Search results for: emergency department admissions

Authors: Jui Hsuan Hung, Jeng Yi Tzeng

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

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

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Authors: Maria Consuelo Doble

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

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

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Authors: Ronit Chakraborty

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Kolkata, formerly known as Calcutta, is the capital of West Bengal state and the former capital of India (1722-1911) of British India. Located at the heart of Hugli river (one of the main channels of Ganges river), the city is the heart of the state, which forms a base for commerce, transport and manufacture. The large and vibrant city thrives amidst the economic, social and political issues arising from the pages of history to the contemporary times. The unique nature, grandeurs, public debates on tea-stalls and obviously the charismatic scenic beauty and heritage keep the city to be criticized in all horizons, across the world. Movies in India are a big source of knowledge, which can be used as a powerful tool for political mobilization and to indirectly communicate with voters since cinema can be used as a tool of propaganda as it has a wide range of public interests. History proves the fact that films produced in India have been apt enough in making public interests be deeply portrayed through their content in a versatile manner. Such is the portrayal of India’s first capital, Kolkata and its ultimate truth being organizingly laid over by the trilogy of two international fame directors-Mrinal Sen and Satyajit Ray, through their ‘magnum opus- the ‘Kolkata trilogy’. Mrinal Sen’s Interview(1971), Calcutta 71(1972), Padatik(The Guerilla Fighter)(1973) and Satyajit Ray’s Pratidwandi (The Adversary)(1970), Seemabaddha(Company Limited)(1971), Jana Aranya(1976). These films picturized the contemporary Kolkata trends, issues and crises arising amidst the political set-up both by the positive and negative variables attributing to the day-to-day happenings of the city. The movies have been set amidst the turmoil that the nation was going through during Indira Gandhi’s declaration of Emergency, resulting from the general sense of disillusionment that prevailed during that time. Ray wasn't affiliated to any political party and his films largely contributed towards the contemporary conditions prevailing in the society. Mrinal Sen, being a Marxist was in constant search of the bitter truth that the society had to offer through his lens under the prevailing darkness through his trilogy. The research paper attempts to widely view and draw a comparative study of the overall description of the city of Kolkata as portrayed by Sen and Ray in their respective trilogies. By the usage of the visual content analysis method, the researcher has explored the six movies; both the trilogies of Mrinal Sen and Satyajit Ray and tried to analyse the differences as well as the similarities pertaining to understand India’s first capital city Kolkata in various dimensions along with its circumference.

Keywords: Kolkata, trilogy, Satyajit Ray, Mrinal Sen, films, comparative study

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

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

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

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Authors: Ewelina Zdebska

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

Keywords: social worker, care, terminal care, hospice

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Authors: Sultan Samah A. Alenezi

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

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

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

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

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

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Authors: Nurten Tasdemir, Busra Baloglu, Zeynep Cingoz, Can Demirel, Zeki Gezer, Barıs Efe

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Student nurses are increasingly exposed to technology in the workplace after graduation with the growing numbers of electric health records (EHRs), handheld computers, barcode scanner medication dispensing systems, and automatic capture of patient data such as vital signs. Internationally, electronic health records (EHRs) systems are being implemented and evaluated. Students will inevitably encounter EHRs in the clinical learning environment and their professional practice. Nursing students must develop competency in the use of EHR. Aim: The study aimed to examine nursing students’ experiences of learning to use electronic health records (EHR) in clinical placements. Method: This study adopted a descriptive approach. The study population consisted of second and third-year nursing students at the Zonguldak School of Health in the West Black Sea Region of Turkey; the study was conducted during the 2015–2016 academic year. The sample consisted of 315 (74.1% of 425 students) nursing students who volunteered to participate. The students, who were involved in clinical practice, were invited to participate in the study Data were collected by a questionnaire designed by the researchers based on the relevant literature. Data were analyzed descriptively using the Statistical Package for Social Sciences (SPSS) for Windows version 16.0. The data are presented as means, standard deviations, and percentages. Approval for the study was obtained from the Ethical Committee of the University (Reg. Number: 29/03/2016/112) and the director of Nursing Department. Findings: A total of 315 students enrolled in this study, for a response rate of 74.1%. The mean age of the sample was 22.24 ± 1.37 (min: 19, max: 32) years, and most participants (79.7%) were female. Most of the nursing students (82.3%) stated that they use information technologies in clinical practice. Nearly half of the students (42.5%) reported that they have not accessed to EHR system. In addition, 61.6% of the students reported that insufficient computers available in clinical placement. Of the students, 84.7% reported that they prefer to have patient information from EHR system, and 63.8% of them found more effective to preparation for the clinical reporting. Conclusion: This survey indicated that nursing students experience to learn about EHR systems in clinical placements. For more effective learning environment nursing education should prepare nursing students for EHR systems in their educational life.

Keywords: electronic health record, clinical placement, nursing student, nursing education

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Authors: Tadele Araya, Tsehaye Asmelash, Girmatsion Fiseha

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

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

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Authors: Anindita Patra, Prasad K. Bhaskaran

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

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

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Authors: P. S. Hsi, Y. F. Wang, Y. F. Ho, P. C. Hung

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The aim of the present study was to explore the dermal exposure assessment model of chemicals that have been developed abroad and to evaluate the feasibility of chemical dermal exposure assessment model for manufacturing industry in Taiwan. We conducted and analyzed six semi-quantitative risk management tools, including UK - Control of substances hazardous to health ( COSHH ) Europe – Risk assessment of occupational dermal exposure ( RISKOFDERM ), Netherlands - Dose related effect assessment model ( DREAM ), Netherlands – Stoffenmanager ( STOFFEN ), Nicaragua-Dermal exposure ranking method ( DERM ) and USA / Canada - Public Health Engineering Department ( PHED ). Five types of manufacturing industry were selected to evaluate. The Monte Carlo simulation was used to analyze the sensitivity of each factor, and the correlation between the assessment results of each semi-quantitative model and the exposure factors used in the model was analyzed to understand the important evaluation indicators of the dermal exposure assessment model. To assess the effectiveness of the semi-quantitative assessment models, this study also conduct quantitative dermal exposure results using prediction model and verify the correlation via Pearson's test. Results show that COSHH was unable to determine the strength of its decision factor because the results evaluated at all industries belong to the same risk level. In the DERM model, it can be found that the transmission process, the exposed area, and the clothing protection factor are all positively correlated. In the STOFFEN model, the fugitive, operation, near-field concentrations, the far-field concentration, and the operating time and frequency have a positive correlation. There is a positive correlation between skin exposure, work relative time, and working environment in the DREAM model. In the RISKOFDERM model, the actual exposure situation and exposure time have a positive correlation. We also found high correlation with the DERM and RISKOFDERM models, with coefficient coefficients of 0.92 and 0.93 (p<0.05), respectively. The STOFFEN and DREAM models have poor correlation, the coefficients are 0.24 and 0.29 (p>0.05), respectively. According to the results, both the DERM and RISKOFDERM models are suitable for performance in these selected manufacturing industries. However, considering the small sample size evaluated in this study, more categories of industries should be evaluated to reduce its uncertainty and enhance its applicability in the future.

Keywords: dermal exposure, risk management, quantitative estimation, feasibility evaluation

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Authors: Caroline Nnokwe, Iheanyi Eneremadu

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Teachers and principals are vital and integral parts of the educational system. For educational objectives to be met, the role of teachers and the functions of the principals are not to be overlooked. However, the inability of teachers and principals to carry out their roles effectively has impacted the outcome of the students’ performance. The study, therefore, examined teachers’ roles and principal’s administrative functions as correlates of effective academic performance of public secondary school students in Imo state, Nigeria. Four research questions and two hypotheses guided the study. The study adopted a correlation research design. The sample size was 5,438 respondents via the Yaro-Yamane technique, which consists of 175 teachers, 13 principals and 5,250 students using the proportional stratified random sampling technique. The instruments for data collection were a researcher-made questionnaire titled Teachers’ Role/Principals’ Administrative Functions Questionnaire (TRPAFQ) with a Cronbach Alpha coefficient of .82 and student's internal results obtained from the school authorities. Data collected were analyzed using the Pearson product-moment correlation coefficient and simple linear regression. Research questions were answered using Pearson Product Moment Correlation statistics, while the hypotheses were tested at 0.05 level of significance using regression analysis. The findings of the study showed that the educational qualification of teachers, organizing, and planning correlated student’s academic performance to a great extent, while availability and proper use of instructional materials by teachers correlated the academic performance of students to a very high extent. The findings also revealed that there is a significant relationship between teachers’ role, principals’ administrative functions and student’s academic performance of public secondary schools in Imo State, The study recommended among others that there is the need for government, through the ministry of education, and education authorities to adequately staff their supervisory department in order to carry out proper supervision of secondary school teachers, and also provide adequate instructional materials to ensure greater academic performance among secondary school students of Imo state, Nigeria.

Keywords: instructional materials, principals’ administrative functions, students’ academic performance, teacher role

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Authors: Memory Ranga, Phillip Pretorious

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The South African Government has invested a lot of money in Information Technology Governance (ITG) within the Government departments. The ITG framework was spearheaded by the Department of Public Service and Administration (DPSA). This led to the development of a governing ITG DPSA framework and later the Government Wide Enterprise Architecture (GWEA) Framework for assisting the departments to implement ITG. In addition to this, the government departments have adopted the Information Systems Audit and Control Association (ISACA) Control Objectives for Information and Related Technology (COBIT) for ITG processes. Despite all these available frameworks, departments fail to fully capitalise and improve the ITG processes mainly as these are too generic and difficult to apply for specific governance needs. There has been less research done to evaluate the progress on ITG initiatives within the government departments. This paper aims to evaluate the existing ITG frameworks within selected government departments in South Africa. A quantitative research approach was used in this study. Data was collected through an online questionnaire targeting ICT Managers and Directors from government departments. The study is undertaken within a case study and only the Eastern Cape Province was selected for the research. Document review mainly on ITG framework and best practices was also used. Data was analysed using the Google Analytic tools and SPSS. A one–sample Chi-Squared Test was used to verity the evaluation findings. Findings show that there is evidence that the current guiding National governance framework (DPSA) is out dated and does not accommodate the new changes in other governance frameworks. The Eastern Cape Government Departments have spent huge amount of money on ITG but not yet able to identify the benefits of the ITG initiatives. The guiding framework is rigid and does to address some of the departmental needs making it difficult to be flexible and apply the DPSA framework. Furthermore, despite the large budget on ITG, the departments still find themselves with many challenges and unable to improve some of the processes and services. All the engaged Eastern Cape departments have adopted the COBIT framework, but none has been conducting COBIT maturity Assessment which is a functionality of COBIT. There is evidence of too many the ITG frameworks and underutilisation of these frameworks. The study provides a comprehensive evaluation of the ITG frameworks that have been adopted by the South African Government Departments in the Eastern Cape Province. The evaluation guides and recommends the government departments to rethink and adopt ITG frameworks that could be customised to accommodate their needs. The adoption and application of ITG by government departments should assist in better governance and service delivery to the citizens.

Keywords: information technology governance, COBIT, evaluate, framework, governance, DPSA framework

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Authors: Lucia Ceccherini Nelli, Alessandra Donato

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The ABITA Master course of the University of Florence offered by the Department of Architecture covers nearly all the energy-relevant issues that can arise in public and private companies and sectors. The main purpose of the Master course, active since 2003, is to analyse the energy consumption of building technologies, components, and structures at the conceptual design stage, so it could be very helpful, for designers, when making decisions related to the selection of the most suitable design alternatives and for the materials choice that will be used in an energy-efficient building. The training course provides a solid basis for increasing the knowledge and skills of energy managers and is developed with an emphasis on practical experiences related to the knowledge through case studies, measurements, and verification of energy-efficient solutions in buildings, in the industry and in the cities. The main objectives are: i)To raise the professional standards of those engaged in energy auditing, ii) To improve the practice of energy auditors by encouraging energy auditing professionals in a continuing education program of professional development, iii) Implement in the use of instrumentations for the typical measurements, iv) To propose an integrated methodology that links energy analysis tools with green building certification systems. This methodology will be applied at the early design stage of a project’s life. The final output of the practical training is to achieve an elevated professionalism in the study of environmental design and Energy management in buildings. The results are the redaction of line guides instruction for the energy refurbishment of Public schools in Florence. The school heritage of the Municipality of Florence requires interventions for the control of energy performance, as old construction buildings are often made without taking into account the necessary envelope performance. For this reason, every year, the Master's course aims to study groups of public schools to enable the Municipality to carry out energy redevelopment interventions on the existing building heritage. The future challenges of the education and training program are related to follow-up activities, the development of interactive tools and the curriculum's customization to meet the constantly growing needs of energy experts from industry.

Keywords: expert in energy, energy auditing, public buildings, thermal analysis

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Authors: Sinisa Prvanov

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This research is an attempt to analyze the existing urban form of outdoor public space of Duhok city and to give proposals for their improvements in terms of urban seating. The aim of this research is to identify the main urban furniture elements and behaviour of users of three central parks of Duhok city, recognizing their functionality and the most common errors. Citizens needs, directly related to the physical characteristics of the environment, are categorized in terms of contact with nature. Parks as significant urban environments express their aesthetic preferences, as well as the need for recreation and play. Citizens around the world desire to contact with nature and places where they can socialize, play and practice different activities, but also participate in building their community and feeling the identity of their cities. The aim of this research is also to reintegrate these spaces in the wider urban context of the city of Duhok, to develop new functions by designing new seating patterns, more improved urban furniture, and necessary supporting facilities and equipment. Urban furniture is a product that uses an enormous number of people in public space. It has a high level of wear and damage due to intense use, exposure to sunlight and weather conditions. Iraq has a hot and dry climate characterized by long, warm, dry summers and short, cold winters. The climate is determined by the Iraq location at the crossroads of Arab desert areas and the subtropical humid climate of the Persian Gulf. The second part of this analysis will describe the possibilities of traditional and contemporary materials as well as their advantages in urban furniture production, providing users protection from extreme local climate conditions, but also taking into account solidities and unwelcome consequences, such as vandalism. In addition, this research represents a preliminary stage in the development of IND307 furniture design course for needs of the Department of Interior design, at the American University in Duhok. Based on results obtained in this research, the course would present a symbiosis between people and technology, promotion of new street furniture design that perceives pedestrian activities in an urban setting, and practical use of anthropometric measurements as a tool for technical innovations.

Keywords: Furniture design, Street furniture, Social interaction, Public space

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Authors: Tin Yee Ling, Kavita Maravar, Ruzica Ardalic

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Background: Uterine torsion (UT) in pregnancy of more than 45-degree along the longitudinal axis is a rare occurrence, and the aetiology remains unclear. Case: A 34-year-old G2P1 woman with a history of one previous caesarean section presented at 36+2 weeks with sudden onset lower abdominal pain, syncopal episode, and tender abdomen on examination. She was otherwise haemodynamically stable. Cardiotocography showed a pathological trace with initial prolonged bradycardia followed by a subsequent tachycardia with reduced variability. An initial diagnosis of uterine dehiscence was made, given the history and clinical presentation. She underwent an emergency caesarean section which revealed a 180-degree UT along the longitudinal axis, with oedematous left round ligament lying transverse anterior to the uterus and a segment of large bowel inferior to the round ligament. Detorsion of uterus was performed prior to delivery of the foetus, and anterior uterine wall was intact with no signs of rupture. There were no anatomical uterine abnormalities found other than stretched left ovarian and round ligaments, which were repaired. Delivery was otherwise uneventful, and she was discharged on day 2 postpartum. Discussion: UT is rare as the number of reported cases is within the few hundreds worldwide. Generally, the uterus is supported in place by uterine ligaments, which limit the mobility of the structure. The causes of UT are unknown, but risk factors such as uterine abnormalities, increased uterine ligaments’ flexibility in pregnancy, and foetal malposition has been identified. UT causes occlusion of uterine vessels, which can lead to ischaemic injury of the placenta causing premature separation of the placenta, preterm labour, and foetal morbidity and mortality if delivery is delayed. Diagnosing UT clinically is difficult as most women present with symptoms similar to placenta abruption or uterine rupture (abdominal pain, vaginal bleeding, shock), and one-third are asymptomatic. The management of UT involves surgical detorsion of the uterus and delivery of foetus via caesarean section. Extra vigilance should be taken to identify the anatomy of the uterus experiencing torsion prior to hysterotomy. There have been a few cases reported with hysterotomy on posterior uterine wall for delivery of foetus as it may be difficult to identify and reverse a gravid UT when foetal well-being is at stake. Conclusion: UT should be considered a differential diagnosis of acute abdominal pain in pregnancy. It is crucial that the torsion is addressed immediately as it is associated with maternal and foetal morbidity and mortality.

Keywords: uterine torsion, pregnancy complication, abdominal pain, torted uterus

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Authors: Yasser Ahmed Mahmoud Ali Helal

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The use of CAD (Computer Aided Design) technology is ubiquitous in the architecture, engineering and construction (AEC) industry. This has led to its inclusion in the curriculum of architecture schools in Nigeria as an important part of the training module. This article examines the ethical issues involved in implementing CAD (Computer Aided Design) content into the architectural education curriculum. Using existing literature, this study begins with the benefits of integrating CAD into architectural education and the responsibilities of different stakeholders in the implementation process. It also examines issues related to the negative use of information technology and the perceived negative impact of CAD use on design creativity. Using a survey method, data from the architecture department of University was collected to serve as a case study on how the issues raised were being addressed. The article draws conclusions on what ensures successful ethical implementation. Millions of people around the world suffer from hepatitis C, one of the world's deadliest diseases. Interferon (IFN) is treatment options for patients with hepatitis C, but these treatments have their side effects. Our research focused on developing an oral small molecule drug that targets hepatitis C virus (HCV) proteins and has fewer side effects. Our current study aims to develop a drug based on a small molecule antiviral drug specific for the hepatitis C virus (HCV). Drug development using laboratory experiments is not only expensive, but also time-consuming to conduct these experiments. Instead, in this in silicon study, we used computational techniques to propose a specific antiviral drug for the protein domains of found in the hepatitis C virus. This study used homology modeling and abs initio modeling to generate the 3D structure of the proteins, then identifying pockets in the proteins. Acceptable lagans for pocket drugs have been developed using the de novo drug design method. Pocket geometry is taken into account when designing ligands. Among the various lagans generated, a new specific for each of the HCV protein domains has been proposed.

Keywords: drug design, anti-viral drug, in-silicon drug design, hepatitis C virus (HCV) CAD (Computer Aided Design), CAD education, education improvement, small-size contractor automatic pharmacy, PLC, control system, management system, communication

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Authors: Evelyn Marie Richmond, Andrew McBride, Chris Johnston, John Marley

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Background: Good quality patient information resources for orthognathic treatment help to reinforce information delivered during the initial consultation and help patients make informed decisions about their care. The Consultant Orthodontists and a Dental Core Trainee noted limited patient engagement with the British Orthodontic Society (BOS) 'Your Jaw Surgery' online resources and that the existing BOS patient information leaflet (PIL) could be customised and developed to meet local requirements. Aim: The quality improvement project (QIP) aimed to improve patients' understanding of orthognathic treatment by ensuring at least 90% of patients had read the new in-house patient information leaflet (PIL) and a minimum of 50% of patients had accessed the British Orthodontic Society (BOS) 'Your Jaw Surgery' online resources before attending the joint orthognathic multidisciplinary clinic by June 2023. Methods: The QIP was undertaken in the orthodontic department of the School of Dentistry, Belfast. Data was collected prospectively during a 6-month period from January 2023 to June 2023 over 3 Plan, Do, Study, Act (PDSA) cycles. Suitable patients were identified at consultant orthodontic new patient clinics. Following initial consultation for orthognathic treatment, patients were contacted to complete a patient questionnaire. Design: The change ideas were a poster with a QR code directing patients to the BOS 'Your Jaw Surgery' website in consultation areas and a new in-house PIL with a QR code directing patients to the BOS 'Your Jaw Surgery' website. Results: In PDSA cycle 1, 86.7% of patients were verbally directed to the BOS 'Your Jaw Surgery' website, and 53.3% accessed the online resources after their initial consultation. Although 100% of patients reported reading the existing PIL, only 64.3% felt it discussed the risks of orthognathic treatment in sufficient detail. By PDSA cycle 3, 100% of patients reported being directed to the BOS 'Your Jaw Surgery' website, however, only 58.3% engaged with the website. 100% of patients who read the new PIL felt that it discussed the risks of orthognathic treatment in sufficient detail. Conclusion: The slight improvement in access to the BOS 'Your Jaw Surgery' website shows that patients do not necessarily choose to access information online despite its availability. The uptake of the new PIL was greater than reported patient engagement with the BOS 'Your Jaw Surgery' website, which indicates patients still value written information despite the availability of online resources.

Keywords: orthognathic surgery, patient information resources, quality improvement project, risks

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Authors: Bronwyn Griffin, Caroline Acton, Tona Gillen, Roy Kimble

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Background: Bicycle riding is a common recreational activity enjoyed by many children throughout Australia that has been associated with the usual caveat of benefits related to exercise and recreation. Given Australia was the first country in the world to introduce cyclist helmet laws in 1991, very few publications have reviewed paediatric cycling injuries (fatal or non-fatal) since. Objectives: To identify trends in children (0-16 years) who required admission for greater than 24 hours following a bicycle-related injury (fatal and non-fatal) in Queensland. Further, to discuss changes that have occurred in paediatric cycling injury trends in Queensland since a prominent local study/publication in 1995. This paper aims to establish evidence to inform interventions promoting safer riding to parents, children and communities. Methods: Data on paediatric (0-16 years) cycling injuries in Queensland resulting in hospital admission more than 24 hours across three tertiary paediatric hospitals in Brisbane between November 2008-June 2015 was compiled by the Paediatric Trauma Data Registry for non-fatal injuries. The Child Death Review Team at the Queensland Families and Childhood Commission provided data on fatalities in children <17years from (June 2004 –June 2015). Comparing trends to a local study published in 1995 Results: Between 2008-2015 there were 197 patients admitted for greater than 24 hours following a cycling injury. The median age was 11 years, with males more frequently involved (n=139, 87%) compared to females. Mean length of stay was three days, with 47 (28%) children admitted to PICU, location of injury was most often the street (n=63, 37%). Between 2004 –2015 there were 15 fatalities (Incidence rate 0.25/100,000); all were male, 14/15 occurred on the street, with eight stated to have not been wearing a helmet, 11/15 children came from the least advantaged socio-economic group (SEIFA) compared to a local publication in 1995, finding of 94 fatalities between (1981-1992). Conclusions: There has been a notable decrease in incidence of fatalities between the two time periods with incidence rates dropping from 1.75-0.25/100,000. More statistics need to be run to ascertain if this is a true reduction or perhaps a decrease in children riding bicycles. Injuries that occur on the street that come in contact with a car remain of serious concern. The purpose of this paper is not to discourage bicycle riding among child and adolescent populations, rather, inform parents and the wider community about the risks associated with cycling in order to reduce injuries associated with this sport, whilst promoting safe cycling.

Keywords: paediatric, cycling, trauma, prevention, emergency

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Authors: Shasta Bula

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This research provides the first case study of the Santa Ana riverbed homeless encampment. It contributes valuable information about the little-studied factors contributing to the formation and dismantling of transient homeless encampments. According to the author’s best knowledge, this is the discussion of three reoccurring characteristics of homeless camps: camps form a self-governing system, camps are viewed by the community as unsavory places, and the campers are viewed as being unable or unwilling to participate in normal society. Three theories are proposed as explanations for these characteristics: the social capital theory as a reason for homeless campers to develop a system of self-government, the aesthetics theory as rationale for camps being viewed as unsavory places, and the theory of vulnerable and inevitable inequality as a reason why campers are seen as being unable or unwilling to participate in normal society. Three hypotheses are introduced to assess these theories: The encampment was created because it provided inhabitants a sense of safety and autonomy. It was dismantled due to its highly visible location and lack of adherence to the Orange County consumption and leisure aesthetic. Most homeless people from this encampment relocated approximately thirty miles east to Riverside County to avoid harassment by police. An extensive review of interviews with camp inhabitants revealed that fifty-one percent resided in the camp because it gave them a sense of safety and autonomy. An examination of Anaheim city council meeting meetings showed that thirty-eight percent of complaints were related to aesthetic concerns. Analysis of population reports from the U.S. Department of Housing and Urban Development indicated that there was a notable increase in homelessness in Orange County the year after the camp was dismantled. These results reflect that the social capital theory is an applicable explanation for the homeless being drawn to set up camp as a collective. The aesthetics theory can be used to explain why a third of residents complained about the encampment. Camp residents did not move East to Riverside after the camp was dismantled. Further investigation into the enforcement of anti-camping ordinances needs to be conducted to evaluate if policing contributed to the vulnerability of the homeless.

Keywords: poverty, social relations, transformation of urban settlements, urban anthropology

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Authors: Kazuki Kohama, Hiroko Ono

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The rainfall in Japan is gradually increasing every year according to Japan Meteorological Agency and Intergovernmental Panel on Climate Change Fifth Assessment Report. It means that the rainfall difference between rainy season and non-rainfall is increasing. In addition, the increasing trend of strong rain for a short time clearly appears. In recent years, natural disasters have caused enormous human injuries in various parts of Japan. Regarding water disaster, local heavy rain and floods of large rivers occur frequently, and it was decided on a policy to promote hard and soft sides as emergency disaster prevention measures with water disaster prevention awareness social reconstruction vision. Okinawa prefecture in subtropical region has torrential rain and water disaster several times a year such as river flood, in which is caused in specific rivers from all 97 rivers. Also, the shortage of capacity and narrow width are characteristic of river in Okinawa and easily cause river flood in heavy rain. This study focuses on Kohatu River that is one of the specific rivers. In fact, the water level greatly rises over the river levee almost once a year but non-damage of buildings around. On the other hand in some case, the water level reaches to ground floor height of house and has happed nine times until today. The purpose of this research is to figure out relationship between precipitation, surface outflow and total treatment water quantity of Kohatu River. For the purpose, we perform hydrological analysis although is complicated and needs specific details or data so that, the method is mainly using Geographic Information System software and outflow analysis system. At first, we extract watershed and then divided to 23 catchment areas to understand how much surface outflow flows to runoff point in each 10 minutes. On second, we create Unit Hydrograph indicating the area of surface outflow with flow area and time. This index shows the maximum amount of surface outflow at 2400 to 3000 seconds. Lastly, we compare an estimated value from Unit Hydrograph to a measured value. However, we found that measure value is usually lower than measured value because of evaporation and transpiration. In this study, hydrograph analysis was performed using GIS software and outflow analysis system. Based on these, we could clarify the flood time and amount of surface outflow.

Keywords: disaster prevention, water disaster, river flood, GIS software

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Authors: Aneal Khan, Elleine Allapitan, Desmond Koo, Katherine-Ann Piedalue, Shaneel Pathak, Utkarsh Subnis

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Background: Disease management of metabolic, genetic disorders is long-term and can be cumbersome to patients and caregivers. Patient-Reported Outcome Measures (PROMs) have been a useful tool in capturing patient perspectives to help enhance treatment compliance and engagement with health care providers, reduce utilization of emergency services, and increase satisfaction with their treatment choices. Currently, however, PROMs are collected during infrequent and decontextualized clinic visits, which makes translation of patient experiences challenging over time. The GRIT study aims to evaluate a digital health journal application called Zamplo that provides a personalized health diary to record self-reported health outcomes accurately and efficiently in patients with metabolic, genetic disorders. Methods: This is a randomized controlled trial (RCT) (1:1) that assesses the efficacy of Zamplo to increase patient activation (primary outcome), improve healthcare satisfaction and confidence to manage medications (secondary outcomes), and reduce costs to the healthcare system (exploratory). Using standardized online surveys, assessments will be collected at baseline, 1 month, 3 months, 6 months, and 12 months. Outcomes will be compared between patients who were given access to the application versus those with no access. Results: Seventy-seven patients were recruited as of November 30, 2021. Recruitment for the study commenced in November 2020 with a target of n=150 patients. The accrual rate was 50% from those eligible and invited for the study, with the majority of patients having Fabry disease (n=48) and the remaining having Pompe disease and mitochondrial disease. Real-time clinical responses, such as pain, are being measured and correlated to disease-modifying therapies, supportive treatments like pain medications, and lifestyle interventions. Engagement with the application, along with compliance metrics of surveys and journal entries, are being analyzed. An interim analysis of the engagement data along with preliminary findings from this pilot RCT, and qualitative patient feedback will be presented. Conclusions: The digital self-care journal provides a unique approach to disease management, allowing patients direct access to their progress and actively participating in their care. Findings from the study can help serve the virtual care needs of patients with metabolic, genetic disorders in North America and the world over.

Keywords: eHealth, mobile health, rare disease, patient outcomes, quality of life (QoL), pain, Fabry disease, Pompe disease

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Authors: Mustafa M. Donma, Orkide Donma

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Obesity and weight gain are associated with increased risk of developing cardiovascular diseases and the progression of liver fibrosis. Aspartate transaminase–to-platelet count ratio index (AST-to-PLT, APRI) and fibrosis-4 (FIB-4) were primarily considered as the formulas capable of differentiating hepatitis from cirrhosis. Recently, they have found clinical use as measures of liver fibrosis and cardiovascular risk. However, their status in children has not been evaluated in detail yet. The aim of this study is to determine APRI and FIB-4 status in obese (OB) children and compare them with values found in children with normal body mass index (N-BMI). A total of sixty-eight children examined in the outpatient clinics of the Pediatrics Department in Tekirdag Namik Kemal University Medical Faculty were included in the study. Two groups were constituted. In the first group, thirty-five children with N-BMI, whose age- and sex-dependent BMI indices vary between 15 and 85 percentiles, were evaluated. The second group comprised thirty-three OB children whose BMI percentile values were between 95 and 99. Anthropometric measurements and routine biochemical tests were performed. Using these parameters, values for the related indices, BMI, APRI, and FIB-4, were calculated. Appropriate statistical tests were used for the evaluation of the study data. The statistical significance degree was accepted as p<0.05. In the OB group, values found for APRI and FIB-4 were higher than those calculated for the N-BMI group. However, there was no statistically significant difference between the N-BMI and OB groups in terms of APRI and FIB-4. A similar pattern was detected for triglyceride (TRG) values. The correlation coefficient and degree of significance between APRI and FIB-4 were r=0.336 and p=0.065 in the N-BMI group. On the other hand, they were r=0.707 and p=0.001 in the OB group. Associations of these two indices with TRG have shown that this parameter was strongly correlated (p<0.001) both with APRI and FIB-4 in the OB group, whereas no correlation was calculated in children with N-BMI. Triglycerides are associated with an increased risk of fatty liver, which can progress to severe clinical problems such as steatohepatitis, which can lead to liver fibrosis. Triglycerides are also independent risk factors for cardiovascular disease. In conclusion, the lack of correlation between TRG and APRI as well as FIB-4 in children with N-BMI, along with the detection of strong correlations of TRG with these indices in OB children, was the indicator of the possible onset of the tendency towards the development of fatty liver in OB children. This finding also pointed out the potential risk for cardiovascular pathologies in OB children. The nature of the difference between APRI vs FIB-4 correlations in N-BMI and OB groups (no correlation versus high correlation), respectively, may be the indicator of the importance of involving age and alanine transaminase parameters in addition to AST and PLT in the formula designed for FIB-4.

Keywords: APRI, children, FIB-4, obesity, triglycerides

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Authors: Marilou P. Angeles

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Seniors are a growing number of population all over the world, and they are getting sick with illnesses like diabetes, high blood, and high cholesterol. It is necessary to see the relationship of their physical illness and its effect on their quality of life. Having chronic illnesses also can affect the mood of the elderly; becoming cranky, lonely, not eating, etc. Therefore, there is a need to study the relationship of the quality of life of the elderly and the level of depression. Depression for elderly is known as late onset depression or vascular depression since it is tied to the vascular illnesses they are experiencing, although this is not homogeneous. There is heterogeneity in seniors. The purpose of the study is to determine how keep the satisfaction in life i.e., quality of life of seniors, as long as possible. This study was made in 4 barangays in Longos, Potrero, Tonsuya and Catmon, in Malabon, Metro Manila, Philippines. These Filipino seniors are availing of free medicines for their diabetes, high blood, and high cholesterol ailments in the barangay health centers, given freely by the Department of Health. Two instruments were used; quality of life (CASP-19) and patient health questionnaire(PHQ-19). The quality of life questionnaire was based on the theory of Abraham Maslow, human: beings are motivated to action by needs, starting from the lowest, physiological to the highest self-transcendence. Severity of depression is determined by PHQ-9, and according to the unified model of depression by Aaron Beck and Kurt B. Bredemeier, depression happens when a person cannot cope with life has not able to satisfy his needs as a person. The Pearson R correlation was used to determine the significance of the relationship between quality of life and depression. Finding is there is negative relationship between quality of life and depression. It means that a high value of quality of life lowers or minimizes depression. CASP-19 found that the Filipino elderly were in control, independent, enjoying their lives even if they are poor, and this is shown by the significant results. Self-transcendence, a need to give back to others, is important for Filipino elderly. Although the seniors have difficulty with money and they were affected by their illnesses, they are full of optimism, they are ignoring their physical pain because they are focusing on helping their loved ones (i.e., self-transcendence), their children and grandchildrenothers, and if problems come, they are resilient accepting of the challenges, because they have strong faith in God. They are also having pleasures interacting with their friends and neighbors who, like them, have the same health problems. And these two coping strategies for the elderlies allow them to live a meaningful life, a life high in quality. Thus, where there is high quality of life, there is none or minimal depression. Recommendation for future study is finding the relationship of spirituality to quality of life of seniors.

Keywords: CASP-19, depression, quality of life, PHQ-9, senior citizen

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Authors: Marcia Teresa Gildo

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The United Nations High Commissioner for Refugees (UNHCR) is responsible to provide international protection and humanitarian assistance to refugees and to seek permanent solutions to their situation. To fulfil this mandate, the agency works in collaboration with its partners and governments. This paper aims to analyse the agency's actions to protect and provide assistance to Mozambican refugees in Malawi. Since July 2015, approximately 12.000 people have fled Mozambique to neighbouring Malawi due to the political-military conflict between the government of Mozambique and RENAMO (the country’s largest opposition party). This led to a series of military clashes between the two parties and the consequent flight of some Mozambicans to Malawi, in search of asylum. Most arrived from the province of Tete, in the central region of Mozambique, and, to a lesser extent, from the province of Zambezia. The asylum seekers arrived in small groups and settled in the village of Kapise in the Mwanza district of Thambani, as well as in Chikwawa and Nsanje districts in Malawi. UNHCR led an interinstitutional response action to manage the flow of Mozambican asylum seekers to Malawi. In view of these aspects and the ongoing challenge of protecting refugees and finding permanent solutions to their situation, UNHCR remains an indispensable international organization. However, there are significant gaps in the international refugee protection regime, and there have been many occasions when UNHCR has failed to fulfill its mandate. The analysis was carried out through qualitative research methods and techniques based essentially on consultation of books, newspapers and scientific articles, television and journalistic reports and interviews with the people who were involved in the process. From the data obtained, it was concluded that UNHCR worked in coordination with its partners and the government of Malawi to provide protection and emergency assistance to the refugees. However, existing funds covered only the immediate needs of refugees, more funds had to be allocated. That was made through an interinstitutional appeal. Although the funds allocated were not sufficient, they allowed the agency to protect and assist the refugees until a permanent solution was found. UNHCR also worked in coordination with the governments of Malawi and Mozambique so that a tripartite agreement was signed between the parties for the voluntary repatriation of Mozambican refugees, since security conditions were guaranteed and the refugees had expressed their willingness to return to their country of origin. UNHCR's actions to protect Mozambican refugees in Malawi have enabled humanitarian conditions to be respected and the rights of refugees to be guaranteed. Cooperation with the different actors involved in the response has allowed UNHCR to fulfil its mandate.

Keywords: assistance , cooperation, international protection, refugees

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Authors: Pushp Lata Sankhwar

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INTRODUCTION: Maternal Hypothyroidism is the most frequent endocrine disorder in pregnancy and varies from 2.5% in the west to 11.0% in India. Maternal Hypothyroidism can have detrimental maternal effects like increased risk of preterm labor, PPROM leading to increased maternal morbidity and also on the neonate in the form of prematurity and its complications, prolonged hospital stay, neurological developmental problems, delayed milestones and mental retardation etc. Henceforth, the study was planned to evaluate the role of Hypothyroidism in preterm labor and its effect on neonates. AIMS AND OBJECTIVES: To Correlate Overt Hypothyroidism, Subclinical Hypothyroidism and Isolated Hypothyroxinemia With Preterm Labor and the neonatal outcome. Material and Methods: A case-control study of singleton pregnancy was performed over a year, in which a total of 500 patients presenting in the emergency with preterm labor were enrolled. The thyroid profile of these patients was sent at the time of admission, on the basis of which they were divided into Cases – Hypothyroidic mothers and Controls – Euthyroid mothers. The cases were further divided into subclinical, overt Hypothyroidism and isolated hypothyroxinemia. The neonatal outcome of these groups was also compared on the basis of the incidence and severity of neonatal morbidity, neonatal respiratory distress, the incidence of neonatal Hypothyroidism and early complications. The feto-maternal data was collected and analysed. RESULTS: In the study, a total of 500 antenatal patients with a history of preterm labor were enrolled, out of which 67 (13.8%) patients were found to be hypothyroid. The majority of the mothers had Subclinical Hypothyroidism (12.2%), followed by Overt Hypothyroidism seen in 1% of the mothers and isolated hypothyroxinemia in 0.6% of cases. The neonates of hypothyroid mothers had higher levels of cord blood TSH, and the mean cord blood TSH levels were highest in the case of neonates of mothers with Overt Hypothyroidism. The need for resuscitation of the neonates at the time of birth was higher in the case of neonates of hypothyroid mothers, especially with Subclinical Hypothyroidism. Also, it was found that the requirement of oxygen therapy in the form of oxygen by nasal prongs, oxygen by a hood, CPAP, CPAP along with surfactant therapy and mechanical ventilation along with surfactant therapy was significantly higher in the case of neonates of hypothyroid mothers. CONCLUSION: The results of our study imply that uncontrolled and untreated maternal Hypothyroidism may also lead to preterm delivery. The neonates of mothers with Hypothyroidism have higher cord blood TSH levels. The study also shows that there is an increased incidence and severity of respiratory distress in the neonates of hypothyroid mothers with untreated subclinical Hypothyroidism. Hence, we propose that routine screening for thyroid dysfunction in pregnant women should be done to prevent thyroid-related feto-maternal complications.

Keywords: high-risk pregnancy, thyroid, dysfunction, hypothyroidism, Preterm labor

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Authors: Raman Sharma, Ashok Kumar, Vipin Koushal

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Healthcare facilities are always seen as places of haven and protection for managing the external incidents, but the situation becomes more difficult and challenging when such facilities themselves are affected from internal hazards. Such internal hazards are arguably more disruptive than external incidents affecting vulnerable ones, as patients are always dependent on supportive measures and are neither in a position to respond to such crisis situation nor do they know how to respond. The situation becomes more arduous and exigent to manage if, in case critical care areas like Intensive Care Units (ICUs) and Operating Rooms (OR) are convoluted. And, due to these complexities of patients’ in-housed there, it becomes difficult to move such critically ill patients on immediate basis. Healthcare organisations use different types of electrical equipment, inflammable liquids, and medical gases often at a single point of use, hence, any sort of error can spark the fire. Even though healthcare facilities face many fire hazards, damage caused by smoke rather than flames is often more severe. Besides burns, smoke inhalation is primary cause of fatality in fire-related incidents. The greatest cause of illness and mortality in fire victims, particularly in enclosed places, appears to be the inhalation of fire smoke, which contains a complex mixture of gases in addition to carbon monoxide. Therefore, healthcare organizations are required to have a well-planned disaster mitigation strategy, proactive and well prepared manpower to cater all types of exigencies resulting from internal as well as external hazards. This case report delineates a true OR fire incident in Emergency Operation Theatre (OT) of a tertiary care multispecialty hospital and details the real life evidence of the challenges encountered by OR staff in preserving both life and property. No adverse event was reported during or after this fire commotion, yet, this case report aimed to congregate the lessons identified of the incident in a sequential and logical manner. Also, timely smoke evacuation and preventing the spread of smoke to adjoining patient care areas by opting appropriate measures, viz. compartmentation, pressurisation, dilution, ventilation, buoyancy, and airflow, helped to reduce smoke-related fatalities. Henceforth, precautionary measures may be implemented to mitigate such incidents. Careful coordination, continuous training, and fire drill exercises can improve the overall outcomes and minimize the possibility of these potentially fatal problems, thereby making a safer healthcare environment for every worker and patient.

Keywords: healthcare, fires, smoke, management, strategies

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Authors: Pariya Sheykhmaleki, Debajyoti Pati

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Rural areas in the United States face numerous challenges in providing quality and assessable primary healthcare services, especially during emergencies such as natural disasters or pandemics. This study showcases a cutting-edge flexible module that aims to overcome these challenges by offering adaptable healthcare facilities capable of providing comprehensive health services in remote and disaster-prone regions. According to the Health Resources and Services Administration (HRSA), approximately 62 million Americans, or 1 in 5 individuals, live in areas designated as Health Professional Shortage Areas (HPSAs) for primary care. These areas are characterized by limited access to healthcare facilities, shortage of healthcare professionals, transportation barriers, inadequate healthcare infrastructure, higher rates of chronic diseases, mental health disparities, and limited availability of specialized care, including urgent circumstances like pandemics that can exacerbate this issue. To address these challenges, the literature study began by examining primary health solutions in very remote areas, e.g., spaceships, to identify the state-of-the-art technologies and the methods used to facilitate primary care needs. The literature study on flexibility in architecture and interior design was also adapted to develop a conceptual design for rural areas. The designed flexible module provides an innovative solution. This module can be prefabricated as all parts are standardized. The flexibility of the module allows the structure to be modified based on local and geographical requirements as well as the ability to expand as required. It has been designed to stand either by itself or work in tandem with public buildings. By utilizing sustainable approaches and flexible spatial configurations, the module optimizes the utilization of limited resources while ensuring efficient and effective healthcare delivery. Furthermore, the poster highlights the key features of this flexible module, including its ability to support telemedicine and telehealth services for all five levels of urgent care conditions, i.e., from facilitating fast tracks to supporting emergency room services, in two divided zones. The module's versatility enables its deployment in rural areas located far from urban centers and disaster-stricken regions, ensuring access to critical healthcare services in times of need. This module is also capable of responding in urban areas when the need for primary health becomes vastly urgent, e.g., during a pandemic. It emphasizes the module's potential to bridge the healthcare gap between rural and urban areas and mitigate the impact of rural health challenges.

Keywords: rural health, healthcare challenges, flexible modular design, telemedicine, telehealth

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Authors: Thammanoon Charmjuree, Yuosre F. Badir, Umar Safdar

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There is a consensus among innovation scholars that knowledge is a vital antecedent for firm’s innovation; e.g., process innovation. Recently, there has been an increasing amount of attention to more open approaches to innovation. This open model emphasizes the use of purposive flows of knowledge across the organization boundaries. Firms adopt open innovation strategy to improve their innovation performance by bringing knowledge into the organization (inbound open innovation) to accelerate internal innovation or transferring knowledge outside (outbound open innovation) to expand the markets for external use of innovation. Reviewing open innovation research reveals the following. First, the majority of existing studies have focused on inbound open innovation and less on outbound open innovation. Second, limited research has considered the possible interaction between both and how this interaction may impact the firm’s innovation performance. Third, scholars have focused mainly on the impact of open innovation strategy on product innovation and less on process innovation. Therefore, our knowledge of the relationship between firms’ inbound and outbound open innovation and how these two impact process innovation is still limited. This study focuses on the firm’s external technology acquisition (ETA) and external technology exploitation (ETE) and the firm’s process innovation performance. The ETA represents inbound openness in which firms rely on the acquisition and absorption of external technologies to complement their technology portfolios. The ETE, on the other hand, refers to commercializing technology assets exclusively or in addition to their internal application. This study hypothesized that both ETA and ETE have a positive relationship with process innovation performance and that ETE fully mediates the relationship between ETA and process innovation performance, i.e., ETA has a positive impact on ETE, and turn, ETE has a positive impact on process innovation performance. This study empirically explored these hypotheses in software development firms in Thailand. These firms were randomly selected from a list of Software firms registered with the Department of Business Development, Ministry of Commerce of Thailand. The questionnaires were sent to 1689 firms. After follow-ups and periodic reminders, we obtained 329 (19.48%) completed usable questionnaires. The structure question modeling (SEM) has been used to analyze the data. An analysis of the outcome of 329 firms provides support for our three hypotheses: First, the firm’s ETA has a positive impact on its process innovation performance. Second, the firm’s ETA has a positive impact its ETE. Third, the firm’s ETE fully mediates the relationship between the firm’s ETA and its process innovation performance. This study fills up the gap in open innovation literature by examining the relationship between inbound (ETA) and outbound (ETE) open innovation and suggest that in order to benefits from the promises of openness, firms must engage in both. The study went one step further by explaining the mechanism through which ETA influence process innovation performance.

Keywords: process innovation performance, external technology acquisition, external technology exploitation, open innovation

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Authors: Samriti Wadhwa, Beena Kumari

Abstract:

Background and Significance: Residue levels of ready mix (chlorpyriphos 50% and cypermethrin 5%), cypermethrin and chlorpyriphos individually in sandy loam soil under okra fruits (Variety, Varsha Uphar) were determined; a field experiment was conducted at Research Farm of Department of Entomology of Chaudhary Charan Singh Haryana Agriculture University, Hisar, Haryana, India. Persistence behavior of cypermethrin and chlorpyriphos was studied following application of a pre-mix formulation of insecticides viz. Action-505EC, chlorpyriphos (Radar 20 EC) and cypermethrin (Cyperkill 10 EC) at the recommended dose and double the recommended dose along with control at fruiting stage. Pesticide application also leads to decline in soil acarine fauna which is instrumental in the breakdown of the litter because of which minerals are released into the soil. So, by this study, one can evaluate the safety of pesticides for the soil health. Methodology: Action-505EC (chlorpyriphos 50% and cypermethrin 5%) at 275 g a .i. ha⁻¹ (single dose) and 550 g a. i. ha⁻¹ (double dose), chlorpyriphos (Radar 20 EC) at 200 g a. i. ha⁻¹ (single dose) and 400 g a. i. ha⁻¹ (double dose) and cypermethrin (Cyperkill 10 EC) at 50 g a. i. ha⁻¹ (single dose) and 100 g a. i. ha⁻¹ (double dose) were applied at the fruiting stage on okra crop. Samples of soils from okra field were collected periodically at 0 (1h after spray), 1, 3, 5, 7, 10, 15 days and at harvest after application as well of control soil sample. After air drying, adsorbing through Florisil and activated charcoal and eluting with hexane: acetone (9:1) then residues in soils were estimated by a gas chromatograph equipped with a capillary column and electron capture detector. Results: No persistence of cypermethrin in ready-mix in soil under okra fruits at single and double dose was observed. In case of chlorpyriphos in ready-mix, average initial deposits on 0 (1 h after treatment) day was 0.015 mg kg⁻¹ and 0.036 mg kg⁻¹ which persisted up to 5 days and up to 7 days for single and double dose, respectively. After that residues reached below a detectable level of 0.010 mg kg⁻¹. Experimental studies on cypermethrin individually revealed that average initial deposits on 0 (1 h after treatment) were 0.008 mg kg⁻¹ and 0.012 mg kg⁻¹ which persisted up to 3 days and 5 days for single and double dose, respectively after that residues reached to below detectable level. The initial deposits of chlorpyriphos individually in soil were found to be 0.055 mg kg⁻¹ and 0.113 mg kg⁻¹ which persisted up to 7 days and 10 days at a lower dose and higher dose, respectively after that residues reached to below determination level. Conclusion: In soil under okra crop, only individual cypermethrin in both the doses persisted whereas no persistence of cypermethrin in ready-mix was observed. Persistence of chlorpyriphos individually is more as compared to chlorpyriphos in ready-mix in both the doses. Overall, the persistence of chlorpyriphos in soil under okra crop is more than cypermethrin.

Keywords: chlorpyriphos, cypermethrin, okra, ready mix, soil

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