Search results for: flood incidence report

Authors: Sumandeep Kaur, Allam Srinivasa Rao, Mula Jayasimhadri

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In recent years, rare earth (RE) ions doped inorganic luminescent materials are seeking great attention due to their excellent physical and chemical properties. These materials offer high thermal and chemical stability and exhibit good luminescence properties due to the presence of RE ions. The luminescent properties of these materials are attributed to their intra-configurational f-f transitions in RE ions. A series of Tb³⁺ doped calcium aluminozincate has been synthesized via sol-gel method. The structural and morphological studies have been carried out by recording X-ray diffraction patterns and SEM image. The luminescent spectra have been recorded for a comprehensive study of their luminescence properties. The XRD profile reveals the single-phase orthorhombic crystal structure with an average crystallite size of 65 nm as calculated by using DebyeScherrer equation. The SEM image exhibits completely random, irregular morphology of micron size particles of the prepared samples. The optimization of luminescence has been carried out by varying the dopant Tb³⁺ concentration within the range from 0.5 to 2.0 mol%. The as-synthesized phosphors exhibit intense emission at 544 nm pumped at 478 nm excitation wavelength. The optimized Tb³⁺ concentration has been found to be 1.0 mol% in the present host lattice. The decay curves show bi-exponential fitting for the as-synthesized phosphor. The colorimetric studies show green emission with CIE coordinates (0.334, 0.647) lying in green region for the optimized Tb³⁺ concentration. This report reveals the potential utility of Tb³⁺ doped calcium aluminozincate phosphors for display and solid-state lighting devices.

Keywords: concentration quenching, phosphor, photoluminescence, XRD

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Authors: Aliyu Damri

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In every educational institution, students of mass communication receive training to report events and issues accurately and objectively in accordance with official controls. However, the complex nature of society today made it possible to use WhatsApp platform that revolutionizes the means of sharing information, ideas, and experiences. This paper examined how students in the Department of Mass Communication, Abdu Gusau Polytechnic, Talata Mafara used WhatsApp platform in spreading fake news. It used in depth interview techniques and focus group discussion with students as well as the use of published materials to gather related and relevant data. Also, the paper used procedures involved to analyze long interview content. This procedure includes observation of a useful utterance, development of expanded observation, examination of interconnection of observed comments, collective scrutiny of observation for patterns and themes, and review and analysis of the themes across all interviews for development of thesis. The result indicated that inadequate and absent of official controls guiding the conduct of online information sharing, inaccuracies and poor source verification, lack of gate keeping procedures to ensure ethical and legal provisions, bringing users into the process, sharing all information, availability of misinformation, disinformation and rumor and problem of conversation strongly encouraged the emergence of fake news. Surprisingly, the idea of information as a commodity has increased, and transparency of a source as new ethics emerged.

Keywords: disinformation, fake news, group, mass communication, misinformation, WhatsApp

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Authors: V. R. Venugopal

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Human being evolved 200,000 years ago in an area which is now the Sahara desert and lived all along in the northern part of Africa. It was around 10,000 to15,00 years that he moved out of Africa. Various ancient civilizations – mainly the Egyptian, Mesopotamian, Indus valley and the Chinese yellow river valley civilizations - developed and perished till the beginning of the Christian era. Strangely the regions where all these civilizations flourished are no deserts. After the ancient civilizations the two major religions of the world the Christianity and Islam evolved. These too evolved in the regions of Jerusalem and Mecca which are now in the deserts of the present Israel and Saudi Arabia. Human activity since ancient age right from his origin was in areas which are now deserts. This is only because wherever Man lived in large numbers he has turned them into deserts. Unfortunately, this is not the case with the ancient days alone. Over the last 500 years the forest cover on the earth is reduced by 80 percent. Even more currently Just over the last forty decades human population has doubled but the number of bugs, beetles, worms and butterflies (micro fauna) have declined by 45%. Deforestation and defaunation are the first signs of desertification and Desertification is a process parallel to the extinction of life. There is every possibility that soon most of the earth will be in deserts. This writer has been involved in the process of forestation and increase of fauna as a profession since twenty years and this is a report of his efforts made in the process, the results obtained and concept generated to revert the ongoing desertification of this earth. This paper highlights how desertification can be reverted by applying these basic principles. 1) Man is not owner of this earth and has no right destroy vegetation and micro fauna. 2) Land owner shall not have the freedom to do anything that he wishes with the land. 3) The land that is under agriculture shall be reduced at least by a half. 4) Irrigation and modern technology shall be used for the forest growth also. 5) Farms shall have substantial permanent vegetation and the practice of all in all out shall stop.

Keywords: desertification, extinction, micro fauna, reverting

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Authors: Harini Chakkera

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Background: Inpatient hyperglycemia is an established independent risk factor among several patient cohorts with hospital readmission. This has not been studied after kidney transplantation. Nearly one-third of patients who have undergone a kidney transplant reportedly experience 30-day readmission. Methods: Data on first-time solitary kidney transplantations were retrieved between September 2015 to December 2018. Information was linked to the electronic health record to determine a diagnosis of diabetes mellitus and extract glucometeric and insulin therapy data. Univariate logistic regression analysis and the XGBoost algorithm were used to predict 30-day readmission. We report the average performance of the models on the testing set on five bootstrapped partitions of the data to ensure statistical significance. Results: The cohort included 1036 patients who received kidney transplantation, and 224 (22%) experienced 30-day readmission. The machine learning algorithm was able to predict 30-day readmission with an average AUC of 77.3% (95% CI 75.30-79.3%). We observed statistically significant differences in the presence of pretransplant diabetes, inpatient-hyperglycemia, inpatient-hypoglycemia, and minimum and maximum glucose values among those with higher 30-day readmission rates. The XGBoost model identified the index admission length of stay, presence of hyper- and hypoglycemia and recipient and donor BMI values as the most predictive risk factors of 30-day readmission. Additionally, significant variations in the therapeutic management of blood glucose by providers were observed. Conclusions: Suboptimal glucose metrics during hospitalization after kidney transplantation is associated with an increased risk for 30-day hospital readmission. Optimizing the hospital blood glucose management, a modifiable factor, after kidney transplantation may reduce the risk of 30-day readmission.

Keywords: kidney, transplant, diabetes, insulin

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Authors: M. Irfan Fareed, Muhammad Tahir, Alvina Gul Kazi

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Castor bean (Ricinus communis; family Euphorbiaceae) is cultivated for the production of oil and as an ornamental plant throughout tropical regions. Leaf samples from castor bean plants with leaf curl and vein thickening were collected from areas around Okara (Pakistan) in 2011. PCR amplification using diagnostic primers showed the presence of a begomovirus and subsequently the specific pair (BurNF 5’- CCATGGTTGTGGCAGTTGATTGACAGATAC-3’, BurNR 5’- CCATGGATTCACGCACAGGGGAACCC-3’) was used to amplify and clone the whole genome of the virus. The complete nucleotide sequence was determined to be 2,759 nt (accession No. HE985227). Alignments showed the highest levels of nucleotide sequence identity (98.8%) with Cotton leaf curl Burewala virus (CLCuBuV; accession No. JF416947) No. JF416947). The virus in castor beans lacks on intact C2 gene, as is typical of CLCuBuV in cotton. An amplification product of ca. 1.4 kb was obtained in PCR with primers for betasatellites and the complete nucleotide sequence of a clone was determined to be 1373 nt (HE985228). The sequence showed 96.3% nucleotide sequence identity to the recombinant Cotton leaf curl Multan betasatellite (CLCuMB; JF502389). This is the first report of CLCuBuV and its betasatellite infecting castor bean, showing this plant species as an alternate host of the virus. Already many alternate host have been reported from different alternate host like tobacco, tomato, hibiscus, okra, ageratum, Digera arvensis, habiscus, Papaya and now in Ricinus communis. So, it is suggested that these alternate hosts should be avoided to grow near cotton growing regions.

Keywords: Ricinus communis, begomovirus, betasatellite, agriculture

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Authors: Chia-Ting Chang, Chia-Yu Lin

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We report on the decisive role of iron phosphate (FePO₄), formed in-situ during the electrochemical characterization, played in the electrocatalytic activity, especially its oxygen tolerance of iron oxides towards H₂O₂ reduction. Iron oxides studied including, Nanorod arrays (NRs) of β-FeOOH, γ-Fe₂O₃, α-Fe₂O₃, α-Fe₂O₃ nanosheets (α-Fe₂O₃NS), α-Fe₂O₃ nanoparticles (α-Fe₂O₃NP), were synthesized using chemical bath deposition. The nanostructure was controlled simply by adjusting the composition of precursor solution and reaction duration for CBD process, whereas the crystal phase was controlled by adjusting the annealing temperature. It was found that iron phosphate (FePO₄) was deposited in-situ onto the surface of this nanostructured α-Fe₂O₃ during the electrochemical pretreatment in the phosphate electrolyte, and both FePO₄ and α-Fe₂O₃ showed the activity in catalysing the electrochemical reduction of H₂O₂. In addition, the interaction/compatibility between deposited FePO₄ and iron oxides has a decisive effect on the overall electrocatalytic activity of the resultant electrodes; FePO₄ only showed synergetic effect on the overall electrocatalytic activity of α-Fe₂O₃NR and α-Fe2O₃NS. Both α-Fe₂O₃NR and α-Fe₂O₃NS showed two reduction peaks in phosphate electrolyte containing H₂O₂, one being pH-dependent and related to the electrocatalytic properties of FePO₄, and the other one being pH-independent and only related to the intrinsic electrocatalytic properties of α-Fe₂O₃NR and α-Fe₂O₃NS. However, all iron oxides showed only one pH-independent reductive peak in non-phosphate electrolyte containing H₂O₂. The synergesitic catalysis exerted by FePO₄ with α-Fe₂O₃NR or α-Fe₂O₃NS providing additional oxygen-insensitive active site for H₂O₂ reduction, which allows their applications to electrochemical detection of H₂O₂ without the interference of O₂ involving in oxidase-catalyzed chemical processes.

Keywords: H₂O₂ reduction, Iron oxide, iron phosphate, O₂ tolerance

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Authors: Muhammad S. Sajid, Asim Shamim, Muhammad Nisar Khan, Ashfaq A. Chatta, Muhammad Saqib

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Goats (Capra hircus) are a valued asset for resource poor farmers globally. But the parasitic infection especially Haemonchus contortus (Trichostrongylid), impact the health and production of goats globally. The present study intended to evaluate resilient and resistance to Haemonchus contortus in indigenous goat breeds (Teddy and Beetal) of Punjab, Pakistan. Out of 60, 30 goats of each breed were divided into 6 groups and each group contain five goats. Two group of each breed received challenged infection with 12000 and 18000 L3 (third stage) larvae of Haemonchus contortus under two infection protocol that is early and trickle and remaining two group of each breed was kept as control. Resilient and resistance of each breed was then measured on the basis of their phenotypic markers like: faecal egg counts, packed cell volume, FAMACHA score system, body weight, total protein, albumin and worm count on 2nd, 4th, 6th, and 8th week of post infection. Variation in response of each goat breeds to Haemonchus contortus was observed. Teddy breed showed significant (P < 0.05)resistance as compared to Beetal. It is probably first attempt to report an evaluation of goat breed response towards Haemonchus contortus in Pakistan. It was concluded that Teddy goats have a greater genetic tendency to resist against to the Haemonchus contortus infection and this breed could be kept and bred from the economic point of view. Evaluation of genetic markers are like: gene, protein expression, Immunoglobulin, Histamines and interleukins determination are recommended for future studies which can be helpful to be fined resistant breed of goats.

Keywords: goat, beetal, teddy, haemonchus contortus, resistance, resilience, phenotypic markers

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Authors: Sanjay Sinha, Mohd Umair Khan

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The level of income inequality in India has been worrisome as the World Inequality Report termed it as a “poor and unequal country, with an affluent elite”. As important as income is to understand inequality and deprivation, it is just one dimension. But the historical roots and current realities of inequality and deprivation in India lies in many of the non-income dimensions such as housing, nutrition, education, agency, sense of inclusion etc. which are often ignored, especially in solution-oriented research. The level of inequality and deprivation among the tribal is one such case. There is a corpus of literature establishing that the tribal communities in India are disadvantageous on various grounds. Given their rural geography, issues of access and quality of basic facilities such as education and healthcare are often unaddressed. COVID-19 has further exacerbated this challenge and climate change will make it even more worrying. With this background, a succinct measurement tool at the village level is necessary to design short to medium-term actions with reference to risk mitigation for tribal communities. This research paper examines the level of inequality and deprivation among the tribal communities in the rural areas of Andhra Pradesh state of India using a Multidimensional Inequality and Deprivation Index based on the Alkire-Foster methodology. The methodology is theoretically grounded in the capability approach propounded by Amartya Sen, emphasizing on achieving the “beings and doings” (functionings) an individual reason to value. In the index, the authors have five domains, including Livelihood, Food Security, Education, Health and Housing and these domains are divided into sixteen indicators. This assessment is followed by domain-wise short-term and long-term solutions.

Keywords: Andhra Pradesh, Alkire-Foster methodology, deprivation, inequality, multidimensionality, poverty, tribal

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Authors: Fatma Koksal Çakirlar, Si̇nem Ozdemir, Selcan Akyol, Revazi̇ye Gulesen, Murat Gunaydin, Nevri̇ye Gonullu, Belkis Levent, Nuri̇ Kiraz

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Vibrio cholerae O1 and O139 are the causative agent of epidemic or pandemic cholera. V. cholerae O1 is generally accepted as a non-invasive enterotoxigenic organism causing gastroenteritis of various severities. Non-O1 V. cholerae can cause small outbreaks of diarrhea due to consumption of contaminated food and water. Particularly, the patients with achlorydria have a risk for vibrio infections. There are numerous case reports of bacteremia caused by vibrio in patients with predisposing conditions like cirrhosis, nephrotic syndrome, diabetes, hematologic malignancy, gastrectomy, and AIDS. We described in this study the first case of nontoxigenic, non-01/non-O139 V. cholerae isolated from the blood culture of a 77-year-old female patient with hipertension, diabetes, coronary artery disease, gout and about 9 years ago migrated breast cancer history. The patient with complaints of shortness of breath, fever and malaise admitted to our emergency clinic were evaluated. There was no diarrhea or abdominal symptoms in the patient. No growth in her urine culture, but blood culture (BACTEC 9120 system, Becton Dickinson, USA) was positive for non-01/non-O139 V. cholerae that was identified by conventional methods and Phoenix automated system (BD Diagnostic Systems, Sparks, MD). It does not secrete the cholera toxin. The agglutination test was negative with polyvalent O1 antisera and O139 antiserum. Empirically ceftriaxone was administered to the patient and she was discharged with improvement in general condition. In this study we report bacteremia by non-01/non-O139 V. cholerae that is rare in the worldwide and first in Turkey.

Keywords: bacteremia, blood culture, immunocompromised patient, Non-O1 vibrio cholerae

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Authors: E. Isaac, I. Jalo, Y. Alkali, A. Ajani, A. Rasaki, Y. Jibrin, K. Mustapha, A. Ayuba, S. Charanchi, H. Danlami

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Introduction: Hepatitis B infection continues to be a serious global health problem with about 2 billion people infected worldwide, many of these in sub-Saharan Africa. Nigeria is one of the countries with the highest incidence, with a prevalence of 10-15%. Methods: Records of Hepatitis B surface and envelope antigen test results in adults in Federal Teaching Hospital, Gombe between May 2000 and May 2015 were retrieved and analyzed. Findings: Adult out-patient consultations and in-patient admissions were 343,083 and 67,761 respectively, accounting for 87% of total. Hepatitis B surface antigenaemia was tested for in 23,888 adults and children. 88.9% (21240) were adults. Males constituted 56% (11902/21240) and females 44% (9211/21240). 5104 (24.0%) of tested individuals were 19-25years; 12,039 (56.7%) 26-45years; 21119 (9.0%) 46-55years; 2.8% (590/21240) and 766 (3.6%) >65years. Among adult males, 17% (2133/11902) was contributed by ages 19-25. 58% (7017/11902), 11.9% (1421/11902), 6.4% (765/11902) and 4.7% (563/11902) of males were 26-45 years old, 46-55 years old and 56-65 years and >65year old respectively. Adults aged 19-25years, 26-45 years, 46-55years, 56-65 and > 65years each constituted 32% (2966/9211); 54.4% (5009/9211); 7.4% (684/9211), 3.8% (350/9211) and 2.2% (201/9211) of females respectively. 16.2% (3431/21,240) demonstrated Hepatitis B surface antigenaemia. The sero-positivity rate was 16.9% (865//5104) between 19-25years, 21.2% (2559/12,039) among 26-45year old individuals. 17.9% (377/2111); 14.1% (83/590) and 7.3% (56/766) of 46-55year old, 56-65year old and >65year old individuals screened were seropositive. The highest sero-positivity rate was found in male young adults aged 19-25years 27.9% (398/1426) and lowest in elderly males 7.4% (28/377). HBe antigen testing rate among HbSAg seropositive individuals was 97.3% (3338/3431). Males constituted 59.7% (1992/3338) and females 40.3% (1345/3338). 25.3% (844/3338) were aged 19-25years; 61.1% (2039/3338) 26-45years; 10.2% (340/3338) 46-55years; 2.7% (90/3338) 56-65years and 0.7% >65years old. HB e antigenaemia was positive in 8.2% (275/3338) of those tested. 41% (113/275); 50.2% (138/275); 5.4% (15/275); 1.8% (5/275) and 1.1 (3/275) of HB e sero-positivity was among age groups 19-25, 26-45, 46-55, 56-65 and > 65year old individuals. Dual sero-positivity rate was highest 13% (113/844) in young adults 19-25years and lowest between 46-55years; 15/340 (4.4%). 4.2% (15/360); 13.5% (69/512); 6.7% (90/1348); 4.6% (10/214); 5% (2/40) and 6.7% (1/15) of males aged 19-25; 26-45; 46-55; 56-65; and >65years had HB e antigenaemia respectively. Among females - 27/293 (9.2%) aged 19-25; 26/500 (5.2%) 26-45; 2/84 (2.4%) 46-55; 1/12 (8.3%) 56-65 and 1/9(11.1%) >65years had dual antigenaemia. In women of childbearing age, 6.9% (53/793) had a dual carriage. Conclusion: Dual hepatitis B surface and envelope antigenaemia are highest in young adult males. This will have significant implications for the development of chronic liver disease and hepatocellular carcinoma.

Keywords: adult, Hepatitis B, Nigeria, dual carriage

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Authors: Kieren Wilson, Gulnaz Majeed

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NHS constitution gives rights to the patient with suspected cancer to be seen by a cancer specialist within 2 weeks of referral. Guys and St Thomas Hospital (GSTT) is one of the largest cancer centres in London. NICE guidelines have provided guidance for health professionals to refer patients appropriately to RAC. In GSTT suspected gynae cancer referrals are mostly by NHS e-Referral Service with some fax, emails as well as paper referrals. The objective of this study was to evaluate compliance with 2-week referral pathway with emphasis on one stop diagnostic service with supporting efficient pathways. A prospective evaluation over 3 months (1 Jan 2017 to 31 Mar 2017) was undertaken. There were 26 clinics, 761 patients were booked in the clinics with a DNA rate of 13% (n=101) hence 606 patients were seen. Majority of referrals were for post menopausal bleeding (PMB) 25% (n=194) followed by cervical, vaginal, vulval reasons 23% (n=179) (abnormal cytology excluded as patients directly referred to colposcopy unit in GSTT), ovarian 7% (n=54) and endometrial 5% (n=41). Women with new or previous established diagnosis of cancer were 24, cervical (n=17), vulva (n=6) and vagina (n=1). Multifocal preinvasive disease vulva (VIN), vagina (VAIN) and cervix (CIN) was confirmed in twenty-six patients 4% (high prevalence in HIV patients). Majority of cervical referrals: PCB (n=14), cervical erosion (n=7), polyps (n=9) and cervical cyst were benign. However, two women with PMB had cervical cancer. Only 2 out of 13 referrals with vaginal concerns had VAIN. One case with non-cervical glandular cytology was confirmed to have endometrial cancer. One stop service based on the diagnostic support of ultrasound, colposcopy and hysteroscopy was achieved in 54% (n=359). Patients were discharged to GP, benign gynaecology, endometriosis, combined vulval/dermatology clinic or gynae oncology. 33% (n=202) required a second visit, 12% (n=70) third visit, 3% (n=19) fourth visit, 1% (n=4) fifth visit and 1% (n=6) sixth visit. Main reasons for follow ups were the unavailability of diagnostic slots, patient choice, need for interpreters, the discussion following gynae MDM review for triage to benign gynae, delay in availability of diagnostic results like histology/MRI/CT. Recommendations following this study are multi disciplinary review of pathways with the availability of additional diagnostic procedure slots to aim for one stop service. Furthermore, establishment of virtual and telephone consultations to reduce follow ups.

Keywords: multifocal disease, post menopausal bleeding, preinvasive disease, rapid access clinic

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Authors: Kayla Renteria

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This study explored the role animal-assisted psychotherapy (AAP) can play in treating Post-Traumatic Stress Disorder (PTSD) when incorporated into Trauma-informed cognitive behavioral therapy (TF-CBT). A review of the literature was performed to show how incorporating AAP could benefit TF-CBT since this treatment model often presents difficulties, such as client motivation and avoidance of the exposure element of the intervention. In addition, the fluidity of treatment goals during complex trauma cases was explored, as this issue arose in the case study. This study follows the course of treatment of a 12-year-old female presenting with symptoms of PTSD. Treatment consisted of traditional components of the TF-CBT model, with the added elements of AAP to address typical treatment obstacles in TF-CBT. A registered therapy dog worked with the subject in all sessions throughout her treatment. The therapy dog was incorporated into components such as relaxation and coping techniques, narrative therapy techniques, and psychoeducation on the cognitive triangle. Throughout the study, the client’s situation and clinical needs required the therapist to switch goals to focus on current safety and stability. The therapy dog provided support and neurophysiological benefits to the client through AAP during this shift in treatment. The client was assessed quantitatively using the Child PTSD Symptom Scale Self Report for DSM-5 (CPSS-SR-5) before and after therapy and qualitatively through a feedback form given after treatment. The participant showed improvement in CPSS-SR-V scores, and she reported that the incorporation of the therapy animal improved her therapy. The results of this study show how the use of AAP provided the client a solid, consistent relationship with the therapy dog that supported her through processing various types of traumas. Implications of the results of treatment and for future research are discussed.

Keywords: animal-assisted therapy, trauma-focused cognitive behavioral therapy, PTSD in children, trauma treatment

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Authors: Beatriz Muñiz Cano, J. Ripoll Sau, D. Pacile, P. M. Sheverdyaeva, P. Moras, J. Camarero, R. Miranda, M. Garnica, M. A. Valbuena

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Graphene, in its pristine state, is a semiconductor with a zero band gap and massless Dirac fermions carriers, which conducts electrons like a metal. Nevertheless, the absence of a bandgap makes it impossible to control the material’s electrons, something that is essential to perform on-off switching operations in transistors. Therefore, it is necessary to generate a finite gap in the energy dispersion at the Dirac point. Intense research has been developed to engineer band gaps while preserving the exceptional properties of graphene, and different strategies have been proposed, among them, quantum confinement of 1D nanoribbons or the introduction of super periodic potential in graphene. Besides, in the context of developing new 2D materials and Van der Waals heterostructures, with new exciting emerging properties, as 2D transition metal chalcogenides monolayers, it is fundamental to know any possible interaction between chalcogenide atoms and graphene-supporting substrates. In this work, we report on a combined Scanning Tunneling Microscopy (STM), Low Energy Electron Diffraction (LEED), and Angle-Resolved Photoemission Spectroscopy (ARPES) study on a new superstructure when Te is evaporated (and intercalated) onto graphene over Ir(111). This new superstructure leads to the electronic doping of the Dirac cone while the linear dispersion of massless Dirac fermions is preserved. Very interestingly, our ARPES measurements evidence a large band gap (~400 meV) at the Dirac point of graphene Dirac cones below but close to the Fermi level. We have also observed signatures of the Dirac point binding energy being tuned (upwards or downwards) as a function of Te coverage.

Keywords: angle resolved photoemission spectroscopy, ARPES, graphene, spintronics, spin-orbitronics, 2D materials, transition metal dichalcogenides, TMDCs, TMDs, LEED, STM, quantum materials

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Authors: Dinoo Kirthinanda, Sujani Wijeratne

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Pseudohyperkalaemia is a common benign in vitro phenomenon caused by the release of potassium ions (K+) from cells during specimen processing. Analysis of haemolysed blood samples for predominantly intracellular electrolytes may lead to re-investigation and potentially harmful interventions. We report a case of a 52-year male with myeloproliferative disease manifested as Polycythaemia Rubra Vera, Hypertension and hypertensive nephropathy with stage 3 chronic kidney disease admitted to Neuro-intensive care unit (NICU) with an intra-cerebral haemorrhage secondary to hypertensive bleed. His initial blood investigations showed hyperkalemia with serum K+ 6.2 mmol/L yet the bedside arterial blood gas analysis yielded K+ of 4.6 mmol/L. The patient was however given hyperkalemia regime twice based on venous electrolyte analysis. The discrepancy between the bedside electrolyte analysis using arterial blood and venous blood prompted further evaluation. The 12 lead Electrocardiogram showed U waves and sinus bradycardia corresponding to the serum K+ of 2.8 mmol/L on arterial blood gas analysis. Immediate K+ replacement ensured the patient did not develop life-threatening cardiac complications. Pseudohyperkalaemia may pose diagnostic challenges in the absence of detectable haemolysis and should be suspected in susceptible patients with normal Electrocardiogram and Glomerular Filtration Rate to avoid potentially life-threatening interventions. When in doubt, rapid analysis of arterial blood gas may be useful for accurate quantification of potassium.

Keywords: patient safety, pseudohyperkalaemia, haemolysis, myeloproliferative disorder

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Authors: Edoghogho Ogbeifun, Charles Mbohwa, J. H. C. Pretorius

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Several research report on the factors responsible for the delays in the completion of construction projects has identified the issue of funding as a critical factor; insufficient funding, low cash-flow or lack of funds. Indeed, adequate funding plays pivotal role in the effective execution of construction projects. In the last twenty years (or so), there has been increase in the funds available for infrastructure development in tertiary institution in Nigeria, especially, through the Tertiary Education Trust Fund. This funding body ensures that there is enough fund for each approved project, which is released in three stages during the life of the construction project. However, a random tour of many of the institutions reveals striking evidence of projects not delivered on schedule, to quality and sometime out rightly abandoned. This suggests, therefore, that there are other latent factors, responsible for project delays, that should be investigated. Thus, this research, a pilot scheme, is aimed at unearthing the possible reasons for the delays being experienced in the execution of construction projects for infrastructure upgrade in public tertiary institutions in Nigeria, funded by Tertiary Education Trust Fund. The multiple site case study of qualitative research was adopted. The respondents were the Directors of Physical Planning and the Directors of Works of four Nigerian Public Universities. The findings reveal that delays can be situated within three entities, namely, the funding body, the institutions and others. Therefore, the emerging factors have been classified as external factors (haven to do with the funding body), internal factors (these concern the operations within the institutions) and general factors. The outcome of this pilot exercise provides useful information to guide the Directors as they interact with the funding body as well as challenges themselves to address the loopholes in their internal operations.

Keywords: delays, external factors, funding, general factors, Internal factors

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Authors: F. Ruiz-Navarro, M. Matzner, G. Kobinia

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Background: Cerebral palsy (CP) encompasses the largest group of childhood movement disorders, the patterns and severity varies widely. Today, the management focuses only on a rehabilitation therapy that tries to secure the functions remained and prevents complications. However the treatments are not aimed to cure the disease. Stem cells (SCs) transplant via intrathecal is a new approach to the disease. Method: Our aim was to performed a pilot study under the condition of unproven treatment on clinical practice to assessed the safety and efficacy of Neuron Point-of-care Stem cell Therapy (N-POCST), an ambulatory procedure of autologous bone marrow derived SCs (BM-SCs) harvested from the posterior superior iliac crest undergo an on-site cell separation for intrathecal infusion via lumbar puncture. Results: 82 patients were treated in a period of 28 months, with a follow-up after 6 months. They had a mean age of 6,2 years old and male predominance (65,9%). Our preliminary results show that: A. No patient had any major side effects, B. Only 20% presented mild headache due to LP, C. 53% of the patients had an improvement in spasticity, D. 61% improved the coordination abilities, 23% improved the motor function, 15% improved the speech, 23% reduced the number of convulsive events with the same doses or less doses of anti-convulsive medication and 94% of the patients report a subjective general improvement. Conclusions: These results support previous worldwide publications that described the safety and effectiveness of autologous BM-SCs transplant for patients wit CP.

Keywords: autologous transplant, cerebral palsy, point of care, childhood movement disorders

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Authors: Falntina Ahmad Alata, Natheer Abu Obeid

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This paper is a research report of an experimental study on a proposed typology system to diagnose and evaluate the affordances of varying architectural environments. The study focused on architectural environments which have been developed with a shift in their use of adaptive reuse. The novelty in the newly developed environments was tested in terms of human responsiveness and interaction using a variety of selected cases. The study is a follow-up on previous research by the same authors, in which a typology of 16 categories of environmental affordances was developed and introduced. The current study introduced other new categories, which together with the previous ones establish what could be considered a basic language of affordance typology. The experiment was conducted on ten architectural environments while adopting two processes: 1. Diagnostic process, in which the environments were interpreted in terms of their affordances using the previously developed affordance typology, 2. The evaluation process, in which the diagnosed environments were evaluated using measures of emotional experience and architectural evaluation criteria of beauty, economy and function. The experimental study demonstrated that the typology system was capable of diagnosing different environments in terms of their affordances. It also introduced new categories of human interaction: “multiple affordances,” “conflict affordances,” and “mix affordances.” The different possible combinations and mixtures of categories demonstrated to be capable of producing huge numbers of other newly developed categories. This research is an attempt to draw a roadmap for designers to diagnose and evaluate the affordances within different architectural environments. It is hoped to provide future guidance for developing the best possible adaptive reuse according to the best affordance category within their proposed designs.

Keywords: affordance theory, affordance categories, architectural environments, architectural evaluation criteria, adaptive reuse environment, emotional experience, shift in use environment

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Authors: Veliswa Nonfundo Hoho, Jabulani Gilford Kheswa

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HIV/AIDS has been a long-term condition worldwide, which does not only affect physical health but also causes psychological and social challenges in people living with this condition. In Sub-Saharan countries, namely; Nigeria, Uganda, Zimbabwe and South Africa, people living with HIV/AIDS come across different challenges especially after one has disclosed his/her status. They experience stigma and discrimination, isolation, lack of accessing and receiving treatment, lack of support and experience psychological distress. By using the evidence-based systematic review as a form of methodology, journal articles, dissertations, internet, and books were explored. This paper seeks to describe the challenges faced by people living with HIV/AIDS after disclosure, which forms a critical component of HIV/AIDS prevention and treatment interventions. The disclosure process model is used to underpin the study. This theory allows one to understand when and why interpersonal and verbal self-disclosure is beneficial for individuals who live with concealable stigmatized identities such as HIV/AIDS. Literature findings advocate that both negative and positive results were noted after disclosing one’s HIV status and psychosocial well-being of the majority of people living with HIV/AIDS also get affected especially in societies which subscribe HIV/AIDS pandemic to witchcraft. As for the infected homosexuals, research indicates that they suffer in silence and to cover their emotional emptiness due to ostracism, they often report low- self-efficacy with regard to condom use and become susceptible to reinfections which further place their lives at heightened risk for low immune system. In this regard, this paper challenges the policies which protect the dignity of people living with HIV/AIDS and calls for unity and financial support in favour of psychoeducational programmes and support groups aimed at curbing discrimination.

Keywords: disclosure, discrimination, homosexuality, self-efficacy

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Authors: A. Alli-Oluwafuyi, A. Amin, S. M. Fii, S. O. Amusa, A. Imam, N. T. Asogwa, W. I. Abdulmajeed, F. Olaseinde, B. V. Owoyele

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Chronic stress or prolonged glucocorticoid administration impairs higher cognitive functions in rodents and humans. However, the mechanisms are not fully clear. Insulin and receptors are expressed in the brain and are involved in cognition. Insulin resistance accompanies Alzheimer’s disease and associated cognitive decline. The goal of this study was to evaluate the effects of sub-chronic administration of a glucocorticoid, dexamethasone (DEX) on behavior and biochemical changes in prefrontal cortex (PFC). Male Wistar rats were administered DEX (2, 4 & 8 mg/kg, IP) or saline for seven consecutive days and behavior was assessed in the following paradigms: “Y” maze, elevated plus maze, Morris’ water maze and novel object recognition (NOR) tests. Insulin, lactate dehydrogenase (LDH) and Superoxide Dismutase (SOD) activity were evaluated in homogenates of the prefrontal cortex. DEX-treated rats exhibited impaired prefrontal cortex function manifesting as reduced locomotion, impaired novel object exploration and impaired short- and long-term spatial memory compared to normal controls (p < 0.05). These effects were not consistently dose-dependent. These behavioral alterations were accompanied by a decrease in insulin concentration observed in PFC of 4 mg/kg DEX-treated rats compared to control (10μIU/mg vs. 50μIU/mg; p < 0.05) but not 2mg/kg. Furthermore, we report a modification of brain stress markers LDH and SOD (p > 0.05). These results indicate that prolonged activation of GCs disrupt prefrontal cortex function which may be related to insulin impairment. These effects may not be attributable to a non-specific elevation of oxidative stress in the brain. Future studies would evaluate mechanisms of GR-induced insulin loss.

Keywords: dexamethasone, insulin, memory, prefrontal cortex

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Authors: Nongyao Intasaso, Atchara Rattanama, Navarat Pewnual

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This research is survey research purposed to study the factor affected to knowledge management efficiency of personnel in Rajamangala University of Technology Srivijaya, and study the problem of knowledge management affected to knowledge development of personnel in the university. The tool used in this study is structures questioner standardize rating scale in 5 levels. The sample selected by purposive sampling and there are 137 participation calculated in 25% of population. The result found that factor affected to knowledge management efficiency in the university included (1) result from the organization factor found that the university provided project or activity that according to strategy and mission of knowledge management affected to knowledge management efficiency in highest level (x̅ = 4.30) (2) result from personnel factor found that the personnel are eager for knowledge and active to learning to develop themselves and work (Personal Mastery) affected to knowledge management efficiency in high level (x̅ = 3.75) (3) result from technological factor found that the organization brought multimedia learning aid to facilitate learning process affected to knowledge management efficiency in high level (x̅ = 3.70) and (4) the result from learning factor found that the personnel communicated and sharing knowledge and opinion based on acceptance to each other affected to knowledge management efficiency in high level (x̅ = 3.78). The problem of knowledge management in the university included the personnel do not change their work behavior, insufficient of collaboration, lack of acceptance in knowledge and experience to each other, and limited budget. The solutions to solve these problems are the university should be support sufficient budget, the university should follow up and evaluate organization development based on knowledge using, the university should provide the activity emphasize to personnel development and assign the committee to process and report knowledge management procedure.

Keywords: knowledge management, efficiency, personnel, learning process

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Authors: Gideon Nyuimbe Gasu

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Sub Saharan Africa is at a critical point, experiencing rapid population growth, particularly in urban areas and young growing force. At the same time, the growing risk of catastrophic global climate change threatens to weaken food production system, increase intensity and frequency of drought, flood, and fires and undermine gains on development and poverty reduction. Although the region has the lowest per capital greenhouse gas emission level in the world, it will need to join global efforts to address climate change, including action to avoid significant increases and to encourage a green economy. Thus, there is a need for the concept of 'greening the economy' as was prescribed at Rio Summit of 1992. Renewable energy is one of the criterions to achieve this laudable goal of maintaining a green economy. There is need to address climate change while facilitating continued economic growth and social progress as energy today is critical to economic growth. Fossil fuels remain the major contributor of greenhouse gas emission. Thus, cleaner technologies such as carbon capture storage, renewable energy have emerged to be commercially competitive. This paper sets out to examine how to achieve a low carbon economy with minimal emission of carbon dioxide and other greenhouse gases which is one of the outcomes of implementing a green economy. Also, the paper examines the different renewable energy sources such as nuclear, wind, hydro, biofuel, and solar voltaic as a panacea to the looming climate change menace. Finally, the paper assesses the different renewable energy and energy efficiency as a propeller to generating new sources of income and jobs and in turn reduces carbon emission. The research shall engage qualitative, evaluative and comparative methods. The research will employ both primary and secondary sources of information. The primary sources of information shall be drawn from the sub Saharan African region and the global environmental organizations, energy legislation, policies and related industries and the judicial processes. The secondary sources will be made up of some books, journal articles, commentaries, discussions, observations, explanations, expositions, suggestions, prescriptions and other material sourced from the internet on renewable energy as a panacea to climate change. All information obtained from these sources will be subject to content analysis. The research result will show that the entire planet is warming as a result of the activities of mankind which is clear evidence that the current development is fundamentally unsustainable. Equally, the study will reveal that a low carbon development pathway in the sub Saharan African region should be embraced to minimize emission of greenhouse gases such as using renewable energy rather than coal, oil, and gas. The study concludes that until adequate strategies are devised towards the use of renewable energy the region will continue to add and worsen the current climate change menace and other adverse environmental conditions.

Keywords: carbon dioxide, climate change, legislation/law, renewable energy

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Authors: Ana M. Lara, Manuela Llano, Felipe Gaitán, Rosa H. Bustos, Ana Maria Perdomo-Arciniegas, Ximena Bonilla

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Umbilical cord blood is used as a source of progenitor and stem cells for the regeneration of the hematopoietic and immune system to treat patients with different hematological or non-hematological diseases. This stem cell source represents an advantage over the use of bone marrow or mobilized peripheral blood because it has a lower incidence rate of graft-versus-host disease, probably due to fewer immunological compatibility restrictions. However, its low cellular dose limits its use in pediatric patients. This work proposes the standardization of a cell expansion technique to compensate for the dose of infused cells through the ex-vivo manipulation of hematopoietic progenitor cells from umbilical cord blood before transplantation. The expansion model is carried out through co-cultures with mesenchymal stem cells (MSC) from bone marrow (BM) and less explored fetal tissues such as Wharton's jelly (WJ) and umbilical cord blood (UCB). Initially, a master cell bank of primary mesenchymal stem cells isolated from different sources was established and characterized following International Society of Cell Therapies (ISCT) indications. Additionally, we assessed the effect of a short 25 Gy cycle of gamma irradiation on cell cycle arrest of mesenchymal cells over the support capacity for the expansion of hematopoietic stem cells from umbilical cord blood was evaluated. The results show that co-cultures with MSC from WJ and UCB allow the cellular dose of HSPC to be maximized between 5 and 16 times having a similar support capacity as BM. In addition, was evaluated the hematopoietic stem progenitor cell's HSPC functionality through the evaluation of migration capacity, their differentiation capacity during culture time by flow cytometry to evaluate the expression of membrane markers associated with lineage-committed progenitors, their clonogenic potential, and the evaluation of secretome profile in the expansion process was evaluated. So far, the treatment with gamma irradiation maintains the hematopoietic support capacity of mesenchymal stem cells from the three sources studied compared to treatments without irradiation, favoring the use of fetal tissues that are generally waste to obtain mesenchymal cell lines for ex-vivo expansion systems. With the results obtained, a standardized protocol that will contribute to the development of ex-vivo expansion with MSC on a larger scale will be achieved, enabling its clinical use and expanding its application in adults.

Keywords: ex-vivo expansion, hematopoietic stem cells, hematopoietic stem cell transplantation, mesenchymal stem cells, umbilical cord blood

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Authors: Demelash Kassaye Debalkie

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The primary objective of this study is to report the tributes that are significantly impeding the Ethiopian police's ability to provide quality services to the people. Policing in Ethiopia started in the medieval period. However, modern policing was introduced instead of vigilantism in the early 1940s. The progress counted since the date police became modernized is, however, under contention when viewed from the standpoint of officers’ development and technologies in the 21st century. The police in Ethiopia are suffering a lot to be set free from any form of political interference by the government and to be loyal to impartiality, equity, and justice in enforcing the law. Moreover, the institutional competence of the police in Ethiopia is currently losing its power derived from the constitution as a legitimate enforcement agency due to the country’s political landscape encouraging ethnic-based politics. According to studies, the impact of ethnic politics has been a significant challenge for police in controlling conflicts between two ethnic groups. The study used qualitative techniques and data was gathered from key informants selected purposely. The findings indicate that governments in the past decades were skeptical about establishing a constitutional police force in the country. This has certainly been one of the challenges of pluralizing the police: building police-community relations based on trust. The study conducted to uncover the obstructions has finally reported that the government’s commitment to form a non-partisan, functionally decentralized, and operationally demilitarized police force is too minimal and appalling. They mainly intend to formulate the missions of the police in accordance with their interests and political will to remain in power. It, therefore, reminds the policymakers, law enforcement officials, and the government in power to revise its policies and working procedures already operational to strengthen the police in Ethiopia based on public participation and engagement.

Keywords: community, constitution, Ethiopia, law enforcement

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Authors: L. K. Nivedha, V. Maruthapandian, R. Kothandaraman

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Rechargeable zinc-air batteries (ZAB) are gaining significant research attention owing to their high energy density and copious zinc resources worldwide. However, the unsolved obstacles such as dendrites, passivation, depth of discharge and the lack of an efficient cathode catalyst restrict their practical application1. By and large, non-noble transition metal-based catalysts are well-reputed materials for catalysing oxygen reduction reaction (ORR) and oxygen evolution reaction (OER) with greater stability in alkaline medium2. Herein, we report the synthesis and application of Mn₃O4-NiFeLDH/Carbon composite as a cathode catalyst for rechargeable ZAB. The synergetic effects of the mixed transition metals (Mn/Ni/Fe) have aided in catalysing ORR and OER in alkaline electrolyte with a shallow potential gap of 0.7 V. The composite, by its distinctive physicochemical characteristics, shows an excellent OER activity with a current density of 1.5 mA cm⁻² at a potential of 1.6 V and a superior ORR activity with an onset potential of 0.8 V when compared with their counterparts. Nevertheless, the catalyst prefers a two-electron pathway for the electrochemical reduction of oxygen which results in a limiting current density of 2.5 mA cm⁻². The bifunctional activity of the Mn₃O₄-NiFeLDH/Carbon composite was utilized in developing rechargeable ZAB. The fully fabricated ZAB delivers an open circuit voltage of 1.4 V, a peak power density of 70 mW cm⁻², and a specific capacity of 800 mAh g⁻¹ at a current density of 20 mA cm⁻² with an average discharge voltage of 1 V and the cell is operable upto 50 mA cm-2. Rechargeable ZAB demonstrated over 110 h at 10 mA cm⁻². Further, the cause for the diminished charge-discharge performance experienced beyond the 100th cycle was investigated, and carbon corrosion was testified using Infrared spectroscopy.

Keywords: rechargeable zinc-air battery, oxygen evolution reaction, bifunctional catalyst, alkaline medium

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Authors: Nikolay P. Brayanov, Anna V. Stoynova

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Model-based development approach is gaining more support and acceptance. Its higher abstraction level brings simplification of systems’ description that allows domain experts to do their best without particular knowledge in programming. The different levels of simulation support the rapid prototyping, verifying and validating the product even before it exists physically. Nowadays model-based approach is beneficial for modelling of complex embedded systems as well as a generation of code for many different hardware platforms. Moreover, it is possible to be applied in safety-relevant industries like automotive, which brings extra automation of the expensive device certification process and especially in the software qualification. Using it, some companies report about cost savings and quality improvements, but there are others claiming no major changes or even about cost increases. This publication demonstrates the level of maturity and autonomy of model-based approach for code generation. It is based on a real live automotive seat heater (ASH) module, developed using The Mathworks, Inc. tools. The model, created with Simulink, Stateflow and Matlab is used for automatic generation of C code with Embedded Coder. To prove the maturity of the process, Code generation advisor is used for automatic configuration. All additional configuration parameters are set to auto, when applicable, leaving the generation process to function autonomously. As a result of the investigation, the publication compares the quality of generated embedded code and a manually developed one. The measurements show that generally, the code generated by automatic approach is not worse than the manual one. A deeper analysis of the technical parameters enumerates the disadvantages, part of them identified as topics for our future work.

Keywords: embedded code generation, embedded C code quality, embedded systems, model-based development

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Authors: Deepthinath Reghunathan, Satheesha Nayak, Sudarshan S., Prasad Alathady Maloor, Prakash Shetty

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Lumbar plexus is formed by the union of ventral rami of T12, L1, L2, L3 spinal nerves and the larger upper division of L4 lumbar spinal nerves. Variations in the normal anatomy of the lumbar and sacral plexus might be seen in some cases and are reported in the literature, but finding such an unusual case comprising of multiple variations which is normally not expected in a clinical setup, proves to be a vital piece of information for clinicians and medical practitioners. During the dissection of the abdomen and pelvis of an approximately 70 year old cadaver, we observed the following variations in the formation of the lumbar and sacral nerves. 1. The genitofemoral nerve bifurcated at a higher level; genital branch of genitofemoral nerve gave branches to the anterior abdominal wall muscles, 2. A communicating branch was given from the lateral cutaneous nerve of thigh to the medial cutaneous nerve of thigh, 3. A muscular branch was given from femoral nerve to psoas major, 4. There was absence of contribution of L4 spinal nerve in the formation of the lumbosacral trunk and 5. Lumbosacral trunk gave communicating branches to the femoral and obturator nerves. Most of the variations found were rare and finding all the above said variations in a single cadaver is even rare. Documentation of such rare cases with multiple variations in the formation of nerves from the lumbar plexus provides vital information on such occurrences. This information would in turn improve the knowledge of clinicians and surgeons dealing with this region. Emphasizing such knowledge of this region would prevent accidental damage to the structures with a variant anatomy.

Keywords: femoral nerve, genitofemoral nerve, lumbar plexus, lumbosacral trunk

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Authors: Artur Cichowicz

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The last active mine in the Central Rand Goldfields area (50 km x 15 km) ceased operations in 2008. This resulted in the closure of the pumping stations, which previously maintained the underground water level in the mining voids. As a direct consequence of the water being allowed to flood the mine voids, seismic activity has increased directly beneath the populated area of Johannesburg. Monitoring of seismicity in the area has been on-going for over five years using the network of 17 strong ground motion sensors. The objective of the project is to improve strategies for mine closure. The evolution of the seismicity pattern was investigated in detail. Special attention was given to seismic source parameters such as magnitude, scalar seismic moment and static stress drop. Most events are located within historical mine boundaries. The seismicity pattern shows a strong relationship between the presence of the mining void and high levels of seismicity; no seismicity migration patterns were observed outside the areas of old mining. Seven years after the pumping stopped, the evolution of the seismicity has indicated that the area is not yet in equilibrium. The level of seismicity in the area appears to not be decreasing over time since the number of strong events, with Mw magnitudes above 2, is still as high as it was when monitoring began over five years ago. The average rate of seismic deformation is 1.6x1013 Nm/year. Constant seismic deformation was not observed over the last 5 years. The deviation from the average is in the order of 6x10^13 Nm/year, which is a significant deviation. The variation of cumulative seismic moment indicates that a constant deformation rate model is not suitable. Over the most recent five year period, the total cumulative seismic moment released in the Central Rand Basin was 9.0x10^14 Nm. This is equivalent to one earthquake of magnitude 3.9. This is significantly less than what was experienced during the mining operation. Characterization of seismicity triggered by a rising water level in the area can be achieved through the estimation of source parameters. Static stress drop heavily influences ground motion amplitude, which plays an important role in risk assessments of potential seismic hazards in inhabited areas. The observed static stress drop in this study varied from 0.05 MPa to 10 MPa. It was found that large static stress drops could be associated with both small and large events. The temporal evolution of the inter-event time provides an understanding of the physical mechanisms of earthquake interaction. Changes in the characteristics of the inter-event time are produced when a stress change is applied to a group of faults in the region. Results from this study indicate that the fluid-induced source has a shorter inter-event time in comparison to a random distribution. This behaviour corresponds to a clustering of events, in which short recurrence times tend to be close to each other, forming clusters of events.

Keywords: inter-event time, fluid induced seismicity, mine closure, spectral parameters of seismic source

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Authors: Ching-Yi Huang, Pi-Fen Cheng, Hui-Zhu Chen, Shi Ting Huang, Heng-Hua Wang

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This is a case of oral cancer after extensive resection and modified right lateral neck lymph node dissection followed by reconstruction with a skin flap. The nursing period lasted From September 25 to October 3, 2017, through observation, interview, physical assessment, and medical record review, the author identified the following nursing problems: acute pain, impaired oral mucous membrane, and body image change. During the nursing period, the author provided individual and overall nursing care and established mutual trust through the use of empathy. Author listened and eased the patient's physical indisposition, such as wound pain, we use medications and acupuncture massage to relieve pain. However, for oral mucosa change caused by surgery, provide continuous and complete oral care and oral exercise training to improve oral mucosal healing and restore swallowing function. In the body-image changes, guided him to express his feeling after the body-image change, and enhanced support and from the family, and encouraged him to attend head and neck cancer survivor alliance which allowed the patient to accept the altered body image and reaffirm self-worth. Hopefully, through sharing this nursing experience will help to the nursing care quality of nursing care for oral cancer patients after extensive resection and modified right lateral neck lymph node dissection followed by reconstruction with a skin flap.

Keywords: oral cancer, acute pain, impaired oral mucous membrane, body image change

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Authors: Karl D. Humm

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The United Nations’ Community-based REDD+ (Reducing Emissions from Deforestation and forest Degradation) (CBR+) is a programme that directly finances grassroots climate change mitigation strategies that uplift Indigenous Peoples (IPs) and other marginalised groups. A pilot for it in six countries was developed in response to criticism of the REDD+ programme for excluding IPs from dialogues about climate change mitigation strategies affecting their lands and livelihoods. Despite the pilot’s conclusion in 2017, no complete report has yet been produced on the results of CBR+. To fill this gap, this study investigated the experiences with involving IPs in the CBR+ programmes and local projects across all six pilot countries. A literature review of official UN reports and academic articles identified challenges and successes with IP participation in REDD+ which became the basis for a framework guiding data collection. A mixed methods approach was used to collect and analyse qualitative and quantitative data from CBR+ documents and written interviews with CBR+ National Coordinators in each country for a cross-country comparative analysis. The study found that the most frequent challenges were lack of organisational capacity, illegal forest activities, and historically-based contentious relationships in IP and forest-dependent communities. Successful programmes included IPs and incorporated respect and recognition of IPs as major stakeholders in managing sustainable forests. Findings are summarized and shared with a set of recommendations for improvement of future projects.

Keywords: climate change, forests, indigenous peoples, REDD+

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Authors: Soroush Pakniyat-Jahromi, Jessica Bucciarelli, Souparno Mitra, Neda Motamedi, Ralph Amazan, Samuel Rothman, Jose Tiburcio, Douglas Reich, Vicente Liz

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Violence is defined as an act of physical force that is intended to cause harm and may lead to physical and/or psychological damage. Violence toward healthcare workers (HCWs) is more common in psychiatric settings, emergency departments, and nursing homes; however, healthcare workers in medical setting are not spared from such events. Workplace violence has a huge burden in the healthcare industry and has a major impact on the physical and mental wellbeing of staff. The purpose of this study is to compare the prevalence of patient agitation and violence in medical-surgical settings in BronxCare Hospital (BCH) Bronx, New York, one year before and during the COVID-19 pandemic. Data collection occurred between June 2021 and August 2021, while the sampling time was from 2019 to 2021. The data were separated into two separate time categories: pre-COVID-19 (03/2019-03/2020) and COVID-19 (03/2020-03/2021). We created frequency tables for 19 variables. We used a chi-square test to determine a variable's statistical significance. We tested all variables against “restraint type”, determining if a patient was violent or became violent enough to restrain. The restraint types were “chemical”, “physical”, or both. This analysis was also used to determine if there was a statistical difference between the pre-COVID-19 and COVID-19 timeframes. Our data shows that there was an increase in incidents of violence in COVID-19 era (03/2020-03/2021), with total of 194 (62.8%) reported events, compared to pre COVID-19 era (03/2019-03/2020) with 115 (37.2%) events (p: 0.01). Our final analysis, completed using a chi-square test, determined the difference in violence in patients between pre-COVID-19 and COVID-19 era. We then tested the violence marker against restraint type. The result was statistically significant (p: 0.01). This is the first paper to systematically review the prevalence of violence in medical-surgical units in a hospital in New York, pre COVID-19 and during the COVID-19 era. Our data is in line with the global trend of increased prevalence of patient agitation and violence in medical settings during the COVID-19 pandemic. Violence and its management is a challenge in healthcare settings, and the COVID-19 pandemic has brought to bear a complexity of circumstances, which may have increased its incidence. It is important to identify and teach healthcare workers the best preventive approaches in dealing with patient agitation, to decrease the number of restraints in medical settings, and to create a less restrictive environment to deliver care.

Keywords: COVID-19 pandemic, patient agitation, restraints, violence

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