Search results for: organisational outcomes

Authors: Nirmala Lama

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The construction of high dams has led to significant challenges in managing flow rates discharging over spillways, resulting in cavitation damages on hydraulic surfaces. To address this, aerator devices were designed and installed to promote fore aeration, thereby controlling and mitigating damages caused by cavitation. Consequently, these aerator types, three-dimensional aerators (3DAEs), have demonstrated superior efficiency in introducing forced air into the flow.This research focuses on the installation and evaluation of three-dimensional aerator devices at the high discharge spillway surface. In the laboratory, the air concentration downstream of the hydraulic structures was extensively measured, and the data were analyzed in details.Multiple flow scenarios and structural arrangements of the aerators were adopted for the study. The outcomes of these experiments are listed as In terms of air concentration value, the comparison between 3 DAE (three-dimensional aerator) with offset only and offset with ramp reveals significant differences. The concentration value on the side wall was justified. The side cavity length was found to increase with higher approach Froude numbers and lateral enlargement widths. Furthermore, 3DAE exhibited shorter side cavity lengths compared to three-dimensional aerator devices without ramps (3DAD), a beneficial features for controlling water fins. An empirical formula to express the side cavity length was derived from the measured data. Also, the comparison were made on the basis of water fin formation between the different arrangements of 3D aerators. In conclusion, this research provides valuable insights into the performance of three-dimensional aerators in mitigating cavitation damages and controlling water fins in high dam spillways. The findings offer practical implications for designers and engineers seeking to enhance the efficiency and safety of hydraulic structures subjected to high flow rates.

Keywords: three-dimension aerator, cavity, water fin, air entrainment

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Authors: Siqin Wang, Jonathan Corcoran, Yan Liu, Thomas Sigler

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Australia is a quintessentially immigrant nation with 28 percent of its residents being foreign-born. By 2011, People’s Republic of China (PRC) overtook the United Kingdom to become the largest source country in Australia. Significantly, the profile of PRC-born migrants has changed to mirror broader global shifts towards high-skilled labour, education-related, and investment-focussed migration, all of which reflect an increasing trend in the mobility of wealthy and/or educated cohorts. Together, these coalesce to form a more complex pattern of migrant settlement –both spatially and socio-economically. This paper focuses on the PRC-born migration, redresses these lacunae, with regard to the settlement outcomes of PRC migrants to Australia, with a particular focus on spatial evolution and residential mobility at both the metropolitan and national scales. By drawing on Census Data and migration Micro Datasets, the aim of this paper is to examine the shifting dynamics of PRC-born migrants in Australian capital cities to unveil their socioeconomic characteristics, residential patterns and change of spatial concentrations during their transition into the new host society. This paper finds out three general patterns in the residential evolution of PRC-born migrants depending on the size of capital cities where they settle down, as well as the association of socio-economic characters with the formation of enclaves. It also examines the residential mobility across states and cities from 2001 to 2011 indicating the rising status of median-size Australian capital cities for receiving PRC-born migrants. The paper concludes with a discussion of evidences for policy formation, facilitates the effective transition of PRC-born populations into the mainstream of host society and enhances social harmony to help Australia become a more successful multicultural nation.

Keywords: Australia, Chinese migrants, residential mobility, spatial evolution

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Authors: Natsuda Rattamanee

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Like other countries, Thailand continually experiences strong protests against dam and reservoir proposals, especially large-scale projects. The protestors are constantly worried about the potential significant adverse impacts of the projects on the environment and society. Although project proponents are required by laws to assess the environmental and social impacts of the dam proposals by making environmental impact assessment (EIA) reports and finding mitigation measures before implementing the plans, the outcomes of the assessments often do not lessen the affected people and public’s concerns about the potential negative effects of the projects. One of the main reasons is that Thailand does not have a proper and efficient law to regulate project proponents when determining the scope of environmental impact assessments. Scoping is the crucial second stage of the preparation of an EIA report. The appropriate scope of assessments will allow EIA studies to focus only on the significant effects of the proposed project on particular resources, areas, and communities. It will offer crucial and sufficient information to the decision-makers and the public. The decision to implement the dam and reservoir projects considered based on the assessments with a proper scoping will eventually be more widely accepted by the public and reduce community opposition. The research work seeks to identify flaws in the current requirements of scoping steps under Thai laws and regulations and proposes recommendations to improve the legal scheme. The paper explores the well-established United States laws and relevant rules regulating how lead agencies determine the scope of their environmental impact assessments and some guidelines concerning scoping published by dominant institutions. Policymakers and legislature will find the results of studies helpful in improving the scoping-step requirements of EIA for dam and reservoir projects and reducing the level of anti-dam protests in Thailand.

Keywords: dam and reservoir, EIA, environmental impact assessment, law, scoping, Thailand

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Authors: Maham Leeza Adil, Mahrukh Alvi, Muhammad Osman

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Introduction: Sheehan's syndrome (SS) is a rare cause of hypopituitarism resulting from postpartum hemorrhage and pituitary necrosis. It remains an underdiagnosed condition, especially in developing countries, due to poor obstetric care and home deliveries. This case report highlights the significance of recognizing atypical presentations of SS, such as pancytopenia, to aid in early diagnosis and management. Case Presentation: A 40-year-old female presented with acute abdomen symptoms and was initially diagnosed with acalculous cholecystitis. However, a detailed history revealed a history of postpartum hemorrhage 18 years prior, leading to a provisional diagnosis of SS. Further investigations confirmed panhypopituitarism, including hypothyroidism, hypocortisolism, and hypogonadism. Notably, the patient also exhibited pancytopenia, a rarely reported hematological manifestation of SS. Discussion: SS often presents with nonspecific symptoms, leading to delayed or missed diagnoses. In this case, the patient's initial presentation of acute abdomen symptoms was attributed to secondary adrenal insufficiency due to panhypopituitarism. The presence of pancytopenia, along with hyponatremia, further complicated the clinical picture. Hormone replacement therapy led to a remarkable improvement in the patient's condition, emphasizing the importance of early diagnosis and intervention. Conclusion: SS is a common cause of panhypopituitarism in developing countries, but its atypical presentations, such as pancytopenia, are rare and often overlooked. This case highlights the need for increased awareness among clinicians to consider SS in patients with unexplained hematological abnormalities, particularly in regions with high rates of postpartum hemorrhage. Early recognition and appropriate hormone replacement therapy can significantly improve patients' outcomes and prevent long-term complications associated with this underdiagnosed syndrome.

Keywords: Sheehan syndrome, panhypopituitarism, pancytopenia, delayed diagnosis

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Authors: Mahboobeh Hemmati, Tahar Messadi, Hongmei Gu

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Today, life cycle assessment (LCA) is a leading method in mitigating the environmental impacts emerging from the building sector. In this paper, LCA is used to quantify the Green House Gas (GHG) emissions during the construction phase of the largest mass timber residential structure in the United States, Adohi Hall. This building is a 200,000 square foot 708-bed complex located on the campus of the University of Arkansas. The energy used for buildings’ operation is the most dominant source of emissions in the building industry. Lately, however, the efforts were successful at increasing the efficiency of building operation in terms of emissions. As a result, the attention is now shifted to the embodied carbon, which is more noticeable in the building life cycle. Unfortunately, most of the studies have, however, focused on the manufacturing stage, and only a few have addressed to date the construction process. Specifically, less data is available about environmental impacts associated with the construction of mass timber. This study presents, therefore, an assessment of the environmental impact of the construction processes based on the real and newly built mass timber building mentioned above. The system boundary of this study covers modules A4 and A5 based on building LCA standard EN 15978. Module A4 includes material and equipment transportation. Module A5 covers the construction and installation process. This research evolves through 2 stages: first, to quantify materials and equipment deployed in the building, and second, to determine the embodied carbon associated with running equipment for construction materials, both transported to, and installed on, the site where the edifice is built. The Global Warming Potential (GWP) of the building is the primary metric considered in this research. The outcomes of this study bring to the front a better understanding of hotspots in terms of emission during the construction process. Moreover, the comparative analysis of the mass timber construction process with that of a theoretically similar steel building will enable an effective assessment of the environmental efficiency of mass timber.

Keywords: construction process, GWP, LCA, mass timber

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Authors: Luís Miguel Estevão Cristóvão, Constâncio Augusto Machanguana, Fernando Chichango, Salvador Grande

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Sub-Saharan African nations depend greatly on agriculture, a sector mainly marked by low production. Most of the farmers live in rural areas and employ basic labor-intensive technologies that lead to time inefficiencies and low overall effectiveness. Even with attempts to enhance farmers’ welfare through improved seeds and fertilizers, meaningful outcomes are yet to be achieved due to huge amounts of post-harvest losses. Such losses significantly endanger food security, economic stability, and result in unsustainable agricultural practices because more land, water, labor, energy, fertilizer, and other inputs must be used to produce more food. Drying, as a critical post-harvest process involving simultaneous heat and mass transfer, deserves attention. Among alternative green-energy sources, solar energy-based drying garners attention, particularly for small-scale farmers in remote communities. However, the intermittent nature of solar radiation poses challenges. To address this, energy storage solutions like rock-based thermal energy storage offer cost-effective solutions tailored to the needs of farmers. Methodologically, three solar dryers were constructed of metal, wood, and clay brick. Several tests were carried out with and without energy storage material. Notably, it has been demonstrated that soapstone stands out as a promising material due to its affordability and high specific energy capacity. By implementing these greener technologies, Sub-Saharan African countries could mitigate post-harvest losses, enhance food availability, improve nutrition, and promote sustainable resource utilization.

Keywords: energy storage, food security, post-harvest, solar dryer

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Authors: Moloud Torkandam

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Any cities must be designed and built in a way that minimizes their need for fossil fuel. Undoubtedly, the necessity of accepting this principle in the previous eras is undeniable with respect to the mode of constructions. Perhaps only due to the great diversity of materials and new technologies in the contemporary era, such a principle in buildings has been forgotten. The question of optimizing energy consumption in buildings has attracted a great deal of attention in many countries and, in this way, they have been able to cut down the consumption of energy up to 30 percent. The energy consumption is remarkably higher than global standards in our country, and the most important reason is the undesirable state of buildings from the standpoint of energy consumption. In addition to providing the means to protect the natural and fuel resources for the future generations, reducing the use of fossil energies may also bring about desirable outcomes such as the decrease in greenhouse gases (whose emissions cause global warming, the melting of polar ice, the rise in sea level and the climatic changes of the planet earth), the decrease in the destructive effects of contamination in residential complexes and especially urban environments and preparation for national self-sufficiency and the country’s independence and preserving national capitals. This research realize that in this modern day and age, living sustainably is a pre-requisite for ensuring a bright future and high quality of life. In acquiring this living standard, we will maintain the functions and ability of our environment to serve and sustain our livelihoods. Electricity is now an integral part of modern life, a basic necessity. In the provision of electricity, we are committed to respecting the environment by reducing the use of fossil fuels through the use of proven technologies that use local renewable and natural resources as its energy source. As far as this research concerned it is completely necessary to work on different type of energy producing such as solar and CPVT system.

Keywords: energy, photovoltaic, termal system, solar energy, CPVT

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Authors: Atakan Aral Ormancı, Tuğçe Arslantaş, Murat Özcü

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This study presents the design and implementation of an experimental chassis-level system for various control applications. Specifically, the height level of the chassis is controlled using proportional integrated derivative, fuzzy logic, and deep learning control methods. Real-time data obtained from height and pressure sensors installed in a 6x2 truck chassis, in combination with pulse-width modulation signal values, are utilized during the tests. A prototype pneumatic system of a 6x2 truck is added to the setup, which enables the Smart Pneumatic Actuators to function as if they were in a real-world setting. To obtain real-time signal data from height sensors, an Arduino Nano is utilized, while a Raspberry Pi processes the data using Matlab/Simulink and provides the correct output signals to control the Smart Pneumatic Actuator in the truck chassis. The objective of this research is to optimize the time it takes for the chassis to level down and up under various loads. To achieve this, proportional integrated derivative control, fuzzy logic control, and deep learning techniques are applied to the system. The results show that the deep learning method is superior in optimizing time for a non-linear system. Fuzzy logic control with a triangular membership function as the rule base achieves better outcomes than proportional integrated derivative control. Traditional proportional integrated derivative control improves the time it takes to level the chassis down and up compared to an uncontrolled system. The findings highlight the superiority of deep learning techniques in optimizing the time for a non-linear system, and the potential of fuzzy logic control. The proposed approach and the experimental results provide a valuable contribution to the field of control, automation, and systems engineering.

Keywords: automotive, chassis level control, control systems, pneumatic system control

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Authors: Mukondi Nethavhakone

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The high prevalence of violence against women is a global public health problem. Our societies have become dangerous places for women. Women during their child-bearing ages are at a higher risk of experiencing emotional, physical, and sexual violence. What makes it more concerning is that these violent acts are perpetrated by family members or partners, or ex-partners. Intimate Partner Violence (IPV) is associated with long-lasting physical, reproductive, sexual, mental, and maternal health implications. Expectedly women’s mental health would dimmish as a result of experiencing IPV. The burden of violence against women is seen to be heavier in low- and middle-income countries (LMICs) compared to the rest of the world. Countries have committed to eliminating all forms of violence against women through the sustainable development goal, aiming to see changes by the year 2030. As such, various countries have implemented psychosocial interventions of different levels of impact. However, little is known, especially in low- and middle-income countries, with regard to the potential of psychosocial interventions for IPV to improve the mental health outcomes for the survivors and/or victims of IPV. Analysing the risk for IPV through a social-ecological theoretical approach, low- and middle-income countries still readdressing gender inequality which is the cause of intimate partner violence. That is why it is taking time for these countries to shift psychosocial interventions to focus more on the improvement of the mental health of the survivors. It is, therefore, against this backdrop that the researcher intends to undertake a scoping review to understand the nature and characteristics of psychosocial interventions that have been implemented in low- and middle-income countries. With the findings from the scoping review, the researcher aims to develop a conceptual framework that may be a useful resource for healthcare practitioners and researchers in low- and middle-income countries. As this area of research has not been thoroughly reviewed, the results from this scoping will determine whether a systematic review will be justifiable. Additionally, the researcher will identify gaps and opportunities for future research in this area.

Keywords: mental health improvement, psychosocial interventions, intimate partner violence, LMICs

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Authors: Oluwayemisi Femi-Pius, Kazeem Arogundade, Eberechukwu Eke, Jimmy Eko

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Introduction: Globally, community involvement in improving their own health has been widely adopted as a strategy in Sub-Saharan Africa principally to ensure equitable access to essential health care as well as improve the uptake of maternal and newborn health services especially in poor-resource settings. Method: The Saving Mother Giving Life (SMGL) Initiative implemented by Pathfinder International with funding support from USAID conducted a Health Facility Assessment (HFA) and found out that maternal mortality ratio in Cross River State was 812 per 100,000 live birth and perinatal mortality was 160 per 1000 live birth. To reduce maternal and perinatal mortality, Pathfinder International mobilized, selected and trained community members as community volunteers, traditional birth attendants, and emergency transport service volunteer drivers mainly to address the delay in decision making and reaching the health facility among pregnant women. Results: The results showed that maternal mortality ratio in Cross River State decrease by 25% from 812 per 100,000 live birth at baseline to 206 per 100,000 live birth at June 2018 and perinatal mortality reduced by 35% from 160 per 100,000 at baseline to 58 per 1000 live birth at June 2018. Data also show that ANC visit increased from 7,451 to 11,344; institutional delivery increased from 8,931 at baseline to 10,784 in June 2018. There was also a remarkable uptake of post-partum family planning from 0 at baseline to 233 in June 2018. Conclusion: There is clear evidence that community involvement yields positive maternal outcomes and is pivotal for sustaining most health interventions.

Keywords: maternal mortality, Nigeria, pathfinder international, perinatal mortality, saving mother giving life

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Authors: Ghalia Shamlan, M. Denise Robertson, Adam Collins

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Appetite control (i.e. control of energy intake) is important for weight maintenance. Exercise contributes to the most variable component of energy expenditure (EE) but its impact is beyond the energy cost of exercise including physiological, behavioural, and appetite effects. Exercise is known to acutely influence effect appetite but evidence as to the independent effect of intensity is lacking. This study investigated the role of exercise intensity on appetite, energy intake (EI), appetite related hormone, fat utilisation and subjective measures of appetite. One hour after a standardised breakfast, 10 sedentary overweight volunteers. Subjects undertook either 8 repeated 60 second bouts of cycling at 95% VO2max (high intensity) or 30 minutes of continuous cycling, at a fixed cadence, equivalent to 50% of the participant’s VO2max (low intensity) in a randomised crossover design. Glucose, NEFA, glucagon-like peptide-1 (GLP-1) were measured fasted, postprandial, and pre and post-exercise. Satiety was assessed subjectively throughout the study using visual analogue scales (VAS). Ad libitum intake of a pasta meal was measured at the end (3-h post-breakfast). Interestingly, there was not significant difference in EE fat oxidation between HI and LI post-exercise. Also, no significant effect of high intensity (HI) was observed on the ad libitum meal, 24h and 48h EI post-exercise. However the mean 24h EI was 3000 KJ lower following HI than low intensity (LI). Despite, no significant differences in hunger score, glucose, NEFA and GLP-1 between both intensities were observed. However, NEFA and GLP-1 plasma level were higher until 30 min post LI. In conclusion, the similarity of EE and oxidation outcomes could give overweight individuals an option to choose between intensities. However, HI could help to reduce EI. There are mechanisms and consequences of exercise in short and long-term appetite control; however, these mechanisms warrant further explanation. These results support the need for future research in to the role of in regulation energy balance, especially for obese people.

Keywords: appetite, exercise, food intake, energy expenditure

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Authors: Bahatti̇n Ki̇mençe, Uğur Ki̇mençe

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In this study, the purpose of obtaining the influence functions of the displacement discontinuity in an anisotropic elastic medium is to produce the boundary element equations. A Displacement Discontinuous Method formulation (DDM) is presented with the aim of modeling two-dimensional elastic fracture problems. This formulation is found by analytical integration of the fundamental solution along a straight-line crack. With this purpose, Kelvin's fundamental solutions for anisotropic media on an infinite plane are used to form dipoles from singular loads, and the various combinations of the said dipoles are used to obtain the influence functions of displacement discontinuity. This study introduces a technique for coupling Fictitious Stress Method (FSM) and DDM; the reason for applying this technique to some examples is to demonstrate the effectiveness of the proposed coupling method. In this study, displacement discontinuity equations are obtained by using dipole solutions calculated with known singular force solutions in an anisotropic medium. The displacement discontinuities method obtained from the solutions of these equations and the fictitious stress methods is combined and compared with various examples. In this study, one or more crack problems with various geometries in rectangular plates in finite and infinite regions, under the effect of tensile stress with coupled FSM and DDM in the anisotropic environment, were examined, and the effectiveness of the coupled method was demonstrated. Since crack problems can be modeled more easily with DDM, it has been observed that the use of DDM has increased recently. In obtaining the displacement discontinuity equations, Papkovitch functions were used in Crouch, and harmonic functions were chosen to satisfy various boundary conditions. A comparison is made between two indirect boundary element formulations, DDM, and an extension of FSM, for solving problems involving cracks. Several numerical examples are presented, and the outcomes are contrasted to existing analytical or reference outs.

Keywords: displacement discontinuity method, fictitious stress method, crack problems, anisotropic material

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Authors: Hsin-Yu Lin, Ching-Hsia Hung

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Obstructive sleep apnea (OSA) is characterized by a complete or partial obstruction of the upper airway during sleep. The vulnerable sites of upper airway collapses are consequences of sleep state-dependent reductions in tone in specific pharyngeal dilators. Clinical examinations reveal multilevel collapses of the upper airway among the patients with OSA. Therefore, an anatomically-based oropharyngeal rehabilitation should comprise a multilevel approach, including retropalatal, retroglossal, hypopharyngeal, temporomandibular, and facial levels, all of which involve different muscle groups and contribute to multifunctional interaction and coordination, such as swallowing, breathing, and phonation. The purpose of the study was to exam the effects of this rehabilitation program with a multilevel approach. In this study, fifteen subjects with newly diagnosed moderate or severe OSA (Apnea-Hypopnea-Index≥15) were randomized into an intervention group and control group. The intervention group (N=8) underwent a 12-week-intervention of a hospital-based rehabilitation program, while the control group (N=7) was kept on the waiting list. The 12-week-intervention comprised an anatomically based multilevel approach. The primary outcome was Polysomnography (PSG) data, and the secondary outcome was oropharyngeal and respiratory muscle function. In the intervention group, Apnea-Hypopnea-Index significantly improved (46.96±19.45 versus 32.78±10.78 events/h, p=0.017) compared with control group (35.77±17.49 versus 42.96±17.32 events/h, p=0.043). While the control group remained no change, the intervention group demonstrated other PSG outcomes significantly improvement, including arousal index (46.04±18.9 versus 32.98±8.35/h, p=0.035), mean SpO2 (92.88±2.1 versus 94.13±1.46%, p=0.039). Besides, the intervention group demonstrated significant improvement in oropharyngeal and respiratory muscle function compared to the control group. This anatomically-based oropharyngeal rehabilitation with a multilevel approach can be proven as a non-invasive therapy for patients with OSA.

Keywords: obstructive sleep apnea, upper airway, oropharyngeal rehabilitation, multilevel approach

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Authors: Ph. Fauquet-Alekhine

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Decision-making occurs several times an hour when working in high risk industry and an erroneous choice might have undesirable outcomes for people and the environment surrounding the industrial plant. Industrial decisions are very often made in a context of acute stress. Time pressure is a crucial stressor leading decision makers sometimes to boost up the decision-making process and if it is not possible then shift to the simplest strategy. We thus found it interesting to update the characterization of the stress factors impairing decision-making at Chinon Nuclear Power Plant (France) in order to optimize decision making contexts and/or associated processes. The investigation was based on the analysis of reports addressing safety events over the last 3 years. Among 93 reports, those explicitly addressing decision-making issues were identified. Characterization of each event was undertaken in terms of three criteria: stressors, biases impairing decision making and weaknesses of the decision-making process. The statistical analysis showed that biases were distributed over 10 possibilities among which the hypothesis confirmation bias was clearly salient. No significant correlation was found between criteria. The analysis indicated that the main stressor was time pressure and highlights an unexpected form of stressor: the trust asymmetry principle of the expert. The analysis led to the conclusion that this stressor impaired decision-making from a psychological angle rather than from a physiological angle: it induces defensive bias of self-esteem, self-protection associated with a bias of confirmation. This leads to the hypothesis that this stressor can intervene in some cases without being detected, and to the hypothesis that other stressors of the same kind might occur without being detected too. Further investigations addressing these hypotheses are considered. The analysis also led to the conclusion that dealing with these issues implied i) decision-making methods being well known to the workers and automated and ii) the decision-making tools being well known and strictly applied. Training was thus adjusted.

Keywords: bias, expert, high risk industry, stress.

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Authors: Zak Maas, Daniel Carson, Rachel McIntyre, Mark Omundsen, Teresa Holm

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Aim: After hemicolectomy a period of obligatory bowel dysfunction is expected, termed postoperative ileus (POI). Prolonged postoperative ileus (PPOI), typically four or more days, is associated with higher morbidity and extended inpatient stay. This leads to significant financial and resource-related burdens on healthcare systems. Several studies including a meta-analysis have compared rates of PPOI in left vs right hemicolectomy, which suggest that right-sided resections may be more likely to result in PPOI. Our study aims to further investigate whether significant differences in PPOI and obligatory POI exist between right versus extended right hemicolectomy. Methods: This is a retrospective review assessing rates of PPOI in patients who underwent right vs extended right hemicolectomy at Tauranga Hospital. Patients were divided and compared depending on approach (open versus laparoscopic) and acuity (acute versus elective). Exclusion criteria included synchronous major operations and patients preoperatively on parenteral nutrition. Primary outcome was PPOI as pre-defined in contemporary literature. Secondary outcomes were time to passage of flatus, passage of stool, toleration of oral diet and rate of complications. Results: There were 669 patients identified for analysis (507 laparoscopic vs 162 open; 194 acute vs 475 elective). Early analysis indicates rates of PPOI was significantly increased in patients undergoing extended right hemicolectomy. Factors including age, gender, ethnicity, preoperative haemaglobin, preoperative albumin and diagnosis of inflammatory bowel disease were examined by multivariate analysis to determine correlation with PPOI. Conclusion: PPOI is a common complication of hemicolectomy surgery. Higher rates of PPOI in extended right vs right hemicolectomy warrants further research into determining the cause. This study examines some other factors which may contribute to PPOI.

Keywords: hemicolectomy, colorectal, complications, postoperative ileus

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Authors: Muhammad Saqib Manzoor, Camille Dickson-Deane, Prashan Karunaratne

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Cobb-Douglas production (utility) function is a fundamental function widely used in economics teaching and research. The key reason is the function's characteristics to describe the actual production using inputs like labour and capital. The characteristics of the function like returns to scale, marginal, and diminishing marginal productivities are covered in the introductory units in both microeconomics and macroeconomics with a 2-dimensional static visualisation of the function. However, less insight is provided regarding three-dimensional surface, changes in the curvature properties due to returns to scale, the linkage of the short-run production function with its long-run counterpart and marginal productivities, the level curves, and the constraint optimisation. Since (freshman) learners have diverse prior knowledge and cognitive skills, the existing “one size fits all” approach is not very helpful. The aim of this study is to bridge this gap by introducing technological intervention with interactive animations of the three-dimensional surface and sequential unveiling of the characteristics mentioned above using Python software. A small classroom intervention has helped students enhance their analytical and visualisation skills towards active and authentic learning of this topic. However, to authenticate the strength of our approach, a quasi-Delphi study will be conducted to ask domain-specific experts, “What value to the learning process in economics is there using a 2-dimensional static visualisation compared to using a 3-dimensional dynamic visualisation?’ Here three perspectives of the intervention were reviewed by a panel comprising of novice students, experienced students, novice instructors, and experienced instructors in an effort to determine the learnings from each type of visualisations within a specific domain of knowledge. The value of this approach is key to suggesting different pedagogical methods which can enhance learning outcomes.

Keywords: cobb-douglas production function, quasi-Delphi method, effective teaching and learning, 3D-visualisations

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Authors: Arman Kishan, Mark Haft, Kiyanna Thomas, Duc Nguyen, Dawn Laporte

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Objective: Patients receiving anticoagulation therapy frequently experience increased rates of postoperative complications. Presently, limited data exist regarding the outcomes of patients undergoing carpal tunnel release surgery (CTR) while on anticoagulation. Our objective is to examine and compare the occurrence of complications in patients on anticoagulation who underwent either endoscopic CTR (ECTR) or open CTR (OCTR) for CTS. Methods: The Trinet X database was utilized to retrospectively identify patients who underwent OCTR or ECTR while concurrently on anticoagulation. Demographic data, medical comorbidities, and complication rates were analyzed. We used multivariable analysis to identify differences in postoperative complications, including wound infection within 90 days, wound dehiscence within 90 days, and intraoperative median nerve injury between the two surgical methods in patients on anticoagulation. Results: A total of 10,919 carpal tunnel syndrome patients on anticoagulation were included in the study, with 9082 and 1837 undergoing OCTR and ECTR, respectively. Among patients on anticoagulation, those undergoing ECTR exhibited a significantly lower occurrence of 90-day wound infection (p < 0.001) and nerve injury (p < 0.001) compared to those who underwent OCTR. However, there was no statistically significant difference in the risk of 90-day wound dehiscence between the two groups (p = 0.323). Conclusion:  In prior studies, ECTR demonstrated reduced rates of postoperative complications compared to OCTR in the general population. Our study demonstrates that among patients on anticoagulation, those undergoing ECTR experienced a significantly lower incidence of 90-day wound infection and nerve injury, with risk reductions of 35% and 40%, respectively. These findings support using ECTR as a preferred surgical method for patients with CTS who are on anticoagulation therapy.

Keywords: endoscopic treatment of carpal tunnel syndrome, open treatment of carpal tunnel syndrome, postoperative complications in patients on anticoagulation, carpal tunnel syndrome

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Authors: Mujahid Ali, Wasif Mohammed Ali, Meraj Ahmad

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Background: Perforation peritonitis is the most common surgical emergency encountered by surgeons all over the world as well as in India. The etiology of perforation peritonitis in India continues to be different from its western counterparts. The aim of this study is to evaluate the spectrum of cases of perforation peritonitis at our hospital. Methods: A prospective study conducted includes three hundred thirtysix patients of perforation peritonitis at J. N. Medical College from October 2015 to July 2017. The patients were admitted, resuscitated and underwent emergency laparotomy. Data were collected in terms of demographic profile, clinical presentations, site of perforations, causes and surgical outcomes. Results: In this study, the most common cause of perforation peritonitis was peptic ulcer disease (43%), followed by enteric perforation (12.8%), tubercular perforation (12.5%), traumatic perforation (11.9%), appendicular perforation (9.8%), amoebic caecal perforation (3%), malignant perforation (1.5%), etc. The sites of perforations were stomach in majority (38.3%), ileum (31%), appendix (8%), duodenum (5.%), caecum (4.4%) ,colon (3%), jejunum (8.5%) and gall bladder (2%). The overall mortality was 21% in our study. Age >50 years (p= <0.0001, OR= 3.9260, CI= 2.2 to 6.9), organ failure (p= <0.0001, OR= 29.2, CI= 14.8 to 57.6), shock (p=<0.0001, OR=20.20, CI= 10.56 to 38.6), diffuse peritonitis (p<0.0015, OR= 6.8810, CI= 2.09 to 22.57) and faecal exudates (p<0.0001) were found to be significant factors affecting mortality. The most common complication associated was superficial wound infection (40%), followed by burst abdomen seen in 21% cases, intra-abdominal sepsis in 18% cases, electrolyte imbalances in 15% cases, anastomotic leak in 6% cases. Conclusion: In this study, stomach is the most common site of perforation with peptic ulcer disease being the most common etiology. Older age, presence of shock, organ failure and faecal peritonitis were the risk factors affecting the mortality of the patients. Early recognition, adequate resuscitation and referral of patients can influence outcome and reduces mortality as well as morbidity.

Keywords: etiology, mortality, perforation, spectrum

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Authors: Denis Duagi, Ben Carter, Maria Farrelly, Stephen Lisk, June S. L. Brown

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Background: Adolescence represents a distinctive phase of development, and variables linked to this developmental period could affect the efficiency of prevention and treatment for depression and anxiety, as well as the long-term prognosis. The objectives of this study were to investigate the long-term effectiveness of psychosocial interventions for adolescents on depression and anxiety symptoms and to assess the influence of different intervention parameters on the long-term effects. Methods: Searches were carried out on the 11ᵗʰ of August 2022 using five databases (Cochrane Library, Embase, Medline, PsychInfo, Web of Science), as well as trial registers. Randomized controlled trials of psychosocial interventions targeting specifically adolescents were included if they assessed outcomes at 1-year post-intervention or more. The Cochrane risk of bias-2 quality assessment tool was used. The primary outcome was depression, and studies were pooled using a standardised mean difference, with an associated 95% confidence interval, p-value, and I². The study protocol was pre-registered (CRD42022348668). Findings: A total of 57 reports (n= 46,678 participants) were included in the review. Psychosocial interventions led to small reductions in depressive symptoms, with a standardised mean difference (SMD) at 1-year of -0.08 (95%CI -0.20, -0.03, p=0.002, I²=72%), 18-months SMD=-0.12, 95% CI -0.22, -0.01, p=0.03, I²=63%) and 2-years SMD=-0.12 (95% CI -0.20, -0.03, p=0.01, I²=68%). Sub-group analyses indicated that targeted interventions produced stronger effects, particularly when delivered by trained mental health professionals (K=18, SMD=-0.24, 95% CI -0.38, -0.10, p=0.001, I²=60%). No effects were detected for anxiety at any assessment. Conclusion: Psychosocial interventions specifically targeting adolescents were shown to have small but positive effects on depression symptoms but not anxiety symptoms, which were sustained for up to 2 years. These findings highlight the potential population-level preventive effects if such psychosocial interventions become widely implemented in accessible settings such as schools.

Keywords: psychosocial, adolescent, interventions, depression, anxiety, meta-analysis, randomized controlled trial

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Authors: Akaash Tawade, Manan Khattar, Lucas Spangher, Costas J. Spanos

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Many grids are increasing the share of renewable energy in their generation mix, which is causing the energy generation to become less controllable. Buildings, which consume nearly 33% of all energy, are a key target for demand response: i.e., mechanisms for demand to meet supply. Understanding the behavior of office workers is a start towards developing demand response for one sector of building technology. The literature notes that dynamic computational modeling can be predictive of individual action, especially given that occupant behavior is traditionally abstracted from demand forecasting. Recent work founded on Social Cognitive Theory (SCT) has provided a promising conceptual basis for modeling behavior, personal states, and environment using control theoretic principles. Here, an adapted linear dynamical system of latent states and exogenous inputs is proposed to simulate energy demand amongst office workers engaged in a social energy shifting game. The energy shifting competition is implemented in an office in Singapore that is connected to a minigrid of buildings with a consistent 'price signal.' This signal is translated into a 'points signal' by a reinforcement learning (RL) algorithm to influence participant energy use. The dynamic model functions at the intersection of the points signals, baseline energy consumption trends, and SCT behavioral inputs to simulate future outcomes. This study endeavors to analyze how the dynamic model trains an RL agent and, subsequently, the degree of accuracy to which load deferability can be simulated. The results offer a generalizable behavioral model for energy competitions that provides the framework for further research on transfer learning for RL, and more broadly— transactive control.

Keywords: energy demand forecasting, social cognitive behavioral modeling, social game, transfer learning

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Authors: Ram Sharan Mehta, Gayanandra Malla, Anita Gurung, Anu Aryal, Divya Labh, Hricha Neupane

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Objectives: Lack of resuscitation skills of nurses and doctors in basic life support (BLS) and advanced life support (ALS) has been identified as a contributing factor to poor outcomes of cardiac arrest victims. The objective of this study was to examine retention of life support measures (BLS/ALS) knowledge and skills of nurses following education intervention programme. Materials and Methods: Pre-experimental research design was used to conduct the study among the nurses working in medical units of B.P Koirala Institute of Health Sciences, where CPR is very commonly performed. Using convenient sampling technique total of 20 nurses agreed to participate and give consent were included in the study. The theoretical, demonstration and re-demonstration were arranged involving the trained doctors and nurses during the three hours educational session. Post-test was carried out after two week of education intervention programme. The 2010 BLS & ALS guidelines were used as guide for the study contents. The collected data were analyzed using SPSS-15 software. Results: It was found that there is significant increase in knowledge after education intervention in the components of life support measures (BLS/ALS) i.e. ratio of chest compression to ventilation in BLS (P=0.001), correct sequence of CPR (p <0.001), rate of chest compression in ALS (P=0.001), the depth of chest compression in adult CPR (p<0.001), and position of chest compression in CPR (P=0.016). Nurses were well appreciated the programme and request to continue in future for all the nurses. Conclusions: At recent BLS/ALS courses (2010), a significant number of nurses remain without any such training. Action is needed to ensure all nurses receive BLS training and practice this skill regularly in order to retain their knowledge.

Keywords: pre-experimental, basic and advance life support, nurses, sampling technique

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Authors: Joseph F. Cabrera, Rachael Dela Cruz

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This study specifically examines patterns that define ethnoracially diverse neighborhoods. Ethnoracial diversity is important as it facilitates cross-racial interactions within neighborhoods which have been theorized to be associated with such outcomes as intergroup harmony, the reduction of racial and ethnic prejudice and discrimination, and increases in racial tolerance. Los Angeles (LA) is an ideal location to study ethnoracial spatial patterns as it is one of the most ethnoracially diverse cities in the world. A large influx of Latinos, as well as Asians, have contributed to LA’s urban landscape becoming increasingly diverse over several decades. Our dataset contains all census tracts in Los Angeles County in 2016 and incorporates Census and ACS demographic and spatial data. We quantify ethnoracial diversity using a derivative of Simpson’s Diversity Index and utilize this measure to test previous literature that suggests Latinos are one of the key drivers of changing ethnoracial spatial patterns in Los Angeles. Preliminary results suggest that there has been an overall increase in ethnoracial diversity in Los Angeles neighborhoods over the past sixteen years. Patterns associated with this trend include decreases in predominantly white and black neighborhoods, increases in predominantly Latino and Asian neighborhoods, and a general decrease in the white populations of the most diverse neighborhoods. A similar pattern is seen in neighborhoods with large Latino increases- a decrease in white population, but with an increase in Asian and black populations. We also found support for previous research that suggests increases in Latino and Asian populations act as a buffer, allowing for black population increases without a sizeable decrease in the white population. Future research is needed to understand the underlying causes involved in many of the patterns and trends highlighted in this study.

Keywords: race, race and interaction, racial harmony, social interaction

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Authors: Pankaj Dhiman, Simranjeet Kaur

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This research paper presents a comprehensive sentiment analysis of social media responses to videos on Facebook, YouTube, Twitter, and Instagram during the 2024 Indian general elections. The study focuses on the sentiment patterns of voters towards the National Democratic Alliance (NDA) and The Indian National Developmental Inclusive Alliance (INDIA) on these platforms. The analysis aims to understand the impact of social media on voter sentiment and its correlation with the election outcome. The study employed a mixed-methods approach, combining both quantitative and qualitative methods. With a total of 200 posts analysed during general election-2024 final phase, the sentiment analysis was conducted using natural language processing (NLP) techniques, including sentiment dictionaries and machine learning algorithms. The results show that NDA received significantly more positive sentiment responses across all platforms, with a positive sentiment score of 47% compared to INDIA's score of 38.98 %. The analysis also revealed that Twitter and YouTube were the most influential platforms in shaping voter sentiment, with 60% of the total sentiment score coming from these two platforms. The study's findings suggest that social media sentiment analysis can be a valuable tool for understanding voter sentiment and predicting election outcomes. The results also highlight the importance of social media in shaping public opinion and the need for political parties to engage effectively with voters on these platforms. The study's implications are significant, as they indicate that social media can be a key factor in determining the outcome of elections. The findings also underscore the need for political parties to develop effective social media strategies to engage with voters and shape public opinion.

Keywords: Indian Elections-2024, NDA, INDIA, sentiment analysis, social media, democracy

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Authors: John Onolame Unuofin, Uchechukuw U. Nwodo, Anthony I. Okoh

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Laccase is constantly gaining status as important biocatalyst in biotechnology. The illimitable potential of its industrial applications and the corresponding aggressive need for phenomenal volumes of extracellularly secreted laccases have called for its interminable production from sources which are able to meet this demand within a relatively short period of time, preferably bacteria. In response to this call, this study was designed to source for laccase-producing bacteria from different environmental matrices. Three sampling environments were chosen such as wastewater treatment plants, University of Fort Hare vicinity and the Hogback woodland, all within the Eastern Cape, South Africa. Samples such as effluents, sediments, leaf litters, degrading wood and rock scrapings were selectively enriched with some model aromatic compounds and were further screened qualitatively and quantitatively on five phenolic substrates ABTS (2,2’-azino-bis(3-ethylbenzothiazoline-6-sulphonic acid), Guaiacol, 1-Naphthol, Potassium Ferric Cyanide and Syringaldazine). Basis for selection was their ability to elicit a colour change on at least three of the above mentioned agar based assay substrates. The choice isolates were further identified based on 16S rRNA molecular identification techniques. 33 isolates were screened out of the 40 representative distinct colonies during the qualitative plate screens, while quantitative screens selected out 11 bacterial isolates. They were, based on molecular identification, desginated as members of the genera Pseudomonas, Stenotrophomonas and Citrobacter of the gammaproteobacteria and Bordetalla and Achromobacter of the betaproteobacteria respectively. We therefore conclude based on our outcomes that we may have isolated efficient laccase-producing bacteria, which might be of beneficial significance in catalysis and biotechnology.

Keywords: beta proteobacteria, catalysis, gammaproteobacteria, laccase

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Authors: Weaam Aldeeban, Majd Aljamali, Lama A. Youssef

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Background & Objective: Warfarin is considered a problematic drug due to its narrow therapeutic window and wide inter-individual response variations, which are attributed to demographic, environmental, and genetic factors, particularly single nucleotide polymorphism (SNPs) in the genes encoding VKORC1 and CYP2C9 involved in warfarin's mechanism of action and metabolism, respectively. CYP2C9*2rs1799853 and CYP2C9*3rs1057910 alleles are linked to reduced enzyme activity, as carriers of either or both alleles are classified as moderate or slow metabolizers, and therefore exhibit higher sensitivity of warfarin compared with wild type (CYP2C9*1*1). Our study aimed to assess the frequency of *1, *2, and *3 alleles in the CYP2C9 gene in a cohort of Syrian patients receiving a maintenance dose of warfarin for different indications, the impact of genotypes on warfarin dosing, and the frequency of adverse effects (i.e., bleedings). Subjects & Methods: This retrospective cohort study encompassed 94 patients treated with warfarin. Patients’ genotypes were identified by sequencing the polymerase chain reaction (PCR) specific products of the gene encoding CYP2C9, and the effects on warfarin therapeutic outcomes were investigated. Results: Sequencing revealed that 43.6% of the study population has the *2 and/or *3 SNPs. The mean weekly maintenance dose of warfarin was 37.42 ± 15.5 mg for patients with the wild-type allele (CYP2C9*1*1), whereas patients with one or both variants (*2 and/or *3) demanded a significantly lower dose (28.59 ±11.58 mg) of warfarin, (P= 0.015). A higher percentage (40.7%) of patients with allele *2 and/or *3 experienced hemorrhagic accidents compared with only 17.9% of patients with the wild type *1*1, (P = 0.04). Conclusions: Our study proves an association between *2 and *3 genotypes and higher sensitivity to warfarin and a tendency to bleed, which necessitates lowering the dose. These findings emphasize the significance of CYP2C9 genotyping prior to commencing warfarin therapy in order to achieve optimal and faster dose control and to ensure effectiveness and safety.

Keywords: warfarin, CYP2C9, polymorphisms, Syrian, hemorrhage

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Authors: Salimah Hasnah, Namratha Radhakrishnan

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Communities play a vital role in mobilizing people and resources for the benefit of all. Since time immemorial, communities have been spear heading different activities ranging from disaster management, palliative care, local economic development and many more with laudable success. Urban agriculture is one such activity where communities can prove to make a real difference. Farming activities in cities across different developed countries have proved to have favorable outcomes in the form of increased food security, neighborhood revitalization, health benefits and local economic growth. However, urban agriculture in the developing nations have never been prioritized as an important planning tool to cater to the basic needs of the public. Urban agricultural practices are being carried out in a fragmented fashion without a formal backing. The urban dwellers rely heavily on their far-off rural counterparts for daily food requirements. With the onset of the pandemic and the recurring lockdowns, the significance of geographic proximity and its impact on the availability of food to the public are gradually being realized around the globe. This warrants a need for localized food systems by shortening the distance between production and consumption of food. The significance of communities in realizing these urban farming benefits is explored in this paper. A case-study approach is adopted to understand how different communities have overcome barriers to urban farming in cities. The applicability of these practices is validated against the state of Kerala in India wherein different community centered approaches have been successful in the past. The existing barriers are assessed and way forward to achieve a self-sufficient localized food systems is formulated with the key lessons from the case studies. These recommendations will be helpful to successfully establish and sustain farming activities in urban areas by leveraging the power of communities.

Keywords: community-centric, COVID-19, drivers and barriers, local food system, urban agriculture

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Authors: Salam M. H. Kareem

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Instructional or teaching procedures and their proper sequence are essential for high-quality learning outcomes. These actions are the path that the teacher takes during the learning process after setting the learning objectives. Teachers and specialists in the education field should include teaching procedures with putting in place an effective mechanism for the procedure’s implementation to achieve a logical sequence with the desired output of overall education process. Determining the sequence of these actions may be a strategic process outlined by a strategic educational plan or drawn by teachers with a high level of experience, enabling them to determine those logical procedures. While specific actions may be necessary for a specific form, many Physical Education (PE) teachers can work out on various sports disciplines. This study was conducted to investigate the impact of using the teaching sequence of the teaching pyramid in raising the level of enjoyment in swimming classes. Four months later of teaching swimming skills to the control and experimental groups of the study, we figured that using the tools shown in the teaching pyramid with the experimental group led to statistically significant differences in the positive tendencies of students to participate in the swimming classes by using the traditional procedures of teaching and using of successive procedures in the teaching pyramid, and in favor of the teaching pyramid, The students are influenced by enhancing their tendency to participate in swimming classes when the teaching procedures followed are sensitive to individual differences and are based on the element of pleasure in learning, and less positive levels of the tendency of students when using traditional teaching procedures, by getting the level of skills' requirements higher and more difficult to perform. The level of positive tendencies of students when using successive procedures in the teaching pyramid was increased, by getting the level of skills' requirements higher and more difficult to perform, because of the high level of motivation and the desire to challenge the self-provided by the teaching pyramid.

Keywords: physical education, swimming classes, teaching process, teaching pyramid

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Authors: Adebowale Olukayode Efunnowo

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This study was carried out to assess the awareness and utilization of Social Network Tools (SNTs) among agricultural science students in Colleges of Education in Ogun State, Nigeria. Simple random sampling techniques were used to select 280 respondents from the study area. Descriptive statistics was used to describe the objectives while Pearson Product Moment Correlation was used to test the hypothesis. The result showed that the majority (71.8%) of the respondents were single, with a mean age of 20 years. Almost all (95.7%) the respondents were aware of Facebook and 2go as a Social Network Tools (SNTs) while 85.0% of the respondents were not aware of Blackplanet, LinkedIn, MyHeritage and Bebo. Many (41.1%) of the respondents had views that using SNTs can enhance extensive literature survey, increase internet browsing potential, promote teaching proficiency, and update on outcomes of researches. However, 51.4% of the respondents perceived that SNTs usage as what is meant for the lecturers/adults only while 16.1% considered it as mainly used by internet fraudsters. Findings revealed that about 50.0% of the respondents browsed Facebook and 2go daily while more than 80% of the respondents used Blackplanet, MyHeritage, Skyrock, Bebo, LinkedIn and My YearBook as the need arise. Major constraints to the awareness and utilization of SNTs were high cost and poor quality of ICTs facilities (77.1%), epileptic power supply (75.0%), inadequate telecommunication infrastructure (71.1%), low technical know-how (62.9%) and inadequate computer knowledge (61.1%). The result of PPMC analysis showed that there was an inverse relationship between constraints and utilization of SNTs at p < 0.05. It can be concluded that constraints affect efficient and effective utilization of SNTs in the study area. It is hereby recommended that management of colleges of education and agricultural institutes should provide good internet connectivity, computer facilities, and alternative power supply in order to increase the awareness and utilization of SNTs among students.

Keywords: awareness, utilization, social network tools, constraints, students

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Authors: Diksha Sapkota, Kathleen Baird, Amornrat Saito, Debra Anderson

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Background: Violence during pregnancy is global public health problem incurring huge amount of social, economic and human costs. It is of particular concern as it affects health of mother, neonates and also disrupt family functioning. Mental illness is one of its commonest consequences affecting both mother and baby and likely to be chronic if left unattended. Past decade has seen advances in knowledge about different forms of violence, its health impacts and intervention/s helping to confront the violence. However, limited range and lack of consistency in measurable outcomes undermine overall effect of interventions, and available evidence are largely slanted towards high-income countries. Despite recognition of integrating screening and counselling for abused pregnant women in health settings, there is a dearth of evidence on its effectiveness from developing countries limiting its applicability and feasibility. This study intends to summarise the high-quality evidence on intimate partner violence interventions in reducing violence and improving mental health and implement the promising intervention in our context. Methods: Quantitative systematic review will be done using PRISMA statement and based on its finding; randomised controlled intervention will be carried out. The study will be conducted among women attending ANC clinic of Dhulikhel Hospital, Nepal. Being the pilot study, samples just adequate to draw the inferences i.e. not less than 30 in each arm will be taken. Phenomological approach will be used to explore the strengths and weaknesses of tested intervention and recommendations for better planning in future. Conclusion: This study intends to provide concrete evidence on what works best in our context and will assist policymakers, programme planners, donors in informed decision making.

Keywords: intimate partner violence/prevention and control, mental health, Nepal, pregnant

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Authors: Yibeltal T. Bayou, Yohana S. Mashalla, Gloria Thupayagale-Tshweneagae

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Background: According to the World Health Organization, caesarean section delivery rates of more than 10-15% caesarean section deliveries in any specific geographic region in the world are not justifiable. The aim of the study was to describe the level and analyse determinants of caesarean section delivery in Addis Ababa. Methods: Data was collected in Addis Ababa using a structured questionnaire administered to 901 women aged 15-49 years through a stratified two-stage cluster sampling technique. Binary logistic regression model was employed to identify predictors of caesarean section delivery. Results: Among the 835 women who delivered their last birth at healthcare facilities, 19.2% of them gave birth by caesarean section. About 9.0% of the caesarean section births were due to mother’s request or service provider’s influence without any medical indication. The caesarean section delivery rate was much higher than the recommended rate particularly among the non-slum residents (27.2%); clients of private healthcare facilities (41.1%); currently married women (20.6%); women with secondary (22.2%) and tertiary (33.6%) level of education; and women belonging to the highest wealth quintile household (28.2%). The majority (65.8%) of the caesarean section clients were not informed about the consequences of caesarean section delivery by service providers. The logistic regression model shows that older age (30-49), secondary and above education, non-slum residence, high-risk pregnancy and receiving adequate antenatal care were significantly positively associated with caesarean section delivery. Conclusion: Despite the unreserved effort towards achieving MDG 5 through safe skilled delivery assistance among others, the high caesarean section rate beyond the recommend limit, and the finding that caesarean sections done without medical indications were also alarming. The government and city administration should take appropriate measures before the problems become setbacks in healthcare provision. Further investigations should focus on the effect of caesarean section delivery on maternal and child health outcomes in the study area.

Keywords: Addis Ababa, caesarean section, mode of delivery, slum residence

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