Search results for: approach to local and institutional level

Authors: Bouchekoua Myriam, Aloui Dorsaf, Trabelsi Sonia

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Introduction Food hygiene in hospitals is important, particularly among patients who could be more vulnerable than healthy subjects to microbiological and nutritional risks. The consumption of contaminated food may be responsible for foodborne diseases, which can be severe among hospitalized patients, especially those immunocompromised. The aim of our study was to assess the state of hygiene in the internal catering department of a Tunisian hospital. Methodology and major results: A prospective study was conducted for one year in the Parasitology-Mycology laboratory of Charles Nicolle Hospital. Samples were taken from the kitchen staff, worktops, and cooking utensils used in the internal catering department. Thirty one employees have benefited from stool exams and scotch tape in order to evaluate the degree of infestation of parasites. 35% of stool exams were positive. Protozoa were the only parasites detected. Blastocystis sp was the species mostly found in nine food handlers. Its role as a human pathogen is still controversial. Pathogenic protozoa were detected in two food handlers (Giardia intestinalis in one person and Dientamoeba fragilis in the other one. Non-pathogenic protozoa were found in two cases; among them, only one had digestive symptoms without a statistically significant association with the carriage of intestinal parasites. Moreover, samples were performed from the hands of the staff in order to search for a fungal carriage. Thus, 25 employees (81%) were colonized by fungi, including molds. Besides, mycological examination among food handlers with a suspected dermatomycosis for diagnostic confirmation concluded foot onychomycosis in 32% of cases and interdigital intertrigo in 26%. Only one person had hand onychomycosis. Among the 17 samples taken from worktops and kitchen utensils, fungal contamination was detected in 13 sites. Hot and cold equipment were the most contaminated. Molds were mainly identified as belonging to five different genera. Cladosporium sp was predominant. Conclusion: In the view of the importance of intestinal parasites among food handlers, the intensity of fungi hand carriage among these employees, and the high level of fungal contamination in worktops and kitchen utensils, a reinforcement of hygiene measures is more than essential in order to minimize the alimentary contamination-risk.

Keywords: hospital kitchen, environment, intestinal parasitosis, fungal carriage, fungal contamination

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Authors: Abdelkader Guendouz, Fatima Zohra Adel

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Even if both the economic and the human development are an axial pillar in its global policy, Algerian government seems to be more and more engaged in the international context aiming to reach of the so called millennium development goals, and this since its beginning. By looking closely at the Algerian economic policy, it is easy to mention the existence of several programs in which both economic and social realisations including among others, poverty reduction, enhancement of education level and conditions, woman statute and gender equity amelioration targets. The efforts of Algerian government in the field of these targets had been acheminated through three main plans, which are: -PSRE (Plan de Soutien à la Relance Economique), for the period of 2001 to 2004, initiated with about 7 billion US dollar, had been focused on three objectives, namely, poverty reduction, job creation and regional equilibrium with rural areas revitalization. -PCSC (le Programme complémentaire de soutien à la croissance économique), for the period of 2005 to 2009, with a starting funding of 114 billion US dollar. This program aims to develop public services and supporting public investments, especially in which concerns social infrastructures. Now, and at the end of the maturity of the MDGs agenda, an important question is to be asked: what are the main realizations regarding these MDGs? In order to answer this question, the present paper tries to examine the Algerian economic policy (but also the social one) by considering the MDGs challenges, for the period from 2000 to 2010, but also until 2015. This examination is focused on three main targets, namely poverty, education, and health. Firstly, statistical assessment for the Algerian economic and social situation shows that almost all MDGs had been reached during the period of 2000 to 2009 and it continues to maintain and improve them. This observation can be endorsed by invoking some achievements. Starting by the reduction of poverty, the proportion of population living with less than 1 US dollar per a day passed from 8.0 % in 2000 to 0.5 % in 2009, and 0.3 % in 2015. For education sphere, the enrolment ratio of six-year child, which is the most significant index for school attendance, is about 98 % for 2009 against 93 % in 1999, and only 43 % in 1966. Concluding with health care and relevant services; the Algerian government has accomplished big steps in providing easy access to this sector for the population. Moreover, the percentage of assisted accouchement had been raised from 91.2 % in 2000 to 97.2 % in 2009.

Keywords: Algerian economic policy, MDGs, poverty, education, health

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Authors: Vilma Zydziunaite, Simona Kersiene

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The concept of focused leadership means that the leader gathers the entire community in various ways to communicate and cooperate with each other, to share their knowledge and responsibility, to get involved in problem-solving, to create a safe and trusting environment and to satisfy the needs and interests of each community member. The study's aim is to analyze the teamwork of teachers working in kindergartens and schools and its CEOs by implementing confused leadership. A mixed research design was used for the research study. Quantitative research used the teamwork test "Team-Puls" (2003). Data is processed by the IBM SPSS version 29.0 software package. Semi-structured interviews were used for data collection, and qualitative content analysis was applied for data analysis. The results of quantitative research show that there is no statistically significant difference between the evaluation averages of kindergarten and school teachers. Likewise, the effectiveness and evaluation of teacher teamwork in educational institutions depend on different characteristics and processes, such as the number of participating teachers, the involvement of the institution's administration or the stages of team formation. In the qualitative research, the components of the focused leadership categories applied by the kindergarten and school CEOs emerged. The categories reflect the components of shared leadership. In the study, the sharing of responsibilities and cooperation among teachers and the sharing of knowledge among themselves is distinguished. This shows that the action takes place between the teachers when they participate in the processes voluntarily, according to their wishes or for certain reasons. Distributed leadership components occurs when leadership responsibility is extended beyond the school CEO. The components of servant leadership are expressed when the CEO achieves organizational goals in the service of others. Servant leadership is helping and striving for others, creating a safe environment. The level of the educational institution does not affect working teachers in the evaluation of working in a team. Giving freedom to teachers, the role of the CEO is dividing responsibilities and creating cooperation between teachers as well as ensuring teachers' interests, needs, emotional well-being and professional development.

Keywords: teamwork, school, teacher, school CEO, school environment, mixed research, Team-Puls test, semi-structured interview, questioning survey, qualitative content analysis, focused leadership, teacher leadership

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Authors: Hillary Mwongyera

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The Semliki basin has become a frontier for petroleum exploration in recent years. Exploration efforts have resulted into extensive seismic data acquisition and drilling of three wells namely; Turaco 1, Turaco 2 and Turaco 3. A petrophysical analysis of the Turaco 1 well was carried out to identify two reservoir zones on which AVO modeling was performed. A combination of seismic modeling and rock physics modeling was applied during reservoir characterization and monitoring to determine variations of seismic responses with amplitude characteristics. AVO intercept gradient analysis applied on AVO synthetic CDP gathers classified AVO anomalies associated with both reservoir zones as Class 1 AVO anomalies. Fluid replacement modeling was carried out on both reservoir zones using homogeneous mixing and patchy saturation patterns to determine effects of fluid substitution on rock property interactions. For both homogeneous mixing and saturation patterns, density (ρ) showed an increasing trend with increasing brine substitution while Shear wave velocity (Vs) decreased with increasing brine substitution. A study of compressional wave velocity (Vp) with increasing brine substitution for both homogeneous mixing and patchy saturation gave quite interesting results. During patchy saturation, Vp increased with increasing brine substitution. During homogeneous mixing however, Vp showed a slightly decreasing trend with increasing brine substitution but increased tremendously towards and at full brine saturation. A sensitivity analysis carried out showed that density was a very sensitive rock property responding to brine saturation except at full brine saturation during homogeneous mixing where Vp showed greater sensitivity with brine saturation. Rock physics modeling was performed to predict diagnostics of reservoir quality using an inverse deterministic approach which showed low shale content and a high degree of shale stiffness within reservoir zones.

Keywords: Amplitude Versus Offset (AVO), fluid replacement modelling, reservoir characterization, AVO attributes, rock physics modelling, reservoir monitoring

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Authors: M.J. Seddighi, Moradchelleh, M. Keyvan

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The ultimate goal in building a city is to provide pleasant, comfortable and nurturing environment as a context of public life. City environment establishes strong connection with people and their surrounding habitant, acting as relevance in social interactions between citizens itself. Urban environment and appropriate municipal facilities are the only way for proper communication between city and citizens and also citizens themselves.There is a need for complement elements between buildings and constructions to settling city life through which the move, comfort, reactions and anxiety will adjust and reflect the spirit to the city. In the surging development of society, urban’ spaces are encountered evolution, sometimes causing the symbols to fade and waste, and as a result, leading to destroy belongs among humans and their physical liquidate. Houses and living spaces exhibit materialistic reflection of life style. In the other words, way of life makes the symbolic essence of living spaces. In addition, it is of sociocultural factor of lifestyle, consisting the concepts and culture, morality, worldview, and national character. Culture is responsible for some crucial meaningful needs which can be wide because they depend on various causes such as perception and interpretation of believes, philosophy of life, interaction with neighbors and protection against climate and enemies. The bi-lateral relationship between human and nature is the main factor that needs to be properly addressed. It is because of the fact that the approach which is taken against landscape and nature has a pertinent influence on creation and shaping the structure of a house. The first response of human in tackling the environment is to build a “shelter” and place as dwelling. This has been a crucial factor in all time periods. In the proposed study, dwelling in Khorasgan’ Stream, as an area located in one of the important historical city of Iran, has been studied. Khorasgan’ Stream is the basic constituent elements of the present architectural form of Isfahan. The influence of Islamic spiritual culture and neighborhood with the historical elements on the dwelling of the selected location, subsequently on other regions of the town are presented.

Keywords: dwelling, neighborhood, historical, Islamic, architectural elements

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Authors: Daniel Gebreslassie Mekonnen

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Effective leadership has a crucial role in excelling in the overall success of a school. Today there is much attention given to school leadership, without which schools can never be successful. Therefore, the study was aimed at investigating the role of principals’ leadership styles and their emotional intelligence on the work motivation and job performance of teachers in Addis Ababa, Ethiopia. The study, thus, first examined the relationship between work motivation and job performance of the teachers in relation to the perceived leadership styles and emotional intelligence of principals. Second, it assessed the mean differences and the interaction effects of the principals’ leadership styles and emotional intelligence on the work motivation and job performance of the teachers. Finally, the study investigated whether principals’ leadership styles and emotional intelligence variables had significantly predicted the work motivation and job performance of teachers. As a means, a quantitative approach and descriptive research design were employed to conduct the study. Three hundred sixteen teachers were selected using multistage sampling techniques as participants of the study from the eight sub-cities in Addis Ababa. The main data-gathering instruments used in this study were the path-goal leadership questionnaire, emotional competence inventory, multidimensional work motivation scale, and job performance appraisal scale. The quantitative data were analyzed by using the statistical techniques of Pearson–product-moment correlation analysis, two-way analysis of variance, and stepwise multiple regression analysis. Major findings of the study have revealed that the work motivation and job performance of the teachers were significantly correlated with the perceived participative leadership style, achievement-oriented leadership style, and emotional intelligence of principals. Moreover, the emotional intelligence of the principals was found to be the best predictor of the teachers’ work motivation, whereas the achievement-oriented leadership style of the principals was identified as the best predictor of the job performance of the teachers. Furthermore, the interaction effects of all four path-goal leadership styles vis-a-vis the emotional intelligence of the principals have shown differential effects on the work motivation and job performance of teachers. Thus, it is reasonable to conclude that emotional intelligence is the sine qua non of effective school leadership. Hence, this study would be useful for policymakers and educational leaders to come up with policies that would enhance the role of emotional intelligence on school leadership effectiveness. Finally, pertinent recommendations were drawn from the findings and the conclusions of the study.

Keywords: emotional intelligence, leadership style, job performance, work motivation

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Authors: Nurvadi Albekov

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Communicative situation is a basis, which designates potential models of ‘constructed forms’, a motivated basis of a text, for a text can be assumed as a product of the communicative situation. It is within the field of emergence the models of text, that can be potentially prognosticated in a certain communicative situation, are designated. Every text can be assumed as conceptual system structured on the base of certain communicative situation. However in the process of ‘structuring’ of a certain model of ‘conceptual system’ consciousness of a recipient is able act only within the border of the field of emergence for going out of this border indicates misunderstanding of the communicative situation. On the base of communicative situation we can witness the increment of meaning where the synergizing of the informative model of communication, formed by using of the invariant units of a language system, is a result of verbalization of the communicative situation. The potential of the models of a text, prognosticated within the field of emergence, also depends on the communicative situation. The conception ‘the field of emergence’ is interpreted as a unit of the language system, having poly-directed universal structure, implying the presence of the core, the center and the periphery, including different levels of means of a functioning system of language, both in terms of linguistic resources, and in terms of extra linguistic factors interaction of which results increment of a text. The conception ‘field of emergence’ is considered as the most promising in the analysis of texts: oral, written, printed and electronic. As a unit of the language system field of emergence has several properties that predict its use during the study of a text in different levels. This work is an attempt analysis of entropy in a text in the aspect of lingua-cultural code, prognosticated within the model of the field of emergence. The article describes the problem of entropy in the field of emergence, caused by influence of the extra-linguistic factors. The increasing of entropy is caused not only by the fact of intrusion of the language resources but by influence of the alien culture in a whole, and by appearance of non-typical for this very culture symbols in the field of emergence. The borrowing of alien lingua-cultural symbols into the lingua-culture of the author is a reason of increasing the entropy when constructing a text both in meaning and in structuring level. It is nothing but artificial formatting of lexical units that violate stylistic unity of a phrase. It is marked that one of the important characteristics descending the entropy in the field of emergence is a typical similarity of lexical and semantic resources of the different lingua-cultures in aspects of extra linguistic factors.

Keywords: communicative situation, field of emergence, lingua-culture, entropy

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Authors: Y. O’Connor, C. Heavin, S. O’ Connor, J. Gallagher, J. Wu, J. O’Donoghue

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Background: To improve the delivery of paediatric healthcare in resource-poor settings, Community Health Workers (CHW) have been provided with a paper-based set of protocols known as Community Case Management (CCM). Yet research has shown that CHW adherence to CCM guidelines is poor, ultimately impacting health service delivery. Digitising the CCM guidelines via mobile technology is argued in extant literature to improve CHW adherence. However, little research exist which outlines how (a) this process can be digitised and (b) adherence could be improved as a result. Aim: To explore how an electronic mobile version of CCM (eCCM) can overcome issues associated with the paper-based CCM protocol (poor adherence to guidelines) vis-à-vis service blueprinting. This service blueprint will outline how (a) the CCM process can be digitised using mobile Clinical Decision Support Systems software to support clinical decision-making and (b) adherence can be improved as a result. Method: Development of a single service blueprint for a standalone application which visually depicts the service processes (eCCM) when supporting the CHWs, using an application known as Supporting LIFE (Low cost Intervention For disEase control) as an exemplar. Results: A service blueprint is developed which illustrates how the eCCM solution can be utilised by CHWs to assist with the delivery of healthcare services to children. Leveraging smartphone technologies can (a) provide CHWs with just-in-time data to assist with their decision making at the point-of-care and (b) improve CHW adherence to CCM guidelines. Conclusions: The development of the eCCM opens up opportunities for the CHWs to leverage the inherent benefit of mobile devices to assist them with health service delivery in rural settings. To ensure that benefits are achieved, it is imperative to comprehend the functionality and form of the eCCM service process. By creating such a service blueprint for an eCCM approach, CHWs are provided with a clear picture regarding the role of the eCCM solution, often resulting in buy-in from the end-users.

Keywords: adherence, community health workers, developing countries, mobile clinical decision support systems, CDSS, service blueprint

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Authors: Aya M. H. Eissa, Ayman H. A. Mahmoud

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When it comes to energy efficient thermal regulation system, natural systems do not only offer an inspirational source of innovative strategies but also sustainable and even regenerative ones. Using biomimetic design an energy efficient thermal regulation system can be developed. Although, conventional design process methods achieved fairly efficient systems, they still had limitations which can be overcome by using parametric design software. Accordingly, the main objective of this study is to apply and assess the efficiency of heat regulation strategies inspired from termite mounds in residential buildings’ thermal regulation system. Parametric design software is used to pave the way for further and more complex biomimetic design studies and implementations. A hot arid region is selected due to the deficiency of research in this climatic region. First, the analysis phase in which the stimuli, affecting, and the parameters, to be optimized, are set mimicking the natural system. Then, based on climatic data and using parametric design software Grasshopper, building form and openings height and areas are altered till settling on an optimized solution. Finally, an assessment of the efficiency of the optimized system, in comparison with a conventional system, is determined by firstly, indoors airflow and indoors temperature, by Ansys Fluent (CFD) simulation. Secondly by and total solar radiation falling on the building envelope, which was calculated using Ladybug, Grasshopper plugin. The results show an increase in the average indoor airflow speed from 0.5m/s to 1.5 m/s. Also, a slight decrease in temperature was noticed. And finally, the total radiation was decreased by 4%. In conclusion, despite the fact that applying a single bio-inspired heat regulation strategy might not be enough to achieve an optimum system, the concluded system is more energy efficient than the conventional ones as it aids achieving indoors comfort through passive techniques. Thus demonstrating the potential of parametric design software in biomimetic design.

Keywords: biomimicry, heat regulation systems, hot arid regions, parametric design, thermal comfort

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Authors: Hsin-Chieh Lee, Fen-Ling Kuo, Jui-Chi Lin

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Background: Upper extremity functional impairment that occurs after stroke includes hemiplegia, synergy movement, muscle hypertonicity, and somatosensory impairment, which result in inefficient and inaccurate movement. Robot-assisted rehabilitation is an intensive training approach that is effective in sensorimotor and hand function recovery. However, these systems mostly focused on the proximal part of the upper limb rather than the distal part. The device used in our study was Gloreha Sinfonia, which focuses on the distal part of the upper limb and uses a dynamic support system to facilitate the whole limb function. The objective of this study was to investigate the effects of robot-assisted therapy (RT) with Gloreha device on sensorimotor, and ADLs in patients with stroke. Method: Patients with stroke (N=25) participated AB or BA (A = 12 RT sessions and B = 12 conventional therapy (CT) sessions) for 6 weeks (60 min at each session, twice a week), with 1-month break for washout period. The performance of the patients was assessed by a blinded assessor at 4 time points (pretest 1, posttest 1, pretest 2, posttest 2) which including the Fugl–Meyer Assessment-upper extremity (FMA-UE), box and block test, electromyography of the extensor digitorum communis (EDC) and brachioradialis, a grip dynamometer for motor evaluation; Semmes–Weinstein hand monofilament and Revision of the Nottingham Sensory Assessment for sensory evaluation; and the Modified Barthel Index (MBI) for assessing the ADL ability. Result: RT group significantly improved FMA-UE proximal scores (p = 0.038), FMA-UE total scores (p = 0.046), and MBI (p = 0.030). The EDC exhibited higher efficiency during the small block grasping task in the RT group than in the CT group (p = 0.050). Conclusions: RT with the Gloreha device might lead to beneficial effects on arm motor function, ADL ability, and EDC muscle recruitment efficacy in patients with subacute to chronic stroke.

Keywords: activities of daily living, hand function, robotic rehabilitation, stroke

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Authors: Agbortoko Manyigbe Ayuk Nkem, Eno Cynthia Osuh

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This paper sets to examine the relationship between climate change and urban livelihood through a vulnerability assessment of the urban poor in Douala. Urban development in Douala places priority towards industrial and city-centre development with little focus on the urban poor in terms of housing units and areas of sustenance. With the high rate of urbanisation and increased land prices, the urban poor are forced to occupy marginal lands which are mainly wetlands, wastelands and along abandoned neighbourhoods prone to natural hazards. Due to climate change and its effects, these wetlands are constantly flooded thereby destroying homes, properties, and crops. Also, most of these urban dwellers have found solace in urban agriculture as a means for survival. However, since agriculture in tropical regions like Cameroon depends largely on seasonal rainfall, the changes in rainfall pattern has led to misplaced periods for crop planting and a huge wastage of resources as rainfall becomes very unreliable with increased temperature levels. Data for the study was obtained from both primary and secondary sources. Secondary sources included published materials related to climate change and vulnerability. Primary data was obtained through focus-group discussions with some urban farmers while a stratified sampling of residents within marginal lands was done. Each stratum was randomly sampled to obtain information on different stressors related to climate change and their effect on livelihood. Findings proved that the high rate of rural-urban migration into Douala has led to increased prevalence of the urban poor and their vulnerability to climate change as evident in their constant fight against flood from unexpected sea level rise and irregular rainfall pattern for urban agriculture. The study also proved that women were most vulnerable as they depended solely on urban agriculture and its related activities like retailing agricultural products in different urban markets which to them serves as a main source of income in the attainment of basic needs for the family. Adaptation measures include the constant use of sand bags, raised makeshifts as well as cultivation along streams, planting after evidence of constant rainfall has become paramount for sustainability.

Keywords: adaptation, Douala, Cameroon, climate change, development, livelihood, vulnerability

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Authors: John Masani Nduko, Joseph Wafula Matofari

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Many spontaneously fermented milk products are produced in Kenya, where they are integral to the human diet and play a central role in enhancing food security and income generation via small-scale enterprises. Fermentation enhances product properties such as taste, aroma, shelf-life, safety, texture, and nutritional value. Some of these products have demonstrated therapeutic and probiotic effects although recent reports have linked some to death, biotoxin infections, and esophageal cancer. These products are mostly processed from poor quality raw materials under unhygienic conditions resulting to inconsistent product quality and limited shelf-lives. Though very popular, research on their processing technologies is low, and none of the products has been produced under controlled conditions using starter cultures. To modernize the processing technologies for these products, our study aims at describing the microbiology and biochemistry of a representative Kenyan spontaneously fermented milk product, Mursik using modern biotechnology (DNA sequencing) and their chemical composition. Moreover, co-creation processes reflecting stakeholders’ experiences on traditional fermented milk production technologies and utilization, ideals and senses of value, which will allow the generation of products based on common ground for rapid progress will be discussed. Knowledge of the value of clean starting raw material will be emphasized, the need for the definition of fermentation parameters highlighted, and standard equipment employment to attain controlled fermentation discussed. This presentation will review the available information regarding traditional fermented milk (Mursik) and highlight our current research work on the application of molecular approaches (metagenomics) for the valorization of Mursik production process through starter culture/ probiotic strains isolation and identification, and quality and safety aspects of the product. The importance of the research and future research areas on the same subject will also be highlighted.

Keywords: lactic acid bacteria, high throughput biotechnology, spontaneous fermentation, Mursik

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Authors: Fang Liu, JiaJia Yao, GuanLin Wu, ZuMaoLi, XueYan Yang, HePeng Zhang, ZhiPeng Sun, JunShuai Xue

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The explosive increasing needs of data processing and information storage strongly drive the advancement of the binary logic system to multiple-valued logic system. Inherent negative differential resistance characteristic, ultra-high-speed switching time, and robust anti-irradiation capability make III-nitride resonant tunneling diode one of the most promising candidates for multi-valued logic devices. Here we report the monolithic integration of GaN resonant tunneling diodes in series to realize multiple negative differential resistance regions, obtaining at least three stable operating states. A multiply-by-three circuit is achieved by this combination, increasing the frequency of the input triangular wave from f0 to 3f0. The resonant tunneling diodes are grown by plasma-assistedmolecular beam epitaxy on free-standing c-plane GaN substrates, comprising double barriers and a single quantum well both at the atomic level. Device with a peak current density of 183kA/cm² in conjunction with a peak-to-valley current ratio (PVCR) of 2.07 is observed, which is the best result reported in nitride-based resonant tunneling diodes. Microwave oscillation event at room temperature was discovered with a fundamental frequency of 0.31GHz and an output power of 5.37μW, verifying the high repeatability and robustness of our device. The switching behavior measurement was successfully carried out, featuring rise and fall times in the order of picoseconds, which can be used in high-speed digital circuits. Limited by the measuring equipment and the layer structure, the switching time can be further improved. In general, this article presents a novel nitride device with multiple negative differential regions driven by the resonant tunneling mechanism, which can be used in high-speed multiple value logic field with reduced circuit complexity, demonstrating a new solution of nitride devices to break through the limitations of binary logic.

Keywords: GaN resonant tunneling diode, negative differential resistance, multiple-valued logic system, switching time, peak-to-valley current ratio

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Authors: Bela Siska Afrida, Wisnu Barlianto, Desy Wulandari, Ery Olivianto

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Background: Allergic asthma, caused by IgE-mediated allergic reactions, remains a global health issue with high morbidity and mortality rates. Immunotherapy is the only etiology-based approach to treating asthma, but no standard biomarkers have been established to evaluate the therapy’s effectiveness. This study aims to determine the correlation between the ratios of serum levels of HDM-specific IgE/total IgE and Asthma Control Test (ACT) score as a biomarker of the response to immunotherapy in pediatric allergic asthma patients. Patient and Methods: This retrospective cohort study involved 26 pediatric allergic asthma patients who underwent HDM-specific subcutaneous immunotherapy for 14 weeks at the Pediatric Allergy Immunology Outpatient Clinic at Saiful Anwar General Hospital, Malang. Serum levels of HDM-Specific IgE and Total IgE were measured before and after immunotherapy using Chemiluminescence Immunoassay and Enzyme-linked Immunosorbent Assay (ELISA) method. Changes in asthma control were assessed using the ACT score. The Wilcoxon Signed Ranked Test and Spearman correlation test were used for data analysis. Results: There were 14 boys and 12 girls with a mean age of 6.48 ± 2.54 years. The study showed a significant decrease in serum HMD-specific levels before immunotherapy [9.88 ± 5.74 kuA/L] compared to those of 14 weeks after immunotherapy [4.51 ± 3.98 kuA/L], p = 0.000. Serum Total IgE levels significant decrease before immunotherapy [207.6 ± 120.8IU/ml] compared to those of 14 weeks after immunotherapy [109.83 ± 189.39 IU/mL], p = 0.000. The ratios of serum HDM-specific IgE/total IgE levels significant decrease before immunotherapy [0.063 ± 0.05] compared to those of 14 weeks after immunotherapy [0.041 ± 0.039], p = 0.012. There was also a significant increase in ACT scores before and after immunotherapy (each 15.5 ± 1.79 and 20.96 ± 2.049, p = 0.000). The correlation test showed a weak negative correlation between the ratios of HDM-specific IgE/total IgE levels and ACT score (p = 0.034 and r = -0.29). Conclusion: In conclusion, this study showed that a decrease in HDM-specific IgE levels, total IgE levels, and HDM-specific IgE/total IgE ratios, and an increase in ACT score, was observed after 14 weeks of HDM-specific subcutaneous immunotherapy. The weak negative correlation between the HDM-specific IgE/total IgE ratio and the ACT score suggests that this ratio can serve as a potential biomarker of the effectiveness of immunotherapy in treating pediatric allergic asthma patients.

Keywords: HDM-specific IgE/total IgE ratio, ACT score, immunotherapy, allergic asthma

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Authors: Muhammad Dawood Idrees, Maria Hafeez, Arsalan Ansari

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Toll tax collection is the earliest method of tax collection and revenue generation. This revenue is utilized for the development of roads networks, maintenance, and connecting to roads and highways across the country. Pakistan is one of the biggest countries, covers a wide area of land, roads networks, and motorways are important source of connecting cities. Every day millions of people use motorways, and they have to stop at toll plazas to pay toll tax as majority of toll plazas are manually collecting toll tax. The purpose of this study is to calculate the waiting time of vehicles at Karachi Hyderabad (M-9) motorway. As Karachi is the biggest city of Pakistan and hundreds of thousands of people use this route to approach other cities. Currently, toll tax collection is manual system which is a major cause for long time waiting at toll plaza. This study calculates the waiting time of vehicles, fuel consumed in waiting time, manpower employed at toll plaza as all process is manual, and it also leads to mental and physical fatigue of driver. All wastages of sources are also calculated, and a most feasible automatic toll tax collection system is proposed which is not only beneficial to reduce waiting time but also beneficial in reduction of fuel, reduction of manpower employed, and reduction in physical and mental fatigue. A cost comparison in terms of wastages is also shown between manual and automatic toll tax collection system (E-Z Pass). Results of this study reveal that, if automatic tool collection system is implemented at Karachi to Hyderabad motorway (M-9), there will be a significance reduction in waiting time of vehicles, which leads to reduction of fuel consumption, environmental pollution, mental and physical fatigue of driver. All these reductions are also calculated in terms of money (Pakistani rupees) and it is obtained that millions of rupees can be saved by using automatic tool collection system which will lead to improve the economy of country.

Keywords: toll tax collection, waiting time, wastages, driver fatigue

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Authors: Vu Hoang Thu Huong

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Background and Purpose: The effects of Extracorporeal Shockwave Therapy (ESWT) in the participants with knee osteoarthritis (KOA) were unclear on physical performance although its effects on pain had been investiagted. This study aims to explore the effects of ESWT on pain relief and physical performance on KOA. Methods: The studies with the randomized controlled design to investigate the effects of ESWT on KOA were systematically searched using inclusion and exclusion criteria through seven electronic databases including Pubmed etc. between 1990 and Dec 2022. To summarize those data, visual analog scale (VAS) or pain scores were determined for measure of pain intensity. Range of knee motion, or the scores of physical activities including Lequesne index (LI), Knee Injury and Osteoarthritis Outcome Score (KOOS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were determined for measure of physical performances. The first evaluate after treatment period was define as the effect of post-treatment period or immediately effect; and the last evaluate was defined as the effect of following period or the end effect in our study. Data analysis was performed using RevMan 5.4.1 software. A significant level was set at p<0.05. Results: Eight studies (number of participant= 499) reporting the ESWT effects on mild-to-moderate severity (Grades I to III Kellgren–Lawrence) of KOA were qualified for meta-analysis. Compared with sham or placebo group, the ESWT group had a significant decrease of VAS rest score (0.90[0.12~1.67] as mean difference [95% confidence interval]) and pain score WOMAC (2.49[1.22~3.76]), and a significant improvement of physical performance with a decrease of the scores of WOMAC activities (8.18[3.97~12.39]), LI (3.47[1.68~5.26]), and KOOS (5.87[1.73~ 10.00]) in the post-treatment period. There were also a significant decrease of WOMAC pain score (2.83[2.12~3.53]) and a significant decrease of the scores of WOMAC activities (9.47[7.65~11.28]) and LI (4.12[2.34 to 5.89]) in the following period. Besides, compared with other treatment groups, ESWT also displayed the improvement in pain and physical performance, but it is not significant. Conclusions: The ESWT was effective and valuable method in pain relief as well as in improving physical activities in the participants with mild-to-moderate KOA. Clinical Relevance: There are the effects of ESWT on pain relief and the improvement of physical performance in the with KOA.

Keywords: knee osteoarthritis, extracorporeal shockwave therapy, pain relief, physical performance, shockwave

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Authors: Kai-Chieh Lin, Chih-Fu Wu, Hsiang Ling Hsu, Yung-Hsiang Tu, Chia-Chen Wu

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With the rapid development of computer technology, the design of computers and keyboards moves towards a trend of slimness. The change of mobile input devices directly influences users’ behavior. Although multi-touch applications allow entering texts through a virtual keyboard, the performance, feedback, and comfortableness of the technology is inferior to traditional keyboard, and while manufacturers launch mobile touch keyboards and projection keyboards, the performance has not been satisfying. Therefore, this study discussed the design factors of slim pressure-sensitive keyboards. The factors were evaluated with an objective (accuracy and speed) and a subjective evaluation (operability, recognition, feedback, and difficulty) depending on the shape (circle, rectangle, and L-shaped), thickness (flat, 3mm, and 6mm), and force (35±10g, 60±10g, and 85±10g) of the keyboard. Moreover, MANOVA and Taguchi methods (regarding signal-to-noise ratios) were conducted to find the optimal level of each design factor. The research participants, by their typing speed (30 words/ minute), were divided in two groups. Considering the multitude of variables and levels, the experiments were implemented using the fractional factorial design. A representative model of the research samples were established for input task testing. The findings of this study showed that participants with low typing speed primarily relied on vision to recognize the keys, and those with high typing speed relied on tactile feedback that was affected by the thickness and force of the keys. In the objective and subjective evaluation, a combination of keyboard design factors that might result in higher performance and satisfaction was identified (L-shaped, 3mm, and 60±10g) as the optimal combination. The learning curve was analyzed to make a comparison with a traditional standard keyboard to investigate the influence of user experience on keyboard operation. The research results indicated the optimal combination provided input performance to inferior to a standard keyboard. The results could serve as a reference for the development of related products in industry and for applying comprehensively to touch devices and input interfaces which are interacted with people.

Keywords: input performance, mobile device, slim keyboard, tactile feedback

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Authors: Dong Seop Lee, Byung Sik Kim

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In the 4th Industrial Revolution, various intelligent technologies have been developed in many fields. These artificial intelligence technologies are applied in various services, including disaster management. Disaster information management does not just support disaster work, but it is also the foundation of smart disaster management. Furthermore, it gets historical disaster information using artificial intelligence technology. Disaster information is one of important elements of entire disaster cycle. Disaster information management refers to the act of managing and processing electronic data about disaster cycle from its’ occurrence to progress, response, and plan. However, information about status control, response, recovery from natural and social disaster events, etc. is mainly managed in the structured and unstructured form of reports. Those exist as handouts or hard-copies of reports. Such unstructured form of data is often lost or destroyed due to inefficient management. It is necessary to manage unstructured data for disaster information. In this paper, the Optical Character Recognition approach is used to convert handout, hard-copies, images or reports, which is printed or generated by scanners, etc. into electronic documents. Following that, the converted disaster data is organized into the disaster code system as disaster information. Those data are stored in the disaster database system. Gathering and creating disaster information based on Optical Character Recognition for unstructured data is important element as realm of the smart disaster management. In this paper, Korean characters were improved to over 90% character recognition rate by using upgraded OCR. In the case of character recognition, the recognition rate depends on the fonts, size, and special symbols of character. We improved it through the machine learning algorithm. These converted structured data is managed in a standardized disaster information form connected with the disaster code system. The disaster code system is covered that the structured information is stored and retrieve on entire disaster cycle such as historical disaster progress, damages, response, and recovery. The expected effect of this research will be able to apply it to smart disaster management and decision making by combining artificial intelligence technologies and historical big data.

Keywords: disaster information management, unstructured data, optical character recognition, machine learning

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Authors: Alena Kulikova, Tatjana Kanonire

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Intelligence research is one of the oldest fields of psychology. Many factors have made a research on intelligence, defined as reasoning and problem solving [1, 2], a very acute and urgent problem. Thus, it has been repeatedly shown that intelligence is a predictor of academic, professional, and social achievement in adulthood (for example, [3]); Moreover, intelligence predicts these achievements better than any other trait or ability [4]. The individual level, a comprehensive assessment of intelligence is a necessary criterion for the diagnosis of various mental conditions. For example, it is a necessary condition for psychological, medical and pedagogical commissions when deciding on educational needs and the most appropriate educational programs for school children. Assessment of intelligence is crucial in clinical psychodiagnostic and needs high-quality intelligence measurement tools. Therefore, it is not surprising that the development of intelligence tests is an essential part of psychological science and practice. Many modern intelligence tests have a long history and have been used for decades, for example, the Stanford-Binet test or the Wechsler test. However, the vast majority of these tests are based on the classic linear test structure, in which all respondents receive all tasks (see, for example, a critical review by [5]). This understanding of the testing procedure is a legacy of the pre-computer era, in which blank testing was the only diagnostic procedure available [6] and has some significant limitations that affect the reliability of the data obtained [7] and increased time costs. Another problem with measuring IQ is that classical line-structured tests do not fully allow to measure respondent's intellectual progress [8], which is undoubtedly a critical limitation. Advances in modern psychometrics allow for avoiding the limitations of existing tools. However, as in any rapidly developing industry, at the moment, psychometrics does not offer ready-made and straightforward solutions and requires additional research. In our presentation we would like to discuss the strengths and weaknesses of the current approaches to intelligence measurement and highlight “points of growth” for creating a test in accordance with modern psychometrics. Whether it is possible to create the instrument that will use all achievements of modern psychometric and remain valid and practically oriented. What would be the possible limitations for such an instrument? The theoretical framework and study design to create and validate the original Russian comprehensive computer test for measuring the intellectual development in school-age children will be presented.

Keywords: Intelligence, psychometrics, psychological measurement, computerized adaptive testing, multistage testing

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Authors: Divya Kanchibhotla, Shashank Kulkarni, Shweta Singh

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Chronic stress and sleep quality reduces mental health and increases the risk of developing depression and anxiety as well. There is increasing evidence for the utility of meditation as an adjunct clinical intervention for conditions like depression and anxiety. The present study is an attempt to explore the impact of Sahaj Samadhi Meditation (SSM), a category of Automatic Self Transcending Meditation (ASTM), on perceived stress and sleep quality in adults. The study design was a single group pre-post assessment. Perceived Stress Scale (PSS) and the Pittsburgh Sleep Quality Index (PSQI) were used in this study. Fifty-two participants filled PSS, and 60 participants filled PSQI at the beginning of the program (day 0), after two weeks (day 16) and at two months (day 60). Significant pre-post differences for the perceived stress level on Day 0 - Day 16 (p < 0.01; Cohen's d = 0.46) and Day 0 - Day 60 (p < 0.01; Cohen's d = 0.76) clearly demonstrated that by practicing SSM, participants experienced reduction in the perceived stress. The effect size of the intervention observed on the 16th day of assessment was small to medium, but on the 60th day, a medium to large effect size of the intervention was observed. In addition to this, significant pre-post differences for the sleep quality on Day 0 - Day 16 and Day 0 - Day 60 (p < 0.05) clearly demonstrated that by practicing SSM, participants experienced improvement in the sleep quality. Compared with Day 0 assessment, participants demonstrated significant improvement in the quality of sleep on Day 16 and Day 60. The effect size of the intervention observed on the 16th day of assessment was small, but on the 60th day, a small to medium effect size of the intervention was observed. In the current study we found out that after practicing SSM for two months, participants reported a reduction in the perceived stress, they felt that they are more confident about their ability to handle personal problems, were able to cope with all the things that they had to do, felt that they were on top of the things, and felt less angered. Participants also reported that their overall sleep quality improved; they took less time to fall asleep; they had less disturbances in sleep and less daytime dysfunction due to sleep deprivation. The present study provides clear evidence of the efficacy and safety of non-pharmacological interventions such as SSM in reducing stress and improving sleep quality. Thus, ASTM may be considered a useful intervention to reduce psychological distress in healthy, non-clinical populations, and it can be an alternative remedy for treating poor sleep among individuals and decreasing the use of harmful sedatives.

Keywords: automatic self transcending meditation, Sahaj Samadhi meditation, sleep, stress

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Authors: Anteneh Wodaje Bayeh, Daniel Manaye Kabtamu, Chen-Hao Wang

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As one of the most promising electrochemical energy storage systems, vanadium redox flow batteries (VRFBs) have received increasing attention owing to their attractive features for largescale storage applications. However, their high production cost and relatively low energy efficiency still limit their feasibility. For practical implementation, it is of great interest to improve their efficiency and reduce their cost. One of the key components of VRFBs that can greatly influence the efficiency and final cost is the electrode, which provide the reactions sites for redox couples (VO²⁺/VO₂ + and V²⁺/V³⁺). Carbon-based materials are considered to be the most feasible electrode materials in the VRFB because of their excellent potential in terms of operation range, good permeability, large surface area, and reasonable cost. However, owing to limited electrochemical activity and reversibility and poor wettability due to its hydrophobic properties, the performance of the cell employing carbon-based electrodes remained limited. To address the challenges, we synthesized heteroatom-doped bimetallic oxide grown on the surface of carbon through the one-step approach. When applied to VRFBs, the prepared electrode exhibits significant electrocatalytic effect toward the VO²⁺/VO₂ + and V³⁺/V²⁺ redox reaction compared with that of pristine carbon. It is found that the presence of heteroatom on metal oxide promotes the absorption of vanadium ions. The controlled morphology of bimetallic metal oxide also exposes more active sites for the redox reaction of vanadium ions. Hence, the prepared electrode displays the best electrochemical performance with energy and voltage efficiencies of 74.8% and 78.9%, respectively, which is much higher than those of 59.8% and 63.2% obtained from the pristine carbon at high current density. Moreover, the electrode exhibit durability and stability in an acidic electrolyte during long-term operation for 1000 cycles at the higher current density.

Keywords: VRFB, VO²⁺/VO₂ + and V³⁺/V²⁺ redox couples, graphite felt, heteroatom-doping

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Authors: Atnafu Ashenef Wondim

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In today’s highly competitive business environment, employees are considered a source of competitive advantage. Researchers have looked into job autonomy's effect on organizational commitment and declared superior organizational performance strongly depends on the effort and commitment of employees. The purpose of this study was to explore the relationship between job autonomy and organizational commitment from newcomer’s point of view. The mediation role of employee engagement (physical, emotional, and cognitive) was also examined in the case of Ethiopian Commercial Banks. An exploratory survey research design with mixed-method approach that included partial least squares structural equation modeling and Fuzzy-Set Qualitative Comparative Analysis technique were using to address the sample size of 348 new employees. In-depth interviews with purposive and convenientsampling techniques are conducted with new employees (n=43). The results confirmed that job autonomy had positive, significant direct effects on physical engagement, emotional engagement, and cognitive engagement (path coeffs. = 0.874, 0.931, and 0.893).The results showed thatthe employee engagement driver, physical engagement, had a positive significant influence on affective commitment (path coeff. = 0.187) and normative commitment (path coeff. = 0.512) but no significant effect on continuance commitment. Employee engagement partially mediates the relationship between job autonomy and organizational commitment, which means supporting the indirect effects of job autonomy on affective, continuance, and normative commitment through physical engagement. The findings of this study add new perspectives by positioning it within a complex organizational African setting and by expanding the job autonomy and organizational commitment literature, which will benefit future research. Much of the literature on job autonomy and organizational commitment has been conducted within a well-established organizational business context in Western developed countries.The findings lead to fresh information on job autonomy and organizational commitment implementation enablers that can assist in the formulation of a better policy/strategy to efficiently adopt job autonomy and organizational commitment.

Keywords: employee engagement, job autonomy, organizational commitment, social exchange theory

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Authors: Dayane de Almeida

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This work aims at presenting a study that demonstrates the usability of categories of analysis from Discourse Semiotics – also known as Greimassian Semiotics in authorship cases in forensic contexts. It is necessary to know if the categories examined in semiotic analysis (the ‘grammar’ of the content plane) can distinguish authors. Thus, a study with 4 sets of texts from a corpus of ‘not on demand’ written samples (those texts differ in formality degree, purpose, addressees, themes, etc.) was performed. Each author contributed with 20 texts, separated into 2 groups of 10 (Author1A, Author1B, and so on). The hypothesis was that texts from a single author were semiotically more similar to each other than texts from different authors. The assumptions and issues that led to this idea are as follows: -The features analyzed in authorship studies mostly relate to the expression plane: they are manifested on the ‘surface’ of texts. If language is both expression and content, content would also have to be considered for more accurate results. Style is present in both planes. -Semiotics postulates the content plane is structured in a ‘grammar’ that underlies expression, and that presents different levels of abstraction. This ‘grammar’ would be a style marker. -Sociolinguistics demonstrates intra-speaker variation: an individual employs different linguistic uses in different situations. Then, how to determine if someone is the author of several texts, distinct in nature (as it is the case in most forensic sets), when it is known intra-speaker variation is dependent on so many factors?-The idea is that the more abstract the level in the content plane, the lower the intra-speaker variation, because there will be a greater chance for the author to choose the same thing. If two authors recurrently chose the same options, differently from one another, it means each one’s option has discriminatory power. -Size is another issue for various attribution methods. Since most texts in real forensic settings are short, methods relying only on the expression plane tend to fail. The analysis of the content plane as proposed by greimassian semiotics would be less size-dependable. -The semiotic analysis was performed using the software Corpus Tool, generating tags to allow the counting of data. Then, similarities and differences were quantitatively measured, through the application of the Jaccard coefficient (a statistical measure that compares the similarities and differences between samples). The results showed the hypothesis was confirmed and, hence, the grammatical categories of the content plane may successfully be used in questioned authorship scenarios.

Keywords: authorship attribution, content plane, forensic linguistics, greimassian semiotics, intraspeaker variation, style

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Authors: M. Yaqoob, C. S. O’Neill, S. Faraj, C. L. O’Neill

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This paper presents the preliminary findings from a study exploring nurse’s contributions to end of life decisions and to the care of dying patients in ICU units in the Kingdom of Bahrain. The process of dying is complex as medical clinicians are frequently unable to say with certainty when death will occur. It is generally accepted that end of life care begins when it is possible to know that death is imminent. Nurses do not make medical treatment decisions when caring for a dying patient. There are, however, many other types of decisions made when a patient is approaching the end of life and nurses are either formally or informally part of these decision making processes. This study explored nurses care practices at the end of life, in two ICU units in large hospitals in the Kingdom of Bahrain. The research design was a grounded theory approach. Ten nurses participated, six of whom were Bahraini nationals and four were Indian. A core category death avoidance talk was supported by three major subcategories, degrees of involvement in decision making; signalling and creating an awareness of death; care shifting from dying patients to family. Despite nurses asserting that they carried out the orders of doctors and had no role in decision making processes at end of life this study showed that there were degrees of nurse involvement. Doctors frequently discussed the patient’s clinical condition with nurses and also sought information regarding the family. Information about the family was of particular relevance if the doctor was considering a DNR order, which the nurses equated with dying. Families were not always informed when a DNR decision was made. When families were not informed the nurses engaged in sophisticated rituals signalling and creating awareness to family members that the death of their loved one was near. This process also involved a subtle shifting of care from the dying patient to the family. This seminar paper will focus particularly on how nurses signal and create an awareness of death in an ICU setting. The findings suggest that despite the avoidance of death talk in the ICU nurses indirectly convey and create an awareness that death is near to family members.

Keywords: decision making, dying patients, end of life, intensive care unit

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Authors: A. H. Nanher, N. P. Singh, Shashidhar Yadav, Sachin Tyagi

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Agricultural production system is an outcome of a complex interaction of seed, soil, water and agro-chemicals (including fertilizers). Therefore, judicious management of all the inputs is essential for the sustainability of such a complex system. Precision agriculture gives farmers the ability to use crop inputs more effectively including fertilizers, pesticides, tillage and irrigation water. More effective use of inputs means greater crop yield and/or quality, without polluting the environment the focus on enhancing the productivity during the Green Revolution coupled with total disregard of proper management of inputs and without considering the ecological impacts, has resulted into environmental degradation. To evaluate a new approach for site-specific nutrient management (SSNM). Large variation in initial soil fertility characteristics and indigenous supply of N, P, and K was observed among Field- and season-specific NPK applications were calculated by accounting for the indigenous nutrient supply, yield targets, and nutrient demand as a function of the interactions between N, P, and K. Nitrogen applications were fine-tuned based on season-specific rules and field-specific monitoring of crop N status. The performance of SSNM did not differ significantly between high-yielding and low-yielding climatic seasons, but improved over time with larger benefits observed in the second year Future, strategies for nutrient management in intensive rice systems must become more site-specific and dynamic to manage spatially and temporally variable resources based on a quantitative understanding of the congruence between nutrient supply and crop demand. The SSNM concept has demonstrated promising agronomic and economic potential. It can be used for managing plant nutrients at any scale, i.e., ranging from a general recommendation for homogenous management of a larger domain to true management of between-field variability. Assessment of pest profiles in FFP and SSNM plots suggests that SSNM may also reduce pest incidence, particularly diseases that are often associated with excessive N use or unbalanced plant nutrition.

Keywords: nutrient, pesticide, crop, yield

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Authors: Muhammad Shafi'u Adamu

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This study examined the effects of two Group Cognitive Behavioural Therapies (Cognitive Restructuring and Rational Emotive Behavioural Therapy) on Psychological Distress of awaiting-trial Inmates in Correctional Centres in North-West, Nigeria. The study had four specific objectives, four research questions, and four null hypotheses. The study used a quasi-experimental design that involved pre-test and post-test. The population comprised of all 7,962 awaiting-trial inmates in correctional centres in North-west, Nigeria. 131 awaiting trial inmates from three intact Correctional Centres were randomly selected using the census technique. The respondents were sampled and randomly put into 3 groups (CR, REBT and Control). Kessler Psychological Distress Scale (K10) was adapted for data collection in the study. The instrument was validated by experts and subjected to pilot study using Cronbach's Alpha with reliability co-efficient of 0.772. Each group received treatment for 8 consecutive weeks (60 minutes/week). Data collected from the field were subjected to descriptive statistics of mean, standard deviation and mean difference to answer the research questions. Inferential statistics of ANOVA and independent sample t-test were used to test the null hypotheses at P≤ 0.05 level of significance. Results in the study revealed that there was no significant difference among the pre-treatment mean scores of experimental and control groups. Statistical evidence also showed a significant difference among the mean sores of the three groups, and thus, results of the Post Hoc multiple-comparison test indicating the posttreatment reduction of psychological distress on the awaiting-trial inmates. Documented output also showed a significant difference between the post-treatment psychologically distressed mean scores of male and female awaiting-trial inmates, but there was no difference on those exposed to REBT. The research recommends that a standardized structured CBT counselling technique treatment should be designed for correctional centres across Nigeria, and CBT counselling techniques could be used in the treatment of PD in both correctional and clinical settings.

Keywords: awaiting-trial inmates, cognitive restructuring, correctional centres, group cognitive behavioural therapies, rational emotive behavioural therapy

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Authors: Jameson Mirimu, Edward Mawejje, Ibra Twinomujuni

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Introduction: Adolescent girls and young women (AGYW) are a vulnerable category whose risk of acquiring HIV is 20 times compared to the general population accounting for 25% of the new infections. Despite proven scientific evidence of preventing HIV acquisition, Oral Pre-Exposure Prophylaxis (PreP) is less used as one of the biomedical interventions among the AGYW. By 2020, only 31000-32000 of the targeted 90,000 persons in Uganda enrolled on Oral PreP LPHS-EC project employed a combination of Expanded Peer Outreach Approach (EPOA) and Effective client follow-up to increase PreP initiation (PrEP_NEW) and continuation for more than three months (PrEP_CT). Method: Quantitatively, data from National Key population Combination tracker retrospectively analyzed by M&E, focused group discussion with AGYWs and Health care workers to identify barriers. Barriers found; hesitancy of AGYW, misconceptions about Oral PrEP, inadequate knowledge and skills in handling adolescent and Data quality issues. To address the mentioned barriers, youth friendly corners initiated in study sites, identified PrEP Champions among the AGYW, oral PrEP dialogues, group Antenatal counselling, CQI Projects initiated, weekly perfomance meetings to track performance. Results: Routine program data review PrEP_NEW and PrEP_CT increased from 5% (4/80) and 4% (2/54), respectively, in July 2022 to 90% (72/80) and 79% (43/54) respectively for PrEP_NEW and PrEP_CT at the end of March 2023. Lessons Learnt: Demystifying misconception about oral Prep through provision of adequate information by involving health care workers through skills enhancement, CQI projects are critical intervention. Conclusion: With improved safe spaces, skills enhancement of health workers, stakeholders’ engagement through Oral Prep dialogues is critical in improving PreP uptake and continuity among the AGYWS.

Keywords: prep, uptake, continuation, AGYW

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Authors: Darawan Augsornwan, Artitaya Sabangbal, Maneewan Srijan, Kanokarn Kongpitee, Lalida Petphai, Palakorn Surakunprapha

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Background: Srinagarind Hospital, Ward 3C, has patients with head and neck cancer, congenital urology anomalies such as hypospadis, cleft lip and cleft palate and congenital megacolon who need surgery. Undergoing surgery is a difficult time for patients/ family; they feel fear and anxiety. Nurses work closely with patients and family for 24 hours in the process of patients care, so should have the good nursing ability, innovation and an efficient nursing care system to promote patients self-care ability reducing suffering and preventing complications. From previous nursing outcomes we found patients did not receive appropriate information, could not take care of their wound, not early ambulation after the operation and lost follow-up. Objective: to develop the nursing system for patients who were undergoing an operation. Method: this is a participation action research. The sample population was 11 nurses and 60 patients. This study was divided into 3 phase: Phase 1. Situation review In this phase we review the clinical outcomes, the process of care from documents such as nurses note and interview nurses, patients and family about the process of care by nurses. Phase 2: focus group with 11 nurses, searching guideline for specific care, nursing care system then establish the protocol. This phase we have the protocol for giving information, teaching protocol and teaching record, leaflet for all of top five diseases, make video media to convey information, ambulation package and protocol for patients with head and neck cancer, patients zoning, primary nurse, improved job description for each staff level. Program to record number of patients, kind of medical procedures for showing nurses activity each day. Phase 3 implementation and evaluation. Result: patients/family receive appropriate information about deep breathing exercise, cough, early ambulation after the operation, information during the stay in the hospital. Patients family satisfaction is 95.04 percent, appropriate job description for a practical nurse, nurse aid, and worker. Nurses satisfaction is 95 percent. The complications can be prevented. Conclusion: the nursing system is the dynamic process using evidence to develop nursing care. The appropriate system depends on context and needs to keep an eye on every event.

Keywords: development, nursing system, patients undergoing operation, 3C Ward

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Authors: Anum Obaid, Iman Fatima, Wanisha Feroz, Haleema Imran, Hammad Tariq

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In Pakistan, the health of unmarried women over thirty is an emerging public health concern due to its increasing prevalence. Achieving the Sustainable Development Goals (SDGs) requires addressing nutrition and public health issues. This research investigates these goals through the lens of nutrition and public health, specifically examining the challenges faced by unmarried women over thirty in Faisalabad, Pakistan. According to a recent United Nations report, there are 10 million unmarried women over the age of 35 in Pakistan. The United Nations defines health as "a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity." Being unmarried and under constant societal pressure profoundly influences the dietary behaviors and nutritional status of these women, affecting their overall health, including physical, mental, and social well-being. A qualitative research approach was employed, involving interviews with both unmarried and married women over thirty. This research examines how marital status influences dietary practices, nutritional status, mental and social health, and their subsequent impacts. Factors such as physical health, mental and emotional status, societal pressure, social health, economic independence, and decision-making power were analyzed to understand the effect of singleness on overall wellness. Findings indicated that marital status significantly affects the dietary patterns and nutritional practices among women in Faisalabad. It was also revealed that unmarried women experienced more stress and had a less optimistic mindset compared to married women, due to loneliness or the absence of a spouse in their lives. Nutritional knowledge varied across marital status, impacting the overall health triangle, including physical, mental, and social health. Understanding these dynamics is crucial for developing targeted interventions to improve nutritional outcomes and overall health among unmarried women in Faisalabad. This study highlights the importance of fostering supportive environments and raising awareness about the health needs of unmarried women over thirty to enhance their overall well-being.

Keywords: health triangle, unmarried woman over thirty, socio-cultural barriers, women’s health

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Authors: Michel Soto Chalhoub

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Building designers in the Mediterranean region and other parts of the world utilize natural stone panels on the exterior façades as skin cover. This type of finishing is not only intended for aesthetic reasons but also environmental. The stone, since the earliest ages of civilization, has been used in construction and to-date some of the most appealing buildings owe their beauty to stone finishing. The stone also provides warmth in winter and freshness in summer as it moderates heat transfer and absorbs radiation. However, as structural codes became increasingly stringent about the dynamic performance of buildings, it became essential to study the performance of stone panels under cyclic loading – a condition that arises under the building is subjected to wind or earthquakes. The present paper studies the performance of stone panels using mechanical connectors when subjected to load reversal. In this paper, we present a theoretical model that addresses modes of failure in the steel connectors, by yield, and modes of failure in the stone, by fracture. Then we provide an experimental set-up and test results for rectangular stone panels of varying thickness. When the building is subjected to an earthquake, its rectangular panels within the structural system are subjected to shear deformations, which in turn impart stress into the stone cover. Rectangular stone panels, which typically range from 40cmx80cm to 60cmx120cm, need to be designed to withstand transverse loading from the direct application of lateral loads, and to withstand simultaneously in-plane loading (membrane stress) caused by inter-story drift and overall building lateral deflection. Results show correlation between the theoretical model which we derive from solid mechanics fundamentals and the experimental results, and lead to practical design recommendations. We find that for panel thickness below a certain threshold, it is more advantageous to utilize structural adhesive materials to connect stone panels to the main structural system of the building. For larger panel thicknesses, it is recommended to utilize mechanical connectors with special detailing to ensure a minimum level of ductility and energy dissipation.

Keywords: solid mechanics, cyclic loading, mechanical connectors, natural stone, seismic, wind, building skin

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