Search results for: national culture

Authors: Nadia Obaed, Lexi Frankel, Amalia Ardeljan, Denis Nigel, Anniki Witter, Omar Rashid

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Breast cancer is the most common cancer among women, with a lifetime risk of one in eight of all women in the United States. Although breast cancer is prevalent throughout the world, the uneven distribution in incidence and mortality rates is shaped by the variation in population structure, environment, genetics and known lifestyle risk factors. Furthermore, the bacterial profile in healthy and cancerous breast tissue differs with a higher relative abundance of bacteria capable of causing DNA damage in breast cancer patients. Previous bacterial infections may change the composition of the microbiome and partially account for the environmental factors promoting breast cancer. One study found that higher amounts of Staphylococcus, Bacillus, and Enterobacteriaceae, of which Escherichia coli (E. coli) is a part, were present in breast tumor tissue. Based on E. coli’s ability to damage DNA, it is hypothesized that there is an increased risk of breast cancer associated with previous E. coli infection. Therefore, the purpose of this study was to evaluate the correlation between E. coli infection and the incidence of breast cancer. Holy Cross Health, Fort Lauderdale, provided access to the Health Insurance Portability and Accountability (HIPAA) compliant national database for the purpose of academic research. International Classification of Disease 9th and 10th Codes (ICD-9, ICD-10) was then used to conduct a retrospective analysis using data from January 2010 to December 2019. All breast cancer diagnoses and all patients infected versus not infected with E. coli that underwent typical E. coli treatment were investigated. The obtained data were matched for age, Charlson Comorbidity Score (CCI score), and antibiotic treatment. Standard statistical methods were applied to determine statistical significance and an odds ratio was used to estimate the relative risk. A total of 81286 patients were identified and analyzed from the initial query and then reduced to 31894 antibiotic-specific treated patients in both the infected and control group, respectively. The incidence of breast cancer was 2.51% and present in 2043 patients in the E. coli group compared to 5.996% and present in 4874 patients in the control group. The incidence of breast cancer was 3.84% and present in 1223 patients in the treated E. coli group compared to 6.38% and present in 2034 patients in the treated control group. The decreased incidence of breast cancer in the E. coli and treated E. coli groups was statistically significant with a p-value of 2.2x10-16 and 2.264x10-16, respectively. The odds ratio in the E. coli and treated E. coli groups was 0.784 and 0.787 with a 95% confidence interval, respectively (0.756-0.813; 0.743-0.833). The current study shows a statistically significant decrease in breast cancer incidence in association with previous Escherichia coli infection. Researching the relationship between single bacterial species is important as only up to 10% of breast cancer risk is attributable to genetics, while the contribution of environmental factors including previous infections potentially accounts for a majority of the preventable risk. Further evaluation is recommended to assess the potential and mechanism of E. coli in decreasing the risk of breast cancer.

Keywords: breast cancer, escherichia coli, incidence, infection, microbiome, risk

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Authors: G. M. Vlasceanu, H. Iovu, E. Vasile, M. Ionita

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Herein, the synthesis and characterization of chitosan-gelatin highly porous scaffold reinforced with graphene oxide, and hydroxyapatite (HAp), crosslinked with genipin was targeted. In tissue engineering, chitosan and gelatin are two of the most robust biopolymers with wide applicability due to intrinsic biocompatibility, biodegradability, low antigenicity properties, affordability, and ease of processing. HAp, per its exceptional activity in tuning cell-matrix interactions, is acknowledged for its capability of sustaining cellular proliferation by promoting bone-like native micro-media for cell adjustment. Genipin is regarded as a top class cross-linker, while graphene oxide (GO) is viewed as one of the most performant and versatile fillers. The composites with natural bone HAp/biopolymer ratio were obtained by cascading sonochemical treatments, followed by uncomplicated casting methods and by freeze-drying. Their structure was characterized by Fourier Transform Infrared Spectroscopy and X-ray Diffraction, while overall morphology was investigated by Scanning Electron Microscopy (SEM) and micro-Computer Tomography (µ-CT). Ensuing that, in vitro enzyme degradation was performed to detect the most promising compositions for the development of in vivo assays. Suitable GO dispersion was ascertained within the biopolymer mix as nanolayers specific signals lack in both FTIR and XRD spectra, and the specific spectral features of the polymers persisted with GO load enhancement. Overall, correlations between the GO induced material structuration, crystallinity variations, and chemical interaction of the compounds can be correlated with the physical features and bioactivity of each composite formulation. Moreover, the HAp distribution within follows an auspicious density gradient tuned for hybrid osseous/cartilage matter architectures, which were mirrored in the mice model tests. Hence, the synthesis route of a natural polymer blend/hydroxyapatite-graphene oxide composite material is anticipated to emerge as influential formulation in bone tissue engineering. Acknowledgement: This work was supported by the project 'Work-based learning systems using entrepreneurship grants for doctoral and post-doctoral students' (Sisteme de invatare bazate pe munca prin burse antreprenor pentru doctoranzi si postdoctoranzi) - SIMBA, SMIS code 124705 and by a grant of the National Authority for Scientific Research and Innovation, Operational Program Competitiveness Axis 1 - Section E, Program co-financed from European Regional Development Fund 'Investments for your future' under the project number 154/25.11.2016, P_37_221/2015. The nano-CT experiments were possible due to European Regional Development Fund through Competitiveness Operational Program 2014-2020, Priority axis 1, ID P_36_611, MySMIS code 107066, INOVABIOMED.

Keywords: biopolymer blend, ectopic osteoinduction, graphene oxide composite, hydroxyapatite

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Authors: Karen Trimmer, Raelene Ward, Linda Wondunna-Foley

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Within Australian tertiary institutions, the subject of Aboriginal and Torres Strait Islander education has been a major concern for many years. Aboriginal and Torres Strait Islander teachers are significantly under-represented in Australian schools and universities. High attrition rates in teacher education and in the teaching industry have contributed to a minimal growth rate in the numbers of Aboriginal and Torres Strait Islander teachers in previous years. There was an increase of 500 Indigenous teachers between 2001 and 2008 but these numbers still only account for one percent of teaching staff in government schools who identified as Aboriginal and Torres Strait Islander Australians (Ministerial Council for Education, Early Childhood Development and Youth Affairs 2010). Aboriginal and Torres Strait Islander teachers are paramount in fostering student engagement and improving educational outcomes for Indigenous students. Increasing the numbers of Aboriginal and Torres Strait Islander teachers is also a key factor in enabling all students to develop understanding of and respect for Aboriginal and Torres Strait Islander histories, cultures, and language. An ambitious reform agenda to improve the recruitment and retention of Aboriginal and Torres Strait Islander teachers will be effective only through national collaborative action and co-investment by schools and school authorities, university schools of education, professional associations, and Indigenous leaders and community networks. Whilst the University of Southern Queensland currently attracts Indigenous students to its teacher education programs (61 students in 2013 with an average of 48 enrollments each year since 2010) there is significant attrition during pre-service training. The annual rate of exiting before graduation remains high at 22% in 2012 and was 39% for the previous two years. These participation and retention rates are consistent with other universities across Australia. Whilst aspirations for a growing number of Indigenous people to be trained as teachers is present, there is a significant loss of students during their pre-service training and within the first five years of employment as a teacher. These trends also reflect the situation where Aboriginal and Torres Strait Islander teachers are significantly under-represented, making up less than 1% of teachers in schools across Australia. Through a project conducted as part the nationally funded More Aboriginal and Torres Strait Islander Teachers Initiative (MATSITI) we aim to gain an insight into the reasons that impact Aboriginal and Torres Strait Islander student’s decisions to exit their program. Through the conduct of focus groups and interviews with two graduating cohorts of self-identified Aboriginal and Torres Strait Islander students, rich data has been gathered to gain an understanding of the barriers and enhancers to the completion of pre-service qualification and transition to teaching. Having a greater understanding of these reasons then allows the development of collaborative processes and procedures to increase retention and completion rates of new Indigenous teachers. Analysis of factors impacting on exit decisions and transitions has provided evidence to support change of practice, redesign and enhancement of relevant courses and development of policy/procedures to address identified issues.

Keywords: graduation, indigenous, pre-service teacher education, retention

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Authors: Leigha C. Crout

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This paper will investigate the categorical disregard of the People’s Republic of China (PRC) in establishing and maintaining a baseline standard of civil guarantees for economic migrant women and their dependents. In light of the relative forward strides in terms of policy facilitating the ascension of female workers in China, this oft-invisible subgroup of women remains neglected from the modern-day “iron rice bowl” of the self-identified communist state. This study is being undertaken to rectify the absence of data on this subject and provide a baseline for future studies on the matter, as the human rights of migrants has become an established facet of transnational dialogue and debate. The basic methodology of this research will consist of the evaluation of China’s compliance with its own national guidelines, and the eight international human rights law treaties it has ratified. Data will be extracted and cross-checked from a number of relevant sources to monitor the extent of compliance, including but by no means limited to the United Nations Human Rights Council (UNHRC) Universal Periodic Review (UPR) reports and responses, submissions and responses of international human rights treaty bodies, local and international nongovernmental organizations (NGOs) and their annual reports, and articles and commentaries authored by specialists on the modern state and implementation of Chinese law. Together, these data will illuminate the vast network of compliance that has forced many migrant women to work within situations of extreme economic precarity. The structure will proceed as follows: first, an outline of the current status of migrant workers and the enforcement of stipulated protections will be provided; next, the analysis of the oft-debated regulations directing and the outline of mandatory services guaranteed to external and internal migrants; and finally, a conclusion incorporating various recommendations to improve transparency and gradually decrease the amount of migrant work turned forced labor that typifies the economic migrant experience, especially in the case of women. The internal and international migrant workers in China are bound by different and uncomplimentary systems. The first, which governs Chinese citizens moving to different regions or provinces to find more sustainable employment (internal migrants), is called the hukou (or huji) residency system. This law enforces strict regulation of the movement of peoples, while ensuring that residents of urban areas receive preferential benefits to those received by their so-called “agricultural” resident counterparts. Given the overwhelming presence of the Communist Party of China throughout the vast state, the management of internal migrants and the disregard for foreign domestic workers is, at minimum, a surprising oversight. This paper endeavors to provide a much-needed foundation for future commentary and discussion on the treatment of female migrant workers and their families in the People’s Republic of China.

Keywords: female migrant worker’s rights, the People’s Republic of China, forced labor, Hukou residency system

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Authors: Ashik Sarder

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Bangladesh is a disaster-prone and one of the most vulnerable countries to climate change. The country has a long coastal area which is frequently being affected by several types of natural disasters due to climate change. The disasters have impacts on the life and livelihood of different natural resources depending on communities living in the coastal areas. The Malo is a Hindu religious traditional fishing community living at Sarafpur Union of Dumuria Upazila of Khulna district of south-west coastal Bangladesh. Fishing is the only means of their livelihood and the community has been engaged in fishing practices inherently in rivers, estuaries, and sea for more than 300 years. and they are totally dependent on this traditional occupation. But, in recent year’s climate change has negative impacts on their only livelihood option. The study aims to examine the impacts of climate change on the livelihood of Malo fishing community in south-west coastal Bangladesh, identify the adaptation strategies undertaken and practiced by Malo fishing community to cope with climate change and sustain their livelihood and explore the changing adaptation strategies undertaken by Malo fishing community and others. The study has been conducted from both qualitative and quantitative perspectives. Data has been collected from both primary and secondary sources. The primary data has been collected in the participatory observation approach following both qualitative and quantitative method. The primary source of data includes village census, face-to-face interview and in-depth case studies using structured questionnaire. The secondary source of the literature includes different national and international documents, policy papers, books and articles; related websites and peer-viewed documents on climate change, vulnerability, adaptation, livelihood, and fisheries. The study has identified different practices of adaption to climate change by Malo fishing community and others in the selected area. Three types of adaption practices have been identified. Firstly, the indigenous adaptation practices by Malo fishing community to cope with climate change have been identified. These identified adaptation practices by Malo fishing community include; ensuring drinking water and sanitation facilities, planting trees to tackle impacts of cyclone, excavating dumps to preserve the valuable assets, growing vegetables and rearing domestic livestock to earn surplus money, taking loans for ensuring continuation of present livelihood and migrating to near city or towns for better livelihood options. Secondly, adaptation initiatives undertaken by the government have provided limited facility to this vulnerable fishing community and made them benefited. And thirdly, some adaptation initiatives commenced by few non-government and community-based organizations have also made the Malo fishing community as beneficiaries. The study has suggested recommendations for Malo fishing community to overcome the challenges and impacts of climate change for retaining their traditional fishing livelihood. The accumulated recommendations would be very useful for the researchers, academicians, policy-makers of Government and non-government organizations to conduct more researches and take initiatives for Malo fishing community to make them more capable to sustain their fishing livelihood.

Keywords: climate change, livelihood, adaptation, anthropology, vulnerability

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Authors: Nautiyal Ruchira, Nautiyal Hemant, Chaudhury Devnanda, Bhargava Surbhi, Chauhan Nidhi

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Introduction: South East Asian region contributes 2.5 million cases of malaria each year to the global burden of 300 to 500 million of which 76% is reported from India. Government of India launched a national program almost half a century ago, still malaria remains a major public health challenge. Pregnant women are more susceptible to severe malaria and its fetomaternal complications. Inadequate surveillance and under-reporting underestimates the problem. Aim: Present study aimed to analyze the clinical course and pattern of malaria during pregnancy and to study the feto-maternal outcome. Methodology: This is a prospective observational study carried out at Himalayan Institute of Medical Sciences – a tertiary care center in the sub-Himalayan state of Uttarakhand, Northern India. All the pregnant women with malaria and its complications were recruited in the study during 2009 to 2014 which included referred cases from the state of western Uttar Pradesh. A thorough history and clinical examination were carried out to assess maternal and fetal condition. Relevant investigations including haemogram, platelet count, LFT, RFT, and USG was done. Blood slides and rapid diagnostic tests were done to diagnose the type of malaria.The primary outcomes measured were the type of malaria infection, maternal complications associated with malaria, outcome of pregnancy and effect on the fetus. Results: 67 antenatal cases with malaria infection were studied. 71% patients were diagnosed with plasmodium vivax infection, 25% cases were plasmodium falciparum positive and in 3% cases mixed infection was found. 38(56%) patients were primigravida and 29(43%) were multiparous. Most of the patients had already received some treatment from their local doctors and presented with severe malaria with the complications. Thrombocytopenia was the commonest manifestation seen in 35(52%) patients, jaundice in 28%, severe anemia in 18%, and severe oligohydramnios in 10% and renal failure in 6% cases. Regarding pregnancy outcome there were 44 % preterm deliveries, 22% had IUFD and abortions in 6% cases.20% of newborn were low birth weight and 6% were IUGR. There was only one maternal death which occurred due to ARDS in falciparum malaria. Although Plasmodium vivax was the main parasite considering the severity of clinical presentation, all the patients received intensive care. As most of the patients had received chloroquine therapy hence they were treated with IV artesunate followed by oral artemesinin combination therapy. Other therapies in the form of packed RBC’s and platelet transfusions, dialysis and ventilator support were provided when required. Conclusion: Even in areas with annual parasite index (API) less than 2 like ours, malaria in pregnancy could be an alarming problem. Vivax malaria cannot be considered benign in pregnancy because of high incidence of morbidity. Prompt diagnosis and aggressive treatment can reduce morbidity and mortality significantly. Increased community level research, integrating ANC checkups with the distribution of insecticide-treated nets in areas of high endemicity, imparting education and awareness will strengthen the existing control strategies.

Keywords: severe malaria, pregnancy, plasmodium vivax, plasmodium falciparum

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Authors: Mohanad Elemary, Imose Itua, Rajeswari B. Matam

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Virologists and public health experts have been predicting potential pandemics from coronaviruses for decades. The viruses which caused the SARS and MERS pandemics and the Nipah virus led to many lost lives, but still, the COVID-19 pandemic caused by the SARS-CoV2 virus surprised many scientific communities, experts, and governments with its ease of transmission and its pathogenicity. Governments of various countries reacted by locking down entire populations to their homes to combat the devastation caused by the virus, which led to a loss of livelihood and economic hardship to many individuals and organizations. To revive national economies and support their citizens in resuming their lives, governments focused on the development and use of contact tracing apps as a digital way to track and trace exposure. Google and Apple introduced the Exposure Notification Systems (ENS) framework. Independent organizations and countries also developed different frameworks for contact tracing apps. The efficiency, popularity, and adoption rate of these various apps have been different across countries. In this paper, we present a critical analysis of the different contact tracing apps with respect to their efficiency, adoption rate and general perception, and the governmental strategies and policies, which led to the development of the applications. When it comes to the European countries, each of them followed an individualistic approach to the same problem resulting in different realizations of a similarly functioning application with differing results of use and acceptance. The study conducted an extensive review of existing literature, policies, and reports across multiple disciplines, from which a framework was developed and then validated through interviews with six key stakeholders in the field, including founders and executives in digital health startups and corporates as well as experts from international organizations like The World Health Organization. A framework of best practices and tactics is the result of this research. The framework looks at three main questions regarding the contact tracing apps; how to develop them, how to deploy them, and how to regulate them. The findings are based on the best practices applied by governments across multiple countries, the mistakes they made, and the best practices applied in similar situations in the business world. The findings include multiple strategies when it comes to the development milestone regarding establishing frameworks for cooperation with the private sector and how to design the features and user experience of the app for a transparent, effective, and rapidly adaptable app. For the deployment section, several tactics were discussed regarding communication messages, marketing campaigns, persuasive psychology, and the initial deployment scale strategies. The paper also discusses the data privacy dilemma and how to build for a more sustainable system of health-related data processing and utilization. This is done through principles-based regulations specific for health data to allow for its avail for the public good. This framework offers insights into strategies and tactics that could be implemented as protocols for future public health crises and emergencies whether global or regional.

Keywords: contact tracing apps, COVID-19, digital health applications, exposure notification system

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Authors: Khin Nyunt Yee, Mu Mu Thein

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Detection survey of mango seed and Pulp weevils was undertaken at major mango production areas, Yat Sauk, Taunggyi, Nyaung Shwe and Hopong Townships, in Shan State (South) of Myanmar on two mango cultivars of Sein Ta Lone and Yinkwe from May to August 2016 to coincide with fruiting season to conduct a survey of mango seed and pulp weevils population. The total numbers of 6300 fruits of both mango cultivars were sampled. Among them, 2900 fruits from 5674 fruit bearing plants were collected for Sein Ta Lone cultivar of five well managed, one unmanaged orchards and Urban in Yatsauk Twonship, 400 fruits from only one well managed orchard in Taunggyi Township, 400 fruits from two managed orchards in Nyaung Shwe Township and 400 fruits from one managed orchard in Hopong Township from May to June. 2200 fruits were collected from 4043 fruit bearing plants for Yinkwe Cultivar of four well managed orchards, one unmanaged orchards and one wild tree only in Yat Sauk Township from July to August, 2016. Fruit sample size was 200 fruits /orchard, / wild or /volunteer trees as minimum number. The pulps of all randomly sampling fruits were longitudinal cut open into three slices on each side of fruit and seed were cut longitudinally to inspect the presence of mango weevils. The collected weevils were identified up to species level at Plant Quarantine Laboratory, Plant Protection Division, Department of Agriculture, Ministry of Agriculture, Livestock and Irrigation, Yangon, Myanmar. Mango Pulp and Seed weevils were found on Sein Ta Lone Mango Cultivar in three out of four surveyed Townships except Hopong with the level of infestation ranged from 0.0% to 3.5% of fruits per Township with 0.0% to 39.0% of fruits per orchard. The highest infestation rate per township was 3.5% of fruits (n=400 fruits) in Nyaung Shwe, then, at Yat Suak, the rate was 2.47% (n=2900 fruits). A well-managed orchard at Taung Gyi had 0.75% (n=400 fruits) whereas Hopong was free 0.0% (n=400). The weevils were also recorded on Yinkwe Mango Cultivar in Yatsauk Township where the infestation level was 12.63% of fruits (n=2200) with 0.0% to 67.0% of fruits per orchard. This high level of infestation was obtained by including an absolutely non Integrated Pest Management (non IPM) orchards in both survey with the infestation rates 63.0% of fruits (n=200) and 67.0% of fruits (n=200) respectively on Yinkwe cultivar. Two different species; mango pulp weevil, Sternochetus frigitus, and mango seed weevil Sternochetus olivieri (Faust) of family Curculionidae under the order Coleoptera were recorded. Sternochetus mangiferae was not found during these surveys. Three different developmental stages of mango seed and pulp weevils: larva, pupa and adult were first detected since the first survey in 3rd week of May and mostly were recorded as adult stages in the following surveys in June, July and August The number of Mango pulp weevil was statistically higher than that of mango seed weevils at P < 0.001%. More precise surveys should be carried out national wide to detect the mango weevils.

Keywords: mango pulp weevil, Sternochetus frigitus, mango seed weevil Sternochetus olivieri, faust, Sternochetus mangiferae, fabricius, Sein Ta Lone, Yinkwe mango cultivars, Shan State (South) Myanmar

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Authors: Lucy H. Kaiser, Kate Boersen

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Kura Kaupapa Māori (kura) and bilingual schools are primary schools in Aotearoa/New Zealand which operate fully or partially under Māori custom and have curricula developed to include Te Reo Māori and Tikanga Māori (Māori language and cultural practices). These schools were established to support Māori children and their families through reinforcing cultural identity by enabling Māori language and culture to flourish in the field of education. Māori kaupapa (values), Mātauranga Māori (Māori knowledge) and Te Reo are crucial considerations for the development of educational resources developed for kura, bilingual and mainstream schools. The inclusion of hazard risk in education has become an important issue in New Zealand due to the vulnerability of communities to a plethora of different hazards. Māori have an extensive knowledge of their local area and the history of hazards which is often not appropriately recognised within mainstream hazard education resources. Researchers from the Joint Centre for Disaster Research, Massey University and East Coast LAB (Life at the Boundary) in Napier were funded to collaboratively develop a toolkit of tsunami risk reduction activities with schools located in Hawke’s Bay’s tsunami evacuation zones. A Māori-led bicultural approach to developing and running the education activities was taken, focusing on creating culturally and locally relevant materials for students and schools as well as giving students a proactive role in making their communities better prepared for a tsunami event. The community-based participatory research is Māori-centred, framed by qualitative and Kaupapa Maori research methodologies and utilizes a range of data collection methods including interviews, focus groups and surveys. Māori participants, stakeholders and the researchers collaborated through the duration of the project to ensure the programme would align with the wider school curricula and kaupapa values. The education programme applied a tuakana/teina, Māori teaching and learning approach in which high school aged students (tuakana) developed tsunami preparedness activities to run with primary school students (teina). At the end of the education programme, high school students were asked to reflect on their participation, what they had learned and what they had enjoyed during the activities. This paper draws on lessons learned throughout this research project. As an exemplar, retaining a bicultural and bilingual perspective resulted in a more inclusive project as there was variability across the students’ levels of confidence using Te Reo and Māori knowledge and cultural frameworks. Providing a range of different learning and experiential activities including waiata (Māori songs), pūrākau (traditional stories) and games was important to ensure students had the opportunity to participate and contribute using a range of different approaches that were appropriate to their individual learning needs. Inclusion of teachers in facilitation also proved beneficial in assisting classroom behavioral management. Lessons were framed by the tikanga and kawa (protocols) of the school to maintain cultural safety for the researchers and the students. Finally, the tuakana/teina component of the education activities became the crux of the programme, demonstrating a path for Rangatahi to support their whānau and communities through facilitating disaster preparedness, risk reduction and resilience.

Keywords: school safety, indigenous, disaster preparedness, children, education, tsunami

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Authors: Miroslaw Wendeker, Piotr Kacejko, Mariusz Duk, Pawel Karpinski

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The research in the field of aircraft internal combustion engines is currently driven by the needs of decreasing fuel consumption and CO2 emissions, while fulfilling the level of safety. Currently, reciprocating aircraft engines are found in sports, emergency, agricultural and recreation aviation. Technically, they are most at a pre-war knowledge of the theory of operation, design and manufacturing technology, especially if compared to that high level of development of automotive engines. Typically, these engines are driven by carburetors of a quite primitive construction. At present, due to environmental requirements and dealing with a climate change, it is beneficial to develop aircraft piston engines and adopt the achievements of automotive engineering such as computer-controlled low-pressure injection, electronic ignition control and biofuels. The paper describes simulation research of the innovative power and control systems for the aircraft radial engine of high power. Installing an electronic ignition system in the radial aircraft engine is a fundamental innovative idea of this solution. Consequently, the required level of safety and better functionality as compared to the today’s plug system can be guaranteed. In this framework, this research work focuses on describing a methodology for optimizing the electronically controlled ignition system. This attempt can reduce emissions of toxic compounds as a result of lowered fuel consumption, optimized combustion and engine capability of efficient combustion of ecological fuels. New, redundant elements of the control system can improve the safety of aircraft. Consequently, the required level of safety and better functionality as compared to the today’s plug system can be guaranteed. The simulation research aimed to determine the vulnerability of the values measured (they were planned as the quantities measured by the measurement systems) to determining the optimal ignition angle (the angle of maximum torque at a given operating point). The described results covered: a) research in steady states; b) velocity ranging from 1500 to 2200 rpm (every 100 rpm); c) loading ranging from propeller power to maximum power; d) altitude ranging according to the International Standard Atmosphere from 0 to 8000 m (every 1000 m); e) fuel: automotive gasoline ES95. The three models of different types of ignition coil (different energy discharge) were studied. The analysis aimed at the optimization of the design of the innovative ignition system for an aircraft engine. The optimization involved: a) the optimization of the measurement systems; b) the optimization of actuator systems. The studies enabled the research on the vulnerability of the signals to the control of the ignition timing. Accordingly, the number and type of sensors were determined for the ignition system to achieve its optimal performance. The results confirmed the limited benefits, in terms of fuel consumption. Thus, including spark management in the optimization is mandatory to significantly decrease the fuel consumption. This work has been financed by the Polish National Centre for Research and Development, INNOLOT, under Grant Agreement No. INNOLOT/I/1/NCBR/2013.

Keywords: piston engine, radial engine, ignition system, CFD model, engine optimization

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Authors: C. Sancho Salvatierra, J. M. Martinez Nieto, R. García Gonzalez-Gordon, M. I. Martinez Bellido

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Introduction: Nature could act as an asset for human health protecting against possible diseases and promoting the state of both physical and mental health. Goals: This paper aims to determine which natural elements present evidence that show positive influence on human health, on which particular aspects and how. It also aims to determine the best biomarkers to measure such influence. Method: A systematic literature review was carried out. First, a general free text search was performed in databases, such as Scopus, PubMed or PsychInfo. Secondly, a specific search was performed combining keywords in order of increasing complexity. Also the Snowballing technique was used and it was consulted in the CSIC’s (The Spanish National Research Council). Databases: Of the 130 articles obtained and reviewed, 80 referred to natural elements that influenced health. These 80 articles were classified and tabulated according to the nature elements found, the health aspects studied, the health measurement parameters used and the measurement techniques used. In this classification the results of the studies were codified according to whether they were positive, negative or neutral both for the elements of nature and for the aspects of health studied. Finally, the results of the 80 selected studies were summarized and categorized according to the elements of nature that showed the greatest positive influence on health and the biomarkers that had shown greater reliability to measure said influence. Results: Of the 80 articles studied, 24 (30.0%) were reviews and 56 (70.0%) were original research articles. Among the 24 reviews, 18 (75%) found positive results of natural elements on health, and 6 (25%) both positive and negative effects. Of the 56 original articles, 47 (83.9%) showed positive results, 3 (5.4%) both positive and negative, 4 (7.1%) negative effects, and 2 (3.6%) found no effects. The results reflect positive effects of different elements of nature on the following pathologies: diabetes, high blood pressure, stress, attention deficit hyperactivity disorder, psychotic, anxiety and affective disorders. They also show positive effects on the following areas: immune system, social interaction, recovery after illness, mood, decreased aggressiveness, concentrated attention, cognitive performance, restful sleep, vitality and sense of well-being. Among the elements of nature studied, those that show the greatest positive influence on health are forest immersion, natural views, daylight, outdoor physical activity, active transport, vegetation biodiversity, natural sounds and the green residences. As for the biomarkers used that show greater reliability to measure the effects of natural elements are the levels of cortisol (both in blood and saliva), vitamin D levels, serotonin and melatonin, blood pressure, heart rate, muscle tension and skin conductance. Conclusions: Nature is an asset for health, well-being and quality of life. Awareness programs, education and health promotion are needed based on the elements that nature brings us, which in turn generate proactive attitudes in the population towards the protection and conservation of nature. The studies related to this subject in Spain are very scarce. Aknowledgements. This study has been promoted and partially financed by the Environmental Foundation Jaime González-Gordon.

Keywords: health, green areas, nature, well-being

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Authors: Shilpa Murthy, Hazlina Binti Abu Bakar, Juliet Mathew, Chandrashekhar Thummala Hlly Sreerama Reddy, Pathiyil Ravi Shankar

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Simulation is defined as a technique that replaces or expands real experiences with guided experiences that interactively imitate real-world processes or systems. Simulation enables learners to train in a safe and non-threatening environment. For decades, simulation has been considered an integral part of clinical teaching and learning strategy in medical education. The several types of simulation used in medical education and the clinical environment can be applied to several models, including full-body mannequins, task trainers, standardized simulated patients, virtual or computer-generated simulation, or Hybrid simulation that can be used to facilitate learning. Simulation allows healthcare practitioners to acquire skills and experience while taking care of patient safety. The recent COVID pandemic has also led to an increase in simulation use, as there were limitations on medical student placements in hospitals and clinics. The learning is tailored according to the educational needs of students to make the learning experience more valuable. Simulation in the pre-clinical years has challenges with resource constraints, effective curricular integration, student engagement and motivation, and evidence of educational impact, to mention a few. As instructors, we may have more reliance on the use of simulation for pre-clinical students while the students’ confidence levels and perceived competence are to be evaluated. Our research question was whether the implementation of simulation-based learning positively influences preclinical medical students' confidence levels and perceived competence. This study was done to align the teaching activities with the student’s learning experience to introduce more low-fidelity simulation-based teaching sessions for pre-clinical years and to obtain students’ input into the curriculum development as part of inclusivity. The study was carried out at International Medical University, involving pre-clinical year (Medical) students who were started with low-fidelity simulation-based medical education from their first semester and were gradually introduced to medium fidelity, too. The Student Satisfaction and Self-Confidence in Learning Scale questionnaire from the National League of Nursing was employed to collect the responses. The internal consistency reliability for the survey items was tested with Cronbach’s alpha using an Excel file. IBM SPSS for Windows version 28.0 was used to analyze the data. Spearman’s rank correlation was used to analyze the correlation between students’ satisfaction and self-confidence in learning. The significance level was set at p value less than 0.05. The results from this study have prompted the researchers to undertake a larger-scale evaluation, which is currently underway. The current results show that 70% of students agreed that the teaching methods used in the simulation were helpful and effective. The sessions are dependent on the learning materials that are provided and how the facilitators engage the students and make the session more enjoyable. The feedback provided inputs on the following areas to focus on while designing simulations for pre-clinical students. There are quality learning materials, an interactive environment, motivating content, skills and knowledge of the facilitator, and effective feedback.

Keywords: low-fidelity simulation, pre-clinical simulation, students satisfaction, self-confidence

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Authors: Jason Ceavers, Travis Thompson, Juan Torres, Ramanakumar Anam, Alan Wong, Andrei Carvalho, Shane Quo, Shawn Alonso, Moises Cintron, Ricardo C. Carrero, German Lopez, Vamsi Garimella, German Giese

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Introduction: Advance directives (AD) are essential for patients to communicate their wishes when they are not able to. Ideally, these discussions should not occur for the first time when a patient is hospitalized with an acute life-threatening illness. There is a large number of patients who do not have clearly documented ADs, resulting in the misutilization of resources and additional patient harm. This is a nationwide issue, and the Joint Commission has it as one of its national quality metrics. Presented here is a proposed protocol to increase the number of documented AD discussions in a community-based, internal medicine residency primary care clinic in South Florida. Methods: The SMART Aim for this quality improvement project is to increase documentation of AD discussions in the outpatient setting by 25% within three months in medicare patients. A survey was sent to stakeholders (clinic attendings, residents, medical assistants, front desk staff, and clinic managers), asking them for three factors they believed contributed most to the low documentation rate of AD discussions. The two most important factors were time constraints and systems issues (such as lack of a standard method to document ADs and ADs not being uploaded to the chart) which were brought up by 25% and 21.2% of the 32 survey responders, respectively. Pre-intervention data from clinic patients in 2020-2021 revealed 17.05% of patients had clear, actionable ADs documented. To address these issues, an AD pocket card was created to give to patients. One side of the card has a brief explanation of what ADs are. The other side has a column of interventions (cardiopulmonary resuscitation, mechanical ventilation, dialysis, tracheostomy, feeding tube) with boxes patients check off if they want the intervention done, do not want the intervention, do not want to discuss the topic, or need more information. These cards are to be filled out and scanned into their electronic chart to be reviewed by the resident before their appointment. The interventions that patients want more information on will be discussed by the provider. If any changes are made, the card will be re-scanned into their chart. After three months, we will chart review the patients seen in the clinic to determine how many medicare patients have a pocket card uploaded and how many have advance directives discussions documented in a progress note or annual wellness note. If there is not enough time for an AD discussion, a follow-up appointment can be scheduled for that discussion. Discussion: ADs are a crucial part of patient care, and failure to understand a patient’s wishes leads to improper utilization of resources, avoidable litigation, and patient harm. Time constraints and systems issues were identified as two major factors contributing to the lack of advance directive discussion in our community-based resident primary care clinic. Our project aims at increasing the documentation rate for ADs through a simple pocket card intervention. These are self-explanatory, easy to read and allow the patients to clearly express what interventions they desire or what they want to discuss further with their physician.

Keywords: advance directives, community-based, pocket card, primary care clinic

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Authors: Jamie Lee Harder

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In the context of rapidly changing social and economic circumstances in the developing world, this paper analyses access to public healthcare for poor people with disabilities in Cambodia. Like other countries of South East Asia, Cambodia is developing at rapid pace. The historical past of Cambodia, however, has set former social policy structures to zero. This past forces Cambodia and its citizens to implement new public health policies to align with the needs of social care, healthcare, and urban planning. In this context, the role of people with disabilities (PwDs) is crucial as new developments should and can take into consideration their specific needs from the beginning onwards. This paper is based on qualitative research with expert interviews and focus group discussions in Cambodia. During the field work it became clear that the identification tool for the poorest households (HHs) does not count disability as a financial risk to fall into poverty neither when becoming sick nor because of higher health expenditures and/or lower income because of the disability. The social risk group of poor PwDs faces several barriers in accessing public healthcare. The urbanization, the socio-economic health status, and opportunities for education; all influence social status and have an impact on the health situation of these individuals. Cambodia has various difficulties with providing access to people with disabilities, mostly due to barriers regarding finances, geography, quality of care, poor knowledge about their rights and negative social and cultural beliefs. Shortened budgets and the lack of prioritizations lead to the need for reorientation of local communities, international and national non-governmental organizations and social policy. The poorest HHs are identified with a questionnaire, the IDPoor program, for which the Ministry of Planning is responsible. The identified HHs receive an ‘Equity Card’ which provides access free of charge to public healthcare centers and hospitals among other benefits. The dataset usually does not include information about the disability status. Four focus group discussions (FGD) with 28 participants showed various barriers in accessing public healthcare. These barriers go far beyond a missing ramp to access the healthcare center. The contents of the FGDs were ratified and repeated during the expert interviews with the local Ministries, NGOs, international organizations and private persons working in the field. The participants of the FGDs faced and continue to face high discrimination, low capacity to work and earn an own income, dependency on others and less social competence in their lives. When discussing their health situation, we identified, a huge difference between those who are identified and hold an Equity Card and those who do not. Participants reported high costs without IDPoor identification, positive experiences when going to the health center in terms of attitude and treatment, low satisfaction with specific capacities for treatments, negative rumors, and discrimination with the consequence of fear to seek treatment in many cases. The problem of accessing public healthcare by risk groups can be adapted to situations in other countries.

Keywords: access, disability, health, inequality, Cambodia

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Authors: Lewis Mehl-Madrona, Barbara Mainguy, Patrick McFarlane

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Introduction: There are many risk factors for attempting suicide, including young age, “minority stress,” which would include Transgender and Gender Diverse orientations (TGD). The rate of TGD youths for suicide attempts is 3 times higher than heterosexual cis-gender youth. Half of TGD youth have seriously contemplated taking their own lives; of those, about half attempted suicide; and 18% of the TGD teenagers reported suicidal thoughts linked to their gender identity. Native American TGD have a six times higher suicide attempt rate. Conventional mental health has not generally helped these individuals. Stigma and discrimination contribute to healthcare disparities. Storytelling plays a crucial role in the development of human culture and individual identities. Sharing narrative artwork, creative writing, and personal stories allow people to build trust and to share their vulnerabilities. This helps people become aware of themselves in relation to others and gain a sense of comfort that their stories are similar; they may also be transformed in the process. Art provides a means to reach people who are otherwise difficult to engage in services. Methods: TGD individuals are recruited through a snowballing procedure. Following a life story interview, participants complete a scale of gender dysphoria, identification with conventional masculinity, patient-reported anxiety, and depression measure, and a quality-of-life scale. The interview completes the Columbia Suicide Scale. Following this, an artist and a therapist works with the participant to create a story related to their gender identity using the six-part story method. This story is then rendered to an artists’ book, which combines narrative with art (drawings, collage, computer images, etc.) and can take the form of a graphic novella, a zine, or a comic book. The pages can range from plain to ornate, as can the covers. Participants describe their process of making the books as the work unfolds and then participate in an exit interview at the completion of their book, remarking on what has changed for them and how the process affected them. Results: Preliminary results show high levels of suicidal thoughts among this population, as expected. Participants participate enthusiastically in the life story interview process and in the construction of a story related to gender identity. They enthusiastically participate in the studio process of putting their story into the form of a graphic novel, zine, or comic book. Participants reported feeling more comfortable with their TGD identity after the process and more able to resist negative judgments of family members and society. Suicidal thoughts diminish, and participants reported improved emotional wellbeing. Quantitative analysis of questionnaire data is underway Conclusions: A process in which narrative therapy is combined with art therapy shows promise for attracting and helping TGD individuals to reduce their risk for suicide without the stigma of going for mental health treatment. This process can be done outside of conventional mental health settings, on college and University campuses. This can provide an exciting alternative pathway for minority stressed and stigmatized individuals to engage in reflective, psychotherapeutic work without the trappings of psychotherapy or mental health treatment.

Keywords: minority stress, narrative process, artists' books, life story interview

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Authors: A. Augustyn, M. Florek, M. Herezniak

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Since the public authorities are constantly pressured by the public opinion to showcase the tangible and measurable results of their efforts, the evaluation of place brand-related activities becomes a necessity. Given the political and social character of place branding process, the legitimization of the branding efforts requires the compliance of the objectives set out in the city brand strategy with the actual needs, expectations, and aspirations of various internal stakeholders. To deliver on the diverse promises, city authorities and brand managers need to translate them into the measurable indicators against which the brand strategy effectiveness will be evaluated. In concert with these observations are the findings from branding and marketing literature with a widespread consensus that places should adopt a more systematic and holistic approach in order to ensure the performance of their brands. However, the measurement of the effectiveness of place branding remains insufficiently explored in theory, even though it is considered a significant step in the process of place brand management. Therefore, the aim of the research presented in the current paper was to collect insights on the nature of effectiveness measurement of city brand strategies and to juxtapose these findings with the theoretical assumptions formed on the basis of the state-of-the-art literature review. To this end, 15 international academic experts (out of 18 initially selected) with affiliation from ten countries (five continents), were individually interviewed. The standardized set of 19 open-ended questions was used for all the interviewees, who had been selected based on their expertise and reputation in the fields of place branding/marketing. Findings were categorized into four modules: (i) conceptualizations of city brand effectiveness, (ii) methodological issues of city brand effectiveness measurement, (iii) the nature of measurement process, (iv) articulation of key performance indicators (KPIs). Within each module, the interviewees offered diverse insights into the subject based on their academic expertise and professional activity as consultants. They proposed that there should be a twofold understanding of effectiveness. The narrow one when it is conceived as the aptitude to achieve specific goals, and the broad one in which city brand effectiveness is seen as an increase in social and economic reality of a place, which in turn poses diverse challenges for the measurement concepts and processes. Moreover, the respondents offered a variety of insights into the methodological issues, particularly about the need for customization and flexibility of the measurement systems, for the employment of interdisciplinary approach to measurement and implications resulting therefrom. Considerable emphasis was put on the inward approach to measurement, namely the necessity to monitor the resident’s evaluation of brand related activities instead of benchmarking cities against the competitive set. Other findings encompass the issues of developing appropriate KPIs for the city brand, managing the measurement process and the inclusion of diverse stakeholders to produce a sound measurement system. Furthermore, the interviewees enumerated the most frequently made mistakes in measurement mainly resulting from the misunderstanding of the nature of city brands. This research was financed by the National Science Centre, Poland, research project no. 2015/19/B/HS4/00380 Towards the categorization of place brand strategy effectiveness indicators – findings from strategic documents of Polish district cities – theoretical and empirical approach.

Keywords: city branding, effectiveness, experts’ insights, measurement

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Authors: Bassey O. Bassey

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Benchmarking has progressively become entrenched as a requisite activity for process improvement and enhancing service delivery at petroleum jetties and terminals, most especially during tanker discharge operations at the ship – shore interface, as avoidable delays result in extra operating costs, non-productive time, high demurrage payments and ultimate product scarcity. The jetty and terminal in focus had been operational for 3 and 8 years respectively, with proper operational and logistic records maintained to evaluate their progress over time in order to plan and implement modifications and review of procedures for greater technical and economic efficiency. Regular and emergency staff meetings were held on a team, departmental and company-wide basis to progressively address major challenges that were encountered during each operation. The process and outcome of the resultant collectively planned changes carried out within the past two years forms the basis of this paper, which mirrors the initiatives effected to enhance operational and maintenance excellence at the affected facilities. Operational modifications included a second cargo receipt line designated for gasoline, product loss control at jetty and shore ends, enhanced product recovery and quality control, and revival of terminal–jetty backloading operations. Logistic improvements were the incorporation of an internal logistics firm and shipping agency, fast tracking of discharge procedures for tankers, optimization of tank vessel selection process, and third party product receipt and throughput. Maintenance excellence was achieved through construction of two new lay barges and refurbishment of the existing one; revamping of existing booster pump and purchasing of a modern one as reserve capacity; extension of Phase 1 of the jetty to accommodate two vessels and construction of Phase 2 for two more vessels; regular inspection, draining, drying and replacement of cargo hoses; corrosion management program for all process facilities; and an improved, properly planned and documented maintenance culture. Safety, environmental and security compliance were enhanced by installing state-of-the-art fire fighting facilities and equipment, seawater intake line construction as backup for borehole at the terminal, remediation of the shoreline and marine structures, modern spill containment equipment, improved housekeeping and accident prevention practices, and installation of hi-technology security enhancements, among others. The end result has been observed over the past two years to include improved tanker turnaround time, higher turnover on product sales, consistent product availability, greater indigenous human capacity utilisation by way of direct hires and contracts, as well as customer loyalty. The lessons learnt from this exercise would, therefore, serve as a model to be adapted by other operators of similar facilities, contractors, academics and consultants in a bid to deliver greater sustainability and profitability of operations at the ship – shore interface to this strategic industry.

Keywords: benchmarking, optimisation, petroleum jetty, petroleum terminal

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Authors: Jun Byung Joon, Seo Seok Hyun, Lee Seo Young

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As carbon dioxide emissions increase due to rapid industrialization and reckless development, abnormal climates such as floods and droughts are occurring. In order to respond to such climate change, the use of existing fossil fuels is reduced, and the proportion of eco-friendly renewable energy is gradually increasing. Korea is an energy resource-poor country that depends on imports for 93% of its total energy. As the global energy supply chain instability experienced due to the Russia-Ukraine crisis increases, countries around the world are resetting energy policies to minimize energy dependence and strengthen security. Seawater thermal energy is a renewable energy that replaces the existing air heat energy. It uses the characteristic of having a higher specific heat than air to cool and heat main spaces of buildings to increase heat transfer efficiency and minimize power consumption to generate electricity using fossil fuels, and Carbon dioxide emissions can be minimized. In addition, the effect on the marine environment is very small by using only the temperature characteristics of seawater in a limited way. K-water carried out a demonstration project of supplying cooling and heating energy to spaces such as the central control room and presentation room in the management building by acquiring the heat source of seawater circulated through the power plant's waterway by using the characteristics of the tidal power plant. Compared to the East Sea and the South Sea, the main system was designed in consideration of the large tidal difference, small temperature difference, and low-temperature characteristics, and its performance was verified through operation during the demonstration period. In addition, facility improvements were made for major deficiencies to strengthen monitoring functions, provide user convenience, and improve facility soundness. To spread these achievements, the basic concept was to expand the seawater heating and cooling system with a scale of 200 USRT at the Tidal Culture Center. With the operational experience of the demonstration system, it will be possible to establish an optimal seawater heat cooling and heating system suitable for the characteristics of the west coast ocean. Through this, it is possible to reduce operating costs by KRW 33,31 million per year compared to air heat, and through industry-university-research joint research, it is possible to localize major equipment and materials and develop key element technologies to revitalize the seawater heat business and to advance into overseas markets. The government's efforts are needed to expand the seawater heating and cooling system. Seawater thermal energy utilizes only the thermal energy of infinite seawater. Seawater thermal energy has less impact on the environment than river water thermal energy, except for environmental pollution factors such as bottom dredging, excavation, and sand or stone extraction. Therefore, it is necessary to increase the sense of speed in project promotion by innovatively simplifying unnecessary licensing/permission procedures. In addition, support should be provided to secure business feasibility by dramatically exempting the usage fee of public waters to actively encourage development in the private sector.

Keywords: seawater thermal energy, marine energy, tidal power plant, energy consumption

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Authors: Patrick Cormier, Cesar Meylan, Matt Jensen, Dana Agar-Newman, Chloe Werle, Ming-Chang Tsai, Marc Klimstra

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Sprint-derived horizontal force-velocity-power (FVP) profiles can be developed with adequate validity and reliability with satellite (GPS/GNSS) systems. However, FVP metrics are sensitive to small nuances in data processing procedures such that minor differences in defining the onset and end of the sprint could result in different FVP metric outcomes. Furthermore, in team-sports, there is a requirement for rapid analysis and feedback of results from multiple athletes, therefore developing standardized and automated methods to improve the speed, efficiency and reliability of this process are warranted. Thus, the purpose of this study was to compare different methods of sprint end detection on the development of FVP profiles from 10Hz GPS/GNSS data through goodness-of-fit and intertrial reliability statistics. Seventeen national team female soccer players participated in the FVP protocol which consisted of 2x40m maximal sprints performed towards the end of a soccer specific warm-up in a training session (1020 hPa, wind = 0, temperature = 30°C) on an open grass field. Each player wore a 10Hz Catapult system unit (Vector S7, Catapult Innovations) inserted in a vest in a pouch between the scapulae. All data were analyzed following common procedures. Variables computed and assessed were the model parameters, estimated maximal sprint speed (MSS) and the acceleration constant τ, in addition to horizontal relative force (F₀), velocity at zero (V₀), and relative mechanical power (Pmax). The onset of the sprints was standardized with an acceleration threshold of 0.1 m/s². The sprint end detection methods were: 1. Time when peak velocity (MSS) was achieved (zero acceleration), 2. Time after peak velocity drops by -0.4 m/s, 3. Time after peak velocity drops by -0.6 m/s, and 4. When the integrated distance from the GPS/GNSS signal achieves 40-m. Goodness-of-fit of each sprint end detection method was determined using the residual sum of squares (RSS) to demonstrate the error of the FVP modeling with the sprint data from the GPS/GNSS system. Inter-trial reliability (from 2 trials) was assessed utilizing intraclass correlation coefficients (ICC). For goodness-of-fit results, the end detection technique that used the time when peak velocity was achieved (zero acceleration) had the lowest RSS values, followed by -0.4 and -0.6 velocity decay, and 40-m end had the highest RSS values. For intertrial reliability, the end of sprint detection techniques that were defined as the time at (method 1) or shortly after (method 2 and 3) when MSS was achieved had very large to near perfect ICC and the time at the 40 m integrated distance (method 4) had large to very large ICCs. Peak velocity was reached at 29.52 ± 4.02-m. Therefore, sport scientists should implement end of sprint detection either when peak velocity is determined or shortly after to improve goodness of fit to achieve reliable between trial FVP profile metrics. Although, more robust processing and modeling procedures should be developed in future research to improve sprint model fitting. This protocol was seamlessly integrated into the usual training which shows promise for sprint monitoring in the field with this technology.

Keywords: automated, biomechanics, team-sports, sprint

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Authors: Khlood F. Salman, Richard Zoucha, Hani Nawafleh

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Introduction: Jordan ranks the fourth highest breast cancer prevalence after Lebanon, Bahrain, and Kuwait. Considerable evidence showed that cultural, ethnic, and economic differences influence a woman’s practice to early detection and prevention of breast cancer. Objectives: To understand women’s health beliefs and values in relation to early detection of breast cancer; and to explore the impact of these beliefs on their decisions regarding reluctance or acceptance of early detection measures such as mammogram screening. Design: A qualitative focused ethnography was used to collect data for this study. Settings: The study was conducted in the second largest city surrounded by a large rural area in Ma’an- Jordan. Participants: A total of twenty seven women, with no history of breast cancer, between the ages of 18 and older, who had prior health experience with health providers, and were willing to share elements of personal health beliefs related to breast health within the larger cultural context. The participants were recruited using the snowball method and words of mouth. Data collection and analysis: A short questionnaire was designed to collect data related to socio demographic status (SDQ) from all participants. A Semi-structured interviews guide was used to elicit data through interviews with the informants. Nvivo10 a data manager was utilized to assist with data analysis. Leininger’s four phases of qualitative data analysis was used as a guide for the data analysis. The phases used to analyze the data included: 1) Collecting and documenting raw data, 2) Identifying of descriptors and categories according to the domains of inquiry and research questions. Emic and etic data is coded for similarities and differences, 3) Identifying patterns and contextual analysis, discover saturation of ideas and recurrent patterns, and 4) Identifying themes and theoretical formulations and recommendations. Findings: Three major themes were emerged within the cultural and religious context; 1. Fear, denial, embarrassment and lack of knowledge were common perceptions of Ma’anis’ women regarding breast health and screening mammography, 2. Health care professionals in Jordan were not quick to offer information and education about breast cancer and screening, and 3. Willingness to learn about breast health and cancer prevention. Conclusion: The study indicated the disparities between the infrastructure and resourcing in rural and urban areas of Jordan, knowledge deficit related to breast cancer, and lack of education about breast health may impact women’s decision to go for a mammogram screening. Cultural beliefs, fear, embarrassments as well as providers lack of focus on breast health were significant contributors against practicing breast health. Health providers and policy makers should provide resources for the establishment health education programs regarding breast cancer early detection and mammography screening. Nurses should play a major role in delivering health education about breast health in general and breast cancer in particular. A culturally appropriate health awareness messages can be used in creating educational programs which can be employed at the national levels.

Keywords: breast health, beliefs, cultural context, ethnography, mammogram screening

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Authors: Lazzat M. Zhamaliyeva, Nurgul A. Abenova, Gauhar S. Dilmagambetova, Ziyash Zh. Tanbetova, Moldir B. Ahmetzhanova, Tatyana P. Ostretcova, Aliya A. Yegemberdiyeva

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Introduction: There are many reasons for the weak training of family doctors in Kazakhstan: the unified national educational program is not focused on competencies, the role of a general practitioner (GP) is not clear, poor funding for the health care and education system, outdated teaching and assessment methods, inefficient management. We highlight two issues in particular. Firstly, academic teachers of family medicine (FM) in Kazakhstan do not practice as family doctors; most of them are narrow specialists (pediatricians, therapists, surgeons, etc.); they usually hold one-time consultations; clinical mentors from practical healthcare (non-academic teachers) do not have the teaching competences, and the vast majority of them are also narrow specialists. Secondly, clinical sites (polyclinics) are unprepared for general practice and do not follow the principles of family medicine; residents do not like to be in primary health care (PHC) settings due to the chaos that is happening there, as well as due to the lack of the necessary equipment for mastering and consolidating practical skills. Aim: We present the concept of the family physicians’ training office (FPTO), which is being created as a friendly learning environment for young general practitioners and for the involvement of academic teachers of family medicine in the practical work and innovative development of PHC. Methodology: In developing the conceptual framework and identifying practical activities, we drew on literature and expert input, and interviews. Results: The goal of the FPTO is to create a favorable educational and clinical environment for the development of the FM residents’ competencies, in which the residents with academic teachers and clinical mentors could understand and accept the principles of family medicine, improve clinical knowledge and skills, and gain experience in improving the quality of their practice in scientific basis. Three main areas of office activity are providing primary care to the patients, improving educational services for FM residents and other medical workers, and promoting research in PHC and innovations. The office arranges for residents to see outpatients at least 50% of the time, and teachers of FM departments at least 1/4 of their working time conduct general medical appointments next to residents. Taking into account the educational and scientific workload, the number of attached population for one GP does not exceed 500 persons. The equipment of the office allows FPTO workers to perform invasive and other manipulations without being sent to other clinics. In the office, training for residents is focused on their needs and aimed at achieving the required level of competence. International methodologies and assessment tools are adapted to local conditions and evaluated for their effectiveness and acceptability. Residents and their faculty actively conduct research in the field of family medicine. Conclusions: We propose to change the learning environment in order to create teams of like-minded people, to unite residents and teachers even more for the development of family medicine. The offices will also invest resources in developing and maintaining young doctors' interest in family medicine.

Keywords: educational environment, family medicine residents, family physicians’ training office, primary care research

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Authors: Ali Baker, Russel Krawitz

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This paper describes a rare occurrence where a potentially fatal complication of COVID-19 infection (MIS-A) was misdiagnosed as an acute abdomen. As most patients with this syndrome present with fever and gastrointestinal symptoms, they may inadvertently fall under the care of the surgical unit. However, unusual imaging findings and a poor response to anti-microbial therapy should prompt clinicians to suspect a non-surgical etiology. More than half of MIS-A patients require ICU admission and vasopressor support. Prompt referral to a physician is key, as the cornerstone of treatment is IVIG and corticosteroid therapy. A 32 year old woman presented with right sided abdominal pain and fevers. She had also contracted COVID-19 two months earlier. Abdominal examination revealed generalised right sided tenderness. The patient had raised inflammatory markers, but other blood tests were unremarkable. CT scan revealed extensive lymphadenopathy along the ileocolic chain. The patient proved to be a diagnostic dilemma. She was reviewed by several surgical consultants and discussed with several inpatient teams. Although IV antibiotics were commenced, the right sided abdominal pain, and fevers persisted. Pan-culture returned negative. A mild cholestatic derangement developed. On day 5, the patient underwent preparation for colonoscopy to assess for a potential intraluminal etiology. The following day, the patient developed sinus tachycardia and hypotension that was refractory to fluid resuscitation. That patient was transferred to ICU and required vasopressor support. Repeat CT showed peri-portal edema and a thickened gallbladder wall. On re-examination, the patient was Murphy’s sign positive. Biliary ultrasound was equivocal for cholecystitis. The patient was planned for diagnostic laparoscopy. The following morning, a marked rise in cardiac troponin was discovered, and a follow-up echocardiogram revealed moderate to severe global systolic dysfunction. The impression was post-COVID MIS with myocardial involvement. IVIG and Methylprednisolone infusions were commenced. The patient had a great response. Vasopressor support was weaned, and the patient was discharged from ICU. The patient continued to improve clinically with oral prednisolone, and was discharged on day 17. Although MIS following COVID-19 infection is well-described syndrome in children, only recently has it come to light that it can occur in adults. The exact incidence is unknown, but it is thought to be rare. A recent systematic review found only 221 cases of MIS-A, which could be included for analysis. Symptoms vary, but the most frequent include fever, gastrointestinal, and mucocutaneous. Many patients progress to multi-organ failure and require vasopressor support. 7% succumb to the illness. The pathophysiology of MIS is only partly understood. It shares similarities with Kawasaki disease, macrophage activation syndrome, and cytokine release syndrome. Importantly, by definition, the patient must have an absence of severe respiratory symptoms. It is thought to be due to a dysregulated immune response to the virus. Potential mechanisms include reduced levels of neutralising antibodies and autoreactive antibodies that promote inflammation. Further research into MIS-A is needed. Although rare, this potentially fatal syndrome should be considered in the unwell surgical patient who has recently contracted COVID-19 and poses a diagnostic dilemma.

Keywords: acute-abdomen, MIS, COVID-19, ICU

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Authors: N. Rambabu, H. Gururaj, Reynold Washington, Oommen George

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Motivation: Under the USAID Strengthening Health Outcomes through Private Sector (SHOPS-TB) initiative, Karnataka Health Promotion Trust (KHPT) with technical support of Abt associates is implementing a TB prevention and care model in Karnataka State, South India. KHPT is the interface agency between the public and private sectors, and providers and the target community facilitating early TB case detection and enhancing treatment compliance through private health care providers (pHCP) engagement in RNTCP. The project coverage is 0.84 million urban poor from 663 slums in 12 districts of Karnataka. Problem Statement: India with the highest burden of global TB (26%) and two million cases annually, accounts for approximately one fifth of the global incidence. WHO estimates 300,000 people die from TB annually in India. India expanded the coverage of Directly Observed Treatment, Short-course chemotherapy (DOTS) to the entire country as early as 2006. However, the performance of RNTCP has not been uniform across states. While the national annual new smear-positive (NSP) case notification rate is 53, it is much lower at 47 in Karnataka. A third of TB patients in India reside in urban slums. Approach: Under SHOPS, KHPT actively engages with communities through key opinion leaders and community structures. Interpersonal communication, by Outreach workers through house-to-house visits and at aggregation points, is the primary method used for communication about TB and its management and to increase demand for sputum examination and DOTS. pHCP are mapped, trained and mentored by KHPT. ORWs also provide patient and family counseling on TB treatment, side effects and adherence, screen close contacts of index patients especially children under 6 years of age and screen co-morbidities including HIV, diabetes and malnutrition and risk factors including alcoholism, tobacco use, occupational hazards making appropriate accompanied or documented referrals. A treatment ‘buddy’ system for the patients involving close friends or family members, ICT-based support, DOTS Prerana (inspiration) groups of TB patients, family members and community, DOTS Mitra (friend) helpline services are also used for care and support services. Results: The intervention educated 39988 slum dwellers, referred 1731 chest symptomatics, tested 1061 patients and initiated 248 patients on anti-TB treatment within three months of intervention through continuous community engagement. Conclusions: The intervention’s potential to increase access to preferred health care providers, reduce patient and health system delays in diagnosis and initiation of treatment, improve health seeking behaviour and enhance compliance of pHCPs to standard treatment protocols is being monitored. Initial results are promising.

Keywords: DOTS, KHPT, health outcomes, public and private sector

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Authors: Faheemah N. Mustafaa, Tamarie Macon, Tabbye Chavous

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A major concern of university leaders worldwide is how to create environments where students from diverse racial/ethnic, national, and cultural backgrounds can thrive. Over the past decade or so in the United States, African American women have done exceedingly well in terms of college enrollment, academic performance, and completion. However, the relative academic successes of African American women in higher education has in some ways overshadowed social challenges many Black women continue to encounter on college campuses in the United States. Within predominantly White institutions (PWIs) in particular, there is consistent evidence that many Black students experience racially hostile climates. However, research studies on racial climates within PWIs have mostly focused on cross-sectional comparisons of minority and majority group experiences, and few studies have examined campus racial climate in relation to short- and longer-term well-being. One longitudinal study reported that African American women’s psychological well-being was positively related to their comfort in cross-racial interactions (a concept closely related to campus climate). Thus, our primary research question was: Do African American women’s perceptions of campus climate (tension and positive association) during their freshman year predict their reports of psychological distress and well-being (self-acceptance) during their sophomore year? Participants were part of a longitudinal survey examining African American college students’ academic identity development, particularly in Science, Technology, Engineering, and Mathematics (STEM) fields. The final subsample included 134 self-identified African American/Black women enrolled in PWIs. Accounting for background characteristics (mother’s education, family income, interracial contact, and prior levels of outcomes), we employed hierarchical regression to examine relationships between campus racial climate during freshman year and psychological adjustment one year later. Both regression models significantly predicted African American women’s psychological outcomes (for distress, F(7,91)= 4.34, p < .001; and for self-acceptance, F(7,90)= 4.92, p < .001). Although none of the controls were significant predictors, perceptions of racial tension on campus were associated with both distress and self-acceptance. More perceptions of tension were related to African American women’s greater psychological distress the following year (B= 0.22, p= .01). Additionally, racial tension predicted later self-acceptance in the expected direction: Higher first-year reports of racial tension were related to less positive attitudes toward the self during the sophomore year (B= -0.16, p= .04). However, perceptions that it was normative for Black and White students to socialize on campus (or positive association scores) were unrelated to psychological distress or self-acceptance. Findings highlight the relevance of examining multiple facets of campus racial climate in relation to psychological adjustment, with possible emphasis on the import of racial tension on African American women’s psychological adjustment. Results suggest that negative dimensions of campus racial climate may have lingering effects on psychological well-being, over and above more positive aspects of climate. Thus, programs targeted toward improving student relations on campus should consider addressing cross-racial tensions.

Keywords: higher education, psychological adjustment, university climate, university students

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Authors: Lia Mania, Ketevan Nanobashvili

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Background: The coronavirus disease COVID-19 has become the cause of a global health crisis during the current pandemic. This study aims to fill the paucity of epidemiological studies on the impact of COVID-19 on the oral health of pediatric populations. Methods: It was conducted an observational, cross-sectional study in Georgia, in Tbilisi (capital of Georgia), among 7 to 12-year-old PCR or rapid test-confirmed post-Covid populations in all districts of Tbilisi (10 districts in total). 332 beneficiaries who were infected with Covid within one year were included in the study. The population was selected in schools of Tbilisi according to the principle of cluster selection. A simple random selection took place in the selected clusters. According to this principle, an equal number of beneficiaries were selected in all districts of Tbilisi. By July 1, 2022, according to National Center for Disease Control and Public Health data (NCDC.Ge), the number of test-confirmed cases in the population aged 0-18 in Tbilisi was 115137 children (17.7% of all confirmed cases). The number of patients to be examined was determined by the sample size. Oral screening, microbiological examination of saliva, and administration of oral health questionnaires to guardians were performed. Statistical processing of data was done with SPSS-23. Risk factors were estimated by odds ratio and logistic regression with 95% confidence interval. Results: Statistically reliable differences between the averages of oral health indicators in asymptomatic and symptomatic covid-infected groups are: for caries intensity (DMF+def) t=4.468 and p=0.000, for modified gingival index (MGI) t=3.048, p=0.002, for simplified oral hygiene index (S-OHI) t=4.853; p=0.000. Symptomatic covid-infection has a reliable effect on the oral microbiome (Staphylococcus aureus, Candida albicans, Pseudomonas aeruginosa, Streptococcus pneumoniae, Staphylococcus epidermalis); (n=332; 77.3% vs n=332; 58.0%; OR=2.46, 95%CI: 1.318-4.617). According to the logistic regression, it was found that the severity of the covid infection has a significant effect on the frequency of pathogenic and conditionally pathogenic bacteria in the oral cavity B=0.903 AOR=2.467 (CL 1.318-4.617). Symptomatic covid-infection affects oral health indicators, regardless of the presence of other risk factors, such as parental employment status, tooth brushing behaviors, carbohydrate meal, fruit consumption. (p<0.05). Conclusion: Risk factors (parental employment status, tooth brushing behaviors, carbohydrate consumption) were associated with poorer oral health status in a post-Covid population of 7- to 12-year-old children. However, such a risk factor as symptomatic ongoing covid-infection affected the oral microbiome in terms of the abundant growth of pathogenic and conditionally pathogenic bacteria (Staphylococcus aureus, Candida albicans, Pseudomonas aeruginosa, Streptococcus pneumoniae, Staphylococcus epidermalis) and further worsened oral health indicators. Thus, a close association was established between symptomatic covid-infection and microbiome changes in the post-covid period; also - between the variables of oral health indicators and the symptomatic course of covid-infection.

Keywords: oral microbiome, COVID-19, population based research, oral health indicators

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Authors: Ágnes Győri, Éva Perpék, Zsófia Bauer, Zsuzsanna Elek

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The aim of the research (funded by Hungarian national grant, NFKI- FK 138315) is to examine the professional mobility, mental health and work environment of social workers with a complex approach. Previous international and Hungarian research has pointed out that those working in the helping professions are strongly exposed to the risk of emotional-mental-physical exhaustion due to stress. Mental and physical strain, as well as lack of coping (can) cause health problems, but its role in career change and high labor turnover has also been proven. Even though satisfaction with working conditions of those employed in the human service sector in the context of the stress burden has been researched extensively, there is a lack of large-sample international and Hungarian domestic studies exploring the effects of profession-specific conditions. Nor has it been examined how the specific features of the social profession and mental health affect the career mobility of the professionals concerned. In our research, these factors and their correlations are analyzed by means of mixed methodology, utilizing the benefits of netnographic big data analysis and a sector-specific quantitative survey. The netnographic analysis of open web content generated inside and outside the social profession offers a holistic overview of the influencing factors related to mental health and the work environment of social workers. On the one hand, the topics and topoi emerging in the external discourse concerning the sector are examined, and on the other hand, focus on mentions and streams of comments regarding the profession, burnout, stress, coping, as well as labor turnover and career changes among social professionals. The analysis focuses on new trends and changes in discourse that have emerged during and after the pandemic. In addition to the online conversation analysis, a survey of social professionals with a specific focus has been conducted. The questionnaire is based on input from the first two research phases. The applied approach underlines that the mobility paths of social professionals can only be understood if, apart from the general working conditions, the specific features of social work and the effects of certain aspects of mental health (emotional-mental-physical strain, resilience) are taken into account as well. In this paper, the preliminary results from this innovative methodological mix are presented, with the aim of highlighting new opportunities and dimensions in the research on social work. A gap in existing research is aimed to be filled both on a methodological and empirical level, and the Hungarian domestic findings can create a feasible and relevant framework for a further international investigation and cross-cultural comparative analysis. Said results can contribute to the foundation of organizational and policy-level interventions, targeted programs whereby the risk of burnout and the rate of career abandonment can be reduced. Exploring different aspects of resilience and mapping personality strengths can be a starting point for stress-management, motivation-building, and personality-development training for social professionals.

Keywords: burnout, mixed methods, netnography, professional mobility, social work

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Authors: Mirain Rhys, Kevin Smith

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In 2017, the Welsh Government introduced an ambitious, new strategy to increase the number of Welsh speakers in Wales to 1 million by 2050. The Welsh education system is a vitally important feature of this strategy. All children attending state schools in Wales learn Welsh as a second language until the age of 16 and are assessed at General Certificate of Secondary Education (GCSE) level. In 2013, a review of Welsh second language instruction in Key Stages 3 and 4 was completed. The report identified considerable gaps in teachers’ preparation and training for teaching Welsh; poor Welsh language ethos at many schools; and a general lack of resources to support the instruction of Welsh. Recommendations were made across a number of dimensions including curriculum content, pedagogical practice, and teacher assessment, training, and resources. With a new national curriculum currently in development, this study builds on this review and provides unprecedented detail into pupils’ and teachers’ perceptions of Welsh language instruction. The current research built on data taken from an existing capacity building research project on Welsh education, the Wales multi-cohort study (WMS). Quantitative data taken from WMS surveys with over 1200 pupils in schools in Wales indicated that Welsh language lessons were the least enjoyable subject among pupils. The current research aimed to unpick pupil experiences in order to add to the policy development context. To achieve this, forty-four pupils and four teachers in three schools from the larger WMS sample participated in focus groups. Participants from years 9, 11 and 13 who had indicated positive, negative and neutral attitudes towards the Welsh language in a previous WMS survey were selected. Questions were based on previous research exploring issues including, but not limited to pedagogy, policy, assessment, engagement and (teacher) training. A thematic analysis of the focus group recordings revealed that the majority of participants held positive views around keeping the language alive but did not want to take on responsibility for its maintenance. These views were almost entirely based on their experiences of learning Welsh at school, especially in relation to their perceived lack of choice and opinions around particular lesson strategies and assessment. Analysis of teacher interviews highlighted a distinct lack of resources (materials and staff alike) compared to modern foreign languages, which had a negative impact on student motivation and attitudes. Both staff and students indicated a need for more practical, oral language instruction which could lead to Welsh being used outside the classroom. The data corroborate many of the review’s previous findings, but what makes this research distinctive is the way in which pupils poignantly address generally misguided aims for Welsh language instruction, poor pedagogical practice and a general disconnect between Welsh instruction and its daily use in their lives. These findings emphasize the complexity of incorporating the educational sector in strategies for Welsh language maintenance and the complications arising from pedagogical training, support, and resources, as well as teacher and pupil perceptions of, and attitudes towards, teaching and learning Welsh.

Keywords: bilingual education, language maintenance, language revitalisation, minority languages, Wales

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Authors: Michal Geca, Grzegorz Baranski, Ksenia Siadkowska

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The work is a part of the project which aims at developing innovative power and control systems for the high power aircraft piston engine ASz62IR. Developed electronically controlled ignition system will reduce emissions of toxic compounds as a result of lowered fuel consumption, optimized combustion and engine capability of efficient combustion of ecological fuels. The tested unit is an air-cooled four-stroke gasoline engine of 9 cylinders in a radial setup, mechanically charged by a radial compressor powered by the engine crankshaft. The total engine cubic capac-ity is 29.87 dm3, and the compression ratio is 6.4:1. The maximum take-off power is 1000 HP at 2200 rpm. The maximum fuel consumption is 280 kg/h. Engine powers aircrafts: An-2, M-18 „Dromader”, DHC-3 „OTTER”, DC-3 „Dakota”, GAF-125 „HAWK” i Y5. The main problems of the engine includes the imbalanced work of cylinders. The non-uniformity value in each cylinder results in non-uniformity of their work. In radial engine cylinders arrangement causes that the mixture movement that takes place in accordance (lower cylinder) or the opposite (upper cylinders) to the direction of gravity. Preliminary tests confirmed the presence of uneven workflow of individual cylinders. The phenomenon is most intense at low speed. The non-uniformity is visible on the waveform of cylinder pressure. Therefore two studies were conducted to determine the impact of this phenomenon on the engine performance: simulation and real tests. Simplified simulation was conducted on the element of the intake system coated with fuel film. The study shows that there is an effect of gravity on the movement of the fuel film inside the radial engine intake channels. Both in the lower and the upper inlet channels the film flows downwards. It follows from the fact that gravity assists the movement of the film in the lower cylinder channels and prevents the movement in the upper cylinder channels. Real tests on aircraft engine ASz62IR was conducted in transients condition (rapid change of the excess air in each cylinder were performed. Calculations were conducted for mass of fuel reaching the cylinders theoretically and really and on this basis, the factors of fuel evaporation “x” were determined. Therefore a simplified model of the fuel supply to cylinder was adopted. Model includes time constant of the fuel film τ, the number of engine transport cycles of non-evaporating fuel along the intake pipe γ and time between next cycles Δt. The calculation results of identification of the model parameters are presented in the form of radar graphs. The figures shows the averages declines and increases of the injection time and the average values for both types of stroke. These studies shown, that the change of the position of the cylinder will cause changes in the formation of fuel-air mixture and thus changes in the combustion process. Based on the results of the work of simulation and experiments was possible to develop individual algorithms for ignition control. This work has been financed by the Polish National Centre for Research and Development, INNOLOT, under Grant Agreement No. INNOLOT/I/1/NCBR/2013.

Keywords: radial engine, ignition system, non-uniformity, combustion process

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Authors: Lhoussain Simour

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This paper discusses the reordering and reorientation Moroccan Oossified and frozen histories in national and colonial archives. It attempts to reexamine Moroccan non-canonical voices beyond borders, their forgotten experiences and itineraries, with the aim of uncovering cultural discourses pertaining to early cultural and artistic interactions between Morocco and the western countries, namely Britain and America. In fact, less attention has been given to the presence of Moroccan entertainers beyond borders in the archives of history. Moroccan historians and cultural critics seem to have paid little critical consideration to Moroccan artistic encounters with the west, Europe and America as a case in point. They have overlooked to deal with travel performances, professional entertainments, and artistic spectacles, initiated by acrobats, as instances of visual cross-cultural encounters between Morocco and the west. The narratives of these professional artists have hardly found their ways into historiographical writing. This contribution attempts to locate the contesting beginnings of Moroccan professional entertainers in western show business in the nineteenth century which witnessed intricate artistic, discursive and cultural junctures by emphasizing connections between theatrical performances, ethnic exhibition and world fair expositions. Moroccan professional performances grew in Europe and America within a zealous context marked by the rise of a paradigmatic racial consciousness that sought to authenticate and legitimate ethnic discourses of power and exclusion. The ethnic taxonomies and racial hierarchies governed by ethnographic and anthropological documentation fueled up entertainment venues and popular theatrical performances and helped in developing a distinctive view about Self and Other paradigms. Moroccan travelers started their journeys to visit European and American countries to exhibit their acrobatics acts. They, in a certain sense, continued, albeit in varying degrees and circumstances, the whole tradition of travel initiated previously by their ancestor diplomats and ambassadors. Professional entertainers embarked on daring journeys across the Mediterranean and the Atlantic to discover new geographies and cultural spaces, and perform their spectacles beyond borders. These travelers left rich archival documents that reflect important cultural and historical moments. The routes of travel started from the margins of the empire towards metropolitan centers of nineteenth century Europe and America included Moroccan women travelers as acrobats and dancing professional artists as well. These also crossed the straits of Gibraltar and journeyed through the Atlantic Ocean to visit western countries. Moroccan women travelers took part in various Euro-American theatre performances and in circus shows as early as 1850 according to newspapers archives and passengers shipping lists. Najat Amburg, Zahar Ben Tahar, Torquia, Fadma, and many more whose names are now lost to us, moved freely in various western capital cities to entertain nineteenth century western audiences.

Keywords: archives, cultural encounters, self and other, Morocco, travel, Moroccan acrobats, Moorish dancing women

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Authors: Beth Vale

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Academic research has often neglected the city after dark. Surprisingly little consideration has been given to the every night life of cities: the spatial tactics and creative insurgencies of urban residents when night falls. The focus on ‘pleasure’ in the nocturnal city has often negated the subtle politics of night-time play, embedded in expressions of identity, attachment and resistance. This paper investigates Johannesburg nightclubs as sites of quotidian political labour, through which young people contest social space and their place in it, thereby contributing to the city’s effective and socio-political cartography. The tactical remodelling of the nocturnal city through nightclubbing traces lines of desire (material, emotional, sexual), affiliation, and fear. These in turn map onto young people’s expressions of their social and political identities, as well as their attempts at place-making in a ‘post-apartheid’ context. By examining the micro-politics of the cities' nightclubs, this paper speaks back to an earlier post-94 literature, which regularly characterised Johannesburg youth as superficial, individualist and idealistic. Similarly, some might position nightclubs as sites of frivolous consumption or liberatory permissiveness. Yet because nightclub spaces are racialised, classed and gendered, historically-signified and socially regulated, they are also profoundly political. Through ordinary encounters on the cities' dancefloors, young Jo’burgers are imagining, contesting and negotiating their socio-political identities and indeed their claims to the city. Meanwhile, the politics of this generation of youth, who are increasingly critical of the utopian post-apartheid city, are being increasingly inserted and coopted into night-time cultures. Data for this study was gathered through five months of ethnographic fieldwork in Johannesburg nightclubs, including over 120 hours of participant observation and in-depth interviews with organisers and partygoers. Interviewees recognised that parties, rather than being simple frivolity, are a cacophony of celebration, mourning, worship, rage, rebellion and attachment. Countering standard associations between partying and escapism, party planners, venue owners and nightclub audiences were infusing night-time infrastructures with the aesthetics of politics and protest. Not unlike parties, local political assemblies so often rely on music, dance, the occupation of space, and a heaving crowd. References to social movements, militancy and anti-establishment emerged in nightclub themes, dress codes and décor. Metaphors of fire crossed over between party and protest, both of which could be described as having ‘been lit’ or having ‘brought flames’. More so, young people’s articulations of the city’s night-time geography, and their place in it, reflected articulations of race, class and ideological affiliation. The location, entrance fees and stylistic choices of one’s chosen club destination demarcated who was welcome, while also signalling membership to a particular politics (whether progressive or materialistic, inclusive or elitist, mainstream or counter-culture). Because of their ability to divide and unite, aggravate and titillate, mask and reveal, club cultures might offer a mirror to the complex socialities of a generation of Jo’burg youth, as they inhabit, and bring into being, a contemporary South African city.

Keywords: affect, Johannesburg, nightclub, nocturnal city, politics

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