Assessment of Drinking Water Quality of Different Areas in Tehsil Isa Khel, Mianwali, Punjab, Pakistan

Water samples were collected from 43 sites of Tehsil Isa Khel areas in order to determine the physicochemical parameters such as pH, electrical conductivity, turbidity, total hardness, calcium hardness, magnesium hardness, M. alkalinity, chloride ion (Cl- ), and fluoride ion (F-) concentration. The obtained results show that in Tehsil Isa Khel, only in Kala Bagh city, Kala Bagh water scheme (w/s), Tola Bangi Khel w/s, Kot Chandna, Awan Wala, Gidran Wala, and Cheena Pora water is drinkable. Overall, electrical conductivity, hardness, total alkalinity, chloride, fluoride levels in the water of Tehsil Isa Khel are very high and not fit for drinking, washing, and industrial purpose. The ultimate result of this study is helpful to address the leading cause of public health problems related to the deteriorated quality of drinking water, and an integrated approach is therefore required to provide safe drinking water to people in Tehsil Isa Khel.

Environmental Concern and Ethical Obligation Influencing the Purchase Intention of Consumers Towards Vegan Fashion Products -A Case in Hanoi, Vietnam

The fundamental purpose of this study is to identify and evaluate factors influencing Hanoi consumers' intention to purchase vegan fashion products based on the framework of the Theory of Planned Behaviour (TPB). The ultimate result indicates that there is an outstanding factor significantly impacting the intention of Hanoi residents towards vegan fashion products: Ethical obligation (β=0.236). In addition, Environmental concern indirectly has an influence on the intention via attitudes. This study has important and practical consequences for governmental agencies and public organizations in terms of encouraging vegan fashion consumption. Based on the study’s findings, some feasible solutions are proposed to help authorities, businesses in Hanoi in particular, and Vietnam in general as well as motivating their customer intention.

Snakes and Ladders Board Game Table Design to Develop Cognitive, Social and Tactual Perception Skills in Blind Children

This study aims to overcome what is experienced by blind children and to invite blind children to take part in playing and not forgetting to put forward special design aesthetics for blind children. The results found result from primary data collection from observations of the daily activities of the subject and interviews with the subject, teacher, and subject's parents and secondary data got from literacy results from related research sources. The research subjects were taken from students of SDLB-A YPAB SURABAYA. The research method used is design thinking by approaching the subject. In the ultimate result, an innovative traditional snake and ladder game was found which was changed in such a way as to be accessible so that it was more friendly for blind children to use.

Impacting Neonatal Patient Care: Reducing Needle Sticks, with an Extended Dwell Catheter

Highlights Abstract Background: The use and efficacy of extended dwell peripheral intravenous catheters (EPIVs) has been extensively described at scientific conferences and in recent literature. The ramifications of repeated needle sticks include damage to vessels and ultimately the need for more invasive and costly access devices, which clearly support the need for reliable forms of vascular access. Methods: This quality improvement project spanned 4 years, 2017 through 2020, and included 128 patients who required a peripherally inserted catheter as their primary or secondary access site for a prescribed therapy. The EPIV utilized was a 4-cm, 22-gauge catheter made of thermosensitive polyurethane inserted using the Seldinger technique. Results: Over the course of 4 years, 128 patients received an EPIV for 2 or more days, totaling 849 days of therapy. Total insertion attempts were 174 or an average of 1.4 per patient. An estimated number of short PIVs needed for 849 days would have been 404 with 1011 attempts. Resultant savings with EPIV are estimated to be $30,686. Conclusions: Reducing the number of patient peripheral intravenous attempts while extending the dwell time results in less patient trauma, reliable longer-term access, reduced infection risk, reduced supply usage, and savings in terms of nursing time. The ultimate result for preterm newborns is more efficient delivery of care with less cost.

RESOURCE MOBILIZATION ANALYSIS OF LAWYERS' MOVEMENT IN PAKISTAN (2007-2009)

Purpose of the study: The purpose of the study is to define and analyse the lawyers' movement in Pakistan remains an active social movement from 2007 to 2009. Methodology: Qualitative research approach is the utmost appropriate approach to explore the resources mobilization process, in the lawyers’ movement in Pakistan. To achieve deeper insights into the actions, perceptions, and experiences of the respondents in the lawyers' movement of Pakistan, almost 20 open-ended interviews were taken in-depth and mostly face-to-face interviews. Give one more line of info about methodology. Main Findings: The lawyers' movement emerged in March 2007 in reaction to the unconstitutional dismissal of Chief Justice (CJ) of Supreme Court Pakistan by former General Pervez Musharraf. The lawyers' movement was the ultimate result of judicial-executive contention in Pakistan. Applications of the Study: This paper will offer analyses of the lawyers' movement in the context of a social movement from a non-western country like Pakistan. This paper seeks to examine the lawyers’ movement (2007–2009) to explore the resource mobilization in the lawyers' movement in Pakistan. Novelty/Originality of this study: The resource mobilization theory (RMT) has been utilized as the theoretical framework with the acumen of qualitative approach for this investigation in the non-western setting.

6. From thought to action

This chapter addresses muscles. The ultimate result of sensation and thought is usually some kind of action, be it moving the whole body; manipulating an object with the hand; or moving diaphragm, mouth, tongue, and voice-box to speak. All of these depend on muscles which, in their various forms, provide a nearly universal means for the nervous system to control the body and the world. Muscle cells are highly adapted for turning chemical energy into mechanical force. The chapter then looks at skeletal muscle and the musculoskeletal system. Some muscles are arranged circumferentially around a cavity. Two examples of this are the heart and the gut.

A Comprehensive Assessment of Hip Damage in Ankylosing Spondylitis, Especially Early Features

Ankylosing spondylitis (AS) is most common in adolescents and the ultimate result is disability, which places a huge burden on patients and society. Therefore, the key to improve the prognosis of AS is the early diagnosis of hip injury. To examine if AS patients whose hip pain is either absent or minimal might already have observable MRI and X-ray hip changes. Clinical and imaging hip data were systematically analyzed in 200 healthy controls (HC) and 300 AS with varying degrees of hip pain. Forty-four patients with early hip osteoarthritis (OA) served as positive imaging controls. In MRI images, BME lesions in the STIR sequence were much more frequent in AS (62%) compared to HC (2%) (p < 0.0001). Most importantly, 42% of AS with no or minimal hip pain had one or more MRI lesions. This was much more frequent compared to the 2% in HC (p < 0.05). These lesions in AS were observed singly or in combination in the trochanters (8%), femoral heads (12%), and acetabula (13%). Parallel finding that X-ray changes were present in patients with minimal or no hip pain was also observed with X-ray. Based on the normal hip width of HC, joint space narrowing was observed in 94.3% of the entire AS cohort, and importantly 56.7% of AS patients with no or mild hip pain. In these latter patients, functional activities of the hips such as walking were normal. At least 40% of AS patients with minimal or no hip pain might already show MRI and X-ray changes.

The Effect of Repeated Direct Observation of Procedural Skills (R-DOPS) Assessment Method on the Clinical Skills of Anesthesiology Residents

Background: The ultimate result of patient care is one of the most important outcomes in medical education. Several methods, including the direct observation of procedural skills (DOPS), have been proposed to assess professional competencies in clinical practice. Objectives: This study aimed to assess the effects of the Repeated DOPS (R-DOPS) method on the performance of procedural skills in anesthesiology residents. Methods: The procedural skill performance of anesthesiology residents was assessed using a standard DOPS protocol from May to October 2019. Their scores were then objectively recorded, and the satisfaction rates regarding the 2 DOPS exams were assessed. Results: We found a considerable improvement in anesthesiology residents’ procedural skill performance, especially in the anesthesiology residency curriculum’s basic items. Besides, anesthesiology residents’ satisfaction was significantly improved after the 2nd DOPS. Conclusions: R-DOPS leads to improved training outcomes, including assessing the procedural skills, time to feedback to trainees, and trainee satisfaction.

Measuring Lean Culture: Designing a Research Instrument

Transformation from conventional manufacturing system to lean manufacturing system has enabled many manufacturing companies to reduce waste and ultimately achieve operational excellence. Unfortunately, there were also many reported cases where manufacturers failed to sustain the transformation until they achieve the ultimate result. Converting organization’s culture into the lean culture is often claimed as one of the mechanisms to sustain lean transformation in manufacturing organizations. Thus, measuring to what level lean manufacturers have converted their organization’s culture relative to lean culture characteristics is critical. Selfadministered questionnaire is a practical research instrument to measure the level of lean culture in multiple manufacturing organizations that are located in far-reaching geographical as it saves time, money and effort. In this paper, 36 questionnaire items for measuring lean culture has been designed. These items can be used as parameters for predicting sustainability of lean transformation using statistical analysis such as linear regression or structural equation modelling.

The Decartes’ paradox and the modern philosophy as the foundation farse

In this article the author identifies a paradox at the heart of Descartes? foundationalist project. The components of the paradox are as follows: on the one hand, ontological certainty of cogito, on the other hand, its epistemic uncertainty: it is impossible for the solus ipse to establish the elementary truth: at present it is impossible to determine whether it is now night or daylight. For Descartes the solution consists of introducing God and in believing in His existence. But this is no solution whatsoever, for a subject would require direct contact with God in order to receive clear and distinct ideas, which are at the same time marks of their truth. The author concludes the following: firstly, Descartes managed to establish a foundation for nothing; secondly, the Cartesian project that includes the necessity of contact with God as a way to attain the Truth, becomes completed only in Hegel?s philosophy of Absolut Knowledge (in Wiss. der Logik), along with his justification provided in the Phenoimenologie des Gesites. The post-Hegelian philosophy, however, has engendered its own paradox by abandoning Hegel?s own solution despite it being fully Cartesian in its character. This was the consequence of abandoning God and declaring Hegel?s philosophy as a deplorable conservative revival of theology; something that was beyond understanding by modern philosophers. The abandonment of God had as its consequence the return to the Cartesian paradox, which reopened the question of truth - connected to the Cogito, and the question of sense (Sinn) - connected to the sum of human subject. The neglect of God leads to the departure from ratio-centrism in two ways: the epistemic perspectivism and relativism, on the one hand, and Nihilism, voluntarism with decisionism, along with existentialism, on the other. Consequently, with the death of God, and the fall of Hegel?s system, the modern metaphysics of subjectivity reveals itself as founded merely on the Will to power - as a will for God, until Hegel, and a will against God, subsequently. Thus, Heidegger was right when he said that Nietzsche?s Will to Power was the end of the Western metaphysics. The author complements this finding by adding that this kind of metaphysic had already been concealed within the Descartes Meditations from the start, in the forms of the will for the Reason and the will for God. Finally, the author concludes that the modern philosophy completes its own Odyssey of looking for a foundation by abandoning the Hegelian solution, blind to the fact that Hegel?s solution was the only consequent Cartesian one. The ultimate result was the fall of ratio-centrism into nihilism, voluntarism, and existentialism, as promoted under a thin vail of Picodellamirandolian humanism.