Search results for: public service reforms

Authors: Laila Khawaja

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In recent years, an increasing emphasis has been placed on measuring program implementation, in part because of the great variability in how complex interventions are delivered in real-life settings. There is an increased awareness that while conducting process evaluations, one should aim to identify and understand the complexities of intervention if they are to be used for future intervention development or the strategies needed to implement the same intervention in a different setting. Complex interventions are public health interventions that are not drugs or surgical procedures but have many potential active aspects of intervention. In this paper, process evaluations are aligned with MRC guidelines to identify contextual factors related to outcomes to assess the quality of implementation. This paper briefly discusses the perceptions of research team on the implementation of the intervention of ‘Engaging Adolescents in Changing Behaviour’ (EACH-B), a school-based complex intervention study aiming to improve diet and physical activity among adolescents aged 12-13 years. Through qualitative interviews and focus groups with 10 staff members, we aimed to understand their experiences and reflections on implementing the EACH-B trial delivered in 49 Schools around Hampshire, England. Data were uploaded into NVivo, and analysis was conducted using thematic analysis. The investigation revealed two overarching themes: (a) how the communication patterns with teachers were impacted during the delivery of implementation and (b) what were the team’s strategies to keep logistics aligned with the research process that impacted the overall implementation of the trial. The paper informs adaptation strategies used by the research team to establish and maintain effective communication with the teachers as well as the thoughtfulness of the team’s logistic strategy for the successful delivery of the trial.

Keywords: complex interventions, process evaluation, adaptation strategies, randomised controlled trial

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Authors: Dan Wang, Qing Ma, Xiaodan Wang, Tianjiao Qi

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The sound of peddling in Beijing, also called “yo-heave-ho” or “cry of one's ware”, is a unique folk culture and usually found in Beijing hutong. For the civilians in Beijing, sound of peddling is part of their childhood. And for those who love the traditional culture of Beijing, it is an old song singing the local conditions and customs of the ancient city. For example, because of his great appreciation, the British poet Osbert Stewart once put sound of peddling which he had heard in Beijing as a street orchestra performance in the article named "Beijing's sound and color".This research aims to collect and integrate the voice/photo resources and historical materials of sound concerning peddling in Beijing by digital technology in order to protect the intangible cultural heritage and pass on the city memory. With the goal in mind, the next stage is to collect and record all the materials and resources based on the historical documents study and interviews with civilians or performers. Then set up a metadata scheme (which refers to the domestic and international standards such as "Audio Data Processing Standards in the National Library", DC, VRA, and CDWA, etc.) to describe, process and organize the sound of peddling into a database. In order to fully show the traditional culture of sound of peddling in Beijing, web design and GIS technology are utilized to establish a website and plan holding offline exhibitions and events for people to simulate and learn the sound of peddling by using VR/AR technology. All resources are opened to the public and civilians can share the digital memory through not only the offline experiential activities, but also the online interaction. With all the attempts, a multi-media narrative platform has been established to multi-dimensionally record the sound of peddling in old Beijing with text, images, audio, video and so on.

Keywords: sound of peddling, GIS, metadata scheme, VR/AR technology

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Authors: Amr Amer

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Cheeses are among those high-protein-containing foodstuffs in which enzymatic and microbial activities cause the formation of biogenic amines from amino acids decarboxylation. The amount of biogenic amines in cheese may act as a useful indicator of the hygienic quality of the product. In other words, their presence in cheese is related to its spoilage and safety. Formation of biogenic amines during Ras cheese (Egyptian hard cheese) ripening was investigated for 4 months. Three batches of Ras cheese were manufactured using Egyptian traditional method. From each batch, Samples were collected at 1, 7, 15, 30, 60, 90 and 120 days after cheese manufacture. The concentrations of biogenic amines (Tyramine, Histamine, Cadaverine and Tryptamine) were analyzed by high performance liquid chromatography (HPLC). There was a significant increased (P<0.05) in Tyramine levels from 4.34± 0.07 mg|100g in the first day of storage till reached 88.77± 0.14 mg|100g at a 120-day of storage. Also, Histamine and Cadaverine levels had the same increased pattern of Tyramine reaching 64.94± 0.10 and 28.28± 0.08 mg|100g in a 120- day of storage, respectively. While, there was a fluctuation in the concentration of Tryptamine level during ripening period as it decreased from 3.24± 0.06 to 2.66± 0.11 mg|100g at 60-day of storage then reached 5.38±0.08 mg|100g in a 120- day of storage. Biogenic amines can be formed in cheese during production and storage: many variables, as pH, salt concentration, bacterial activity as well as moisture, storage temperature and ripening time, play a relevant role in their formation. Comparing the obtained results with the recommended standard by Food and Drug Administration "FDA" (2001), High levels of biogenic amines in various Ras cheeses consumed in Egypt exceeded the permissible value (10 mg%) which seemed to pose a threat to public health. In this study, presence of high concentrations of biogenic amines (Tyramine, Histamine, cadaverine and Tryptamine) in Egyptian Ras cheeses reflects the bad hygienic conditions under which they produced and stored. Accordingly, the levels of biogenic amines in different cheeses should be come in accordance with the safe permissible limit recommended by FDA to ensure human safety.

Keywords: Ras cheese, biogenic amines, tyramine, histamine, cadaverine

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Authors: Sadaf Ambreen, Ayesha Bibi, Sara Rafiq

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Hypertension is a medical condition in which blood pressure in the arteries is elevated than the normal, having systolic blood pressure more than 120mmHg and diastolic blood pressure more than 80 mmHg. It leads to health complications and increase the risk of diseases such as stroke, heart failure, heart attack, and even death. The aim of the current study was to evaluate nutritional status and activity level among hypertensive early adults in District Mardan Data was collected from the subjects of Public Hospital, Mardan Medical Complex, through questionnaire. A complete information about individual sociodemographic, anthropometry and health status were collected, and physical activity was assessed by using IPAQ questionnaire. A total of 150 individuals were included in the study, in which 90% were females, and 10% were males. Data was analyzed through SPSS Version 22. Majority of the study subjects, 88%, were married, 70% having nuclear living system, 43% were having elementary education, and 43% were working as laborer. Body mass index and waist circumference in female counterpart were found to be positively associated with hypertension and was found statistically significant P=<0.01. Results showed that majority of females were fall in hypertension crisis category with mild activity, and males were having hypertension stage 1 with moderate activity. Our study concluded that non-optimal nutritional status and physical inactivity resulted in elevated blood pressure in females, therefore, lifestyle change such as optimal nutritional status and physical activity may play key role in reducing risk of hypertension.

Keywords: obesity/overwight, body mass index, waist circumference, early adulthood

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Authors: Mary Joy C. Montenegro, Voltaire M. Mistades

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This action research was implemented to enhance the teaching of linear motion and to improve students' conceptual understanding and engagement using a developed 7R-based module called 'module on vectors and one-dimensional kinematics' (MVOK). MVOK was validated in terms of objectives, contents, format, and language used, presentation, usefulness, and overall presentation. The validation process revealed a value of 4.7 interpreted as 'Very Acceptable' with a substantial agreement (0. 60) from the validators. One intact class of 46 Grade 12 STEM students from one of the public schools in Paranaque City served as the participants of this study. The students were taught using the module during the first semester of the academic year 2019–2020. Employing the mixed-method approach, quantitative data were gathered using pretest/posttest, activity sheets, problem sets, and survey form, while qualitative data were obtained from surveys, interviews, observations, and reflection log. After the implementation, there was a significant difference of 18.4 on students’ conceptual understanding as shown in their pre-test and post-test scores on the 24-item test with a moderate Hake gain equal to 0.45 and an effect size of 0.83. Moreover, the scores on activity and problem sets have a 'very good' to 'excellent' rating, which signifies an increase in the level of students’ conceptual understanding. There also exists a significant difference between the mean scores of students’ engagement overall (t= 4.79, p = 0.000, p < 0.05) and in the dimension of emotion (t = 2.51, p = 0.03) and participation/interaction (t = 5.75, p = 0.001). These findings were supported by gathered qualitative data. Positive views were elicited from the students since it is an accessible tool for learning and has well-detailed explanations and examples. The results of this study may substantiate that using MVOK will lead to better physics content understanding and higher engagement.

Keywords: conceptual understanding, engagement, linear motion, module

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Authors: A. Felimban, A. Prieto, U. Knaack, T. Klein

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This study aims to present an overview of recent research in building energy-retrofitting strategy applications and analyzing them within the context of hot arid climate regions which is in this case study represented by the Kingdom of Saudi Arabia. The main goal of this research is to do an analytical study of recent research approaches to show where the primary gap in knowledge exists and outline which possible strategies are available that can be applied in future research. Also, the paper focuses on energy retrofitting strategies at a building envelop level. The study is limited to specific measures within the hot arid climate region. Scientific articles were carefully chosen as they met the expression criteria, such as retrofitting, energy-retrofitting, hot-arid, energy efficiency, residential buildings, which helped narrow the research scope. Then the papers were explored through descriptive analysis and justified results within the Saudi context in order to draw an overview of future opportunities from the field of study for the last two decades. The conclusions of the analysis of the recent research confirmed that the field of study had a research shortage on investigating actual applications and testing of newly introduced energy efficiency applications, lack of energy cost feasibility studies and there was also a lack of public awareness. In terms of research methods, it was found that simulation software was a major instrument used in energy retrofitting application research. The main knowledge gaps that were identified included the need for certain research regarding actual application testing; energy retrofitting strategies application feasibility; the lack of research on the importance of how strategies apply first followed by the user acceptance of developed scenarios.

Keywords: energy efficiency, energy retrofitting, hot arid, Saudi Arabia

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Authors: Thomas LaRocca

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This study explores the development of a public-school music teacher’s professional identity within three domains: as an educator in the profession at large, as a music teacher in a school, and as a professional musician. An autoethnographic method is employed by calling upon undergraduate student teaching reflections, graduate writing assignments and presentations, cover letters for employment, professional correspondence, and reflective memos. These artifacts provide a reference for phenomenological insights into the values, hopes, and criticisms within each domain over time –all of which provide a window into the overall ontological perspective of one’s professional life at different moments in their career. While the topic of music teacher identity has been examined using autoethnographical methods before, by accessing materials over the course of ten years, the study is able to investigate the ‘how’ of identity development in a temporal context; from undergraduate student to established professional. Additionally, while the field offers a considerable amount of work surrounding the child and adolescent identity development, there are unmined opportunities to examine identity development in the adult years, especially surrounding adult professional life. Employing a postpositivist approach with social constructionism as a backdrop, this study examines adult identity formation and the contradictions, resonances, and priorities within each domain, between each domain, and perceived expectations of the professional community. What is revealed is a journey of self-improvement motivated by failure and success, marked by negotiation and sacrifice; as each domain competes for mental and temporal resources, identity is viewed as not just who one is, but also as what one leaves behind. These insights offer a window into the ontology of identity of a music educator and may provide considerations for differentiating professional development based on what stage educators are at in their careers.

Keywords: identity, longitudinal autoethnography, music teacher education, music teacher ontology

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Authors: Mehwish Azam, Muhammad Imran, Humaira Jabeen, Sumreen Begum, Rashida Qasim

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Background: Metabolic syndrome is a cluster of metabolic risk factors including obesity, glucose intolerance, insulin resistance, dyslipidemia and hypertension. Metabolic syndrome in obese and type 2 diabetic subjects increases the risk of cardiovascular diseases (CVD). Globally, the prevalence of metabolic syndrome ranges from 10%-50% and in Pakistan ranges from 18%-46%. The objective of the present study is to estimate the prevalence of metabolic syndrome (MS) in obese type 2 diabetic subjects by using International Diabetes Federation (IDF) and National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) definitions. Methods: Obese type 2 diabetic subjects and normal healthy subjects of both genders were selected from diabetic clinics and hospitals of various localities of Karachi, Pakistan. The frequency of metabolic syndrome was estimated by the proposed definitions of IDF and NCEP-ATP III. Results: The prevalence of metabolic syndrome using International Diabetes Federation (IDF) definition in obese type 2 diabetic subjects was 85.7%. It is significantly higher (p<0.05) in females (47.1%) as compared to males (38.6%). While, using National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) definition the overall prevalence of metabolic syndrome in obese type 2 diabetic subjects was 75.7%, the prevalence is significantly higher (p<0.05) in females (45.7%) than males (30.0%). Conclusion: It is concluded that, the overall prevalence of metabolic syndrome is increasing significantly in obese type 2 diabetic subjects by using IDF and NCEP–ATP III definitions. Therefore, it is need to initiate the preventive measures by arranging public awareness programmes to highlight the significance of a healthy lifestyle and emphasis should be given to reduce weight, increase physical activity, and increase intake of healthy low-glycemic-index foods.

Keywords: metabolic syndrome, diabetes mellitus, obesity, IDF, NCEP-ATP III

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Authors: Nunila Ferreira de Oliveira, Silvana Martins Mishima

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Diabetes mellitus type 2 (DM2) prevalence, is increasing on the world, in Brazil is considered a public health problem. Treatment focuses on glycemic control depending primarily of lifestyle changes - not drug treatment (NDT), may involve drug therapy (DT) and requires continuous health monitoring. In Brazil this monitoring is performed by the Unified Health System (SUS) through Primary Health Care (PHC), which stimulate people with DM2 empowerment for care management. SUS was approved in 1988 and the PHC operationalization was strengthened with the creation of the Family Health Strategy (FHS) in 1994. Our aim was to analyze the people with DM2 participation in front of the care management health monitoring in the FHS. Qualitative research was carried out through non-participant observation of attendance of 25 people with DM2 in the FHS and interviewed at home. Ethical guidelines were followed. It was found that people with DM2 only follow professionals’ recommendations that make sense according to their own conceptions of health/disease; most of them emphasize the importance of (DT) with little emphasis on the NDT, was found great difficulty in the NDT and lack of knowledge about the disease and care. As regards monitoring the FHS, were observed therapeutic practices based on the bio medical model, although the APS search for another care perspective; NDT is not systematically accompanied by the health team and takes place a few educational activities on the DM2 in the FHS, with low user adoption. The work of the FHS is done by multidisciplinary teams, but we see the need for greater participation of nurses in clinical-care follow-up of this population and may also act in adapting to the NDT. Finally we emphasize the need for professional practices that consider the difficulties to care management by people with DM2, especially because of the NDT. It is noticed that the measures recommended by the FHS professionals are not always developed by people with DM2. We must seek the empowerment of people with DM2 to manage the form of care associated with the FHS team, seeking to reduce the incidence of complications and higher quality of life.

Keywords: diabetes mellitus, primary health care, nursing, management of care

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Authors: Rian O. Miranda, Lidia V. de Sa, Julio C. Suita

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The Brazilian Nuclear Energy Commission (CNEN) is the main manufacturer of radiopharmaceuticals in Brazil. The Nuclear Engineering Institute (IEN), located at Rio de Janeiro, is one of its main centers of research and production, attending public and private hospitals in the state. This radiopharmaceutical production is used in diagnostic and therapy procedures and allows one and a half million nuclear medicine procedures annually. Despite this, the country is not self-sufficient to meet national demand, creating the need for importation and consequent dependence on other countries. However, IEN facilities were designed in the 60's, and today its structure is inadequate in relation to the good manufacturing practices established by sanitary regulator (ANVISA) and radiological protection leading to the need for a new project. In order to adapt and increase production in the country, a new plant will be built and integrated to the existing facilities with a new 30 MeV Cyclotron that is actually in project detailing process. Thus, it is proposed to survey current CNEN and ANVISA standards for radiopharmaceutical production facilities, as well as the radiological protection analysis of each area of the plant, following good manufacturing practices recommendations adopted nationally besides licensing exigencies for radioactive facilities. In this way, the main requirements for proper operation, equipment location, building materials, area classification, and maintenance program have been implemented. The access controls, interlocks, segregation zones and pass-through boxes integrated into the project were also analyzed. As a result, IEN will in future have the flexibility to produce all necessary radioisotopes for nuclear medicine application, more efficiently by simultaneously bombarding two targets, allowing the simultaneous production of two different radioisotopes, minimizing radiation exposure and saving operating costs.

Keywords: cyclotron, legislation, norms, production, radiopharmaceuticals

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Authors: William L. Whitehouse, Louisa H. Y. Lo, Andrew B. Kinghorn, Simon C. C. Shiu, Julian. A. Tanner

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C-reactive protein (CRP) is an acute-phase reactant and sensitive indicator for sepsis and other life-threatening pathologies, including systemic inflammatory response syndrome (SIRS). Currently, clinical turn-around times for established CRP detection methods take between 30 minutes to hours or even days from centralized laboratories. Here, we report the development of an electrochemical biosensor using redox probe-tagged DNA aptamers functionalized onto cheap, commercially available screen-printed electrodes. Binding-induced conformational switching of the CRP-targeting aptamer induces a specific and selective signal-ON event, which enables single-step and reagentless detection of CRP in as little as 1 minute. The aptasensor dynamic range spans 5-1000nM (R=0.97) or 5-500nM (R=0.99) in 50% diluted human serum, with a LOD of 3nM, corresponding to 2-orders of magnitude sensitivity under the clinically relevant cut-off for CRP. The sensor is stable for up to one week and can be reused numerous times, as judged from repeated real-time dosing and dose-response assays. By decoupling binding events from the signal induction mechanism, structure-switching electrochemical aptamer-based sensors (SS-EABs) provide considerable advantages over their adsorption-based counterparts. Our work expands on the retinue of such sensors reported in the literature and is the first instance of an SS-EAB for reagentless CRP detection. We hope this study can inspire further investigations into the suitability of SS-EABs for diagnostics, which will aid translational R&D toward fully realized devices aimed at point-of-care applications or for use more broadly by the public.

Keywords: structure-switching, C-reactive protein, electrochemical, biosensor, aptasensor.

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Authors: A. Vahanyan

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The paper touches upon the problem of revision and modernization of the current curriculum on translation studies at the Armenian Higher Education Institutions (HEIs). In the contemporary world where quality and speed of services provided are mostly valued, certain higher education centers in Armenia though do not demonstrate enough flexibility in terms of the revision and amendment of courses taught. This issue is present for various curricula at the university level and Translation Studies related curriculum, in particular. Technological innovations that are of great help for translators have been long ago smoothly implemented into the global Translation Industry. According to the European Master's in Translation (EMT) framework, translation service provision comprises linguistic, intercultural, information mining, thematic, and technological competencies. Therefore, to form the competencies mentioned above, the curriculum should be seriously restructured to meet the modern education and job market requirements, relevant courses should be proposed. New courses, in particular, should focus on the formation of technological competences. These suggestions have been made upon the author’s research of the problem across various HEIs in Armenia. The updated curricula should include courses aimed at familiarization with various computer-assisted translation (CAT) tools (MemoQ, Trados, OmegaT, Wordfast, etc.) in the translation process, creation of glossaries and termbases compatible with different platforms), which will ensure consistency in translation of similar texts and speeding up the translation process itself. Another aspect that may be strengthened via curriculum modification is the introduction of interdisciplinary and Project-Based Learning courses, which will enable info mining and thematic competences, which are of great importance as well. Of course, the amendment of the existing curriculum with the mentioned courses will require corresponding faculty development via training, workshops, and seminars. Finally, the provision of extensive internship with translation agencies is strongly recommended as it will ensure the synthesis of theoretical background and practical skills highly required for the specific area. Summing up, restructuring and modernization of the existing curricula on Translation Studies should focus on three major aspects, i.e., introduction of new courses that meet the global quality standards of education, professional development for faculty, and integration of extensive internship supervised by experts in the field.

Keywords: competencies, curriculum, modernization, technical literacy, translation studies

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Authors: Lie-Fen Lin, Tzu-Hsuan Lin, Ching-Heng Lin

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Hospice care for terminally ill patients provides not only a better quality of life but also cost-saving benefits. However, the utilization of home-based hospice care (HBH care) remains low even for countries covered by National Health Insurance (NHI) programs in Taiwan. In the current commercial insurance policy, only hospital-based hospice benefits were covered. It may have an influence on the insureds chosen to receive end-of-life care in a hospitalized manner. Thus, how to propose a feasible method to advocate HBH care utilization rate of public health policies is an important issue. A total of 130,219 cancer decedents in the year 2011-2013 from the National Health Insurance Research Database (NHIRD) in Taiwan were included in this study. By adding a day volume pays benefits of HBH care as a commercial insurance rider, will provide alternative benefits for the insureds. A multiple-state Markov chain model was incorporated to estimate the transition intensities of patients in different states at the end of their lives (Non-hospice, HBH, hospital-based hospice), and the premiums were estimated. HBH care insurance benefits provide financial support and reduce the burden of care for patients. The rate-making of this product is very sensitive while the utilization rate is rising, especially for high ages. The proposed HBH care insurance is a feasible way to reduce the financial burden, enhance the care quality and family satisfaction of insureds. Meanwhile, insurance companies can participate in advocating a good medical policy to enhance the social image. In addition, the medical costs of NHI can reduce effectively.

Keywords: home-based hospice care, commercial insurance, Markov chain model, the day volume pays

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Authors: Dongshuo Wang, Minjie Xing

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International businesses prefer to hire people who speak more than one language. With the booming of China’s market, industries and trade, business leaders are looking for people who can speak Chinese and operate successfully in a Chinese cultural context, and therefore an increasing number of tertiary students choose a Business Chinese (BC) course. As a result, BC syllabus design is urgently needed. What business knowledge should be included in China’s context? What aspects of BC culture should be included? How much Chinese language should be introduced to conduct business in China? With these research questions, this research explores a syllabus design that integrates the three aspects of subject knowledge of business in communication, business practice including the procedure of and strategies for communicating business in practice and language skills including the disciplinary and professional contexts in which linguistic choices are made. After literature review and consultancy with China-related business professionals, senior staff from business schools and representatives of students, the authors of this paper, together with language tutors drafted a syllabus based on the integrated approach to include subject knowledge, business practice and language skills. Due to the nature of this research which requires trial/test and detailed description for each correction, qualitative methods are adopted. Two in-depth focus group interviews (with 2 staff and 4 students in each group), and 18 individual interviews (8 staff and 10 students) were conducted. QDA was used for systematizing, organizing, and analysing qualitative data. It was discovered that the business knowledge related to a Chinese cultural context, including face value, networking skills, strategic plans for signing a contract, marketing, sales, and after-sale service, should be introduced through lectures and seminars; business practice could be implemented by students setting up their own companies, virtual or real; and language skills would be trained via writing business messages and presenting their companies in fairs and exhibitions. After a longitudinal study of trials and amendments for three years from 2013 to 2016, the syllabus was approved by staff and students and the university. Students appreciated the syllabus, as they could apply the subject knowledge into practice by using it in their own companies and Chinese language was used throughout the process. The syllabus is now ready to be used in universities offering BC, and the designing process can be applied to other new courses as well.

Keywords: business Chinese, syllabus design, business knowledge, language skills

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Authors: W. L. Tsang, H. Y. Li, S. L. Wong, T. Y. Kwok, S. C. Yuen, S. S. Kwok, P. S. Ko, S. Y. Lau

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Introduction: Palliative care is no doubt necessary in surgery. When one looks at studies of what patients with life-threatening illness want and compares to what they experience in surgical units, the gap is huge. Surgical nurses, being patient advocates, should engage with patients and families sooner rather than later in their illness trajectories to consider how to manage the illness, not just their capacity to survive. Objective: This clinical practice guide aims to fill the service gap of palliative care in surgery by producing a quality-driven, evidence-based yet straightforward clinical practice guide based on a focus strategy. Methodology: In line with Guide to Good Nursing Practice: End-of-Life Care recommended by Nursing Council of Hong Kong and the strategic goal of improving quality of palliative care proposed in HA Strategic Plan 2017-2022, multiple phases of work were undertaken from July 2015 to December 2017. A pragmatic clinical practice guide for surgical patients facing life-threatening conditions was developed based on assessments on knowledge of and attitudes towards end-of-life care of surgical nurses. Key domains, including preparation for bereavement, nursing care for imminently dying patients and at the dying scene were crystallized according to the results of the assessments and the palliative care checklist formulated by UCH Palliative Care Team. After a year of rollout, its content was refined through analyses of implementation in routine practice and consensus opinions from frontline nurses. Results and Outcomes: This clinical practice guide inspires surgical nurses with the art of care to provide for patients’ comfort, function, and longevity. It provides practical directions and assists nurses to master the skills on advance care planning and learn how to be clear with patients, families and themselves about the realities of the disease pictures. Through the implementation, patients and families are included in the decision process, and their wishes are honored. The delivery of explicit and high-quality palliative care maintains good nurse-to-patient relations and enhances satisfaction of hospital care of patients and families. Conclusion: Surgical nursing has always been up to the unique challenges of the era. This clinical practice guide has become an island of credibility for our nurses as they traverse the often stormy waters of life-limiting illness.

Keywords: palliative care delivery, palliative care in surgery, hospice care, end-of-life care

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Authors: Ali Mahfouz

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Egypt's cultural heritage and artistic riches find themselves at a complex intersection of preservation and urban development, where they face intricate challenges exacerbated by climate change, pollution, urbanization, and construction activities. In this research, it delves into the multifaceted dynamics involved in conserving Egypt's heritage within urban contexts, spotlighting the historic Cairo cemetery as a poignant and timely case study. The historic Cairo cemetery serves as a repository of priceless cultural assets, housing the final resting places of public figures, artists, historians, politicians, and other luminaries. These graves are adorned with magnificent artworks and rare tombstones, collectively representing an irreplaceable slice of Egypt's history and culture. Yet, the looming threat of demolition to make way for new infrastructure projects underscores the delicate equilibrium that preservation efforts must maintain in the face of urban development pressures. This paper illuminates the collaborative efforts of historians, intellectuals, and civil society organizations who are determined to forestall the destruction of this invaluable cultural heritage. Their initiatives, driven by a shared commitment to documenting and safeguarding the cemetery's treasures, underscore the urgent imperative of protecting Egypt's cultural legacy. Through this case study, It gain insights into how Egypt navigates the challenges of preserving its rich heritage amidst urban expansion and a changing climate, emphasizing the broader importance of heritage conservation in an evolving world.

Keywords: Egypt’s cultural heritage, urban development, historic Cairo cemetery, tombstone artworks, demolition threat, heritage conservation, civil society initiatives

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Authors: Zahra Mila Elmi, Mahsa Khanekheshi

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Almost half of the population and potential manpower in the country and rural areas are women. Manpower especially educated people, plays an important role in the production and economic growth. Also, the potential of rural areas to create employment should not be overlooked. In this research, the effects of socio-economic and demographic factors on women's economic participation in rural areas of Iran's provinces will be studied. Therefore, this study was performed by using the results of the rural households income and expenditure surveys -has been taken in 2016- in the framework of pseudo panel data. This study used the logit model and the maximum likelihood method to study the rural women's participation, with 28,265 observations. Results show the inverted U-shaped relationship between age and the probability of female participation; In other words, young women are more likely to participate in labor markets more than the other groups. Divorced and single woman has more chance of participation in comparison with who was being married. With increasing the divorce rate and singleness in Iran, economic policymakers must provide appropriate solutions for this challenge in the coming years. On the base of the results, being a student and the presence of an infant under the age of 6 in the household has a negative effect on the possibility of women's participation in the labor market. The women's education level has a U-shaped relationship with their participation rate. Illiteracy and high education have a strong positive effect on the economic participation of rural women. This shows the dual labor market for women in Iran. Illiterate women are attracted to service jobs, and educated woman are more attracted to education and health jobs. Increasing household income has a small but positive and significant effect on the probability of rural female participation. In the overlook, due to the frequency of the women population in the age group of 25 to 35 years, and more willingness of women in the age 35 to 44 years to participate in the labor market, and studying ofa significant portion of the rural women, the increase of rural female participation is expected in the years ahead. Thus, it is expected policy maker to create new job opportunities for the employment of educated women and take the necessary plan to improve the current situation for women.

Keywords: female participation rate, rural area, provincial data, pseudo-panel data method

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Authors: Mahnaz Seyedoshohadaee

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Background and Aims: Hospitalization of one of the family members in the hospital, especially in the emergency department, causes anxiety and psychological problems in family members and others. The way nurses interact with patients and their companions can play an important role in controlling and managing their anxiety. This study aims to determine the relationship between the anxiety of family members of patients referring to emergency departments and their views on the communication skills of nurses. Materials and Methods: The current research was a descriptive-correlation cross-sectional study on 263 family members of patients referred to the department. The emergency of two selected medical training centers affiliated with Iran University of Medical Sciences was performed. The samples were selected continuously in 2018 based on the inclusion criteria. Information was collected using the Health Communication Questionnaire (HCCQ) and Beck Anxiety Questionnaire (BAI). To analyze the data, Pearson's correlation coefficient, independent t-tests, analysis of variance, and Kruskal-Wallis were used at a significance level of 0.05. The data was analyzed using SPSS version 16 statistical software. Results: The mean score of communication skills of emergency department nurses from the point of view of patients' companions was at a low level (74.36 with a standard deviation of 3.7). 3.75% of patients' companions had anxiety at a mild level. There was no statistically significant correlation between the anxieties of the patient's companions. The anxiety of the patient's companions had a statistically significant relationship with the educational level (P=0.039), economic status (P=0.033), and family relationship with the patient (P=0.001). Also, the average anxiety score in children was significantly higher than that of patients' wives (P=0.008). The triage level of the patient also had a statistically significant relationship with the anxiety of the patient's companions (P>0.001). Conclusion: Most of the family members of the patients referred to the emergency room experienced mild anxiety. Also, from their point of view, the communication skills of emergency nurses were at a weak level. Despite the fact that there was no statistically significant relationship between the patient's family member's anxiety and their opinion about nurses' communication skills in this study, it seems that the weak communication skills of nurses from the patient's family member's point of view need special attention. The results of the present study can provide the necessary grounds for planning to improve the communication skills of nurses and also control the anxiety of patient caregivers through in-service training or other incentive mechanisms.

Keywords: anxiety, family, emergency department, communication skills, nurse

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Authors: Alyaa Farouk AbdelFattah Ibrahim, Agnes Monica, Dolores I. Cabansag

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The prevalence of diabetes mellitus is reaching epidemic proportions in many parts of the world causing an increasing public health concern. Cases of Type 2 diabetes are rapidly increasing in the Middle East region. Deprived of lifestyle deviations, a section of the Middle East’s inhabitants will be pretentious by 2035. As all sociocultural factors have created unhealthy lifestyles, which have become part of the social norms within Saudi society, thereby increased the prevalence of sedentary lifestyle and obesity in women living in Saudi Arabia. So, this study aimed to assess the impact of diabetes mellitus on quality of life of female nursing students in King Saud bin Abdulaziz University for Health Sciences, Riyadh. In a crossectional study design, 151 nursing students at King Saud bin Abdulaziz University for health sciences in Riyadh were included in the study. Biosociodemographic questionnaire and Short-Form 36 (SF-36) Health Related Quality of life Survey Arabic version were used for data collection, and all included students were screened for random blood glucose level. Results depicted that among 151 subjects included in the study 17 (11.3%) had diagnosed medical problems, and 29.4% of those participants with medical problems were diabetics. Univariate regression model for the relation between diabetes mellitus and overall percent score of SF-36 health survey domains showed no statistically significant difference between diabetic and non-diabetic subjects 0.990(0.931-1.053). In conclusion, although the diabetes prevalence was high among the study subjects it did not affect their quality of life may be due to age of the study population.

Keywords: diabetes mellitus, diabetes prevalence, quality of life, university students' health

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Authors: Opara Monica, Suriani Ismail, Ahmad Iqmer Nashriq Mohd Nazan

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The true magnitude of the mortality and morbidity attributable to malaria worldwide is, at best, a scientific guess, although it is not disputable that the greatest burden is in sub-Saharan Africa. Those at highest risk are children younger than 5 years and pregnant women, particularly primigravidae. Nationally, malaria remains the third leading cause of death and is still considered a major public health problem. Therefore, this study is aimed to assess the effectiveness of health education intervention on insecticide-treated net use and its practices among pregnant women attending antenatal clinics. Materials and Methods: This study will be an intervention study with two arms double parallel randomized controlled trial (blinded) to be conducted in 3 stages. The first stage will develop health belief model (HBM) program, while in the second stage, pregnant women will be recruited, assessed (baseline data), randomized into two arms of the study, and follow-up for six months. The third stage will evaluate the impact of the intervention on HBM and disseminate the findings. Data will be collected with the use of a structured questionnaire which will contain validated tools. The main outcome measurement will be the treatment effect using HBM, while data will be analysed using SPSS, version 22. Discussion: The study will contribute to the existing knowledge on hospital-based care programs for pregnant women in developing countries where the literature is scanty. It will generally give insight into the importance of HBM measurement in interventional studies on malaria and other related infectious diseases in this setting.

Keywords: malaria, health education, insecticide-treated nets, sub-Saharan Africa

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Authors: Bua Srikos, Phusit Phukamchanoad

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The purpose is to study the model and characteristic of participation of the suitable community to lead to develop permanent water marketing in Bang Noi Floating Market, Bangkonti District, Samutsongkhram Province. A total of 342 survey questionnaires were administered to potential respondents. The researchers interviewed the leader of the community. Appreciation Influence Control (AIC) was used to talk with 20 villagers on arena. The findings revealed that overall, most people had the middle level of the participation in developing the durable Bang Noi Floating Market, Bangkonti, Samutsongkhram Province and in aspects of gaining benefits from developing it with atmosphere and a beautiful view for tourism. For example, the landscape is beautiful with public utilities. The participation in preserving and developing Bang Noi Floating Market remains in the former way of life. The basic factor of person affects to the participation of people such as age, level of education, career, and income per month. Most participants are the original hosts that have houses and shops located in the marketing and neighbor. These people involve with the benefits and have the power to make a water marketing strategy, the major role to set the information database. It also found that the leader and the villagers play the important role in setting a five-physical database. Data include level of information such as position of village, territory of village, road, river, and premises. Information of culture consists of a two-level of information, interesting point, and Itinerary. The information occurs from presenting and practicing by the leader and villagers in the community.All of phases are presented for listening and investigating database together in both the leader and villagers in the process of participation.

Keywords: participation, community, sustainable development, encouragement, tourism

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Authors: Maretha Le Roux, Corinna Walsh, Mariette M. Nel

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Introduction: The first 1000 days from conception to 24 months, is a critical period for healthy growth and development. In South Africa, stunting is a major public health issue with significant health consequences. We determined associations between demographic, health and anthropometric indicators of mothers and their infants. Methods: A cross-sectional study was conducted in all districts in the Northern Cape. All mothers with 5-7 week old babies visiting PHC facilities could participate. A questionnaire was completed in a structured interview with each mother. Weight and length of the baby at birth and at 6 weeks were used to determine stunting, while weight and height of the mother were measured for body mass index (BMI). Results: Eight hundred questionnaires were completed in 92 facilities. The median age of mothers was 26 years (range 10-46 years), and 44,9% were married. Almost 40% relied on a government grant as main source of income. Two-thirds (64,9%) had not planned the pregnancy, and 19.4% had a Caesarian section. Although 79% breastfed exclusively, more than a quarter (26,1%) smoked cigarettes or used snuff during pregnancy, while 9,4% drank alcohol. At birth, 17.7% of boys and 13.0% of girls were stunted (height-for-age below -2SD from the WHO reference values), while at 6 weeks this had increased to 30.8% of boys and 14.1% of girls. In terms of mothers, 25,4% were classified as obese and 24,6% as overweight at 6 weeks. Compared to babies that were not stunted, significantly more babies of mothers that were older, overweight, used ART, relied on a grant and smoked/snuffed during pregnancy were stunted. Conclusion: To address stunting, interventions aimed at encouraging healthy lifestyles with the emphasis on maintaining a healthy weight, healthy eating and smoking cessation before pregnancy are urgently required.

Keywords: growth, health, South Africa, stunting

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Authors: Nuwan Karunarathna, Hemali Seneviratne

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Distribution Utilities inherently present electrical hazards for their workers in addition to the general public especially due to bare overhead lines spreading out over a large geographical area. Therefore, certain procedures such as; de-energization, verification of de-energization, isolation, lock-out tag-out and earthing are carried out to ensure safe working conditions when conducting maintenance work on de-energized overhead lines. However, measures must be taken to coordinate the above procedures and to ensure successful and accurate execution of those procedures. Issuing of 'Work Permits' is such a measure that is used by the Distribution Utility considered in this paper. Unfortunately, the Work Permit method adopted by the Distribution Utility concerned here has not been successful in creating the safe working conditions as expected which was evidenced by four (4) number of fatalities of workers due to electrocution occurred in the Distribution Utility from 2016 to 2018. Therefore, this paper attempts to identify deficiencies in the Work Permit method and related contributing factors through careful analysis of the four (4) fatalities and work place practices to rectify the short comings to prevent future incidents. The analysis shows that the present level of coordination between the 'Authorized Person' who issues the work permit and the 'Competent Person' who performs the actual work is grossly inadequate to achieve the intended safe working conditions. The paper identifies the need of active participation of a 'Control Person' who oversees the whole operation from a bird’s eye perspective and recommends further measures that are derived through the analysis of the fatalities to address the identified lapses in the current work permit system.

Keywords: authorized person, competent person, control person, de-energization, distribution utility, isolation, lock-out tag-out, overhead lines, work permit

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Authors: Rai Mansoor Imtiaz

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Guardians in hybrid regimes fragment opposition parties and ban their political leaders, and disenfranchise their voters' political participation. When guardians in hybrid regimes are so powerful that they remain decisive on electoral politics of states, and have powers to ban political parties and their leadership, then "why do political parties backed by those powerful guardians lose elections" and "how do anti-establishment parties make electoral inroads at the local and national levels." These two questions are interrelated with the key research question of my research "why do people vote for political parties rejected by powerful guardians in establishmentarian democracies." Furthermore, this research question is important to be explored for two reasons. First, existing literature only reflects the electoral victories of opposition parties or defeats of military-sponsored parties (see Thailand and Turkey) but remains silent on political change that led the anti-military parties to win the elections. Second, why is it a case that people belonging to the countries where militaries remain popular among the public (see Turkey and Pakistan) have started putting their trust in anti-establishment politicians who criticise the military against their intervention in politics? For instance, in Pakistan, where commenting against the military is meant to comment against the state –– an anti-military narrative is getting popular support. The conceptual framework of hybrid states in this research relies on the concept of a 'reserved domain/tutelary body' (guardians of hybrid states). However, this research makes a case that hybrid states are not consolidated separate political entities but rather vacillated states that fluctuate between democratic and authoritarian practices. This paper, therefore, uses the term establishmentarian democracy as a subtype of the hybrid regime, which is more consolidated than a hybrid democracy.

Keywords: Guardians, Hybrid Regimes, Voters, Elections, Democracy, South Asia

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Authors: Rohit Gautam, Kumari Vandana Singh, Jayprakash Nirala, Nina Nancy Murmu, Ramovatar Meena, Paulraj Rajamani

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Mobile phones have become a vital part of everyone’s life. Mobile phone and mobile phone towers emit RF-EMR (Radiofrequency Electromagnetic Radiation), which becomes a cause of concern to the general public. The study was designed to evaluate the effect of 3G (RF-EMR) on the reproductive system of male Wistar rats. Adult male Wistar rats were used for the study. Animals were divided into two groups, RF-exposed, and sham-exposed (control). RF-exposed rats were exposed to radio frequency radiation (2100 MHz) for 2 hours/day for 45 days. Emitted power density and specific absorption rate (SAR) values were measured during exposure. At the end of the exposure, testis and epididymis were excised out, and their weights were recorded. Sperm cell count, morphology, viability, and reactive oxygen species (ROS) levels were checked. Lipid peroxidation and sperm mitochondrial activity were measured. Histopathology of testis and ultrastructure analysis of sperm were also checked. Result showed a decrease in organ weight and sperm count with alteration in the sperm morphology in exposed group rats. A significant decrease in sperm viability, membrane integrity, and mitochondrial activity was found. Also, an increase in lipid peroxidation and ROS level were found in exposed group animals as compared to control. It may be concluded that exposure to radiofrequency radiation emits from mobile phones leads to oxidative stress-mediated changes in reproductive parameters.

Keywords: electromagnetic radiation, oxidative stress, reactive oxygen species, sperm

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Authors: Deepak L. Waikar

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Unprecedented natural as well as human made disasters have been responsible for loss of hundreds of thousands of lives, injury & displacement of millions of people and damages in billions of dollars in various parts of the world. Scientists, experts, associations and united nation have been warning about colossal disregard for human safety and environment in exploiting natural resources for insatiable greed for economic growth and rising lavish life style of the rich. Usual blame game is routinely played at international forums & summits by vested interests in developing and developed nations, while billions of people continue to suffer in abject energy poverty. Energy security, on the other hand, is becoming illusive with the dominance of few players in the market, poor energy governance mechanisms, volatile prices and geopolitical conflicts in supply chain. Conflicting scenarios have been cited as one of the major barriers for transformation to a low carbon economy. Policy makers, researchers, academics, businesses, industries and communities have been evaluating sustainable alternatives, albeit at snail’s pace. This presentation focuses on technologies, energy governance, policies & practices, economics and public concerns about safe, prudent & sustainable harnessing of energy resources. Current trends and potential research & development projects in power & energy sectors which students can undertake will be discussed. Speaker will highlight on how youths can be engaged in meaningful, safe, enriching, inspiring and value added self-development programmes in our quest for sustainability in the midst of conflict between climate and energy security.

Keywords: clean energy, energy policy, energy security, sustainable energy

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Authors: Harsha Kumar H. N., Anshu Kumar Jha, Khushboo Kamal Taneja, Krishan Kabra, Mohamed Hafeez Sadiq

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Introduction: The increasing use of preservatives and flavouring agents has the potential to cause health problem among the people. There are no published studies from India exploring the awareness, safety perception, & practices about Food Preservatives (FPs) and Flavouring Agents (FAs). So this study was conducted with the objectives of assessing the awareness, safety perceptions & practices about Food Preservatives (FPs), Flavouring Agents (FAs) in commonly bought / purchased packed food items. Materials & method: This cross-sectional study was conducted in January 2012. Sample size of 126 was computed using the formula for infinite population. People who bought packed food items in malls were approached and requested to fill a pre-tested semi-structured questionnaire. The questionnaire explored awareness, safety perception & practices of FPs & FAs. Data was then analyzed using SPSS version 10.0. Chi-square test was used to know if the observed differences were statistically significant. ‘p’ value <0.05 was considered significant. Results: Totally 123 people (males- 48.8% and females-51.2%) participated (response rate of 97.6%) in the study. Majority of the people were aware about presence of ‘FPs’ (91.7%) and ‘FAs’ (84.9%) though their knowledge was inadequate. Breakup of the study subjects according to level of awareness about FPs was as follows (%): Good (37.4), Satisfactory (40.6), Poor (22) & FAs (%): Good (49.6), Satisfactory (36) & Poor (14). Distribution according to type of practices for FPs was as follows (%): Favourable (14), Unfavourable (86) & FAs (%): Favourable (30.5), Unfavourable (69.5). There was a gap between knowledge and practices. Conclusion: Though there was awareness, the knowledge was inadequate. Unfavourable practices were observed. The gaps in the knowledge and unhealthy practices need to be addressed by public awareness campaign.

Keywords: food preservatives, flavouring agents, knowledge and practices, general population

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Authors: Aliyaa Zaidan, Rayan Bahabri

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The twenty-first century revealed an accelerating change and intensifying complexity of communication technology. Online social networking engines have gained astounding recognition worldwide. The influence of those social media platforms on dentistry and dental students is not well established. Therefore, this study aimed to evaluate the impact of using social media on professional and profile level among dental students in Saudi Arabia. A cross-sectional study developed via online questionnaire concerning on social media usage and its effect on professional and profile level of dental students and dental interns from several universities in Saudi Arabia. A total of 296 dental students and dental interns in Saudi Arabia responded to the questionnaire. Ninety-eight percent of the participants usually use the social media on a regular basis. Most social media sites used among the participants were Snapchat, Instagram, and YouTube by 85%, 81%, 77% respectively. Forty-one percent of the participants agreed that using social media in the dental field is a necessity nowadays. Thirty-eight percent of participants agreed that using social media is an easy way to gain a reliable knowledge, while 43% agreed that social media will improve the quality of healthcare. Furthermore, 65% of the students deemed using social media for academic purposes will improve their performance. Fifty-five percent of the respondents often use social media tools to obtain information about subject or procedures related to the dental field. Regarding profile reputation of dental students, 40% of the respondents agreed that their profile information published on social networking websites, could be used by others to judge their level of professionalism. Male and female dental students both agreed that their reputation would be adversely affected by 37%,63%, respectively, if their social networking activity were viewed by members of the public. The discrepancy among student levels reveals that social media profile positively influence the acceptance to postgraduate programs (P= 0.01).

Keywords: dental students, professional, reputation, social media

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Authors: Anne Jane M. Hallasgo

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This study assessed the level of job satisfaction and organizational commitment among job order personnel at the Overseas Workers Welfare Administration (OWWA) Regional Welfare Office Caraga. The primary objective of the study was to determine a correlation between the employees’ level of organizational commitment, job satisfaction, and their work performance. A carefully selected sample of twenty-five job orders from the OWWA Regional Welfare Office Caraga participated in the study. These individuals were chosen to represent the organization’s job order workforce. For accuracy and dependability, various types of statistical methods and instruments were employed, including advanced statistical tests like the independent sample T-test, one-way analysis of variance (ANOVA), and Spearman's rank correlation coefficient, as well as descriptive statistics like mean, frequency, and percentage. The study found an acceptable level of job satisfaction regarding work performance. It revealed a significant relationship between affective commitment and job satisfaction concerning leadership and coworkers. A correlation was observed between normative commitment and work performance. The findings suggest that organizations emphasizing positive leadership, fostering supportive coworker relationships, aligning with employee values, and promoting a culture of commitment are likely to enhance both affective and normative commitment, thereby improving overall employee satisfaction. The study recommends designing and implementing a holistic employee well-being program that addresses physical, mental, and emotional health contributing to increased job satisfaction and organizational commitment, creating a healthier and engaged workforce. This research contributes to the understanding of the dynamics of organizational commitment and job satisfaction among job order employees in the public sector.

Keywords: affective commitment, continuous commitment, normative commitment, job satisfaction

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Authors: Normah Sulaiman, Yong Zhi Kang, Nor Hayati Hussain, Abdul Rehman Khalid

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Segara Ninda owned by Din Ku Meh, the governor of the province Satul, a Malay man with a big role liaising with Thailand. This mansion is part of the legacy he left behind among other properties in George Town, Penang, besides his family. The island’s geographical location is strategic which has benefitted it through important trade routes for Europe, Middle, East, India, and China in the past. Due to this reasoning, various architectural styles were introduced in Penang; Late Straits Eclectic style is one of the forms of the Colonial Architectural style widely spread as vernacular shophouses in George Town. Segara Ninda is located among the mixture of nouveau-riche, historical and heritage sites at the most important street; Penang Road, which dated back to the late 18th century. This paper examines the strait eclectic style that Segara Ninda encompasses. Acknowledging the mixture of colonial architecture in Georgetown, we argue that the mansion faces challenging issues in conservation processes to be vindicated. This is reflected by analysing the spatial layout, visual elements quality, and its activity through interviews with the occupants of the mansion. The focus will be on the understanding of building form, features, and functions; respecting the architectural spaces and their activity. The methodology applied is to promote our understanding of the mix of culture that the mansion holds through documentation, observation and measuring exercises. This offers a positional interpretation of the mix of culture that the mansion holds. This conservation effort will further contribute exposure to the public and recognize it in the society as its essence is a deficiency character to the existing built environment.

Keywords: eclectic, heritage, spatial organization, culture

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