths of stay, greater costs of patient care, and increased patient mortality. Evidence-based preventative care bundles exist to establish consistent, safe patient-care practices throughout an entire organization, helping to ensure the collective application of care strategies that aim to improve patient outcomes and minimize complications. The cardiac intensive care unit at a nationally ranked teaching and research hospital in the United States exceeded its annual CAUTI and CLABSI targets in the fiscal year 2019, prompting examination into the unit’s infection prevention efforts that included preventative care bundles for both HAIs. Adherence to the CAUTI and CLABSI preventative care bundles was evaluated through frequent audits conducted over three months, using standards and resources from The Joint Commission, a globally recognized leader in quality improvement in healthcare and patient care safety. The bundle elements with the lowest scores were identified as the most commonly missed elements. Three elements from both bundles, six elements in total, served as key content areas for the educational interventions targeted to bedside nurses. The CAUTI elements included appropriate urinary catheter order, appropriate continuation criteria, and urinary catheter care. The CLABSI elements included primary tubing compliance, needleless connector compliance, and dressing change compliance. An integrated, multi-platform education campaign featured content on each CAUTI and CLABSI preventative care bundle in its entirety, with additional reinforcement focused on the lowest scoring elements. One-on-one educational materials included an informational pamphlet, badge buddy, a presentation to reinforce nursing care standards, and real-time application through case studies and electronic health record demonstrations. A digital hub was developed on the hospital’s Intranet for quick access to unit resources, and a bulletin board helped track the number of days since the last CAUTI and CLABSI incident. Audits continued to be conducted throughout the education campaign, and staff were given real-time feedback to address any gaps in adherence. Nearly every nurse in the cardiac intensive care unit received all educational materials, and adherence to all six key bundle elements increased after the implementation of educational interventions. Recommendations from this implementation include providing consistent, comprehensive education across multiple teaching tools and regular audits to track adherence. The multi-platform education campaign brought focus to the evidence-based CAUTI and CLABSI bundles, which in turn will help to reduce CAUTI and CLABSI rates in clinical practice.

Keywords: education, healthcare-associated infections, infection, nursing, prevention

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Authors: Gagandeep Singh Grover, Vini Mahajan, Bhagmal, Priti Thaware, Jaspreet Takkar

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Dengue is a mosquito-borne viral disease endemic in many countries in the tropics and sub-tropics. The state of Punjab in India shows cyclical and seasonal variation in dengue cases. The Case Fatality Rate of Dengue has ranged from 0.6 to 1.0 in the past years. The department has initiated a review of the cases that have died due to dengue in order to know the exact cause of the death in a case of dengue. The study has been undertaken to know the other associated co-morbidities and factors causing death in a case of dengue. The study used the predesigned proforma on which the records (medical and Lab) were recorded and reviewed by the expert committee of the doctors. This study has revealed that cases of dengue having co-morbidities have a longer stay in the hospital. Fluid overload and co-morbidities have been found as major factors leading to death, however, in a confirmed case of dengue hepatorenal shutdown was found to be a major cause of mortality. The data obtained will help in sensitizing the treating physicians in order to decrease the mortality due to dengue in future.

Keywords: dengue, death, morbidities, DHF, DSS

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Authors: Estela Mayra de Moura Vianna, Thiago José Tavares Ávila, Bruno Morais Silva, Diego Henrique Bezerra, Paulo Henrique Gomes Silva, Alan Pedro da Silva

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The Brazilian Federal Constitution defines the access to information as a crucial right of the citizen and the Law on Access to Public Information, which regulates this right. Accordingly, the Fiscal Responsibility Act, 2000, amended in 2009 by the “Law of Transparency”, began demanding a wider disclosure of public accounts for the society, including electronic media for public access. Thus, public entities began to create "Transparency Portals," which aim to gather a diversity of data and information. However, this information, in general, is still published in formats that do not simplify understanding of the data by citizens and that could be better especially available for audit purposes. In this context, a proposal of ontology about Brazilian Transparency Portal can play a key role in how these data will be better available. This study aims to identify and implement in ontology, the data model about Transparency Portal ecosystem, with emphasis in activities that use these data for some applications, like audits, press activities, social government control, and others.

Keywords: audit, government transparency, ontology, public sector

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Authors: Jiawei Dai, Xinrong Li, Yulong Sun, Yunxiao Hao

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Recently, participatory approaches have become popular in a variety of fields, including social work, community, and population health, as important research tools for researchers to understand and immerse communities and conceptualize social phenomena. The participatory visual research methods promote the diversification and depth of the exploration process and communication forms to support the feasibility and practicality of the scheme, which helps to further inspire designers and avoid blind spots caused by the solidification of single thinking. This paper focuses on how to develop visual toolkits for participatory methods to assist and shape crowd participation and trigger idea generation in community issues. This project helps to verify the value of participatory visual tools in shaping participation and arousing expression, which provides support for gaining community diversity insights and community problem-solving. In addition, a visual toolbox was developed based on an actual case in a community for field testing, and further discussion was carried out after the data results were analyzed.

Keywords: participatory design, community service, visual toolbox, visual metaphor

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Authors: U. P. Rathnakar, Medha Urval, K. Ashok Shenoy

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Introduction: There are many tools available for the measurement of health literacy. REALM (Rapid Estimate of Adult Literacy in Medicine) is a very commonly used tool in advanced countries. It comes in two forms-one with 66 words and shorter version (REALM-SF) with seven words. We decided to test the applicability of shorter version of the REALM test among our patients. Methodology: REALM (SF) was tested among 200 patients in a tertiary hospital. Discussion and conclusion: From the analysis of results, when the results of pronunciation indicate adequate levels of HL skills, analysis of comprehension shows that mere reading skills is likely to be misleading. So it is proposed that in Indian population who have adequate reading skills without adequate comprehension the REALM-SF test tool in its present form may not be an ideal testing tool for assessing HL.

Keywords: health literacy, REALM, short form, India

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Authors: Rolf Katzenbach, Frithjof Clauss, Jie Zheng

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The final energy use can be divided mainly in four sectors: commercial, industrial, residential, and transportation. The trend in final energy consumption by sector plays as a most straightforward way to provide a wide indication of progress for reducing energy consumption and associated environmental impacts by different end use sectors. According to statistics the average share of end use energy for residential sector in the world was nearly 20% until 2011, in Germany a higher proportion is between 25% and 30%. However, it remains less studied than energy use in other three sectors as well its impacts on climate and environment. The reason for this involves a wide range of fields, including the diversity of residential construction like different housing building design and materials, living or energy using behavioral patterns, climatic condition and variation as well other social obstacles, market trend potential and financial support from government. This paper presents an extensive and in-depth analysis of the manner by which projects researched and operated by authors in the fields of energy efficiency primarily from the perspectives of both technical potential and initiative energy saving consciousness in the residential sectors especially in social housing buildings.

Keywords: energy efficiency, renewable energy, retro-commissioning, social housing, sustainability

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Authors: Dharam Bhugun

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The growth of immigration and social diversity and advances in global technology, have contributed to an increase in intercultural marriages and relationships in Australia. Consequently, intercultural parenting experience is shaping as an important issue within society. Parenting experiences can be both challenging and rewarding for the intercultural couple and their children. Much of the Australian literature has focussed on parenting styles among different cultural groups and the experiences of children, with more research needed on the parenting experience of intercultural couples, with emphasis on those who have not sought professional help. This study employed a qualitative research design consistent with humanistic approaches in social sciences. A social constructionism theoretical framework was used to explore the experience of intercultural parents. Participants were selected through purposive sampling, and semi-structured interviews in English were employed to collect data. Thematic analysis was used to examine participant’s experiences. It is anticipated that the research will generate insights and findings that may assist current and future intercultural parents, add to the family systems theory to inform practice, and suggest possible professional strategies for clinicians and other government and community agencies.

Keywords: culture, intercultural couples, parenting styles and practices, conflicts resolution

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Authors: Nick Toossi, Joseph Hartland

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Background: Malawi is an example of a low resource setting which faces a chronic shortage of doctors and other medical staff. This shortfall is made up for by clinical officers (COs), who are para-medicals trained for 4 years. The literature suggests to improve outcomes surgical skills training specifically should be promoted for COs in district and mission hospitals. Accordingly, the primary author was tasked with developing a basic surgical skills teaching package for COs of Mulanje Mission Hospital (MMH), Malawi, as part of a 4th year medical student External Student Selected Component field trip. MMH is a hospital based in the South of Malawi near the base of Mulanje Mountain and works in an extremely isolated environment with some of the poorest communities in the country. Traveling to Malawi the medical student author performed an educational needs assessment to develop and deliver a bespoke basic surgical skills teaching package. Methodology: An initial needs assessment identified the following domains: basic surgical skills (instrument naming & handling, knot tying, suturing principles and suturing techniques) and perineal repair. Five COs took part in a teaching package involving an interactive group simulation session, overseen by senior clinical officers and surgical trainees from the UK. Non-organic and animal models were used for simulation practice. This included the use of surgical skills boards to practice knot tying and ox tongue to simulate perineal repair. All participants spoke and read English. The impact of the session was analysed in two different ways. The first was via a pre and post Single Best Answer test and the second a questionnaire including likert’s scales and free text response questions. Results: There was a positive trend in pre and post test scores on competition of the course. There was increase in the mean confidence of learners before and after the delivery of teaching in basic surgical skills and simulated perineal repair, especially in ‘instrument naming and handling’. Whilst positively received it was discovered that learners desire more frequent surgical skills teaching sessions in order to improve and revise skills. Feedback suggests that the learners were not confident in retaining the skills without regular input. Discussion: Skills and confidence were improved as a result of the teaching provided. Learner's written feedback suggested there was an overall appetite for regular surgical skills teaching in the clinical environment and further opportunities to allow for deliberate self-practice. Surgical mentorship schemes facilitating supervised theatre time among trainees and lead surgeons along with improving access to surgical models/textbooks were some of the simple suggestions to improve surgical skills and confidence among COs. Although, this study is limited by population size it is reflective of the small, isolated and low resource environment in which this healthcare is delivered. This project does suggest that current surgical skills packages used in the UK could be adapted for employment in low resource settings, but it is consistency and sustainability that staff seek above all in their on-going education.

Keywords: clinical officers, education, Malawi, surgical skills

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Authors: Mohammad Hossain Validad, Maryam Nakhaei-Moghadam, Monire Mahjoob

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Introduction: The prevalence of type 1 diabetes is increasing worldwide, and given the role of ethnicity and race in complications of diabetes, this study was designed to evaluate the ocular complications of type 1 diabetes mellitus in Zahedan. Methods: This prospective cross-sectional study was conducted on Type 1 diabetic children that referred to Alzahra Eye Hospital. All patients had a dilated binocular indirect ophthalmoscopy using a +90 D condensing lens and slit-lamp biomicroscopy. Age, gender, onset, duration of diabetes, and HbA1c level were recorded. Results: 76 type 1 diabetes patients with an age of 11.93 ± 3.76 years participated in this study. Out of 76 patients with diabetes, 19 people (25%) had ocular complications. There was a significant difference in age (P=0.01) and disease duration (P=0.07) between the two groups with and without ocular complications. Odd ratios for ocular complications with age and duration of diabetes were 1.32 and 1.32, respectively. Conclusion: Cataract was the most common ocular complication in type 1 diabetes in Zahedan, a tropical region that was significantly related to the duration of the disease and the age of the patients.

Keywords: diabet mellitus type one, cataract, ocular complication, hemoglobin A1C

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Authors: Montserrrat Dopico Gonzalez, Ramon Lopez Facal

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The development of a critical, open and plural citizenship constitutes one of the main challenges of the school institution in the present multicultural societies. Didactics in Social Sciences has conducted important contributions to the development of active methodologies to promote the development of the intercultural competencies of the student body. Research in intercultural education has demonstrated the efficiency of the cooperative learning techniques to improve the intercultural relations in the classroom. Our study proposes to check the effect that, concerning the development of intercultural competencies of the student body, the emotional education can have in the context of the use of active methodologies such as the learning by projects and the cooperative learning. To that purpose, a programme of intervention based on activities focussed on controversial issues related to cultural diversity has been implemented in several secondary schools. Through a methodology which combines intercultural competence scales with interviews and also with the analysis of the school body’s productions, the persistence of stereotypes against immigration and the efficacy of the introduction of emotional education elements in the development of intercultural competencies have both been observed.

Keywords: active methodologies, didactics in social sciences, intercultural competences, intercultural education

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Authors: Rhaed Khiati, Muhammad Hanif

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In the past decade, smart healthcare systems have been on an ascendant drift, especially with the evolution of hospitals and their increasing reliance on bioinformatics and software specializing in healthcare. Doctors have become reliant on technology more than ever, something that in the past would have been looked down upon, as technology has become imperative in reducing overall costs and improving the quality of patient care. With patient-doctor interactions becoming more necessary and more complicated than ever, systems must be developed while taking into account costs, patient comfort, and patient data, among other things. In this work, we proposed a smart hospital bed, which mixes the complexity and big data usage of traditional healthcare systems with the comfort found in soft beds while taking certain concerns like data confidentiality, security, and maintaining SLA agreements, etc. into account. This research work potentially provides users, namely patients and doctors, with a seamless interaction with to their respective nurses, as well as faster access to up-to-date personal data, including prescriptions and severity of the condition in contrast to the previous research in the area where there is lack of consideration of such provisions.

Keywords: big data, smart healthcare, distributed systems, bioinformatics

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Authors: Gokulan Vethanayakam, Daniel Aston

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Introduction: The ReSPECT process supports healthcare professionals when making patient-centered decisions in the event of an emergency. It has been widely adopted by the NHS in England and allows patients to express thoughts and wishes about treatments and outcomes that they consider acceptable. It includes (but is not limited to) cardiopulmonary resuscitation decisions. ReSPECT conversations should ideally occur prior to ICU admission and should be documented in the eight sections of the nationally-standardised ReSPECT form. This audit evaluated the use of ReSPECT on a busy cardiothoracic ICU in an NHS Trust where established policies advocating its use exist. Methods: This audit was a retrospective review of ReSPECT forms for a sample of high-risk patients admitted to ICU at the Royal Papworth Hospital between January 2021 and March 2022. Patients all received one of the following interventions: Veno-Venous Extra-Corporeal Membrane Oxygenation (VV-ECMO) for severe respiratory failure (retrieved via the national ECMO service); cardiac or pulmonary transplantation-related surgical procedures (including organ transplants and Ventricular Assist Device (VAD) implantation); or elective non-transplant cardiac surgery. The quality of documentation on ReSPECT forms was evaluated using national standards and a graded ranking tool devised by the authors which was used to assess narrative aspects of the forms. Quality was ranked as A (excellent) to D (poor). Results: Of 230 patients (74 VV-ECMO, 104 transplant, 52 elective non-transplant surgery), 43 (18.7%) had a ReSPECT form and only one (0.43%) patient had a ReSPECT form completed prior to ICU admission. Of the 43 forms completed, 38 (88.4%) were completed due to the commencement of End of Life (EoL) care. No non-transplant surgical patients included in the audit had a ReSPECT form. There was documentation of balance of care (section 4a), CPR status (section 4c), capacity assessment (section 5), and patient involvement in completing the form (section 6a) on all 43 forms. Of the 34 patients assessed as lacking capacity to make decisions, only 22 (64.7%) had reasons documented. Other sections were variably completed; 29 (67.4%) forms had relevant background information included to a good standard (section 2a). Clinical guidance for the patient (section 4b) was given in 25 (58.1%), of which 11 stated the rationale that underpinned it. Seven forms (16.3%) contained information in an inappropriate section. In a comparison of ReSPECT forms completed ahead of an EoL trigger with those completed when EoL care began, there was a higher number of entries in section 3 (considering patient’s values/fears) that were assessed at grades A-B in the former group (p = 0.014), suggesting higher quality. Similarly, forms from the transplant group contained higher quality information in section 3 than those from the VV-ECMO group (p = 0.0005). Conclusions: Utilisation of the ReSPECT process in high-risk patients is yet to be well-adopted in this trust. Teams who meet patients before hospital admission for transplant or high-risk surgery should be encouraged to engage with the ReSPECT process at this point in the patient's journey. VV-ECMO retrieval teams should consider ReSPECT conversations with patients’ relatives at the time of retrieval.

Keywords: audit, critical care, end of life, ICU, ReSPECT, resuscitation

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Authors: Aptin Rahnavard, Ghavamaldin Asadian, Khalil Pourshamsian, Mariamalsadat Taghavi

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Dog rose is one of the important rose species in Iran that the distant past had been considered due to nutritional value and medicinal. Despite its long history of use, due to poor information on the genetic modification of plants has been done resources inheritance. In this study was to assess the genetic diversity. Total of 30 genotypes Dog rose from areas of northern Iran in the Caspian region (provinces of Guilan and Mazandaran) were evaluated using 25 RAPD primers. The number of bands produced total of 202 and for each primer were measured in a bands with an average 8-band .The number of polymorphic bands per primer ranged from 1 to 13 and the bands were in the range of 300 to 3000 bp. Based on the results OPA-04 primer with 13 bands and PRA-1, E-09 and A-04 with 5-band were created maximum and minimum number of amplified fragments. Molecular marker genotypes showed a high degree of polymorphism. Studied genotypes based on RAPD results were divided into 2 groups and 2 subgroups. Most similar in subgroups A2 and B group was the lowest.

Keywords: rosa canina spp., RAPD marker, genetic variation, caspian climate

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Authors: Jung-Hsuan Hsu

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Due to intense competition within the industry, companies have increasingly recognized partnerships with other companies. In addition, with outsourcing and globalization of the supply chain, it leads to companies' increasing reliance on external resources. Consequently, supply chain network becomes complex, so that it reduces the visibility of the manufacturing process. Therefore, this study is going to focus on the impact of supply chain relationship quality (SCRQ) on cooperative strategy and visibility. Questionnaire survey is going to be conducted as research method, using the organic food industry as the research subject, and the sampling method is random sampling. Finally, the data analysis will use SPSS statistical software and AMOS software to analyze and verify the hypothesis. The expected results in this study is to evaluate the supply chain relationship quality between Taiwan's food manufacturing and their suppliers regarding whether it has a positive impact for the persistence, frequency and diversity of cooperative strategy, as well as the dimensions of supply chain relationship quality on visibility regarding whether it has a positive effect.

Keywords: supply chain relationship quality (SCRQ), cooperative strategy, visibility, competition

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Authors: Oludele A. Akinboade

Abstract:

The paper discusses cultural aspects of tax compliance of medium size companies (MEs) in South Africa to enhance tax compliance. A survey of 641 companies in eight provinces was made. Racial identities of ME owners are not significant in explaining differences in tax registration compliance. Black ownership of MEs is negatively and highly significantly correlated with pay as you earn compliance. The opposite is found in favour of Asian ME owners. White ownership of MEs is negative and weakly (10%) significantly correlated with company income tax compliance while the opposite is found in favour of Asian ownership. Race is negative and highly significant in explaining White owned MEs value added tax compliance behaviour. The opposite is found in favour of Asian ME owners. Black ownership of MEs is negatively and weakly significantly(10%) associated with timely submission of tax returns.

Keywords: tax compliance, cultural diversity, medium size companies, South Africa

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Authors: F. Noto, G. Costa, L. Celona, F. Chines, G. Ciavola, G. Cuttone, S. Gammino, O. Leonardi, S. Marletta, G. Torrisi

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At Istituto Nazionale di Fisica Nucleare – Laboratorio Nazionale del Sud (INFN-LNS), a broad experience in the design, construction and commissioning of ECR and microwave ion sources is available. The AISHa ion source has been designed by taking into account the typical requirements of hospital-based facilities, where the minimization of the mean time between failures (MTBF) is a key point together with the maintenance operations, which should be fast and easy. It is intended to be a multipurpose device, operating at 18 GHz, in order to achieve higher plasma densities. It should provide enough versatility for future needs of the hadron therapy, including the ability to run at larger microwave power to produce different species and highly charged ion beams. The source is potentially interesting for any hadron therapy facility using heavy ions. In this paper, we analyzed the dimensional test and electrical test about an innovative solution for the containment chamber that allows us to solve our isolation and structural problems.

Keywords: FEM analysis, electron cyclotron resonance ion source, dielectrical measurement, hadron therapy

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Authors: Lauren Zammerilla Westcott, Ronald C. Jones, James W. Fleshman

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The surgical treatment of breast cancer has rapidly evolved over the past 50 years, progressing from Halsted’s radical mastectomy to a public campaign of surgical options, aesthetic reconstruction, and patient empowerment. This article examines the happenings that led to the transition of breast surgery as a subset of general surgery to its own specialized field. Sparked by the research of Dr. Bernard Fisher and the first National Surgical Adjuvant Breast and Bowel Project trial in 1971, the field of breast surgery underwent significant growth over the next several decades, enabling general surgeons to limit their practices to the breast. High surgical volumes eventually led to the development of the first formal breast surgical oncology fellowship in a large community-based hospital at Baylor University Medical Center in 1982. The establishment of the American Society of Breast Surgeons, as well several landmark clinical trials and public campaign efforts, further contributed to the advancement of breast surgery, making it the specialized field of the current era.

Keywords: breast cancer, breast fellowship, breast surgery, surgical history

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Authors: Tomasz Balabanski, Anna Biedunkiewicz

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Research on basic bacteriological and physicochemical parameters conducted by state institutions (Provincial Sanitary and Epidemiological Station and District Sanitary and Epidemiological Station) are limited to bathing waters under constant sanitary and epidemiological supervision. Unfortunately, no routine or monitoring tests are carried out for the presence of microfungi. This also applies to beach sand used for recreational purposes. The purpose of the planned own research was to determine the diversity of the mycobiota present on supervised and unsupervised sandy beaches, on the shores of lakes, of municipal baths used for recreation. The research material consisted of microfungi isolated from April to October 2019 from sandy beaches of supervised and unsupervised lakes located within the administrative boundaries of the city of Olsztyn (North-Eastern Poland, Europe). Four lakes, out of the fifteen available (Tyrsko, Kortowskie, Skanda, and Ukiel), whose bathing waters are subjected to routine bacteriological tests, were selected for testing. To compare the diversity of the mycobiota composition on the surface and below the sand mixing layer, samples were taken from two depths (10 cm and 50 cm), using a soil auger. Micro-fungi from sand samples were obtained by surface inoculation on an RBC medium from the 1st dilution (1:10). After incubation at 25°C for 96-144 h, the average number of CFU/dm³ was counted. Morphologically differing yeast colonies were passaged into Sabouraud agar slants with gentamicin and incubated again. For detailed laboratory analyses, culture methods (macro- and micro-cultures) and identification methods recommended in diagnostic mycological laboratories were used. The conducted research allowed obtaining 140 yeast isolates. The total average population ranged from 1.37 × 10⁻² CFU/dm³ before the bathing season (April 2019), 1.64 × 10⁻³ CFU/dm³ in the season (May-September 2019), and 1.60 × 10⁻² CFU/dm³ after the end of the season (October 2019). More microfungi were obtained from the surface layer of sand (100 isolates) than from the deeper layer (40 isolates). Reported microfungi may circulate seasonally between individual elements of the lake ecosystem. From the sand/soil from the catchment area beaches, they can get into bathing waters, stopping periodically on the coastal phyllosphere. The sand of the beaches and the phyllosphere are a kind of filter for the water reservoir. The presence of microfungi with various pathogenicity potential in these places is of major epidemiological importance. Therefore, full monitoring of not only recreational waters but also sandy beaches should be treated as an element of constant control by appropriate supervisory institutions, allowing recreational areas for public use so that the use of these places does not involve the risk of infection. Acknowledgment: 'Development Program of the University of Warmia and Mazury in Olsztyn', POWR.03.05.00-00-Z310/17, co-financed by the European Union under the European Social Fund from the Operational Program Knowledge Education Development. Tomasz Bałabański is a recipient of a scholarship from the Programme Interdisciplinary Doctoral Studies in Biology and Biotechnology (POWR.03.05.00-00-Z310/17), which is funded by the 'European Social Fund'.

Keywords: beach, microfungi, sand, yeasts

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Authors: Dimpi A. Patel, Pankaj Raina, Ramesh Chinnasamy, Sunetro Ghosal

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The herpetological fauna of Ladakh has been surveyed few times till 1999. In 2019, a rapid survey to document current herpetofaunal composition was undertaken in which a total of 6 species belonging to 2 orders and five families along with their altitudinal ranges were recorded. We present a revised checklist of reptiles found in Ladakh trans Himalayas based on historical records and recent field surveys. Records for erroneously reported species in literature are discussed and recommended for removal from the list from this region. For several species, new elevation range records have been recorded. This paper contributes to the present status of the richness of reptiles and amphibians in the region by documenting the composition and ecological distribution of the herpetofauna of unstudied sites. Species-specific temperature and humidity regimes were also recorded during the survey periods. Our study creates baseline information for future ecological and behavioral studies on the herpetofauna of the region by providing habitat preferences and distribution in detail.

Keywords: amphibians, distribution, diversity, reptiles, trans-Himalaya

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