Abstract： Topology is in a certain sense secondary if interpreted as a repercussion of internal status, that is as a dynamic and static consequence, especially, secondary to the other two types of surficial sciences: surficial osal anatomy and surficial muscular anatomy. The way the osal anatomy forms the muscular anatomy, both previous anatomies, form the third anatomy, the outer surficial anatomy of the body. Topology dynamics is complex and multilayered, as it involves the at least two internal dynamics mentioned here, as well as their interaction. The paper deals with the systematic problems of surface anatomy, first of all, in relation to a certain number of external surficial phenomena, focusing boldly on folds, metacarpal, substernal and rectusal shallow systems.

Abstract： Community Child Health (CCH) is the branch of Paediatrics that specialises in childhood Neurodevelopmental and Emotional problems (NDEP), such as Attention Deficit Hyperactivity Disorder (ADHD), developmental delays and common emotional issues. A retrospective review of all patients seen in the local outpatient clinics between June 2016 and May 2017 within an NHS Fife region was carried out. No identifiable patient record was used and no research ethical approval was required. A total of 543 patients were seen in 908 clinic sessions, aged between two months and 18 years 6 months (average of 104 months) and 74％ males. The largest age group (47％) was school-aged (5-9 years) children while young people (16–19 years) constituted 6％ of the clinical caseload. The largest cases (46％) were seen in summer, but new referrals peaked during winter/spring (66％). The greatest proportion of patients (78％) lived in the most deprived 60％ (Quintiles 1 to 3) of the community. The commonest NDEPs were difficulties with behaviour (45％), sleep (30％), social communications (27％), coordination (24.5％), sensory processing (22％), LD (19％), ADHD (17％), and speech/language delay (17％). Over 25 other multi-agency professionals were involved, including the OT (33％), SALT (26％), Health Visitors (18％), CAMHS (17％), Educational (16％) and Clinical Psychologists (15％). This study highlights the significant public health importance of childhood Neurodevelopmental disorders requiring high levels of integrated multi-professional involvement. It has implications for CCH training curriculum. The high risk of future mental health problems in adulthood demands a corresponding long-term follow-up and surveillance of children with NDEPs.

Abstract： Background and objective: Family centered care is an innovative approach to design, implement and evaluate the health care implemented through a reciprocal participation of providers of the carers, patients, and families. Recognizing and paying attention to the families who have a patient in an ICU is an essential part of nurses’ responsibilities. The present study is aimed at clarifying the concept of family centered care and shedding more light into its specifications, outcomes, and results in nursing. Methodology: The study was carried out using Rodgers Evolutionary concept analysis approach. Published papers between 1997 and 2018 on family centered care in nursing ICU patients were searched in ScienceDirect, Pub Med, Proquest, Google Scholar, Cochrane, IranMedex, Magiran, and SID. The keywords used in the search were “family centered care, ICU patients, barriers, and executive approaches” and the Farsi equivalents. Findings: The key points of family centered care were respecting family members, dynamic and flexible care, giving honest information to family for decision making, cooperating at all care levels of the medical system, proper planning to cooperate with patients and families, and giving family members in optimal patient care. Conclusion: Taking into account the critical condition of patients in ICUs, family centered care is one of the ways to give the family members a role in making decision about the cares provided to the patient. This leads to a higher satisfaction in the family members. Given the unique structure of ICUs, the executive barriers of family cntered care should be taken into account by the policy makers in nursing profession.

Abstract： Water treatment and distribution systems are highly dynamic and versatile in terms of microbial populations. Rigorous control, maintenance and monitoring schemes should be followed to ensure delivery of water with high microbiological standards of safety from the feed sources to the final consumption points. Otherwise, consequences will be devastating to human health and possibly life itself. The current study aimed to investigate the microbiological quality in healthcare facility in urban districts region in African country using standard pharmacopeia microbiological techniques. A random samples of water from different points from feed chlorinated municipal water, water treatment plants, point-of-use and final purified water in a product with a total number of samples reaching 105 bottles of water. Isolation of microorganisms was performed using Nutrient Agar (NA), MacConkey Agar (MAC), Tryptic Soya Agar (TSA) and Muller Hinton Agar (MHA). Microbial identification of the isolates was performed biochemically. Microorganisms from seven samples were not recovered from recovery media. Two isolates from 27 specimens could not be identified using biochemical techniques and require identification using molecular methods. Eight of the final consumable products showed signs of microbial contamination with one of them could not be identified biochemically. One of the products was contaminated with two different bacteria: Escherichia coli and Staphylococcus vitulinus. Three more samples were contaminated with E. coli while S. aureus was found in one sample. Two samples were found contaminated with Pentoea spp. water stations were found to be contaminated with E. coli and S. lentus in tanks. While the reverse osmosis (RO) units were found to be contaminated with Pseudomonas luteola, Enterococcus columbae, Streptococcus uberis, E. coli and S. lentus. Water from municipal sources showed the presence of Pseudomonas luteola, Serratia ficaria, Pentoea spp, E. coli, S. aureus and S. vitulinus. The study indicated that water system control and monitoring require crucial improvements.