Search results for: status quo

Authors: G. Feletti, D. Tedesco, P. Trucco

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The present study aims to develop a dashboard of Key Performance Indicators (KPI) to enhance information and predictive capabilities in Emergency Medical Services (EMS) systems, supporting both operational and strategic decisions of different actors. The employed research methodology consists of a first phase of revision of the technical-scientific literature concerning the indicators currently in use for the performance measurement of EMS. It emerges that current studies focus on two distinct areas and independent objectives: the ambulance service, a fundamental component of pre-hospital health treatment, and the patient care in the Emergency Department (ED). Conversely, the perspective proposed by this study is to consider an integrated view of the ambulance service process and the ED process, both essential to ensure high quality of care and patient safety. Thus, the proposal covers the end-to-end healthcare service process and, as such, allows considering the interconnection between the two EMS processes, the pre-hospital and hospital ones, connected by the assignment of the patient to a specific ED. In this way, it is possible to optimize the entire patient management. Therefore, attention is paid even to EMS aspects that in current literature tend to be neglected or underestimated. In particular, the integration of the two processes enables to evaluate the advantage of an ED selection decision having visibility on EDs’ saturation status and therefore considering, besides the distance, the available resources and the expected waiting times. Starting from a critical review of the KPIs proposed in extant literature, the design of the dashboard was carried out: the high number of analyzed KPIs was reduced by eliminating firstly the ones not in line with the aim of the study and then the ones supporting a similar functionality. The KPIs finally selected were tested on a realistic dataset, which draw us to exclude additional indicators due to unavailability of data required for their computation. The final dashboard, that was discussed and validated by experts in the field, includes a variety of KPIs able to support operational and planning decisions, early warning, and citizens’ awareness on EDs accessibility in real time. The association of each KPI to the EMS phase it refers to enabled the design of a well-balanced dashboard, covering both efficiency and effectiveness performance objectives of the entire EMS process. Indeed, just the initial phases related to the interconnection between ambulance service and patient care are covered by traditional KPIs. Future developments could be directed to building a hierarchical dashboard, composed by a high-level minimal set of KPIs for measuring the basic performance of the EMS system, at an aggregate level, and lower levels of KPIs that bring additional and more detailed information on specific performance dimensions or EMS phases.

Keywords: Emergency Medical Services, Key Performance Indicators, Dashboard, Decision Support.

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Authors: Jung-Hong Hong, Jing-Cen Yang, Cai-Yu Ou

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The analysis of geographic inequality heavily relies on the use of location-enabled statistical data and quantitative measures to present the spatial patterns of the selected phenomena and analyze their differences. To protect the privacy of individual instance and link to administrative units, point-based datasets are spatially aggregated to area-based statistical datasets, where only the overall status for the selected levels of spatial units is used for decision making. The partition of the spatial units thus has dominant influence on the outcomes of the analyzed results, well known as the Modifiable Areal Unit Problem (MAUP). A new spatial reference framework, the Taiwan Geographical Statistical Classification (TGSC), was recently introduced in Taiwan based on the spatial partition principles of homogeneous consideration of the number of population and households. Comparing to the outcomes of the traditional township units, TGSC provides additional levels of spatial units with finer granularity for presenting spatial phenomena and enables domain experts to select appropriate dissemination level for publishing statistical data. This paper compares the results of respectively using TGSC and township unit on the mortality data and examines the spatial characteristics of their outcomes. For the mortality data between the period of January 1^st, 2008 and December 31^st, 2010 of the Taitung County, the all-cause age-standardized death rate (ASDR) ranges from 571 to 1757 per 100,000 persons, whereas the 2^nd dissemination area (TGSC) shows greater variation, ranged from 0 to 2222 per 100,000. The finer granularity of spatial units of TGSC clearly provides better outcomes for identifying and evaluating the geographic inequality and can be further analyzed with the statistical measures from other perspectives (e.g., population, area, environment.). The management and analysis of the statistical data referring to the TGSC in this research is strongly supported by the use of Geographic Information System (GIS) technology. An integrated workflow that consists of the tasks of the processing of death certificates, the geocoding of street address, the quality assurance of geocoded results, the automatic calculation of statistic measures, the standardized encoding of measures and the geo-visualization of statistical outcomes is developed. This paper also introduces a set of auxiliary measures from a geographic distribution perspective to further examine the hidden spatial characteristics of mortality data and justify the analyzed results. With the common statistical area framework like TGSC, the preliminary results demonstrate promising potential for developing a web-based statistical service that can effectively access domain statistical data and present the analyzed outcomes in meaningful ways to avoid wrong decision making.

Keywords: Mortality map, spatial patterns, statistical area, variation.

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Authors: Mustafa M. Donma, Orkide Donma

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Obesity is known to be associated with many clinically important diseases including metabolic syndrome (MetS). Vitamin B₁₂ plays essential roles in fat and protein metabolisms and its cooperation with vitamin B₉ is well-known. The aim of this study is to investigate the possible contributions as well as associations of these micronutrients upon obesity and MetS during childhood. A total of 128 children admitted to Namik Kemal University, Medical Faculty, Department of Pediatrics Outpatient Clinics were included into the scope of this study. The mean age±SEM of 92 morbid obese (MO) children and 36 with MetS were 118.3±3.8 months and 129.5±6.4 months, respectively (p > 0.05). The study was approved by Namık Kemal University, Medical Faculty Ethics Committee. Written informed consent forms were obtained from the parents. Demographic features and anthropometric measurements were recorded. WHO BMI-for age percentiles were used. The values above 99 percentile were defined as MO. Components of MetS [waist circumference (WC), fasting blood glucose (FBG), triacylglycerol (TRG), high density lipoprotein cholesterol (HDL-Chol), systolic pressure (SP), diastolic pressure (DP)] were determined. Routine laboratory tests were performed. Serum vitamin B₁₂ concentrations were measured using electrochemiluminescence immunoassay. Vitamin B₉ was analyzed by an immunoassay analyzer. Values for vitamin B₁₂ < 148 pmol/L, 148-221 pmol/L, > 221 pmol/L were accepted as low, borderline and normal, respectively. Vitamin B₉ levels ≤ 4 mcg/L defined deficiency state. Statistical evaluations were performed by SPSSx Version 16.0. p≤0.05 was accepted as statistical significance level. Statistically higher body mass index (BMI), WC, hip circumference (C) and neck C were calculated in MetS group compared to children with MO. No difference was noted for head C. All MetS components differed between the groups (SP, DP p < 0.001; WC, FBG, TRG p < 0.01; HDL-Chol p < 0.05). Significantly decreased vitamin B₉ and vitamin B₁₂ levels were detected (p < 0.05) in children with MetS. In both groups percentage of folate deficiency was 5.5%. No cases were below < 148 pmol/L. However, in MO group 14.3% and in MetS group 22.2% of the cases were of borderline status. In MO group B₁₂ levels were negatively correlated with BMI, WC, hip C and head C, but not with neck C. WC, hip C, head C and neck C were all negatively correlated with HDL-Chol. None of these correlations were observed in the group of children with MetS. Strong positive correlation between FBG and insulin as well as strong negative correlation between TRG and HDL-Chol detected in MO children were lost in MetS group. Deficiency state end-products of both B₉ and B₁₂ may interfere with the expected profiles of MetS components. In this study, the alterations in MetS components affected vitamin B₁₂ metabolism and also its associations with anthropometric body measurements. Further increases in vitamin B₁₂ and vitamin B₉ deficiency in MetS associated with the increased vitamin B₁₂ as well as vitamin B₉ deficiency metabolites may add to MetS parameters.

Keywords: Children, cobalamin, folate, metabolic syndrome, obesity.

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Authors: Valentina Piric, Maja Martinovic, Zoran Barac

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The application of marketing to the domain of politics has become relevant in recent times. With this article the authors wanted to explore the issue of the current political engagement among young people in Croatia. The question is what makes young people (age 18-30) politically active in young democracies such as that of the Republic of Croatia. Therefore, the objective of this study was to discover the real or hidden motivations behind the decision to actively participate in politics among young members of the two largest political parties in the country – the Croatian Democratic Union and the Social Democratic Party of Croatia. The study expected to find that the motivation for political engagement of young people is often connected with a possible achievement of individual goals and egoistic needs such as: self-acceptance, social success, financial success, prestige, reputation, status, recognition from the others etc. It was also expected that, due to the poor economic and social situation in the country, young people feel an increasing disconnection from politics. Additionally, the authors expected to find that there is a huge potential to engage young people in the political life of the country through a proper and more interactive use of marketing communication campaigns and social media platforms, with an emphasis on highly ethical motives of political activity and their benefits to society. All respondents included in the quantitative survey (sample size [N=100]) are active in one of the two largest political parties in Croatia. The sampling and distribution of the survey occurred in the field in September 2016. The results of the survey demonstrate that in Croatia, the way young people feel about politics and act accordingly, are in fact similar to what the theory describes. The research findings reveal that young people are politically active; however, the challenge is to find a way to motivate even more young people in Croatia to actively participate in the political and democratic processes in the country and to encourage them to see additional benefits out of this practice, not only related to their individual motives, but related more to the well-being of Croatia as a country and of every member of society. The research also discovered a huge potential for political marketing communication possibilities, especially related to interactive social media. It is possible that the social media channels have a stronger influence on the decision-making process among young people when compared to groups of reference. The level of interest in politics among young Croatians varies; some of them are almost indifferent, whilst others express a serious interest in different ways to actively contribute to the political life of the country, defining a participation in the political life of their country almost as their moral obligation. However, additional observations and further research need to be conducted to get a clearer and more precise picture about the interest in politics among young people in Croatia and their social potential.

Keywords: Croatia, marketing communication, motivation, politics, young people.

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Authors: Mustafa M. Donma, Orkide Donma

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Obesity is associated with cardiovascular disease risk factors and metabolic syndrome (MetS). In this study, associations between adipokines and adipokine as well as obesity indices were evaluated. Plasma adipokine levels may exhibit variations according to body adipose tissue mass. Besides, upon consideration of obesity as an inflammatory disease, adipokines may play some roles in this process. The ratios of proinflammatory adipokines to adiponectin may act as highly sensitive indicators of body adipokine status. The aim of the study is to present some adipokine indices, which are thought to be helpful for the evaluation of childhood obesity and also to determine the best discriminators in the diagnosis of MetS. 80 prepubertal children (aged between 6-9.5 years) included in the study were divided into three groups; 30 children with normal weight (NW), 25 morbid obese (MO) children and 25 MO children with MetS. Physical examinations were performed. Written informed consent forms were obtained from the parents. The study protocol was approved by Ethics Committee of Namik Kemal University Medical Faculty. Anthropometric measurements, such as weight, height, waist circumference (C), hip C, head C, neck C were recorded. Values for body mass index (BMI), diagnostic obesity notation model assessment Index-II (D2 index) as well as waist-to-hip, head-to-neck ratios were calculated. Adiponectin, resistin, leptin, chemerin, vaspin, progranulin assays were performed by ELISA. Adipokine-to-adiponectin ratios were obtained. SPSS Version 20 was used for the evaluation of data. p values ≤ 0.05 were accepted as statistically significant. Values of BMI and D2 index, waist-to-hip, head-to-neck ratios did not differ between MO and MetS groups (p ≥ 0.05). Except progranulin (p ≤ 0.01), similar patterns were observed for plasma levels of each adipokine. There was not any difference in vaspin as well as resistin levels between NW and MO groups. Significantly increased leptin-to-adiponectin, chemerin-to-adiponectin and vaspin-to-adiponectin values were noted in MO in comparison with those of NW. The most valuable adipokine index was progranulin-to-adiponectin (p ≤ 0.01). This index was strongly correlated with vaspin-to-adiponectin ratio in all groups (p ≤ 0.05). There was no correlation between vaspin-to-adiponectin and chemerin-to--adiponectin in NW group. However, a correlation existed in MO group (r = 0.486; p ≤ 0.05). Much stronger correlation (r = 0.609; p ≤ 0.01) was observed in MetS group between these two adipokine indices. No correlations were detected between vaspin and progranulin as well as vaspin and chemerin levels. Correlation analyses showed a unique profile confined to MetS children. Adiponectin was found to be correlated with waist-to-hip (r = -0.435; p ≤ 0.05) as well as head-to-neck (r = 0.541; p ≤ 0.05) ratios only in MetS children. In this study, it has been investigated if adipokine indices have priority over adipokine levels. In conclusion, vaspin-to-adiponectin, progranulin-to-adiponectin, chemerin-to-adiponectin along with waist-to-hip and head-to-neck ratios were the optimal combinations. Adiponectin, waist-to-hip, head-to-neck, vaspin-to-adiponectin, chemerin-to-adiponectin ratios had appropriate discriminatory capability for MetS children.

Keywords: Adipokine indices, metabolic syndrome, obesity indices, pediatric obesity.

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Authors: Gerald Amatre, Julius Bunny Lejju, Morgan Andama

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Despite several interventions, jigger flea infestations continue to be reported in the Busoga sub-region in Eastern Uganda. The purpose of this study was to identify factors that expose the indigenous people to jigger flea infestations and evaluate the effectiveness of any indigenous materials used in flea control by the affected communities. Flea compositions in residences were described, factors associated with flea infestation and indigenous materials used in flea control were evaluated. Field surveys were conducted in the affected communities after obtaining preliminary information on jigger infestation from the offices of the District Health Inspectors to identify the affected villages and households. Informed consent was then sought from the local authorities and household heads to conduct the study. Focus group discussions were conducted with key district informants, namely, the District Health Inspectors, District Entomologists and representatives from the District Health Office. A GPS coordinate was taken at central point at every household enrolled. Fleas were trapped inside residences using Kilonzo traps. A Kilonzo Trap comprised a shallow pan, about three centimetres deep, filled to the brim with water. The edges of the pan were smeared with Vaseline to prevent fleas from crawling out. Traps were placed in the evening and checked every morning the following day. The trapped fleas were collected in labelled vials filled with 70% aqueous ethanol and taken to the laboratory for identification. Socio-economic and environmental data were collected. The results indicate that the commonest flea trapped in the residences was the cat flea (Ctenocephalides felis) (50%), followed by Jigger flea (Tunga penetrans) (46%) and rat flea (Xenopsylla Cheopis) (4%), respectively. The average size of residences was seven squire metres with a mean of six occupants. The residences were generally untidy; with loose dusty floors and the brick walls were not plastered. The majority of the jigger affected households were headed by peasants (86.7%) and artisans (13.3%). The household heads mainly stopped at primary school level (80%) and few at secondary school level (20%). The jigger affected households were mainly headed by peasants of low socioeconomic status. The affected community members use soil-cow dung-ash mixture to smear floors of residences as the only measure to control fleas. This method was found to be ineffective in controlling the insects. The study recommends that home improvement campaigns be continued in the affected communities to improve sanitation and hygiene in residences as one of the interventions to combat flea infestations. Other cheap, available and effective means should be identified to curb jigger flea infestations.

Keywords: Cow dung-soil-ash mixture, infestations, Jigger flea, Tunga penetrans.

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Authors: Ana Cristina García-Luna Romero

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This document seeks to reflect on the urban project from its conceptual identity root. In the first instance, a proposal is made on how the city project is sustained from the conceptual root, from the logos: it opens a way to assimilate the imagination; what we imagine becomes a reality. In this way, firstly, the need to use language as a vehicle for transmitting the stories that sustain us as humanity can be deemed as an important social factor that enables us to social behavior. Secondly, the need to attend to the written language as a mechanism of power, as a means to consolidate a dominant ideology or a political position, is raised; as it served to carry out the modernization project, it is therefore addressed differences between the real and the literate city. Thus, the consolidated urban-architectural project is based on logos, the project, and planning. Considering the importance of materiality and its relation to subjective well-being contextualized from a socio-urban approach, we question ourselves into how we can look at something that is doubtful. From a philosophy perspective, the truth is considered to be nothing more than a matter of correspondence between the observer and the observed. To understand beyond the relative of the gaze, it is necessary to expose different perspectives since it depends on the understanding of what is observed and how it is critically analyzed. Therefore, the analysis of materiality, as a political field, takes a proposal based on this research in the principles in transgenesis: principle of communication, representativeness, security, health, malleability, availability of potentiality or development, conservation, sustainability, economy, harmony, stability, accessibility, justice, legibility, significance, consistency, joint responsibility, connectivity, beauty, among others. The (urban) human being acts because he wants to live in a certain way: in a community, in a fair way, with opportunity for development, with the possibility of managing the environment according to their needs, etc. In order to comply with this principle, it is necessary to design strategies from the principles in transgenesis, which must be named, defined, understood, and socialized by the urban being, the companies, and from themselves. In this way, the technical status of the city in the neoliberal present determines extraordinary conditions for reflecting on an almost emergency scenario created by the impact of cities that, far from being limited to resilient proposals, must aim at the reflection of the urban process that the present social model has generated. Therefore, can we rethink the paradigm of the perception of life quality in the current neoliberal model in the production of the character of public space related to the practices of being urban. What we are trying to do within this document is to build a framework to study under what logic the practices of the social system that make sense of the public space are developed, what the implications of the phenomena of the inscription of action and materialization (and its results over political action between the social and the technical system) are and finally, how we can improve the quality of life of individuals from the urban space.

Keywords: Cities, nature, society, urban quality of life.

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Authors: Mustafa M. Donma, Orkide Donma, Savas Guzel

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Iron is physiologically essential. However, it also participates in the catalysis of free radical formation reactions. Its deficiency is associated with amplified health risks. This trace element establishes some links with another physiological process related to cell death, apoptosis. Both iron deficiency and iron overload are closely associated with apoptosis. Soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) has the ability to trigger apoptosis and plays a dual role in the physiological versus pathological inflammatory responses of tissues. The aim of this study was to investigate the status of these parameters as well as the associations among them in children with obesity, a low-grade inflammatory state. The study was performed on groups of children with normal body mass index (N-BMI) and obesity. 43 children were included in each group. Based upon age- and sex-adjusted BMI percentile tables prepared by the World Health Organization, children whose values varied between 85 and 15 were included in N-BMI group. Children, whose BMI percentile values were between 99 and 95, comprised obese (OB) group. Institutional ethical committee approval and informed consent forms were taken prior to the study. Anthropometric measurements (weight, height, waist circumference, hip circumference, head circumference, neck circumference) and blood pressure values (systolic blood pressure and diastolic blood pressure) were recorded. Routine biochemical analyses, including serum iron, total iron binding capacity (TIBC), transferrin saturation percent (Tf Sat %) and ferritin, were performed. sTWEAK levels were determined by enzyme-linked immunosorbent assay. study data were evaluated using appropriate statistical tests performed by the statistical program SPSS. Serum iron levels were 91 ± 34 mcrg/dl and 75 ± 31 mcrg/dl in N-BMI and OB children, respectively. The corresponding values for TIBC, Tf Sat %, ferritin were 265 mcrg/dl vs. 299 mcrg/dl, 37.2 ± 19.1% vs. 26.7 ± 14.6%, and 41 ± 25 ng/ml vs 44 ± 26 ng/ml. In N-BMI and OB groups, sTWEAK concentrations were measured as 351 ng/L and 325 ng/L, respectively (p > 0.05). Correlation analysis revealed significant associations between sTWEAK levels and iron related parameters (p < 0.05) except ferritin. In conclusion, iron contributes to apoptosis. Children with iron deficiency have decreased apoptosis rate in comparison with that of healthy children. sTWEAK is an inducer of apoptosis. OB children had lower levels of both iron and sTWEAK. Low levels of sTWEAK are associated with several types of cancers and poor survival. Although iron deficiency state was not observed in this study, the correlations detected between decreased sTWEAK and decreased iron as well as Tf Sat % values were valuable findings, which point out decreased apoptosis. This may induce a proinflammatory state, potentially leading to malignancies in the future lives of OB children.

Keywords: Apoptosis, children, iron-related parameters, obesity, soluble tumor necrosis factor-like weak inducer of apoptosis.

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Authors: W. S. Mohamed, A. A. Hammam

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Sandy soils under arid and semi-arid conditions are characterized by poor physical and biochemical properties such as low water retention, rapid organic matter decomposition, low nutrients use efficiency, and limited crop productivity. Addition of organic amendments is crucial to develop soil properties and consequently enhance nutrients use efficiency and lessen organic carbon decomposition. Two years field experiments were developed to investigate the feasibility of using poultry manure and its derived biochar integrated with different levels of N fertilizer as a soil amendment for newly reclaimed sandy soils in Western Desert of El-Minia Governorate, Egypt. Results of this research revealed that poultry manure and its derived biochar addition induced pronounced effects on soil moisture content at saturation point, field capacity (FC) and consequently available water. Data showed that application of poultry manure (PM) or PM-derived biochar (PMB) in combination with inorganic N levels had caused significant changes on a range of the investigated sandy soil biochemical properties including pH, EC, mineral N, dissolved organic carbon (DOC), dissolved organic N (DON) and quotient DOC/DON. Overall, the impact of PMB on soil physical properties was detected to be superior than the impact of PM, regardless the inorganic N levels. In addition, the obtained results showed that PM and PM application had the capacity to stimulate vigorous growth, nutritional status, production levels of wheat and sorghum, and to increase soil organic matter content and N uptake and recovery compared to control. By contrast, comparing between PM and PMB at different levels of inorganic N, the obtained results showed higher relative increases in both grain and straw yields of wheat in plots treated with PM than in those treated with PMB. The interesting feature of this research is that the biochar derived from PM increased treated sandy soil organic carbon (SOC) 1.75 times more than soil treated with PM itself at the end of cropping seasons albeit double-applied amount of PM. This was attributed to the higher carbon stability of biochar treated sandy soils increasing soil persistence for carbon decomposition in comparison with PM labile carbon. It could be concluded that organic manures applied to sandy soils under arid and semi-arid conditions are subjected to high decomposition and mineralization rates through crop seasons. Biochar derived from organic wastes considers as a source of stable carbon and could be very hopeful choice for substituting easily decomposable organic manures under arid conditions. Therefore, sustainable agriculture and productivity in newly reclaimed sandy soils desire one high rate addition of biochar derived from organic manures instead of frequent addition of such organic amendments.

Keywords: Biochar, dissolved organic carbon, N-uptake, poultry, sandy soil.

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Authors: Benjamin Osei Tutu, Sharon Annison

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On 21^st November, 2016, an outbreak of foodborne illness occurred after a buffet lunch served during a stakeholders’ consultation meeting held in Accra. An investigation was conducted to characterise the affected people, determine the etiologic food, the source of contamination and the etiologic agent and to implement appropriate public health measures to prevent future occurrences. A retrospective cohort study was conducted via telephone interviews, using a structured questionnaire developed from the buffet menu. A case was defined as any person suffering from symptoms of foodborne illness e.g. diarrhoea and/or abdominal cramps after eating food served during the stakeholder consultation meeting in Accra on 21^st November, 2016. The exposure status of all the members of the cohort was assessed by taking the food history of each respondent during the telephone interview. The data obtained was analysed using Epi Info 7. An environmental risk assessment was conducted to ascertain the source of the food contamination. Risks of foodborne infection from the foods eaten were determined using attack rates and odds ratios. Data was obtained from 54 people who consumed food served during the stakeholders’ meeting. Out of this population, 44 people reported with symptoms of food poisoning representing 81.45% (overall attack rate). The peak incubation period was seven hours with a minimum and maximum incubation periods of four and 17 hours, respectively. The commonly reported symptoms were diarrhoea (97.73%, 43/44), vomiting (84.09%, 37/44) and abdominal cramps (75.00%, 33/44). From the incubation period, duration of illness and the symptoms, toxin-mediated food poisoning was suspected. The environmental risk assessment of the implicated catering facility indicated a lack of time/temperature control, inadequate knowledge on food safety among workers and sanitation issues. Limited number of food samples was received for microbiological analysis. Multivariate analysis indicated that illness was significantly associated with the consumption of the snacks served (OR 14.78, P < 0.001). No stool and blood or samples of etiologic food were available for organism isolation; however, the suspected etiologic agent was Staphylococcus aureus or Clostridium perfringens. The outbreak could probably be due to the consumption of unwholesome snack (tuna sandwich or chicken. The contamination and/or growth of the etiologic agent in the snack may be due to the breakdown in cleanliness, time/temperature control and good food handling practices. Training of food handlers in basic food hygiene and safety is recommended.

Keywords: Accra, buffet, C. perfringens, cohort study, food poisoning, gastroenteritis, office workers, Staphylococcus aureus.

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Authors: Hayder H. Kareem, Shunqi Pan

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Groundwater is a vital water resource in many areas in the world, particularly in the Middle-East region where the water resources become scarce and depleting. Sustainable management and planning of the groundwater resources become essential and urgent given the impact of the global climate change. In the recent years, numerical models have been widely used to predict the flow pattern and assess the water resources security, as well as the groundwater quality affected by the contaminants transported. In this study, MODFLOW is used to study the current status of groundwater resources and the risk of water resource security in the region centred at Al-Najaf City, which is located in the mid-west of Iraq and adjacent to the Euphrates River. In this study, a conceptual model is built using the geologic and hydrogeologic collected for the region, together with the Digital Elevation Model (DEM) data obtained from the "Global Land Cover Facility" (GLCF) and "United State Geological Survey" (USGS) for the study area. The computer model is also implemented with the distributions of 69 wells in the area with the steady pro-defined hydraulic head along its boundaries. The model is then applied with the recharge rate (from precipitation) of 7.55 mm/year, given from the analysis of the field data in the study area for the period of 1980-2014. The hydraulic conductivity from the measurements at the locations of wells is interpolated for model use. The model is calibrated with the measured hydraulic heads at the locations of 50 of 69 wells in the domain and results show a good agreement. The standard-error-of-estimate (SEE), root-mean-square errors (RMSE), Normalized RMSE and correlation coefficient are 0.297 m, 2.087 m, 6.899% and 0.971 respectively. Sensitivity analysis is also carried out, and it is found that the model is sensitive to recharge, particularly when the rate is greater than (15mm/year). Hydraulic conductivity is found to be another parameter which can affect the results significantly, therefore it requires high quality field data. The results show that there is a general flow pattern from the west to east of the study area, which agrees well with the observations and the gradient of the ground surface. It is found that with the current operational pumping rates of the wells in the area, a dry area is resulted in Al-Najaf City due to the large quantity of groundwater withdrawn. The computed water balance with the current operational pumping quantity shows that the Euphrates River supplies water into the groundwater of approximately 11759 m³/day, instead of gaining water of 11178 m³/day from the groundwater if no pumping from the wells. It is expected that the results obtained from the study can provide important information for the sustainable and effective planning and management of the regional groundwater resources for Al-Najaf City.

Keywords: Al-Najaf city, conceptual modelling, groundwater, unconfined aquifer, visual MODFLOW.

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Authors: Areti Tziboula, Anna-Maria Rentzeperi-Tsonou

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The present study examines the way Gioachino Rossini’s librettos are selected and formed demonstrating the evolutionary trajectory of the composer during his operatic career. Rossini, a dominant figure in the early 19th century Italian opera, is demanding in his choice of librettos and has a preference for subjects inspired by European literature, of his time or earlier. He begins his operatic career with farsae and operas buffae, but he mainly continues with operas seriae, to end it with a grand opera that conforms to the spirit of romanticism as manifested in Paris of his time. His farsae, operas buffae and comic operas in general are representative of the trends of the time: in some the irrational and the exaggeration prevail, in others the upheavals, others are semi-serious and emotional with a happy ending and others are comedies with more realistic characters, but usually the styles are mixed and complement each other. The stories that refer to his modern era unfold mocking human characters, beliefs attitudes and their expressions in every day habits, satirizing current affairs, presenting innovative elements in dramatic intervention and dealing with a variety of social and national issues. Count Ory, his final comic work, consists of a complex witty urban comic opera entwined with romantic sensitivity. The themes he chooses for his operas seriae are characterized by tragic passion, take place in the era of the Trojan War, the Roman Empire, the Middle Ages, and the Age of the Crusades and are set in Italy, England, Poland, Greece, Switzerland, Israel and Egypt. In his early works he sketches the characters remotely, objectively and with static, reflexive emotional expression and a happy ending. Then he continues with operas for the San Carlo Theater, which are characterized by experimentation and innovation to end up his Italian operatic career with the ostensibly backward but in fact tragic Semiramis followed in Paris by William Tell, his ultimate dramatic achievement. There are indirect references to burning issues of his era but the censorship of the time does not allow direct reference to topics that would upset the status quo. In addition, Rossini lives in a temporal period of peace after the Napoleonic Wars and by temperament he resists openly engaging in political strife. Furthermore, the need for survival necessitates the search for the more profitable contracts. In conclusion, Rossini, as a liberal personality, shapes his librettos without interruptions or setbacks, with ideas that come out after a lot of thought and a strong sense of purpose. He moves from the moral and aesthetic clarity of the classic tradition of his early works to a more elaborate and morally ambiguous romantic style in a moderate and hesitant way.

Keywords: Gioachino Rossini, libretto, nineteenth century music, opera.

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Authors: Mona Salah El-Din Hassanein

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Faced with a sudden, unexpected, and overwhelming event, the individual's normal cognitive processing may cease to function, trapping the psyche in "speechless terror", while images, feelings and sensations are experienced with emotional intensity. Unable to master such situation, the individual becomes a trauma victim who will be susceptible to traumatic recollections like intrusive thoughts, flashbacks, and repetitive re-living of the primal event in a way that blurs the distinction between past and present, and forecloses the future. Trauma is timeless, repetitious, and contagious; a trauma observer could fall prey to "secondary victimhood". Central to the process of healing the psychic wounds in the aftermath of trauma is verbalizing the traumatic experience (i.e., putting it into words) – an act which provides a chance for assimilation, testimony, and reevaluation. In light of this paradigm, this paper proposes a reading of Oscar Wilde's The Ballad of Reading Gaol, written shortly after his release from prison, as a post-traumatic text which traces the disruptive effects of the traumatic experience of Wilde's imprisonment for homosexual offences and the ensuing reversal of fortune he endured. Post-traumatic writing demonstrates the process of "working through" a trauma which may lead to the possibility of ethical agency in the form of a "survivor mission". This paper draws on fundamental concepts and key insights in literary trauma theory which is characterized by interdisciplinarity, combining the perspectives of different fields like critical theory, psychology, psychiatry, psychoanalysis, history, and social studies. Of particular relevance to this paper are the concepts of "vicarious traumatization" and "survivor mission", as The Ballad of Reading Gaol was written in response to Wilde's own prison trauma and the indirect traumatization he experienced as a result of witnessing the execution of a fellow prisoner whose story forms the narrative base of the poem. The Ballad displays Wilde's sense of mission which leads him to recognize the social as well as ethical implications of personal tragedy. Through a close textual analysis of The Ballad of Reading Gaol within the framework of literary trauma theory, the paper aims to: (a) demonstrate how the poem's thematic concerns, structure and rhetorical figures reflect the structure of trauma; (b) highlight Wilde's attempts to come to terms with the effects of the cataclysmic experience which transformed him into a social outcast; and (c) show how Wilde manages to transcend the victim status and assumes the role of ethical agent to voice a critique of the Victorian penal system and the standards of morality underlying the cruelties practiced against wrong doers and to solicit social action.

Keywords: Ballad of Reading Gaol, post-traumatic writing, trauma theory, Wilde.

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Authors: Chalise Kiran

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The prime idea of inclusive education is to mainstream every child in education. However, it will be challenging for implementation when there are policy and practice gaps. It will be even more challenging when children have disabilities. Generally, the focus will be on the policy gap, but the problem may not always be with policy. The proper practice could be a challenge in the countries like Nepal. In determining practice, the teachers’ perceptions toward inclusive will play a vital role. Nepal has categorized disability in 7 types (physical, visual, hearing, vision/hearing, speech, mental, and multiple). Out of these, hearing impairment is the study realm. In the context of a limited number of researches on children with disabilities and rare researches on CWHI and their education in Nepal, this study is a pioneering effort in knowing basically the problems and challenges of CWHI focused on inclusive education in the schools including gaps and barriers in its proper implementation. Philosophically, the paradigm of the study is post-positivism. In the post-positivist worldview, the quantitative approach with the description of the situation and inferential relationship are revealed out in the study. This is related to the natural model of objective reality. The data were collected from an individual survey with the teachers and head teachers of 35 schools in Nepal. The survey questionnaire was prepared and filled by the respondents from the schools where the CWHI study in 7 provincial 20 districts of Nepal. Through these considerations, the perceptions of CWHI focused inclusive education were explored in the study. The data were analyzed using both descriptive and inferential tools on which the Likert scale-based analysis was done for descriptive analysis, and chi-square mathematical tool was used to know the significant relationship between dependent variables and independent variables. The descriptive analysis showed that the majority of teachers have positive perceptions toward implementing CWHI focused inclusive education, and the majority of them have positive perceptions toward CWHI focused inclusive education, though there are some problems and challenges. The study has found out the major challenges and problems categorically. Some of them are: a large number of students in a single class; availability of generic textbooks for CWHI and no availability of textbooks to all students; less opportunity for teachers to acquire knowledge on CWHI; not adequate teachers in the schools; no flexibility in the curriculum; less information system in schools; no availability of educational consular; disaster-prone students; no child abuse control strategy; no disabled-friendly schools; no free health check-up facility; no participation of the students in school activities and in child clubs and so on. By and large, it is found that teachers’ age, gender, years of experience, position, employment status, and disability with him or her show no statistically significant relation to successfully implement CWHI focused inclusive education and perceptions to CWHI focused inclusive education in schools. However, in some of the cases, the set null hypothesis was rejected, and some are completely retained. The study has suggested policy implications, implications for educational authority, and implications for teachers and parents categorically.

Keywords: Children with hearing impairment, disability, inclusive education, perception.

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Authors: R. G. Ariyawansa, M. A. N. R. M. Perera

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“House” is a powerful symbol of socio-economic background of individuals and families. In fact, housing provides all types of needs/wants from basic needs to self-actualization needs. This phenomenon can be realized only having analyzed hidden motives of buyers and sellers of the housing market. Hence, the aim of this study is to examine the socio-economic insight of the secondary housing market in Colombo suburbs. This broader aim was achieved via analyzing the general pattern of the secondary housing market, identifying socio-economic motives of sellers of the secondary housing market, and reviewing sellers’ experience of buyer behavior. A purposive sample of 50 sellers from popular residential areas in Colombo such as Maharagama, Kottawa, Piliyandala, Punnipitiya, and Nugegoda was used to collect primary data instead of relevant secondary data from published and unpublished reports. The sample was limited to selling price ranging from Rs15 million to Rs25 million, which apparently falls into middle and upper-middle income houses in the context. Participatory observation and semi-structured interviews were adopted as key data collection tools. Data were descriptively analyzed. This study found that the market is mainly handled by informal agents who are unqualified and unorganized. People such as taxi/tree-wheel drivers, boutique venders, security personals etc. are engaged in housing brokerage as a part time career. Few fulltime and formally organized agents were found but they were also not professionally qualified. As far as housing quality is concerned, it was observed that 90% of houses was poorly maintained and illegally modified. They are situated in poorly maintained neighborhoods as well. Among the observed houses, 2% was moderately maintained and 8% was well maintained and modified. Major socio-economic motives of sellers were “migrating foreign countries for education and employment” (80% and 10% respectively), “family problems” (4%), and “social status” (3%). Other motives were “health” and “environmental/neighborhood problems” (3%). This study further noted that the secondary middle income housing market in the area directly related with the migrants who motivated for education in foreign countries, mainly Australia, UK and USA. As per the literature, families motivated for education tend to migrate Colombo suburbs from remote areas of the country. They are seeking temporary accommodation in lower middle income housing. However, the secondary middle income housing market relates with the migration from Colombo to major global cities. Therefore, final transaction price of this market may depend on migration related dates such as university deadlines, visa and other agreements. Hence, it creates a buyers’ market lowering the selling price. Also it was revealed that the buyers tend to trust more on this market as far as the quality of construction of houses is concerned than brand new houses which are built for selling purpose.

Keywords: Informal housing market, hidden motives of buyers and sellers, secondary housing market, socio-economic insight.

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Authors: Frances Turner

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Gloves are significant physical objects, being one of the oldest forms of dress. Glove culture is part of every facet of life; its extraordinary history encompasses practicality, and symbolism reflecting a wide range of social practices. The survival of not only the gloves but associated articles enables the possibility to analyse real lives, however so far this area has been largely neglected. Limited information is available to students, researchers, or those involved with the design and making of gloves. There are several museums and independent collectors in England that hold collections of gloves (some from as early as 16th century), machinery, tools, designs and patterns, marketing materials and significant archives which demonstrate the rich heritage of English glove design and manufacturing, being of national significance and worthy of international interest. Through a research glove network which now exists thanks to research grant funding, there is potential for the holders of glove collections to make connections and explore links between these resources to promote a stronger understanding of the significance, breadth and heritage of the English glove industry. The network takes an interdisciplinary approach to bring together interested parties from academia, museums and manufacturing, with expert knowledge of the production, collections, conservation and display of English leather gloves. Academics from diverse arts and humanities disciplines benefit from the opportunities to share research and discuss ideas with network members from non-academic contexts including museums and heritage organisations, industry, and contemporary designers. The fragmented collections when considered in entirety provide an overview of English glove making since earliest times and those who wore them. This paper makes connections and explores links between these resources to promote a stronger understanding of the significance, breadth and heritage of the English Glove industry. The following areas are explored: current content and status of the individual museum collections, potential links, sharing of information histories, social and cultural and relationship to history of fashion design, manufacturing and materials, approaches to maintenance and conservation, access to the collections and strategies for future understanding of their national significance. The facilitation of knowledge exchange and exploration of the collections through the network informs organisations’ future strategies for the maintenance, access and conservation of their collections. By involving industry in the network, it is possible to ensure a contemporary perspective on glove-making in addition to the input from heritage partners. The slow fashion movement and awareness of artisan craft and how these can be preserved and adopted for glove and accessory design is addressed. Artisan leather glove making was a skilled and significant industry in England that has now declined to the point where there is little production remaining utilising the specialist skills that have hardly changed since earliest times. This heritage will be identified and preserved for future generations of the rich cultural history of gloves may be lost.

Keywords: Artisan glove making skills, English leather gloves, glove culture, glove network.

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Authors: N. K. Ambujam, V. Sudha

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Reservoirs are being contaminated all around the world with point source and Non-Point Source (NPS) pollution. The most common NPS pollutants are sediments and nutrients. Krishnagiri Reservoir (KR) has been chosen for the present case study, which is located in the tropical semi-arid climatic zone of Tamil Nadu, South India. It is the main source of surface water in Krishnagiri district to meet the freshwater demands. The reservoir has lost about 40% of its water holding capacity due to sedimentation over the period of 50 years. Hence, from the research and management perspective, there is a need for a sound knowledge on the spatial and seasonal variations of KR water quality. The present study encompasses the specific objectives as (i) to investigate the longitudinal heterogeneity and seasonal variations of physicochemical parameters, nutrients and biological characteristics of KR water and (ii) to examine the extent of degradation of water quality in KR. 15 sampling points were identified by uniform stratified method and a systematic monthly sampling strategy was selected due to high dynamic nature in its hydrological characteristics. The physicochemical parameters, major ions, nutrients and Chlorophyll a (Chl a) were analysed. Trophic status of KR was classified by using Carlson's Trophic State Index (TSI). All statistical analyses were performed by using Statistical Package for Social Sciences programme, version-16.0. Spatial maps were prepared for Chl a using Arc GIS. Observations in KR pointed out that electrical conductivity and major ions are highly variable factors as it receives inflow from the catchment with different land use activities. The study of major ions in KR exhibited different trends in their values and it could be concluded that as the monsoon progresses the major ions in the water decreases or water quality stabilizes. The inflow point of KR showed comparatively higher concentration of nutrients including nitrate, soluble reactive phosphorus (SRP), total phosphors (TP), total suspended phosphorus (TSP) and total dissolved phosphorus (TDP) during monsoon seasons. This evidently showed the input of significant amount of nutrients from the catchment side through agricultural runoff. High concentration of TDP and TSP at the lacustrine zone of the reservoir during summer season evidently revealed that there was a significant release of phosphorus from the bottom sediments. Carlson’s TSI of KR ranged between 81 and 92 during northeast monsoon and summer seasons. High and permanent Cyanobacterial bloom in KR could be mainly due to the internal loading of phosphorus from the bottom sediments. According to Carlson’s TSI classification Krishnagiri reservoir was ranked in the hyper-eutrophic category. This study provides necessary basic data on the spatio-temporal variations of water quality in KR and also proves the impact of point and NPS pollution from the catchment area. High TSI warrants a greater threat for the recovery of internal P loading and hyper-eutrophic condition of KR. Several expensive internal measures for the reduction of internal loading of P were introduced by many scientists. However, the outcome of the present research suggests for the innovative algae harvesting technique for the removal of sediment nutrients.

Keywords: Hyper-eutrophication, Krishnagiri reservoir, nutrients, NPS pollution.

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Authors: Z. Zaman Asam, M. Ajmal, R. Saeed, H. Miraj, M. Muhammad Ahtisham, B. Hameed, A. -Sattar Nizami

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In Pakistan, environmental degradation and consequent human health deterioration has rapidly accelerated in the past decade due to solid waste mismanagement. As the situation worsens with time, establishment of proper waste management practices is urgently needed especially in semi urban and rural areas of Pakistan. This study uses a concept of Waste Bank, which involves a transfer station for collection of sorted waste fractions and its delivery to the targeted market such as recycling industries, biogas plants, composting facilities etc. The management efficiency and effectiveness of Waste Bank depend strongly on the proficient sorting and collection of solid waste fractions at household level. However, the social attitude towards such a solution in semi urban/rural areas of Pakistan demands certain prerequisites to make it workable. Considering these factors the objectives of this study are to: [A] Obtain reliable data about quantity and characteristics of generated waste to define feasibility of business and design factors, such as required storage area, retention time, transportation frequency of the system etc. [B] Analyze the effects of various social factors on waste generation to foresee future projections. [C] Quantify the improvement in waste sorting efficiency after awareness campaign. We selected Gujrat city of Central Punjab province of Pakistan as it is semi urban adjoined by rural areas. A total of 60 houses (20 from each of the three selected colonies), belonging to different social status were selected. Awareness sessions about waste segregation were given through brochures and individual lectures in each selected household. Sampling of waste, that households had attempted to sort, was then carried out in the three colored bags that were provided as part of the awareness campaign. Finally, refined waste sorting, weighing of various fractions and measurement of dry mass was performed in environmental laboratory using standard methods. It was calculated that sorting efficiency of waste improved from 0 to 52% as a result of the awareness campaign. The generation of waste (dry mass basis) on average from one household was 460 kg/year whereas per capita generation was 68 kg/year. Extrapolating these values for Gujrat Tehsil, the total waste generation per year is calculated to be 101921 tons dry mass (DM). Characteristics found in waste were (i) organic decomposable (29.2%, 29710 tons/year DM), (ii) recyclables (37.0%, 37726 tons/year DM) that included plastic, paper, metal and glass, and (iii) trash (33.8%, 34485 tons/year DM) that mainly comprised of polythene bags, medicine packaging, pampers and wrappers. Waste generation was more in colonies with comparatively higher income and better living standards. In future, data collection for all four seasons and improvements due to expansion of awareness campaign to educational institutes will be quantified. This waste management system can potentially fulfill vital sustainable development goals (e.g. clean water and sanitation), reduce the need to harvest fresh resources from the ecosystem, create business and job opportunities and consequently solve one of the most pressing environmental issues of the country.

Keywords: Integrated solid waste management, waste segregation, waste bank, community development.

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Authors: P. C. Kutschera, Elena C. Tesoro, Mary Grace Talamera-Sandico, Jose Maria G. Pelayo III

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Second generation military Filipino Amerasians comprise a formidable contemporary segment of the estimated 250,000-plus biracial Amerasians in the Philippines today. Overall, they are a stigmatized and socioeconomically marginalized diaspora; historically, they were abandoned or estranged by U.S. military personnel fathers assigned during the century-long Colonial, Post- World War II and Cold War Era of permanent military basing (1898- 1992). Indeed, U.S. military personnel are assigned in smaller numbers in the Philippines today. This inquiry is an outgrowth of two recent small sample studies. The first surfaced the impact of the U.S. military prostitution system on formation of the ‘Derivative Amerasian Family Construct’ on first generation Amerasians; a second, qualitative case study suggested the continued effect of the prostitution systems' destructive impetuous on second generation Amerasians. The intent of this current qualitative, multiple-case study was to actively seek out second generation sex industry toilers. The purpose was to focus further on this human phenomenon in the postbasing and post-military prostitution system eras. As background, the former military prostitution apparatus has transformed into a modern dynamic of rampant sex tourism and prostitution nationwide. This is characterized by hotel and resorts offering unrestricted carnal access, urban and provincial brothels (casas), discos, bars and pickup clubs, massage parlors, local barrio karaoke bars and street prostitution. A small case study sample (N = 4) of female and male second generation Amerasians were selected. Sample formation employed a non-probability ‘snowball’ technique drawing respondents from the notorious Angeles, Metro Manila, Olongapo City ‘AMO Amerasian Triangle’ where most former U.S. military installations were sited and modern sex tourism thrives. A six-month study and analysis of in-depth interviews of female and male sex laborers, their families and peers revealed a litany of disturbing, and troublesome experiences. Results showed profiles of debilitating human poverty, history of family disorganization, stigmatization, social marginalization and the ghost of the military prostitution system and its harmful legacy on Amerasian family units. Emerging were testimonials of wayward young people ensnared in a maelstrom of deep economic deprivation, familial dysfunction, psychological desperation and societal indifference. The paper recommends that more study is needed and implications of unstudied psychosocial and socioeconomic experiences of distressed younger generations of military Amerasians require specific research. Heretofore apathetic or disengaged U.S. institutions need to confront the issue and formulate activist and solution-oriented social welfare, human services and immigration easement policies and alternatives. These institutions specifically include academic and social science research agencies, corporate foundations, the U.S. Congress, and Departments of State, Defense and Health and Human Services, and Homeland Security (i.e. Citizen and Immigration Services) It is them who continue to endorse a laissez-faire policy of non-involvement over the entire Filipino Amerasian question. Such apathy, the paper concludes, relegates this consequential but neglected blood progeny to the status of humiliating destitution and exploitation. Amerasians; thus, remain entrapped in their former colonial, and neo-colonial habitat. Ironically, they are unwitting victims of a U.S. American homeland that fancies itself geo-politically as a strong and strategic military treaty ally of the Philippines in the Western Pacific.

Keywords: Asian Americans, Filipino Amerasians, diaspora, military prostitution, stigmatization.

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