Search results for: stay abroad

Authors: Lena Shulyakovskaya

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Every year, schools aim to develop and adopt new technology and pedagogy as a way to equip today's students with the needed 21st Century skills. However, the field of primary and secondary education may not be as open to embracing change in reality. Despite the drive to reform and innovation, the field of education in Canada is still very much steeped in tradition and uses many of the practices that came into effect over 50 years ago. Among those are employment and retention practices. Millennials are the youngest generation of professionals entering the workplace at this time and the ones leaving their jobs within just a few years. Almost half of new teachers leave Canadian schools within their first five years on the job. This paper discusses one of the contributing factors that lead Canadian millennial teachers to either leave or stay in the profession - standardized education system. Using an exploratory case study approach, in-depth interviews with former and current millennial teachers were conducted to learn about their experiences within the K-12 system. Among the findings were the young teachers' concerns about the constant changes to teaching practices and technological implementations that claimed to advance teaching and learning, and yet in reality only disguised and reiterated the same traditional, outdated, and standardized practices that already existed. Furthermore, while many millennial teachers aspired to be innovative with their curriculum and teaching practices, they felt trapped and helpless in the hands of school leaders who were very reluctant to change. While many new program ideas and technological advancements are being made openly available to teachers on a regular basis, it is important to consider the education field as a whole and how it plays into the teachers' ability to realistically implement changes. By the year 2025, millennials will make up approximately 75% of the North American workforce. It is important to examine generational differences among teachers and understand how millennial teachers may be shaping the future of primary and secondary schools, either by staying or leaving the profession.

Keywords: 21st century skills, millennials, teacher attrition, tradition

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Authors: Vasishtha Avadhani Upadrasta, Mradul Kumar Daga, Smita Kaushik

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Background: Caffeine consumption has skyrocketed in the recent decades as we try to match pace with the machines. Studies have been conducted on animals and a few on humans, mainly on the acute effects of high-dose caffeine intake. Almost none have been conducted on the chronic effects of caffeine consumption. This study involved Medical professionals as case subjects, who consumed caffeine daily. Methods: This study, over a period of 3 months, involved 96 volunteers (chosen randomly w.r.t. gender and field in medical fraternity), including people who drank >500mg of caffeine a day to people who consumed none. People with any co-morbidities at all were excluded straight away. Two sets of blood samples were drawn and assessed. Three groups were created, Group 1 (>200mg caffeine/day) and Group 2 (15-200 mg caffeine/day) and Group 3 (<200mg Caffeine/day). Results: The result of the study found that exposure to caffeine at doses >200mg/day for more than 6 months leads to a significant difference in circulating free T3 [(-0.96 pmol/L ± 0.07) = (-18.5%), CI 95%, p = .000024] and Cortisol [(-123 nmol/L ± 9.8) = (-46.8%), CI 95%, p = .00029] hormones but shows an insignificant effect on circulating TSH [0.4 mIU/L, CI 95%, p=.37] and ACTH [(-3.2 pg/ml ± 0.3), CI 95%, p = .53) hormones, which stay within normal physiological ranges, irrespective of the daily dose of consumption. Results also highlight that women are more susceptible to decrement in fT3 than men (Relative Risk =1.58, ANOVA F-static = 7.15, p = 0.0105). Conclusions: Caffeine consumption in excess of 200mg/day, for more than or equal to 6 months, causes significant derangement in basal fT3 and Cortisol hormone levels, without affecting the TSH and ACTH (regulatory) hormone levels, indicating disturbance of action at the peripheral and/or cellular levels, possibly via the Paraventricular Nucleus –Leptin-CAR-Adenosine interactions. Women are more susceptible to decrement in fT3 levels than men (at same dose of caffeine).

Keywords: ACTH, adrenals, caffeine, cortisol, thyroid, thyroxin, TSH

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Authors: Wen Hsin Hsu, Pin Lin

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Objective: Thirst discomfort is the most common yet often overlooked symptom in patients in the intensive care unit (ICU), with an incidence rate of 69.8%. If not properly cared for, it can easily lead to irritability, affect sleep quality, and increase the incidence of delirium, thereby extending the length of hospital stay. Research points out that the sensation of coldness is an effective strategy to alleviate thirst. Using a combined care approach for thirst can prolong the sensation of coldness in the mouth and reduce thirst discomfort. Therefore, it needs to be further analyzed and its effectiveness reviewed. Methods: This study uses systematic literature review and meta-analysis methodologies and searched databases including PubMed, MEDLINE, EMBASE, Cochrane, CINAHL, and two Chinese databases (CEPS and CJTD) based on keywords. JBI was used to appraise the quality of the literature. RevMen 5.4 software package was used, and Fix Effect Model was applied for data analysis. We selected experimental articles, including those in English and Chinese, that met the inclusion and exclusion criteria. Three research articles were included in total, with a sample size of 416 people. Two were randomized controlled trials, and one was a quasi-experimental design. Results: The results show that the combined care for thirst, which includes ice water spray or oral swab wipes, menthol mouthwash, and lip balm, can significantly relieve thirst intensity MD=-1.36 (3 studies, 95% CI (-1.77, -0.95), p <0.001) and thirst distress MD=-0.71 (2 studies, 95% CI (-1.32, -0.10), p =0.02). Therefore, it is recommended that medical staff identify high-risk groups for thirst early on. Implications for Practice: For patients who cannot eat orally, providing combined care for thirst can increase oral comfort and improve the quality of care.

Keywords: thirst bundle care, intensive care units, meta-analysis, ice water spray, menthol

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Authors: Sasirin Srisomkiew, Sireewan Ratsadornasai, Tanomkwan Tipvong, Isariya Meesing

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Cassava is an important food source in the tropics and has recently gained attention as a potential source of biofuel that can replace limited fossil fuel sources. As a result, the demand for cassava production to support industries both within the country and abroad has increased. In Thailand, most farmers prefer to grow cassava in sandy and sandy loam areas where the soil has low natural fertility. Cassava is a tuber plant that has large roots to store food, resulting in the absorption of large amounts of nutrients from the soil, such as nitrogen, phosphorus, and potassium. Therefore, planting cassava in the same area for a long period causes soil erosion and decreases soil fertility. The loss of soil fertility affects the economy, society, and food and energy security of the country. Therefore, it is necessary to know the level of soil fertility and the amount of nutrients in the soil. To address this problem, this study applies geo-informatics technology and mathematical equations to assess erosion and soil fertility and to analyze factors affecting the amount of cassava production in Maha Sarakham Province. The results show that the area for cassava cultivation has increased in every district of Maha Sarakham Province between 2015-2022, with the total area increasing to 180,922 rai or 5.47% of the province’s total area during this period. Furthermore, it was found that it is possible to assess areas with soil erosion problems that had a moderate level of erosion in areas with high erosion rates ranging from 5-15 T/rai/year. Soil fertility assessment and information obtained from the soil nutrient map for 2015–2023 reveal that farmers in the area have improved the soil by adding chemical fertilizers along with organic fertilizers, such as manure and green manure, to increase the amount of nutrients in the soil. This is because the soil resources of Maha Sarakham Province mostly have relatively low agricultural potential due to the soil texture being sand and sandy loam. In this scenario, the ability to absorb nutrients is low, and the soil holds little water, so it is naturally low in fertility. Moreover, agricultural soil problems were found, including the presence of saline soil, sandy soil, and acidic soil, which is a serious restriction on land use because it affects the release of nutrients into the soil. The results of this study may be used as a guideline for managing soil resources and improving soil quality to prevent soil degradation problems that may occur in the future.

Keywords: Cassava, geoinformatics, soil erosion, soil fertility, land use change

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Authors: Hui-Chi Huang, Su-Ju Yang, Ching-Wei Lin, Jui-Yao Tsai, Liang-Yiang

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Background: The most common serious complication following acute stroke is pneumonia. It has been associated with the increased morbidity, mortality, and medical cost after acute stroke in elderly patients. Purpose: The aim of this retrospective study was to investigate the relationship between stroke patients, risk factors of pneumonia, and one-year survival rates in a group of patients, in a tertiary referal center in Northern Taiwan. Methods: From January 2012 to December 2013, a total of 1730 consecutively administered stroke patients were recruited. The Survival analysis and multivariate regression analyses were used to examine the predictors for the one-year survival in stroke patients of a stroke registry database from northern Taiwan. Results: The risk of stroke mortality increased with age≧ 75 (OR=2.305, p < .0001), cancer (OR=3.221, p=<.0001), stayed in intensive care unit (ICU) (OR=2.28, p <.0006), dysphagia (OR=5.026, p<.0001), without speech therapy(OR=0.192, p < .0001),serum albumin < 2.5(OR=0.322, p=.0053) , eGFR > 60(OR=0.438, p <. 0001), admission NIHSS >11(OR=1.631, p=.0196), length of hospitalization (d) > 30(OR=0.608, p=.0227), and stroke subtype (OR=0.506, p=.0032). After adjustment of confounders, pneumonia was not significantly associated with the risk of mortality. However, it is most likely to develop in patients who are age ≧ 75, dyslipidemia , coronary artery disease , albumin < 2.5 , eGFR <60 , ventilator use , stay in ICU , dysphagia, without speech therapy , urinary tract infection , Atrial fibrillation , Admission NIHSS > 11, length of hospitalization > 30(d) , stroke severity (mRS=3-5) ,stroke Conclusion: In this study, different from previous research findings, we found that elderly age, severe neurological deficit and rehabilitation therapy were significantly associated with Post-stroke Pneumonia. However, specific preventive strategies are needed to target the high risk groups to improve their long-term outcomes after acute stroke. These findings could open new avenues in the management of stroke patients.

Keywords: stroke, risk, pneumonia, survival

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Authors: Anis Al-Yakhiri

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Introduction: The World Health Organization (WHO) classifies malignant epithelial thyroid tumors into four major groups (papillary, follicular, medullar and undifferentiated) . Papillary thyroid carcinoma (PTC) is the most common type, for about eight out of ten thyroid cancers belong to this histological type. Radioactive iodine (RAI) is considered effective for patients with total or nearly total thyroidectomy, but the beneficial effects of RAI are still controversial. War conditions forced us to study alternative methods of using radioactive iodine in the treatment of patients with PTC. Material and methods: Between January 2014 and June 2021, in Al-Yakhiri hospital, 57 Total Thyroidectomy with Radical BilateralNeckDissection (RBND) were performed, 50 for malignant disease,7 for false positive cytology.RBND involves surgical clearance of Levels II-VI. Mean age was 40.7 years old and 92% of the patients were female. 7(14%) patients had hypothyroidism which required preoperative thyroid hormone treatment. The Thyroid Stimulating Hormone- Suppression Therapy (TSH-ST) immediately started after RBND for mostpatients on the first day. It consisted in reducing the level of TSH< 0.1 mIU/L. Results: The Apron flap was used on most operations (40)80% and with lateral extensions had 10(20%). RBND involves surgical clearance of Levels II-VI performed in all operated patients, besides that, 4(8%) of them had resection of sternocleidomastoid muscle (SCM) and accessory nerve (XIn) and internal jugular vein (IJV) withclearance of Levels IB. The PTC was the most common 80.9% (38 patients from 47)by histopathological report. and 4(8%) patients of 50 had resection of sternocleidomastoid muscle (SCM) and accessory nerve (XIn) and internal jugular vein (IJV). The postoperative mortality rate not observed (0%). The postoperative morbidity rate was 22.8% (n =13).Seroma(8.7%),Hypocalcimia(7%), Wound infection(5.3%), Bleeding(1.8%). To suppress TSH and growth of any residual thyroid theTSH-ST (levothyroxine150 – 600mcg)was performed in all patients 57(100%) on the first day afterRBND. We tracked the results of treatment for two years in 30 patients with PTC, only 3 of them received radioactive iodine abroad. Biennial Recurrence rate for PTC appeared in one woman (2%), who had RAI postoperatively in the form of neck lymph nodes metastasis. Conclusion: For patients with PTC, thyroidectomy plus prophylacticRBND is a safe and efficient procedure and it results in lower recurrence rate. Postoperative treatment with exogenous thyroid hormone in doses sufficient to suppress TSH (not less than 150mcg), decreases incidence of recurrence. Total Thyroidectomy with RBND followed by TSH-ST, in our opinion, applicable optimal treatment scheme care for this patient population.

Keywords: thyroid cancer, Yemen war, absence of radioactive iodine, neck dissection, surgery results

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Authors: Nighat Bakhtiar, Ali Raza Khan, Shahid Khan Khattak, Aamir Ali Syed

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Introduction: Chemoradiation followed by resection has been the standard therapy for resectable (cT1-4aN0-3M0) esophageal carcinoma. The optimal surgical approach remains a matter of debate. Therefore, the purpose of this study was to share our experiences of minimal invasive esophagectomies concerning morbidity, mortality and oncological quality. This study aims to enlighten the world about the surgical outcomes after minimally invasive esophagectomy at Shaukat Khanum Hospital Lahore. Objective: The purpose of this study is to review an institutional experience of Surgical outcomes of Minimal Invasive esophagectomies for esophageal cancer. Methodology: This retrospective study was performed after ethical approval at Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC) Pakistan. Patients who underwent Minimal Invasive esophagectomies for esophageal cancer from March 2018 to March 2023 were selected. Data was collected through the human information system (HIS) electronic database of SKMCH&RC. Data was described using mean and median with minimum and maximum values for quantitative variables. For categorical variables, a number of observations and percentages were reported. Results: A total of 621 patients were included in the study, with the mean age of the patient was 39 years, ranging between 18-58 years. Mean Body Mass Index of patients was 21.2.1±4.1. Neo-adjuvant chemoradiotherapy was given to all patients. The mean operative time was 210.36 ± 64.51 minutes, and the mean blood loss was 121 milliliters. There was one mortality in 90 days, while the mean postoperative hospital stay was 6.58 days with a 4.64 standard deviation. The anastomotic leak rate was 4.2%. Chyle leak was observed in 12 patients. Conclusion: The minimal invasive technique is a safe approach for esophageal cancers, with minimal complications and fast recovery.

Keywords: minimal invasive, esophagectomy, laparscopic, cancer

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Authors: Y. Kunitani, Y. Nakashima, S. Yamauchi, Y. Ishigami, K. Naito, K. Numata, M. Mizobe, Y. Homma, J. Takahashi, T. Inoue, T. Shiga, H. Funakoshi

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Background: Japanese Spotted Fever (JSF) is one of the Rickettsial infections, caused by Rickettsia japonica, which is transmitted by ticks. JSF is seen in limited area, such as Japan and South Korea. Its clinical triad is rash, eschar and fever. It often shows leukocytopenia, thrombopenia, elevated transaminase and high C-reactive protein (CRP). Sometimes it can be life-threatening due to disseminated intravascular coagulation or multiple organ failure. Study Aim: The aim of this study is to describe the features of JSF, as this unique infection is rapidly growing in Japan. Methods: This is a case series of JSF from 2009 to 2016, in Mie Prefectural Hospital in Japan. We collected JSF cases, which were diagnosed by polymerase chain reaction (PCR) of the skin or blood serum, or the elevation of the antibody titer of paired blood samples. Results: There were 43 JSF patients (19 male, 24 female) with a median age of 71 years [IQR:65-80]. The median body temperature was 38.1°C[IQR: 37.5-39.0]. 95% had a rash, 67% had eschar and 50% had fever. The median WBC count was 6,700 [IQR: 5,750-8,200] and leukocytopenia was observed in only 7%. The median platelet count was 14x104 [IQR10x104-17x104], thrombopenia was observed in 65%. The median aspartate transaminase (AST) was 53 IU/L [IQR: 41-93]; the median alanine aminotransferase (ALT) was 34 IU/L [IQR: 24-54]; the median CRP was 10.4 mg/dL [IQR:7.2-13.9]; the median lactate dehydrogenase (LDH) was 352IU/L [IQR:282-451]. CRP and LDH were elevated in almost all of the patients. Median length of stay in hospital was 8 days [IQR: 6-11]. All patients were treated with tetracycline and quinolone on the day of the presentation. There was no fatality from JSF. Conclusion: The patients with JSF classically presents with eschar, rash and fever. However, in this study, the half of the patients were afebrile. Although JSF is not a common infectious disease worldwide, if the patient had previously visited Japan or South Korea and presented with rash and eschar with or without fever, we should consider JSF as a potential diagnosis.

Keywords: infectious disease, Japanese spotted fever, Rickettsial disease, Rickettsia japonica

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Authors: Arash Gharibi

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Mankind has always used models to solve problems. Essentially, models are simplified versions of reality, whose need stems from having to deal with complexity; many processes or phenomena are too complex to be described completely. Thus a fundamental model requirement is that it contains the characteristic features that are essential in the context of the problem to be solved or described. Models are used in virtually every scientific domain to deal with various problems. During the recent decades, the number of models has increased exponentially. Publication of models as part of original research has traditionally been in in scientific periodicals, series, monographs, agency reports, national journals and laboratory reports. This makes it difficult for interested groups and communities to stay informed about the state-of-the-art. During the modeling process, many important decisions are made which impact the final form of the model. Without a record of these considerations, the final model remains ill-defined and open to varying interpretations. Unfortunately, the details of these considerations are often lost or in case there is any existing information about a model, it is likely to be written intuitively in different layouts and in different degrees of detail. In order to overcome these issues, different domains have attempted to implement their own approaches to preserve their models’ information in forms of model documentation. The most frequently cited model documentation approaches show that they are domain specific, not to applicable to the existing models and evolutionary flexibility and intrinsic corrections and improvements are not possible with the current approaches. These issues are all because of a lack of unified standards for model documentation. As a way forward, this research will propose a new standard for capturing and managing models’ information in a unified way so that interoperability and reusability of models become possible. This standard will also be evolutionary, meaning members of modeling realm could contribute to its ongoing developments and improvements. In this paper, the current 3 of the most common metamodels are reviewed and according to pros and cons of each, a new metamodel is proposed.

Keywords: metamodel, modeling, interoperability, reuse

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Authors: R.T.P. De Silva, T. K. Wijayasiriwardhane, B. Jayawardena

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Most people nowadays spend their time indoor environment. Because of that, a quality indoor environment needs for them. This study was conducted to identify how to improve indoor visual comfort using a personalized light system. Light intensity, light color, glare, and contrast are the main facts that affect visual comfort. The light intensity which needs to perform a task is changed according to the task. Using necessary light intensity and we can improve the visual comfort of occupants. The hue can affect the emotions of occupants. The preferred light colors and intensity change according to the occupant's age and gender. The research was conducted to identify is there any relationship between personalization and visual comfort. To validate this designed an Internet of Things-based reading light. This light can work according to the standard light levels and personalized light levels. It also can measure the current light intensity of the environment and maintain continuous light levels according to the task. The test was conducted by using 25 undergraduates, and 5school students, and 5 adults. The feedbacks are gathered using Post-occupancy evaluation (POE) techniques. Feedbacks are gathered in three steps, It was done without any light control, with standard light level, and with personalized light level Users had to spend 10 minutes under each condition. After finishing each step, collected their feedbacks. According to the result gathered, 94% of participants rated a personalized light system as comfort for them. The feedbacks show stay under continuous light level help to keep their concentrate. Future research can be conducted on how the color of indoor light can affect for indoor visual comfort of occupants using a personalized light system. Further proposed IoT based can improve to change the light colors according to the user's preference.

Keywords: indoor environment quality, internet of things based light system, post occupancy evaluation, visual comfort

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Authors: Varinder Kaur, Amanjit Kaur, Simran Kaur, Samriti Vaid

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Coating of fabrics with anti-microbial dyes is an adaptable technique of protection from various diseases. Natural dyes, which are known to possess antibacterial properties, can be used for antibacterial finishing of fibers like cotton, wool, bamboo and so many. Dyeing of fabrics with natural dyes normally requires the use of mordants so that dyes can stay on the fabric as well as into interstices of the fabric during multiple washings. In this study, the mordants used are alum and chitosan for ensuring a reasonable color fastness to light and washing. Chitosan is a natural polysaccharide having significant biological and chemical properties such as biodegradability, biocompatibility, bioactivity, microbial activity and polycationicity. The metal ion of alum mordant can act as electron acceptor for electron donor to form coordination bond with the dye molecule, making them insoluble in water. The dyeing of bamboo fabric using a natural dye extracted from turmeric has been studied using conventional dyeing method. Natural dye was extracted using water as solvent by Soxhlet extraction method. The extracted color was characterized by spectroscopic studies like UV/visible and further tested for antimicrobial activity. The effect of mordants on the dyeing outcome in terms of colour depth as well as fastness properties of the dyeing was investigated. It has been found that employing the conventional dyeing technique at 100 oC, the mordanted samples were deeper in depth than their unmordanted counterparts. The results of fastness properties of the dyed fabrics were fair to good. Turmeric extract was found to enhance microbial resistance of bamboo as well as was itself as a good cause of coloration. These textiles dyed with the turmeric as natural dye can be very useful in developing clothing for infants, elderly and infirm people to protect them against common infections. The outcome of this study will provide a new feature to the interface of dyeing and pharmaceutical industry.

Keywords: antimicrobial activity, bamboo fabric, natural dye, turmeric

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Authors: Marta Blavia

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Magiciens de la terre, organized in 1989 by the Centre Pompidou, became 'the first worldwide exhibition of contemporary art' by presenting artists from Western and non-Western countries, including three Chinese artists. For the first time, West turned its eyes to other countries not as exotic sources of inspiration, but as places where contemporary art was also being created. One year later, Chine: demain pour hier was inaugurated as the first Chinese avant-garde group-exhibition in Occident. Among the artists included was Cai Guo-Qiang who, like many other Chinese artists, had left his home country in the eighties in pursuit of greater creative freedom. By exploring artistic non-Western perspectives, both landmark exhibitions questioned the predominance of the Eurocentric vision in the construction of history art. But more than anything else, these exhibitions laid the groundwork for the rise of the so-called phenomenon 'global contemporary art'. All the same time, 1989 also was a turning point in Chinese art history. Because of the Tiananmen student protests, The Chinese government undertook a series of measures to cut down any kind of avant-garde artistic activity after a decade of a relative openness. During the eighties, and especially after the Tiananmen crackdown, some important artists began to leave China to move overseas such as Xu Bing and Ai Weiwei (USA); Chen Zhen and Huang Yong Ping (France); or Cai Guo-Qiang (Japan). After emigrating abroad, Chinese overseas artists began to develop projects in accordance with their new environments and audiences as well as to appear in numerous international exhibitions. With their creations, that moved freely between a variety of Eastern and Western art sources, these artists were crucial agents in the emergence of global contemporary art. As other Chinese artists overseas, Cai Guo-Qiang’s career took off during the 1990s and early 2000s right at the same moment in which Western art world started to look beyond itself. Little by little, he developed a very personal artistic language that redefines Chinese ideas, symbols, and traditional materials in a new world order marked by globalization. Cai Guo-Qiang participated in many of the exhibitions that contributed to shape global contemporary art: Encountering the Others (1992); the 45th Venice Biennale (1993); Inside Out: New Chinese Art (1997), or the 48th Venice Biennale (1999), where he recreated the Chinese monumental social realist work Rent Collection Courtyard that earned him the Golden Lion Award. By examining the different stages of Cai Guo-Qiang’s artistic path as well as the transnational dimensions of his creations, this paper aims at offering a comprehensive survey on the construction of the discourse of global contemporary art.

Keywords: Cai Guo-Qiang, Chinese artists overseas, emergence global art, transnational art

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

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

Keywords: hemicolectomy, colorectal, complications, postoperative ileus

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Authors: Pampita Chakraborty, Sukumar Mukherjee

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This study was done to determine the prevalence of nosocomial infections in the ICU and to identify the common microorganisms causing these infections and their antimicrobial sensitivity pattern. Nosocomial infection or hospital-acquired infection is a localized or a systemic condition resulting from an adverse reaction to the presence of infectious agents. Nosocomial infections are not present or incubating when the patient is admitted to hospital or other health care facility. They are caused by pathogens that easily spread through the body. Many hospitalized patients have compromised immune systems, so they are less able to fight off infections. These infections occur worldwide, both in the developed and developing the world. They are a significant burden to patients and public health. They are a major cause of death and increased morbidity in hospitalized patients, which is a matter of serious concern today. This study was done during the period of one year (2012-2013) in the ICU of the tertiary care hospital in eastern India. Prevalence of nosocomial infection was determined; site of infection and the pattern of microorganisms were identified along with the assessment of antibiotic susceptibility profile. Patients who developed an infection after 48 hours of admission to the ICU were included in the study. A total of 324 ICU patients were analyzed, of these 79 patients were found to have developed a nosocomial infection (24.3% prevalence). Urinary tract infection was found to be more predominant followed by respiratory tract infection and soft tissue infection. The most frequently isolated microorganism was E. coli, Pseudomonas aeruginosa, Klebsiella pneumoniae followed by other organisms respectively. Antibiotic susceptibility test of these isolates was done against commonly used antibiotics. Patients admitted to the ICU are especially susceptible to nosocomial infections. Despite adequate antimicrobial treatment, nosocomial ICU infections can significantly affect ICU stay and can cause an increase in patient’s morbidity and mortality. Adherence to infection protocol, proper monitoring and the judicious use of antibiotics are important in preventing such infections on a regular basis.

Keywords: antibiotic susceptibility, intensive care unit, nosocomial infection, nosocomial pathogen

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Authors: Yi Shan Cheng, Ya Hui Yeh, Hsiao Wen Hsu

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Delirium is an acute state of confusion, which is mainly the result of the interaction of many factors, including: age>65 years, comorbidity, cognitive function and visual/auditory impairment, dehydration, pain, sleep disorder, pipeline retention, general anesthesia and major surgery… etc. Researches show the prevalence of delirium in hospitalized elderly patients over 50%. If it doesn't improve in time, may cause cognitive decline or impairment, not only prolong the length of hospital stay but also increase mortality. Some studies have shown that multiple nonpharmacological interventions are the most effective and common strategies, which are reorientation, early mobility, promoting sleep and nutritional support (including water intake), could improve or prevent delirium in the hospitalized elderly. In Taiwan, only one research to compare the delirium incidence of the older patients who have received orthopedic surgery between multi-nonpharmacological interventions and general routine care. Therefore, the purpose of this study is to address the prevention or improvement of delirium incidence density in medical hospitalized elderly, provide clinical nurses as a reference for clinical implementation, and develop follow-up related research. This study is a quasi-experimental design using purposive sampling. Samples are from two wards: the geriatric ward and the general medicine ward at a medical center in central Taiwan. The sample size estimated at least 100, and then the data will be collected through a self-administered structured questionnaire, including: demographic and professional evaluation items. Case recruiting from 5/13/2023. The research results will be analyzed by SPSS for Windows 22.0 software, including descriptive statistics and inferential statistics: logistic regression、Generalized Estimating Equation(GEE)、multivariate analysis of variance(MANOVA).

Keywords: multiple nonpharmacological interventions, hospitalized elderly, delirium incidence, delirium

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Authors: Shlomit Hon-Snir, Sharon Teitler-Regev, Anabel Lifszyc Friedlander

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Tourism, one of the world's largest and fastest growing industries, exerts a major economic influence. The number of international tourists is growing every year, and the relative portion of independent (FIT) tourists is growing as well. The characteristics of independent tourists differ from those of tourists who travel in organized trips. The purpose of the research is to identify the factors that affect the individual tourist's expenses in Israel: total expenses, expenses per day, expenses per tourist, expenses per day per tourist, accommodation expenses, dining expenses and transportation expenses. Most of the research analyzed the total expenses using OLS regression. The determinants influencing expenses were divided into four groups: budget constraints, socio-demographic data, psychological characteristics and travel-related characteristics. Since the effect of each variable may change over different levels of total expenses the quantile regression (QR) theory will be applied. The current research will use data collected by the Israeli Ministry of Tourism in 2015 from individual independent tourists at the end of their visit to Israel. Preliminary results show that: At lower levels of expense, only income has a (positive) effect on total expenses, while at higher levels of expense, both income and length of stay have (positive) effects. -The effect of income on total expenses is higher for higher levels of expenses than for lower level of expenses. -The number of sites visited during the trip has a (negative) effect on tourist accommodation expenses only for tourists with a high level of total expenses. Due to the increasing share of independent tourism in Israel and around the world and due to the importance of tourism to Israel, it is very important to understand the factors that influence the expenses and behavior of independent tourists. Understanding the factors that affect independent tourists' expenses in Israel can help Israeli policymakers in their promotional efforts to attract tourism to Israel.

Keywords: independent tourist, quantile regression theory, tourism expenses, tourism

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Authors: Merouane Salhi, Mohamed Roudane, Abdelkader Kirad

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In this work, we present a new form of characteristics method, which is a technique for solving partial differential equations. Typically, it applies to first-order equations; the aim of this method is to reduce a partial differential equation to a family of ordinary differential equations along which the solution can be integrated from some initial data. This latter developed under the real gas theory, because when the thermal and the caloric imperfections of a gas increases, the specific heat and their ratio do not remain constant anymore and start to vary with the gas parameters. The gas doesn’t stay perfect. Its state equation change and it becomes for a real gas. The presented equations of the characteristics remain valid whatever area or field of study. Here we need have inserted the developed Prandtl Meyer function in the mathematical system to find a new model when the effect of stagnation pressure is taken into account. In this case, the effects of molecular size and intermolecular attraction forces intervene to correct the state equation, the thermodynamic parameters and the value of Prandtl Meyer function. However, with the assumptions that Berthelot’s state equation accounts for molecular size and intermolecular force effects, expressions are developed for analyzing the supersonic flow for thermally and calorically imperfect gas. The supersonic parameters depend directly on the stagnation parameters of the combustion chamber. The resolution has been made by the finite differences method using the corrector predictor algorithm. As results, the developed mathematical model used to design 2D minimum length nozzles under effect of the stagnation parameters of fluid flow. A comparison for air with the perfect gas PG and high temperature models on the one hand and our results by the real gas theory on the other of nozzles shapes and characteristics are made.

Keywords: numerical methods, nozzles design, real gas, stagnation parameters, supersonic expansion, the characteristics method

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Authors: Rona Lee Suelo-Calanao, Mahmoud Loubani

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Objective: Sternal wound infection (SWI) following cardiac operation has a significant impact on patient morbidity and mortality. It also contributes to longer hospital stays and increased treatment costs. SWI management is mainly focused on treatment rather than prevention. This study looks at the effect of closed incision negative pressure therapy (ciNPT) dressing to help reduce the incidence of superficial SWI in high-risk patients after cardiac surgery. The ciNPT dressing was evaluated at 3 cardiac hospitals in the United Kingdom". Methods: All patients who had cardiac surgery from 2013 to 2021 were included in the study. The patients were classed as high risk if they have two or more of the recognised risk factors: obesity, age above 80 years old, diabetes, and chronic obstructive pulmonary disease. Patients receiving standard dressing (SD) and patients using ciNPT were propensity matched, and the Fisher’s exact test (two-tailed) and unpaired T-test were used to analyse categorical and continuous data, respectively. Results: There were 766 matched cases in each group. Total SWI incidences are lower in the ciNPT group compared to the SD group (43 (5.6%) vs 119 (15.5%), P=0.0001). There are fewer deep sternal wound infections (14(1.8%) vs. 31(4.04%), p=0.0149) and fewer superficial infections (29(3.7%) vs. 88 (11.4%), p=0.0001) in the ciNPT group compared to the SD group. However, the ciNPT group showed a longer average length of stay (11.23 ± 13 days versus 9.66 ± 10 days; p=0.0083) and higher mean logistic EuroSCORE (11.143 ± 13 versus 8.094 ± 11; p=0.0001). Conclusion: Utilization of ciNPT as an approach to help reduce the incidence of superficial and deep SWI may be effective in high-risk patients requiring cardiac surgery.

Keywords: closed incision negative pressure therapy, surgical wound infection, cardiac surgery complication, high risk cardiac patients

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Authors: Nana Bolashvili, Vakhtang Geladze, Tamazi Karalashvili, Nino Machavariani, George Geladze, Davit Kartvelishvili, Ana Karalashvili

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Fresh water is the major natural resource of Georgia. The average perennial sum of the rivers' runoff in Georgia is 52,77 km³, out of which 9,30 km³ inflows from abroad. The major volume of transit river runoff is ascribed to the Chorokhi river. Average perennial runoff in Western Georgia is 41,52 km³, in Eastern Georgia 11,25 km³. The indices of Eastern and Western Georgia were calculated with 50% and 90% river runoff respectively, while the same index calculation for other countries is based on a 50% river runoff. Out of total volume of resources, 133,2 m³/sec (4,21 km³) has been geologically prospected by the State Commission on Reserves and Acknowledged as reserves available for exploitation, 48% (2,02 km³) of which is in Western Georgia and 2,19 km³ in Eastern Georgia. Considering acknowledged water reserves of all categories per capita water resources accounts to 2,2 m³/day, whereas high industrial category -0. 88 m³ /day fresh drinking water. According to accepted norms, the possibility of using underground water reserves is 2,5 times higher than the long-term requirements of the country. The volume of abundant fresh-water reserves in Georgia is about 150 m³/sec (4,74 km³). Water in Georgia is consumed mostly in agriculture for irrigation purposes. It makes 66,4% around Georgia, in Eastern Georgia 72,4% and 38% in Western Georgia. According to the long-term forecast provision of population and the territory with water resources in Eastern Georgia will be quite normal. A bit different is the situation in the lower reaches of the Khrami and Iori rivers which could be easily overcome by corresponding financing. The present day irrigation system in Georgia does not meet the modern technical requirements. The overall efficiency of their majority varies between 0,4-0,6. Similar is the situation in the fresh water and public service water consumption. Organization of the mentioned systems, installation of water meters, introduction of new methods of irrigation without water loss will substantially increase efficiency of water use. Besides new irrigation norms developed from agro-climatic, geographical and hydrological angle will significantly reduce water waste. Taking all this into account we assume that for irrigation agricultural lands in Georgia is necessary 6,0 km³ water, 5,5 km³ of which goes to Eastern Georgia on irrigation arable areas. To increase water supply in Eastern Georgian territory and its population is possible by means of new water reservoirs as the runoff of every river considerably exceeds the consumption volume. In conclusion, we should say that fresh water resources by which Georgia is that rich could be significant source for barter exchange and investment attraction. Certain volume of fresh water can be exported from Western Georgia quite trouble free, without bringing any damage to population and hydroecosystems. The precise volume of exported water per region/time and method/place of water consumption should be defined after the estimation of different hydroecosystems and detailed analyses of water balance of the corresponding territories.

Keywords: GIS, management, rivers, water resources

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Authors: Nduduzo Andrias Ngxongo, Nsizwazikhona Simon Chili

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This analytical exploration illustrates how the non-existence of a proper marketing strategy for a tourism destination may have resulted in a radical decline in both financial outputs and visitor arrivals. The marketing strategy is considered as the foundation for any tourism destination’s marketing tactics. Tourism destinations are ought to have dynamic and adaptive marketing strategies that will develop a promotional approach to help the destination to gain market share, identify its target markets, stay relevant to its existing clients, attract new visitors, and increase profits-earned. Accordingly, the Moses Mabhida Stadium (MMS), one of the prominent tourist attractions in KwaZulu-Natal; boasting a world-class architectural design, several international prestigious awards, and vibrant, adventurous activities, has in recent years suffered a gradual slump in both visitors and profits. Therefore, the basis of this paper was to thoroughly establish precisely how the existing MMS marketing strategy may be a basis for a decline in the number of visitors and profits-earned in recent years. The study adopted mixed method research strategy, with 380 participants. The outcome of the study suggests some costly disparities in the marketing strategy of MMS which has led to poor performance and a loss in tourism market share. In consequence, the outcome further suggests that the non-existence of market research analysis and destination marketing tools contributed vastly to the in-progress dilemma. This fact-finding exploration provides a birds-eye outlook of MMS marketing strategy, and based on the results, the study recommends for the introduction of a more far-reaching and revitalising marketing strategy through; constant and persistent market research initiatives, minimal political interference in the administration of state-funded organisations, reassessment of the feasibility study, vigorous, and sourcing of proficient personnel.

Keywords: tourism, destination, marketing , marketing strategy

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Authors: Ratna Sharma, Kaveri Dutta

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Assam (India), the gate way to the Northeast India is mainly known for its exquisite silks, the art and craft. The state has a rich collection of traditional jewellery which is unique and exclusive to the state. These jewelleries hold a special place in the heart of the Assamese women. Similarly handloom industry of Assam is basically silk oriented. Among the wild silk, Eri silk fabric has remained as “the poor man’s silk” but it is closely attached to the assamese society, dress for it's warm quality. In view of the changing market trends, fashion and consumer demands, Silk is emerging as a fashion fabric both in India and abroad. In case of Eri silk fabric it has limited use in clothing and accessories. Hence the restructured and redesigned traditional jewellery motifs of Assam (India) over Eri silk products will have greater potential in reviving the decline of art, generate revenue, self employment towards craftsmen and also recognition of the art. The information incorporated in the paper is primary and the data have been collected by purposive sampling method. This work of art was expressed on Eri silk fabric in the form of traditional hand embroidery as it is closely connected with the era of the individual in history of mankind and reflects the personal expression of an entity. For this study selected traditional motifs of Assamese ornaments was used. Some of the popular traditional Assamese jewellery include earrings with exquisite Lokaparo, Keru, Thuriya, Jangphai, etc. An array of necklaces including Golpata, Satsori, Jon biri, Bena, Gejera, Dhol biri, Doog doogi, Biri Moni, Mukuta Moni, Poalmoni, Silikha Moni and Magardana and diversified rings including Senpata, Horinsakua, Jethinejia, bakharpata and others. Selected two motifs each from necklace, earring and finger ring designs. Selected motifs were further developed into 3 categories- the border, the main motif and all over butta followed by placement of developed patterns on products. Products developed were stoles, scarf’s, purses, brooch pins, skirts for women and ties, handkerchief, jackets for men. The developed products were surveyed by selected respondents. From the present study it can be observed that the embellished traditional jewellery motifs resulted in fresh and colourful pattern on developed Eri silk products. Moreover the motifs which were gradually fading among the community itself showed a very good recognition towards art. The embroidered Eri silk fabric also created a huge change in a positive way among craftsman.

Keywords: Art and craft of Assam, eri silk, hand embroidery, traditional Assamese jewellery motifs

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Authors: Muhammed Ordu, Eren Demir, Chris Tofallis

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The number of inpatient admissions in the UK has been significantly increasing over the past decade. These increases cause bed occupancy rates to exceed the target level (85%) set by the Department of Health in England. Therefore, hospital service managers are struggling to better manage key resource such as beds. On the other hand, this severe demand pressure might lead to confusion in wards. For example, patients can be admitted to the ward of another inpatient specialty due to lack of resources (i.e., bed). This study aims to develop a simulation-optimization model to reallocate the available number of beds in a mid-sized hospital in the UK. A hospital simulation model was developed to capture the stochastic behaviours of the hospital by taking into account the accident and emergency department, all outpatient and inpatient services, and the interactions between each other. A couple of outputs of the simulation model (e.g., average length of stay and revenue) were generated as inputs to be used in the optimization model. An integer linear programming was developed under a number of constraints (financial, demand, target level of bed occupancy rate and staffing level) with the aims of maximizing number of admitted patients. In addition, a sensitivity analysis was carried out by taking into account unexpected increases on inpatient demand over the next 12 months. As a result, the major findings of the approach proposed in this study optimally reallocate the available number of beds for each inpatient speciality and reveal that 74 beds are idle. In addition, the findings of the study indicate that the hospital wards will be able to cope with 14% demand increase at most in the projected year. In conclusion, this paper sheds a new light on how best to reallocate beds in order to cope with current and future demand for healthcare services.

Keywords: bed occupancy rate, bed reallocation, discrete event simulation, inpatient admissions, integer linear programming, projected usage

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Authors: Trunov V.O., Ryabov A. B., Poddubny I.V

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Introduction: cystic and solid pancreatic tumors have a relevant and disruptive position in many positions. The results of the treatment of children with tumors and pancreatic cysts aged 3 to 17 years for the period from 2008 to 2019 on the basis of the Morozov State Children's Clinical Hospital in Moscow were analyzed. The total number of children with solid tumors was 17, and 31 with cysts. In all children, the diagnosis was made on the basis of ultrasound, followed by CT and MRI. In most patients with solid tumors, they were located in the area of the pancreas tail - 58%, in the body area - 14%, in the area of the pancreatic head - 28%. In patients with pancreatic cysts, the distribution of patients by topography was as follows: head of the pancreas - 10%, body of the pancreas - 16%, tail of the pancreas - 68%, total cystic transformation of the Wirsung duct - 6%. In pancreatic cysts, the method of surgical treatment was based on the results of MRCP, the level of amylase in the contents of the cyst, and the localization of the cyst. Thus, pathogenetically substantiated treatment included: excision of cysts, internal drainage on an isolated loop according to Ru, the formation of pancreatojejunoanastomosis in a child with the total cystic transformation of the Wirsung duct. In patients with solid pancreatic lesions, pancretoduodenalresection, central resection of the pancreas, and distal resection from laparotomy and laparoscopic access were performed. In the postoperative period, in order to prevent pancreatitis, all children underwent antisecretory therapy, parenteral nutrition, and drainage of the omental bursa. Results: hospital stay ranged from 7 to 12 days. The duration of postoperative fermentemia in patients with solid formations lasted from 3 to 6 days. In all cases, according to the histological examination, a pseudopapillary tumor of the pancreas was revealed. In the group of children with pancreatic cysts, fermentemia was observed from 2 to 4 days, recurrence of cysts in the long term was detected in 3 children (10%). Conclusions: the treatment of cystic and solid pancreatic neoplasms is a difficult task in connection with the anatomical and functional features of the organ.

Keywords: pancreas, tumors, cysts, resection, laparoscopy, children

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Authors: Sherif Sabri, Suzy Fawzi, Sanaa Abdelshafy, Ayman Nagah

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Introduction: Static derangements in lactate homeostasis during ICU stay have become established as a clinically useful marker of increased risk of hospital and ICU mortality. Lactate indices or kinetic alteration of the anaerobic metabolism make it a potential parameter to evaluate disease severity and intervention adequacy. This is an inexpensive and simple clinical parameter that can be obtained by a minimally invasive means. Aim of work: Comparing the predictive value of dynamic indices of hyperlactatemia in the first twenty four hours of intensive care unit (ICU) admission with other static values are more commonly used. Patients and Methods: This study included 40 critically ill patients above 18 years old of both sexes with Hyperlactamia (≥ 2 m mol/L). Patients were divided into septic group (n=20) and low oxygen transport group (n=20), which include all causes of low-O2. Six lactate indices specifically relating to the first 24 hours of ICU admission were considered, three static indices and three dynamic indices. Results: There were no statistically significant differences among the two groups regarding age, most of the laboratory results including ABG and the need for mechanical ventilation. Admission lactate was significantly higher in low-oxygen transport group than the septic group [37.5±11.4 versus 30.6±7.8 P-value 0.034]. Maximum lactate was significantly higher in low-oxygen transport group than the septic group P-value (0.044). On the other hand absolute lactate (mg) was higher in septic group P-value (< 0.001). Percentage change of lactate was higher in the septic group (47.8±11.3) than the low-oxygen transport group (26.1±12.6) with highly significant P-value (< 0.001). Lastly, time weighted lactate was higher in the low-oxygen transport group (1.72±0.81) than the septic group (1.05±0.8) with significant P-value (0.012). There were statistically significant differences regarding lactate indices in survivors and non survivors, whether in septic or low-oxygen transport group. Conclusion: In critically ill patients, time weighted lactate and percent in lactate change in the first 24 hours can be an independent predictive factor in ICU mortality. Also, a rising compared to a falling blood lactate concentration over the first 24 hours can be associated with significant increase in the risk of mortality.

Keywords: critically ill patients, lactate indices, mortality in intensive care, anaerobic metabolism

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Authors: Kunal K. S., Shwetashri K. R., Keerthan G., Ajinkya R.

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Background: Normal pressure hydrocephalus is a condition caused by abnormal accumulation of cerebrospinal fluid (CSF) within the brain resulting in enlarged cerebral ventricles due to a disruption of CSF formation, absorption, or flow. Over the course of time, ventriculoperitoneal shunt under general anesthesia has become a standard of care. Yet only a finite number of centers have started the inclusion of regional anesthesia techniques for the such patient cohort. Stem Case: We report a case of a 75-year-old male with underlying aortic sclerosis and cardiomyopathy who presented with complaints of confusion, forgetfulness, and difficulty in walking. Neuro-imaging studies revealed disproportionally enlarged subarachnoid space hydrocephalus (DESH). The baseline blood pressure was 116/67 mmHg with a heart rate of 106 beats/min and SpO2 of 96% on room air. The patient underwent smooth induction followed by sonographically guided superficial cervical plexus block and transverse abdominis plane block. Intraoperative pain indices were monitored with Analgesia nociceptive index monitor (ANI, MdolorisTM) and surgical plethysmographic index (SPI, GE Healthcare, Helsinki, FinlandTM). These remained stable during the application of the block and the entire surgical duration. No significant hemodynamic response was observed during the tunneling of the skin by the surgeon. The patient underwent a smooth recovery and emergence. Conclusion: Our decision to incorporate peripheral nerve blockade in conjunction with general anesthesia resulted in opioid-sparing anesthesia and decreased post-operative analgesic requirement by the patient. This blockade was successful in suppressing intraoperative stress responses. Our patient recovered adequately and underwent an uncomplicated post-operative stay.

Keywords: desh, NPH, VP shunt, cervical plexus block, transversus abdominis plane block

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Authors: Tebikew Yeneabat, Tefera Belachew, Muluneh Haile

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Background: Exclusive breast-feeding (EBF) is the practice of feeding only breast milk (including expressed breast milk) during the first six months and no other liquids and solid foods except medications. The time to cessation of exclusive breast-feeding, however, is different in different countries depending on different factors. Studies showed the risk of diarrhea morbidity and mortality is higher among none exclusive breast-feeding infants, common during starting other foods. However, there is no study that evaluated the time to cessation of exclusive breast-feeding in the study area. The aim of this study was to show time to cessation of EBF and its predictors among mothers of index infants less than twelve months old. Methods: We conducted a community-based cross-sectional study from February 13 to March 3, 2012 using both quantitative and qualitative methods. This study included a total of 592 mothers of index infant using multi-stage sampling method. Data were collected by using interviewer administered structured questionnaire. Bivariate and multivariate Cox regression analyses were performed. Results: Cessation of exclusive breast-feeding occurred in 392 (69.63%) cases. Among these, 224 (57.1%) happened before six months, while 145 (37.0%) and 23 (5.9%) occurred at six months and after six months of age of the index infant respectively. The median time for infants to stay on exclusive breast-feeding was 6.36 months in rural and 5.13 months in urban, and this difference was statistically significant on a Log rank (Cox-mantel) test. Maternal and paternal occupation, place of residence, postnatal counseling on exclusive breast-feeding, mode of delivery, and birth order of the index infant were significant predictors of cessation of exclusive breast-feeding. Conclusion: Providing postnatal care counseling on EBF, routine follow-up and support of those mothers having infants stressing for working mothers can bring about implementation of national strategy on infant and young child feeding.

Keywords: exclusive breastfeeding, cessation, median duration, Ankesha Guagusa Woreda

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Authors: Haiyan Huang, Jan Blommaert, Ellen Van Praet

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The embrace of neoliberal economic system in China has engendered the entry of global commodity capitalism into domestic Chinese market and ushered in the post-feminism that is closely associated with consumerism from western culture. Chinese women are instilled and thus hold the belief of empowering themselves and expressing their individualism through consumption. To unravel the consumerist ideologies embedded in Li’s discursive practices, we rely on critical discourse analysis (CDA) as our research framework. The data analyses suggest that cosmopolitanism and class are two repeating themes when Li engages in persuading consumerist behaviors from the female audience. Through hints and cues such as “going on business trips”, “traveling abroad”, “international brands” and among others, Li provides the access to and possibility of imagining cosmopolitan and middle class identity for his audience. Such yearning for western culture and global citizen identity also implicates the aspiration for a well-off socioeconomic status, proving that post-feminism in China not only embodies western consumerism but also implicates the struggle of class movement. These defining elements of choice and freedom are well-situated in contemporary Chinese society where women are enjoying more educational and economic independence than before. However a closer examination reveals conflicts between hegemonic discourse of post-feminism and the status quo. First, propagating women’s power through consumption obscure the entrenched gender inequality in China. Philosophies such as employment discrimination, equal payment, education right, etc., the cornerstones of feminism did not exist in China, leading to historical gender issues unsolved. Second, the lengthy broadcastings (which normally last more than 2 hours) featured with big discounts on products beg the question who are the real audience of ecommerce livestreaming. Seemingly addressing to young well-off Chinese females, Li’s discursive practice can be targeting at young but not wealthy girls who aspire to mimic the lifestyle of middle class women. By selling the idea of empowering and constructing identity through consuming beauty products (e.g., lipsticks), capitalists are endeavoring to create the post-feminism illusion and cause anxieties among Chinese females. Through in-depth analyses of hegemonic discourse on ecommerce livestreaming of lipsticks, the paper contributes to a better understanding of post-feminism in contemporary China and meanwhile illustrates the problems Chinese women face in securing power and equality.

Keywords: Chinese women, critical discourse analysis, ecommerce livestreaming, post-feminism

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Authors: Annika Kjallman Alm, Ove Hellzen, Malin Rising-Holmstrom

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Worldwide, the number of people who are living with dementia is increasing because of an aging population, which leads to increased financial and social costs, including reduced quality of life for people with dementia and their care partners. Most people who have dementia reside in the community. Aging in place could be described as having the health and social supports and services you need to live safely and independently in your home or your society for as long as you wish and are able. People with dementia are not different than people without dementia where they want to remain at home, if possible, with a sense of familiarity and engagement in typical everyday activities. So how do persons with dementia or cognitive decline see their possibilities to be socially involved and experience support? The aim of this study was to explore persons with cognitive decline's sense of involvement and support living in the ordinary dwelling. The study was approved by the Ethical Review Authority in Sweden prior to the interviews. Interviews were conducted with 20 persons living at home, either alone or in a relationship. The persons had perceived cognitive decline; some were under investigation or already had a diagnose of early dementia. Thematic analysis was used to identify, analyze, and report patterns within the data. Researchers extracted three main themes through participants’ interviews: a) Importance of social involvement with family and friends. b) Hindrances for social involvement. c) Struggling mentally with a new life situation. Results found that going to activity centers, staying involved, and meeting friends and family enhanced the sense of involvement and support. There were also hindrances to a sense of involvement and support as they struggled with the diagnose and the changes in daily life, such as physical problems, mental problems, or economic issues. The mental struggle of accepting the cognitive decline and the changes in daily life it brought was also an issue for some of the participants. A multidimensional support should be provided by the community to enable persons with cognitive decline to stay involved in family and community in the comfort of their own homes.

Keywords: aging in place, cognitive decline, dementia, sense of involvement

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Authors: Sara Mosallanejad, Bogdan Z. Dlugogorski, Jeff Gore, Mohammednoor Altarawneh

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Ammonium nitrate (NH­₄NO₃, AN) is commonly used as the main component of AN emulsion and fuel oil (ANFO) explosives, that use extensively in civilian and mining operations for underground development and tunneling applications. The emulsion formulation and wettability of AN prills, which affect the physical stability and detonation of ANFO, highly depend on the surface tension, density, viscosity of the used liquid. Therefore, for engineering applications of this material, the determination of density and surface tension of concentrated aqueous solutions of AN is essential. The molecular dynamics (MD) simulation method have been used to investigate the density and the surface tension of high concentrated ammonium nitrate solutions; up to its solubility limit in water. Non-polarisable models for water and ions have carried out the simulations, and the electronic continuum correction model (ECC) uses a scaling of the charges of the ions to apply the polarisation implicitly into the non-polarisable model. The results of calculated density and the surface tension of the solutions have been compared to available experimental values. Our MD simulations show that the non-polarisable model with full-charge ions overestimates the experimental results while the reduce-charge model for the ions fits very well with the experimental data. Ions in the solutions show repulsion from the interface using the non-polarisable force fields. However, when charges of the ions in the original model are scaled in line with the scaling factor of the ECC model, the ions create a double ionic layer near the interface by the migration of anions toward the interface while cations stay in the bulk of the solutions. Similar ions orientations near the interface were observed when polarisable models were used in simulations. In conclusion, applying the ECC model to the non-polarisable force field yields the density and surface tension of the AN solutions with high accuracy in comparison to the experimental measurements.

Keywords: ammonium nitrate, electronic continuum correction, non-polarisable force field, surface tension

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Authors: Naeemeh Silvari

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The tourism industry is important for different nations in two ways. Apart from economic benefits, it provides a basis for getting acquainted with the culture of different regions of the world. Depending on the capacities and contexts of their geography, countries try to attract more people to their country in different ways. Health tourism has been an important branch of the tourism industry in recent years, and many countries around the world are trying to make progress in this field and attract many tourists from around the world. Iran, like many developing countries in the Middle East and East Asia, is trying to improve and develop tourist attractions in the field of health. Due to the cheapness of providing medical services to tourists, many people have traveled to Iran for medical and health care. However, there is a long way to go before recognizing and reaching the desired position in this field. Due to the direct relationship between tourism and culture, the negative attitude towards the context of Iran has caused foreign travelers not to choose this country as their tourist destination. In this article, we tried to study the change in their attitude towards Iran by using semi-structured interviews of foreign travelers who traveled to Iran for treatment and medical services. The text of the interviews was coded and analyzed by MAX QDA software. Many of the people in the sample were from Middle Eastern and Arabic-speaking countries. Influenced by the media, they felt rejected by the Iranians before the trip. During their stay in Iran and in connection with the health care staff, in the first stage, they pointed out that many of their anxieties about the kind of treatment of Iranians have been allayed. In addition to the satisfaction with the medical services provided, they considered the atmosphere of Iranians' interaction with foreign travelers to be relatively appropriate, and some stated that Iran would be the destination of their leisure trip in the future. At the end of the research, policymakers were suggested that in order to resolve cultural contradictions rooted in values, they should first be recognized and seek to use other opportunities to resolve contradictions and form interactions with other cultures.

Keywords: cultural conflict, health tourism, cultural prejudice, advertising and media

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