Search results for: musculoskeletal involvement

Authors: S. M. Khairul Halim, Mojtaba Ghodsi, Morteza Mohammadzaheri

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Gait analysis is essential for diagnosing musculoskeletal and neurological conditions. However, current methods are often complex and expensive. This paper introduces a methodology for analysing gait parameters using a smart insole with a built-in accelerometer. The system measures stance time, swing time, step count, and cadence and wirelessly transmits data to a user-friendly IoT dashboard for centralized processing. This setup enables remote monitoring and advanced data analytics, making it a versatile tool for medical diagnostics and everyday usage. Integration with IoT enhances the portability and connectivity of the device, allowing for secure, encrypted data access over the Internet. This feature supports telemedicine and enables personalized treatment plans tailored to individual needs. Overall, the approach provides a cost-effective (almost 25 GBP), accurate, and user-friendly solution for gait analysis, facilitating remote tracking and customized therapy.

Keywords: gait analysis, IoT, smart insole, accelerometer sensor

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Authors: Laura Gleason, Sahithi Talasila, Lauren Banner, Ladan Afifi, Neda Nikbakht

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Primary cutaneous anaplastic large cell lymphoma (pcALCL) accounts for 9% of all cutaneous T-cell lymphomas. pcALCL is classically characterized as a solitary papulonodule that often enlarges, ulcerates, and can be locally destructive, but overall exhibits an indolent course with overall 5-year survival estimated to be 90%. Distinguishing pcALCL from systemic ALCL (sALCL) is essential as sALCL confers a poorer prognosis with average 5-year survival being 40-50%. Although extremely rare, there have been several cases of ALK-positive ALCL diagnosed on skin biopsy without evidence of systemic involvement, which poses several challenges in the classification, prognostication, treatment, and follow-up of these patients. Objectives: We present a case of cutaneous ALK-positive ALCL without evidence of systemic involvement, and a narrative review of the literature to further characterize that ALK-positive ALCL limited to the skin is a distinct variant with a unique presentation, history, and prognosis. A 30-year-old woman presented for evaluation of an erythematous-violaceous papule present on her right chest for two months. With the development of multifocal disease and persistent lymphadenopathy, a bone marrow biopsy and lymph node excisional biopsy were performed to assess for systemic disease. Both biopsies were unrevealing. The patient was counseled on pursuing systemic therapy consisting of Brentuximab, Cyclophosphamide, Doxorubicin, and Prednisone given the concern for sALCL. Apropos of the patient we searched for clinically evident, cutaneous ALK-positive ALCL cases, with and without systemic involvement, in the English literature. Risk factors, such as tumor location, number, size, ALK localization, ALK translocations, and recurrence, were evaluated in cases of cutaneous ALK-positive ALCL. The majority of patients with cutaneous ALK-positive ALCL did not progress to systemic disease. The majority of cases that progressed to systemic disease in adults had recurring skin lesions and cytoplasmic localization of ALK. ALK translocations did not influence disease progression. Mean time to disease progression was 16.7 months, and significant mortality (50%) was observed in those cases that progressed to systemic disease. Pediatric cases did not exhibit a trend similar to adult cases. In both the adult and pediatric cases, a subset of cutaneous-limited ALK-positive ALCL were treated with chemotherapy. All cases treated with chemotherapy did not progress to systemic disease. Apropos of an ALK-positive ALCL patient with clinical cutaneous limited disease in the histologic presence of systemic markers, we discussed the literature data, highlighting the crucial issues related to developing a clinical strategy to approach this rare subtype of ALCL. Physicians need to be aware of the overall spectrum of ALCL, including cutaneous limited disease, systemic disease, disease with NPM-ALK translocation, disease with ALK and EMA positivity, and disease with skin recurrence.

Keywords: anaplastic large cell lymphoma, systemic, cutaneous, anaplastic lymphoma kinase, ALK, ALCL, sALCL, pcALCL, cALCL

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Authors: Noha Mohamed Abdelhafez Dahy, Azza Abd El-Aziz, Eman Ahmed, Marwa El-Sayed

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Osteoporosis is a metabolic bone disease characterized by low bone mass, deterioration of bone tissue, and disruption of bone microarchitecture, which leads to compromised bone strength and an increased risk of fracture, commonly it occurs in women 10-15 years after menopause, the mean age of menopause is 51 years. Menopause is natural physiological changes primary because of decline of ovaries function with age which leads to decrease of estrogen hormone production which is the main hormone for bone continuous remodeling for bone density maintenance. Exercise increase stimulation of bone growth to keep bone mass by the effect of the mechanical stimulation, antigravity loading and stress exerted on musculoskeletal muscles. Purpose: This study aimed to determine the effect of aerobic exercise on estrogen hormone and bone mineral density (BMD) in osteoporotic women and the correlation between the estrogen and BMD.

Keywords: Osteoporosis, Postmenopause, Aerobic exercise, DEXA, Serum Estrogen

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Authors: Tinatin Sabauri, Eduard Gelagutashvili, Salome Pataridze

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The COVID-19 pandemic presents a serious challenge to all sectors of the country. Particularly difficult and important was the rapid mobilization of educational institutions to ensure the continuous flow of the educational process and effective fulfillment of the transaction. Developed countries managed to overcome this challenge quickly because, before the pandemic, part of universities had implemented blended learning (a mixture of online and face-to-face learning). The article aims to evaluate the use of electronic platforms by non-Georgian-speaking students and their involvement in the e-learning process at Ilia State University. Based on the phenomenological research design, a comparative analysis has been conducted - what was the use of electronic systems by non-Georgian-speaking students before 2019, and what was it like during the COVID-19 pandemic? Concretely, the phenomenological design was used in the research to evaluate the efficiency of distance learning with non-Georgian speaking students at Ilia State University. Focus groups were created within the phenomenological design. In the focus groups, students answered a pre-designed semi-structured questionnaire. Based on the analysis of the questionnaires, it was revealed that online learning and access to electronic portals were not a particular difficulty for ethnic minorities. The following positive and negative aspects of e-learning were identified in the research. Students named as positive aspects: Enables joining online classes directly from home before the start of the lecture, It saves time and money on travel and accommodation (for some students). It was named as negative aspects: Learning a language online is more difficult than in face-to-face classrooms, lack of teamwork activity, lack of strong and stable internet connections, and audio problems. Based on the results of the research, it was shown that in the post-pandemic period, the involvement of non-Georgian speaking students has significantly increased; therefore, the use of electronic systems by non-Georgian speaking students.

Keywords: electronic system, distance learning, COVID-19, students

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Authors: Madelaine F. Gatchalian, Mary Jane D. Tepora

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This study was designed to determine the relationship between learning environment and motivation of CNHS, SY 2012-2013. There were 376 respondents taken randomly. Frequency distribution, percentage, mean, standard deviation, Mann Whitney Test, Kruskall Wallis One-way ANOVA and Spearman Rank Correlational Coefficient were used in analyzing the data. As to age, most of the respondents were 13 years old while female students outnumbered the male students. Majority of parents’ educational attainment of CNHS students were high school/vocational graduates. Most fathers worked in the private sector, while majority of the mothers were unemployed whose family income range from Php 5,000.00 to Php 14,999.00. Most of the respondents were first child composed of five family members. Findings showed no significant differences in perceived learning environment when respondents were grouped in terms of age, sex, parents’ educational attainment, parents’ occupation, sibling order and number of family members. Only monthly family income showed significant differences in perceived learning environment. There are no significant differences in perceived learning motivation when respondents were grouped in terms of age, sex, parents’ educational attainment (father), parents’ occupation (father), sibling order, and number of family members. Parents’ educational attainment (mother), parents’ occupation (mother) and monthly family income showed significant differences in perceived learning motivation. There is significant relationship between the six subscales of perceived learning environment, namely: student cohesiveness, teacher support, involvement, task orientation, cooperation and equity and perceived learning motivation of CNHS students, SY, 2012-2013. The results of this study indicated that learning environment including student cohesiveness, teachers support, involvement, task orientation, cooperation and equity is significantly related to students’ learning motivation.

Keywords: learning environment, motivation, demographic profile, secondary students

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Authors: Claudia Camargo Wilson, Enrique Javier de la Vega Bustillos, Jesús Everardo Olguín Tiznado, Juan Andrés López Barreras, Sandra K. Enriquez

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This study focuses on the application of sensory thermography, as a non-invasive method to evaluate the musculoskeletal injuries that industry workers performing Highly Repetitive Movements (HRM) may acquire. It was made at a wireless company having the target of analyze temperatures in worker’s wrists, elbows and shoulders in workstations during their activities, this thru sensorial thermography with the goal of detecting maximum temperatures (Tmax) that could indicate possible injuries. The tests were applied during 3 hours for only 2 workers that work in workstations where there’s been the highest index of injuries and accidents. We were made comparisons for each part of the body that were study for both because of the similitude between the activities of the workstations; they were requiring both an immediate evaluation. The Tmax was recorder during the test of the worker 2, in the left wrist, reaching a temperature of 35.088ºC and with a maximum increase of 1.856°C.

Keywords: thermography, maximum temperaturas (Tmax), highly repetitive movements (HRM), operator

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Authors: Ashish Khanal, Suja Giri

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The scrap collection work is associated with multiple health hazards. Cut and scratches during collection and transportation of scraps are common. IWBs purchase the scraps mainly papers, cartoons, glass bottles and metals from the households. This study was conducted in Kathmandu, the capital city of Nepal. The location was chosen because Kathmandu is the biggest city of Nepal with highest number of IWBs. The research used a case study strategy to examine the occupational health hazards of IWBs. The only mode of collecting and transporting of scraps in Kathmandu is the bicycle. They have to do this regular work even during the scorching sun and chilled winter. The musculoskeletal and gastrointestinal disorders are the common health problem shared by IWBs in Kathmandu, Nepal. Despite of these problems, IWBs don’t take it seriously and rarely goes for the health check-up. There is need of personal protective equipment and guidance for safety of IWBs. IWBs need to wear closed shoes and use gloves to avoid cuts during the collection and transportation of the recyclables.

Keywords: itinerant waste buyers, Kathmandu, occupational health, scrap

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Authors: Manvelidze irakli, Iashvili Genadi

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Research has shown that public institutions in Autonomous Republic of Ajara try their best to make their official electronic data (web-pages, social websites) more informative and improve them. Part of public institutions offer interesting electronic services and initiatives to the public although they are seldom used in communication process. The statistical analysis of the use of web-pages and social websites of public institutions for example their facebook page show lack of activity. The reason could be the fact that public institutions give people less possibility of interaction in official web-pages. Second reason could be the fact that these web-pages are less known to the public and the third reason could be the fact that heads of these institutions lack awareness about the necessity of strengthening citizens’ involvement. In order to increase people’s involvement in this process it is necessary to have at least 23 e-services in one web-page. The research has shown that 11 of the 16 public institutions have only 5 services which are contact, social networks and hotline. Besides introducing innovative services government institutions should evaluate them and make them popular and easily accessible for the public. It would be easy to solve this problem if public institutions had concrete strategic plan of public relations which involved matters connected with maximum usage of electronic services while interaction with citizens. For this moment only one governmental body has a functioning action plan of public relations. As a result of the research organizational, social, methodological and technical problems have been revealed. It should be considered that there are many feedback possibilities like forum, RSS, blogs, wiki, twitter, social networks, etc. usage of only one or three of such instruments indicate that there is no strategy of regional electronic governance. It is necessary to develop more mechanisms of feedback which will increase electronic interaction, discussions and it is necessary to introduce the service of online petitions. It is important to reduce the so-called “digital inequality” and increase internet access for the public. State actions should decrease such problems. In the end if such shortcomings will be improved the role of electronic interactions in democratic processes will increase.

Keywords: e-Government, electronic services, information technology, regional government, regional government

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Authors: Irena Lucy Ishimora, Eva Maria Putri Salsabila

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The constellation on Indonesian Legal System that varies shows a structural injustice – as a result of patriarchy – exists from the biggest range as a country to the smallest such as a family. Women in their lives, carry out excessive responsibilities in the community. However, the unequal positions between men and women in the society restrain women to fulfill their constructed role. Therefore, increasing the chance for women to become the victim of structural injustice. The lack of authority given to women and its effects can be seen through a case study of the Cirompang Indigenous Women’s involvement in natural resources management. The decision to make the Mount Halimun-Salak as a National Park and the expansion itself did not involve nor consider the existence of indigenous people (Kasepuhan Ciromopang) – especially the women’s experience regarding natural resources management – has been significantly impacting the fulfillment of the indigenous women’s rights. Moreover, the adat law that still reflects patriarchy, made matters worse because women are restricted from expressing their opinion. The writers explored the experience of Cirompang indigenous women through in-depth interviews with them and analyzed it with several theories such as ecofeminism, woman’s access to land and legal pluralism. This paper is important to show how the decision and expansion of the National Park reduced the rights of access to land, natural resources, expressing an opinion, and participating in development. Reflecting on the Cirompang Indigenous Women’s conditions on natural resources management, this paper aims to present the implications of the regulations that do not acknowledge Indigenous women’s experience and the proposed solutions. First, there should be an integration between the law regarding indigenous people and traditional rights in a regulation to align the understanding of indigenous people and their rights. Secondly, Indonesia as a country that’s rich with diversity should ratify the ILO Convention no 169 to reaffirm the protection of Indigenous people’s rights. Last, considering the position of indigenous women that still experienced unjustness in the community, the government and NGOs must collaborate to provide adequate assistance for them.

Keywords: Cirompang indigenous women, indigenous women’s rights, structural injustice, women access to land

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Authors: Ahmed Usman Egye, Hamza Muhammad

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Poverty alleviation is one of the most difficult challenges facing third world countries in their development efforts. Evidences in Nigeria showed that the number of those in poverty has continued to increase. This paper is aimed at analyzing the performance of poverty alleviation measures undertaken by successive administrations in Nigeria with a view to addressing the quagmire. The study identified the whole gamut of factors that served as stumbling blocks to the implementation of each of the strategies and recommended the involvement of local people in the identification and design of projects so that sufficient participation could be achieved.

Keywords: poverty, development, strategies, Nigeria

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Authors: Gehan Hussein, Hala Agha, Rasha Abdelraof, Marina George, Antoine Fakhri

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Background: β-Thalassemia major (TM) and sickle cell disease (SCD) are inherited hemoglobin disorders resulting in chronic hemolytic anemia. Cardiovascular involvement is an important cause of morbidity and mortality in these groups of patients. The narrow border is between overt myocardial dysfunction and clinically silent left ventricular (LV) and / or right ventricular (RV) dysfunction in those patients. 3 D Speckle tracking echocardiography (3D STE) is a novel method for the detection of subclinical myocardial involvement. We aimed to study myocardial affection in SCD and TM using 3D STE, comparing it with conventional echocardiography, correlate it with serum ferritin level and lactate dehydrogenase (LDH). Methodology: Thirty SCD and thirty β TM patients, age range 4-18 years, were compared to 30 healthy age and sex matched control group. Cases were subjected to clinical examination, laboratory measurement of hemoglobin level, serum ferritin, and LDH. Transthoracic color Doppler echocardiography, 3D STE, tissue Doppler echocardiography, and aortic speckle tracking were performed. Results: significant reduction in global longitudinal strain (GLS), global circumferential strain (GCS), and global area strain (GAS) in SCD and TM than control (P value <0.001) there was significantly lower aortic speckle tracking in patients with TM and SCD than control (P value< 0.001). LDH was significantly higher in SCD than both TM and control and it correlated significantly positive mitral inflow E, (p value:0.022 and 0.072. r: 0.416 and -0.333 respectively) lateral E/E’ (p value.<0.001and 0.818. r. 0.618 and -0. 044.respectively) and septal E/E’ (p value 0.007 and 0.753& r value 0.485 and -0.060 respectively) in SCD but not TM and significant negative correlation between LDH and aortic root speckle tracking (value 0.681& r. -0.078.). The potential diagnostic accuracy of LDH in predicting vascular dysfunction as represented by aortic root GCS with a sensitivity 74% and aortic root GCS was predictive of LV dysfunction in SCD patients with sensitivity 100% Conclusion: 3D STE LV and RV systolic dysfunction in spite of their normal values by conventional echocardiography. SCD showed significantly lower right ventricular dysfunction and aortic root GCS than TM and control. LDH can be used to screen patients for cardiac dysfunction in SCD, not in TM

Keywords: thalassemia major, sickle cell disease, 3d speckle tracking echocardiography, LDH

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Authors: Lovorka Galetić, Ivana Načinović Braje, Nevenka Čavlek

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The purpose of this paper is to analyze the relationship between corporate culture and firm performance. Extensive theoretical and empirical evidence on this issue is provided. A quantitative methodology was used to explore relationship between corporate culture and performance among large Croatian companies. Corporate culture was explored by using Denison framework. The research revealed a positive, statistically significant relationship between mission and performance. Other dimensions of corporate culture (involvement, consistency and adaptability) show only partial relationship with performance.

Keywords: corporate culture, Croatia, Denison culture model, performance

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Authors: Irfan Abdulrahman Sheth, Sohil Pothiawala

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Dermatomyositis is an idiopathic inflammatory myopathy, traditionally characterized by a progressive, symmetrical proximal muscle weakness and pathognomonic or characteristic cutaneous manifestations. We report a case of a 60-year old Chinese female who was referred from polyclinic for allergic rash over the body after applying hair dye 3 weeks ago. It was associated with puffiness of face, shortness of breath and hoarse voice since last 2 weeks with decrease effort tolerance. She also complained of dysphagia/ myalgia with progressive weakness of proximal muscles and palpitations. She denied chest pain, loss of appetite, weight loss, orthopnea or fever. She had stable vital signs and appeared cushingoid. She was noted to have rash over the scalp/ face and ecchymosis over the right arm with puffiness of face and periorbital oedema. There was symmetrical muscle weakness and other neurological examination was normal. Initial impression was of allergic reaction and underlying nephrotic syndrome and Cushing’s syndrome from TCM use. Diagnostic tests showed high Creatinine kinase (CK) of 1463 u/l, CK–MB of 18.7 ug/l and Troponin –T of 0.09 ug/l. The Full blood count and renal panel was normal. EMG showed inflammatory myositis. Patient was managed by rheumatologist and discharged on oral prednisolone with methotrexate/ ergocalciferol capsule and calcium carb, vitamin D tablets and outpatient follow up. In some patients, cutaneous disease exists in the absence of objective evidence of muscle inflammation. Management of dermatomyositis begins with careful investigation for the presence of muscle disease or of additional systemic involvement, particularly of the pulmonary, cardiac or gastrointestinal systems, and for the possibility of an accompanying malignancy. Muscle disease and systemic involvement can be refractory and may require multiple sequential therapeutic interventions or, at times, combinations of therapies. Thus, we want to highlight to the physicians that the cutaneous disease of dermatomyositis should not be confused with allergic reaction. It can be particularly challenging to diagnose. Early recognition aids appropriate management of this group of patients.

Keywords: dermatomyositis, myopathy, allergy, cutaneous disease

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Authors: Yael Livneh, Shay Tzafrir, Ilan Meshoulam

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Technological startup companies have been recognized as bearing tremendous potential for business and economic success. However, many entrepreneurs who produce promising innovative ideas fail to implement them as successful businesses. A key argument for such failure is the entrepreneurs' lack of competence in adaptation of the relevant level of formality of human resource management (HRM). The purpose of the present research was to examine multiple antecedents and consequences of HRM formality in growing startup companies. A review of the research literature identified two central components of HRM formality: HR control and professionalism. The effect of three contextual predictors was examined. The first was an intra-organizational factor: the development level of the organization. We based on a differentiation between knowledge exploration and knowledge exploitation. At a given time, the organization chooses to focus on a specific mix of these orientations, a choice which requires an appropriate level of HRM formality, in order to efficiently overcome the challenges. It was hypothesized that the mix of orientations of knowledge exploration and knowledge exploitation would predict HRM formality. The second predictor was the personal characteristics the organization's leader. According the idea of blueprint effect of CEO's on HRM, it was hypothesized that the CEO's cognitive style would predict HRM formality. The third contextual predictor was an external organizational factor: the level of investor involvement. By using the agency theory, and based on Transaction Cost Economy, it was hypothesized that the level of investor involvement in general management and HRM would be positively related to the HRM formality. The effect of formality on trust was examined directly and indirectly by the mediation role of procedural justice. The research method included a time-lagged field study. In the first study, data was obtained using three questionnaires, each directed to a different source: CEO, HR position-holder and employees. 43 companies participated in this study. The second study was conducted approximately a year later. Data was recollected using three questionnaires by reapplying the same sample. 41 companies participated in the second study. The organizations samples included technological startup companies. Both studies included 884 respondents. The results indicated consistency between the two studies. HRM formality was predicted by the intra-organizational factor as well as the personal characteristics of the CEO, but not at all by the external organizational context. Specifically, the organizational orientations was the greatest contributor to both components of HRM formality. The cognitive style predicted formality to a lesser extent. The investor's involvement was found not to have any predictive effect on the HRM formality. The results indicated a positive contribution to trust in HRM, mainly via the mediation of procedural justice. This study contributed a new concept for technological startup company development by a mixture of organizational orientation. Practical implications indicated that the level of HRM formality should be matched to that of the company's development. This match should be challenged and adjusted periodically by referring to the organization orientation, relevant HR practices, and HR function characteristics. A relevant matching could enhance further trust and business success.

Keywords: control, formality, human resource management, organizational development, professionalism, technological startup company

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Authors: Teresa Isabel Lozano Pérez, Sandra Soca Lozano

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In Cuba, the childcare is one of the programs prioritized by the Ministry of Public Health and the birth of a child becomes a desired and rewarding event for the family, which is prepared for the reception of a healthy child. When this does not happen and after the first months of the child's birth begin to appear developmental deviations that indicate the presence of a disorder, the event becomes a live event potentially negative and generates disruptions in the family health. A quantitative, descriptive, and cross-sectional research methodology was conducted to describe the impact on family health of diagnosis of autism in a sample of 25 families of children diagnosed with infantile autism at the University Pediatric Hospital Juan Manuel Marquez Havana, Cuba; in the period between January 2014 and May 2015. The sample was non probabilistic and intentional from the inclusion criteria selected. As instruments, we used a survey to identify the structure of the family, life events inventory and an instrument to assess the relative impact, adaptive resources of family and social support perceived (IRFA) to identify the diagnosis of autism as life event. The main results indicated that the majority of families studied were nuclear, small and medium and in the formation stage. All households surveyed identified the diagnosis of autism in a child as an event of great importance and negative significance for the family, taking in most of the families studied a high impact on the four areas of family health and impact enhancer of involvement in family health. All the studied families do not have sufficient adaptive resources to face this situation, sensing that they received social support frequently, mainly in information and emotional areas. We conclude that the diagnosis of autism one of the members of the families studied is valued as a life event highly significant with unfavorably way causing an enhancer impact of involvement in family health especially in the areas ‘health’ and ‘socio-psychological’. Among the social support networks health institutions, partners and friends are highlighted. We recommend developing intervention strategies in families of these children to support them in the process of adapting the diagnosis.

Keywords: family, family health, infantile autism, life event

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Authors: Vladimir V. Iakovlev, Erin T. Carey, John Steege

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The use of polypropylene mesh devices for Pelvic Organ Prolapse (POP) spread rapidly during the last decade, yet our knowledge of the mesh-tissue interaction is far from complete. We aimed to perform a thorough pathological examination of explanted POP meshes and describe findings that may explain mechanisms of complications resulting in product excision. We report a spectrum of important findings, including nerve ingrowth, mesh deformation, involvement of detrusor muscle with neural ganglia, and polypropylene degradation. Analysis of these findings may improve and guide future treatment strategies.

Keywords: transvaginal, mesh, nerves, polypropylene degradation

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Authors: Siti Salina Abdullah

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Drug abuse is a global problem that affects individuals everywhere. The onset of drug use is usually during adolescence. The use of most drugs has been found to be more prevalent among adolescents than among adults. Drug abuse among adolescents is receiving more attention from parents, friends, communities, and policymakers. Adolescent drug use has been linked to higher rates of physical and mental illness, as well as decreased overall health and well-being. Furthermore, adolescents who use drugs are more susceptible to addiction. The increasing trend of drug use among young generations, particularly in Malaysia, is causing significant concerns. Adolescent drug use is commonly linked to peers, environment, and families. The National Anti-Drugs Agency (NADA) is the main agency in Malaysia that works with the Ministry of Home Affairs to prevent drug and substance abuse. NADA operates by providing preventive drug education, enforcement and security measures, treatment, medical rehabilitation, and international relations. The objective of this study is to examine the involvement of parents living in high-risk drug environments in drug prevention programs. It also discusses the difficulties they face when participating in drug prevention programs. This study was conducted in high-risk areas identified by National Anti-Drug Agencies (Malaysia). A total of 515 drug-free parents were interviewed in this study. The findings showed that B40 families were the majority among families living in high-risk drug environments. The study shows that drug prevention programs have a low participation rate among respondents. Previous research has demonstrated that drug prevention programs have a low rate of participation. The NADA campaign 'Prevention Start from Home' requires that this issue is addressed. To ensure that this campaign works, families, especially those at risk, should be empowered to participate in drug prevention programs. To fight drug problems among teenagers, it is crucial for families to take the first step in conducting prevention measures. To ensure that families with young children are equipped with drug prevention information, more advocacy programs are required. In addition, the drug prevention program should be accessible and reachable to families.

Keywords: drug prevention program, drug abuse, family, malaysia

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Authors: M. Yaqoob, C. S. O’Neill, S. Faraj, C. L. O’Neill

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This paper presents the preliminary findings from a study exploring nurse’s contributions to end of life decisions and to the care of dying patients in ICU units in the Kingdom of Bahrain. The process of dying is complex as medical clinicians are frequently unable to say with certainty when death will occur. It is generally accepted that end of life care begins when it is possible to know that death is imminent. Nurses do not make medical treatment decisions when caring for a dying patient. There are, however, many other types of decisions made when a patient is approaching the end of life and nurses are either formally or informally part of these decision making processes. This study explored nurses care practices at the end of life, in two ICU units in large hospitals in the Kingdom of Bahrain. The research design was a grounded theory approach. Ten nurses participated, six of whom were Bahraini nationals and four were Indian. A core category death avoidance talk was supported by three major subcategories, degrees of involvement in decision making; signalling and creating an awareness of death; care shifting from dying patients to family. Despite nurses asserting that they carried out the orders of doctors and had no role in decision making processes at end of life this study showed that there were degrees of nurse involvement. Doctors frequently discussed the patient’s clinical condition with nurses and also sought information regarding the family. Information about the family was of particular relevance if the doctor was considering a DNR order, which the nurses equated with dying. Families were not always informed when a DNR decision was made. When families were not informed the nurses engaged in sophisticated rituals signalling and creating awareness to family members that the death of their loved one was near. This process also involved a subtle shifting of care from the dying patient to the family. This seminar paper will focus particularly on how nurses signal and create an awareness of death in an ICU setting. The findings suggest that despite the avoidance of death talk in the ICU nurses indirectly convey and create an awareness that death is near to family members.

Keywords: decision making, dying patients, end of life, intensive care unit

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Authors: Dorottya Horváth, Tímea Harmath-Tánczos

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Attention deficit hyperactivity disorder (ADHD) and learning disabilities are common neurocognitive disorders that can have a significant impact on a child's academic performance. ADHD is characterized by inattention, hyperactivity, and impulsivity, while learning disabilities are characterized by difficulty with specific academic skills, such as reading, writing, or math. The aim of this study was to investigate the working memory, executive, and attention functions of neurotypical children and children with ADHD and learning disabilities in order to fill the gaps in the Hungarian mean test scores of these cognitive functions in children with neurocognitive disorders. Another aim was to specify the neuropsychological differential diagnostic toolkit in terms of the relationships and peculiarities between these cognitive functions. The research question addressed in this study was: How do the working memory, executive, and attention functions of neurotypical children compare to those of children with ADHD and learning disabilities? A self-administered test battery was used as a research tool. Working memory was measured with the Non-Word Repetition Test, the Listening Span Test, the Digit Span Test, and the Reverse Digit Span Test; executive function with the Letter Fluency, Semantic Fluency, and Verb Fluency Tests; and attentional concentration with the d2-R Test. The data for this study was collected from 115 children aged 9-14 years. The children were divided into three groups: neurotypical children (n = 44), children with ADHD without learning disabilities (n = 23), and children with ADHD with learning disabilities (n = 48). The data was analyzed using a variety of statistical methods, including t-tests, ANOVAs, and correlational analyses. The results showed that the performance of children with neurocognitive involvement in working memory, executive functions, and attention was significantly lower than the performance of neurotypical children. However, the results of children with ADHD and ADHD with learning disabilities did not show a significant difference. The findings of this study are important because they provide new insights into the cognitive profiles of children with ADHD and learning disabilities and suggest that working memory, executive functions, and attention are all impaired in children with neurocognitive involvement, regardless of whether they have ADHD or learning disabilities. This information can be used to develop more effective diagnostic and treatment strategies for these disorders.

Keywords: ADHD, attention functions, executive functions, learning disabilities, working memory

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Authors: Mohammed Mainoma, Abubakar Tijanni, Mohammed Aliyu

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Globalization has brought a structural change in industry. It is the breaking of artificial boundaries and given way to new product, new service, new market, and new technology among others. It leads to the realization that men entrepreneurs’ alone cannot meet the demand of the teeming population. Therefore there is a need for the participation, involvement, and engagement of females in the production and distribution of goods and services. This will enhance growth and development of a nation. It is in line with the above that this paper attempt to discuss meaning of women entrepreneurs, roles, types, problems, and prospects. Also, on the basis of conclusion the paper recommended that entrepreneurship education should be introduced in all Tertiary Institutions in Nigeria.

Keywords: women, entrepreneurs, issues, challenges

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Authors: K. Appasamy, P. Paul

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Mauritius, a developing small-island-state, is facing a recession which is having a considerable economic impact particularly on its construction sector. Further, the presence of foreign entities, both as companies and workers, within this sector is creating a very competitive environment for local firms. This study investigates the key drivers that allow foreign firms to participate in this sector, in particular looking at the international and local tender processes, and the capacity of local industry to participate. This study also looks at how the current set up may hinder the latter’s involvement. The methodology used included qualitative semi-structured interviews conducted with established foreign companies, local companies, and public bodies. Study findings indicate: there is an adequate availability of professional skills and expertise within the Mauritian construction industry but a lack of skilled labour especially at the operative level; projects awarded to foreign firms are either due to their uniqueness and hence lack of local knowledge, or due to foreign firms having lower tender bids; tendering systems and processes are weak, including monitoring and enforcement, which encourages corruption and favouritism; a high level of ignorance of this sector’s characteristics and opportunities exists amongst the local population; local entities are very profit oriented and have short term strategies that discourage long term investment in workforce training and development; but most importantly, stakeholders do not grasp the importance of encouraging youngsters to join this sector, they have no long term vision, and there is a lack of mutual involvement and collaboration between them. Although local industry is highly competent, qualified and experienced, the tendering and procurement systems in Mauritius are not conducive enough to allow for effective strategic planning and an equitable allocation of projects during an economic downturn so that the broadest spread of stakeholders’ benefit. It is of utmost importance that all sector and government entities collaborate to formulate strategies and reforms on tender processes and capacity building to ensure fairness and continuous growth of this sector in Mauritius.

Keywords: construction industry, tender process, international firms, local capacity, Mauritius

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Authors: M. Fry, L. Fitzpatrick, Julie Considine, R. Z. Shaban, Kate Curtis

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Introduction: The vast majority of older Australians lives independently and are self-managing at home, despite a growing number living with a chronic illness that requires health intervention. Evidence shows that between 50% and 80% of people presenting to the emergency department (ED) are in pain. Australian EDs manage 7.2 million attendances every year and 1.4 million of these are people aged 65 years or more. Research shows that 28% of ED patients aged 65 years or more have Cognitive impairment (CI) associated with dementia, delirium and neurological conditions. Background: Traditional ED service delivery may not be suitable for older people who present with multiple, complex and ongoing illnesses. Likewise, ED clinical staff often perceive that their role should be focused more on immediate and potential lifethreatening illness and conditions which are episodic in nature. Therefore, the needs of older people and their family/carers may not be adequately addressed in the context of an ED presentation. Aim: We aimed to explore the utilisation and characteristics of older people presenting to four metropolitan EDs. Method: The findings being presented are part of a program of research exploring pain management practices for older persons with long bone fractures. The study was conducted across four metropolitan emergency departments of older patients (65years and over) and involved a 12-month randomised medical record audit (n=255). Results: ED presentations across four ED sites in 2012 numbered 168021, with 44778 (26.6%) patients aged 65 and over. Of the 44778 patients, the average age was 79.1 years (SD 8.54). There were more females 23932 (53.5%). The majority (26925: 85.0%) of older persons self-referred to the ED and lived independently. The majority arrived by ambulance (n=18553: 41.4%) and were allocated triage category was 3 (n=19,507:43.65%) or Triage category 4 at (n=15,389: 34.43%). The top five triage symptom presentations involved pain (n=8088; 18.25%), dyspnoea (n=4735; 10.7%), falls (n=4032; 9.1%), other (n=3984; 9.0%), cardiac (n=2987; 6.7%). The top five system based diagnostic presentations involved musculoskeletal (n=8902; 20.1%), cardiac (n=6704:15.0%), respiratory (n=4933; 11.0%), neurological (n=4909; 11.0%), gastroenterology (n=4321; 9.7%). On review of one tertiary hospital database the vital signs on average at time triage: Systolic Blood Pressure 143.6mmHg. Heart Rate 83.4 beats/minute; Respiratory Rate 18.5 breaths/ minute; Oxygen saturation 97.0% and Tympanic temperature 36.7 and Blood Glucose Level 7.4mmols/litre. The majority presented with a Glasgow Coma Score of 14 or higher. On average the older person stayed in the ED 4:56 (SD 3:28minutes).The average time to be seen was 39 minutes (SD 48 minutes). The majority of older persons were admitted (n=27562: 61.5%), did not wait for treatment (n= 8879: 0.02%) discharged home (n=16256: 36.0%). Conclusion: The vast majority of older persons are living independently, although many require admission on arrival to the ED. Many arrived in pain and with musculoskeletal injuries and or conditions. New models of care need to be considered, which may better support self-management and independent living of the older person and the National Emergency Access Targets.

Keywords: chronic, older person, aged care, emergency department

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Authors: G. Nadirova, B. Aktaulova

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The main question of the research is- how did the Kazakhs manage to keep their religious thinking in the period of active propaganda of Soviet atheism, for seventy years of struggle against religion with the involvement of the scientific worldview as the primary means of proving the absence of the divine nature and materiality of the world? Our hypothesis is that In case of Kazakhstan the conservative female religious consciousness seems to have been a factor that helped to preserve the “everyday” religiousness of Kazakhs, which was far from deep theological contents of Islam, but able to revive in a short time after the decennia of proclaimed atheism.

Keywords: woman, religious thinking, Kazakhstan, soviet ideology, rituals, family

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Authors: Giorgi Katamadze

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Open public service and accountability towards citizens is an important feature of democratic state based on rule of law. Effective use of electronic resources simplifies bureaucratic procedures, makes direct communications, helps exchange information, ensures government’s openness and in general helps develop electronic/digital democracy. Development of electronic democracy should be a strategic dimension of Georgian governance. Formation of electronic democracy, its functional improvement should become an important dimension of the state’s information policy. Electronic democracy is based on electronic governance and implies modern information and communication systems, their adaptation to universal standards. E-democracy needs involvement of governments, voters, political parties and social groups in an electronic form. In the last years the process of interaction between the citizen and the state becomes simpler. This process is achieved by the use of modern technological systems which gives to a citizen a possibility to use different public services online. For example, the website my.gov.ge makes interaction between the citizen, business and the state more simple, comfortable and secure. A higher standard of accountability and interaction is being established. Electronic democracy brings new forms of interactions between the state and the citizen: e-engagement – participation of society in state politics via electronic systems; e-consultation – electronic interaction among public officials, citizens and interested groups; e-controllership – electronic rule and control of public expenses and service. Public transparency is one of the milestones of electronic democracy as well as representative democracy as only on mutual trust and accountability can democracy be established. In Georgia, institutional changes concerning establishment and development of electronic democracy are not enough. Effective planning and implementation of a comprehensive and multi component e-democracy program (central, regional, local levels) requires telecommunication systems, institutional (public service, competencies, logical system) and informational (relevant conditions for public involvement) support. Therefore, a systematic project of formation of electronic governance should be developed which will include central, regional, municipal levels and certain aspects of development of instrumental basis for electronic governance.

Keywords: e-democracy, e-governance, e-services, information technology, public administration

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Authors: Mouhoubi Nedjima, Sassi Boudemagh Souad

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In this paper, we will try to demonstrate the importance of the project approach in the urban to deal with uncertainty, the importance of the involvement of all stakeholders in the urban project process and that the absence of an actor can lead to project failure but also the importance of the urban project management. These points are handled through the following questions: Does the urban adhere to the theory of complexity? Does the project approach bring hope and solution to make urban planning "sustainable"? How converging visions of actors for the same project? Is the management of urban project the solution to support the urban project approach?

Keywords: strategic planning, project, urban project stakeholders, management

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Authors: Constâncio Augusto Machanguana

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The world over, resettling communities, for whatever purpose (mining, dams, forestry and wildlife management, roads, or facilitating services delivery), often leads to tensions between those resettled, the investors, and the local and national governments involved in the process. Causes include unclear government legislation and regulations, confusing Corporate Social Responsibility policies and guidelines, and other social-economic policies leading to unrealistic expectations among those being resettled, causing frustrations within the community, shifting them to any imminent conflict against the investors (company). The exploitation of heavy mineral sands along Mozambique’s long coastline and hinterland has not been providing a benefit for the affected communities. A case in point is the exploration, since 2018, of heavy sands in Chibuto District in the Southern Province of Gaza. A likely contributing factor is the standard type of socio-economic surveys and community involvement processes that could smooth the relationship among the parties. This research aims to investigate alternative processes to plan, initiate and guide resettlement processes in such a way that tensions and conflicts are avoided. Based on the process already finished, compared to similar cases along with the country, mixed methods to collect primary data were adopted: three focus groups of 125 people, representing 324 resettled householders; five semi-structured interviews with relevant stakeholders such as the local government, NGO’s and local leaders to understand their role in all stages of the process. The preliminary results show that the community has limited or no understanding of the potential impacts of these large-scale explorations, and the apparent harmony between the parties (community and company) may hide the dissatisfaction of those resettled. So, rather than focusing on negative mining impacts, the research contributes to science by identifying the best resettlement approach that can be replicated in other contexts along with the country in the actual context of the new discovery of mineral resources.

Keywords: conflict mitigation, resettlement, mining, Mozambique

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Authors: Sheikha Turki Alketbi

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Objectives: 1. Documenting the spontaneous resolution of AML following the initiation of anti-TB therapy. 2. Presenting an uncommon type of relapse in Acute Myeloid Leukemia. 3. Highlighting the role of immune markers in the diagnosis of Leukemia cutis. 4. Exploring and highlighting the possibility of skin relapse as the exclusive manifestation, even when skin involvement is known secondary manifestation in AML. Background: Spontaneous remission of Acute Myeloid Leukemia (AML) is a rare phenomenon that has only been reported in some case reports, usually following severe infections. Some studies have described the occurrence of tuberculosis (TB) infection with AML, usually after starting chemotherapy. Spontaneous resolution of AML after starting anti TB therapy (ATT), without starting chemotherapy has never been described in the literature. Moreover, Leukemia cutis is another rare skin manifestation of Acute Myeloid Leukemia as a result of infiltration of the skin or subcutaneous tissue by leukemic cells, in which can present during, precedes, after or independently of systemic leukemia. Methods: Here, we present a case of a 13-year-old male who presented with fever, weight loss, lethargy, epistaxis, bruising and dry cough and was later diagnosed with AML. Before initiating leukemia treatment, the patient was tested for TB and was found to have active TB infection. His leukemia treatment was postponed to clear the TB infection and he was commenced on ATT. Two months later, repeat blood film and bone marrow biopsy showed resolution of his AML. The patient remained in remission for 1 month, after which he presented with symmetrical blue purple well-defined round indurated plaques on the chest and thighs. Our differentials were leukemia cutis and Kaposi sarcoma. Results: Skin Biopsy with immune markers done, showed a picture of Acute Myeloid Leukemia. Immunohistochemistry (IHC) showed neoplastic cells diffusely and strongly positive for LCA, CD2, CD31, MPO, CD117, Lysozymes and TDT, and moderately positive for CD34, CD99, CD43 and CD6 And patchy for CD68. Ki67 showed 60% proliferation index. They were negative for the remaining markers. This suggested acute myeloid leukemia (AML). Conclusion: In summary, we present a rare case of TB with AML that resolved after treatment of TB with ATT but relapsed later as leukemia cutis. While skin involvement might occur as a secondary manifestation of AML, Skin relapse could be the only one.

Keywords: Leukemia cutis, Leukemia relapse, Acute Myeloid Leukemia, spontaneous resolution of AML

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Authors: Mohammad Ehson Rangiha, Bill Karakostas

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Social Business Process Management (SBPM) promises to overcome limitations of traditional BPM by allowing flexible process design and enactment through the involvement of users from a social community. This paper proposes a meta-model and architecture for socially driven business process management systems. It discusses the main facets of the architecture such as goal-based role assignment that combines social recommendations with user profile, and process recommendation, through a real example of a charity organization.

Keywords: business process management, goal-based modelling, process recommendation social collaboration, social BPM

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Authors: Charn Loong Ng, Mamun Bin Ibne Reaz

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As elderly population grows globally, the percentage of people diagnosed with musculoskeletal disorder (MSD) increase proportionally. Electromyography (EMG) is an important biosignal that contributes to MSD’s clinical diagnose and recovery process. Conventional conductive electrode has many disadvantages in the continuous EMG measurement application. This research has design a new surface EMG biosensor based on the parallel-plate capacitive coupling principle. The biosensor is developed by using a double-sided PCB with having one side of the PCB use to construct high input impedance circuitry while the other side of the copper (CU) plate function as biosignal sensing metal plate. The metal plate is insulated using kapton tape for contactless application. The result implicates that capacitive biosensor is capable to constantly capture EMG signal without having galvanic contact to human skin surface. However, there are noticeable noise couple into the measured signal. Post signal processing is needed in order to present a clean and significant EMG signal. A complete design of single ended, non-contact, high input impedance, front end EMG biosensor is presented in this paper.

Keywords: contactless, capacitive, biosensor, electromyography

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Authors: Meltem Ramoglu, Ertugrul Safran, Hikmet Ucgun, Busra Kepenek Varol, Hulya Nilgun Gurses

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Down’s syndrome (DS) is a human genetic disorder caused by the presence of all or part of an extra chromosome 21. Many patients with DS have musculoskeletal problems that affect weak muscle tone (hypotonia) and ligament laxity. This leads to excessive joint hypermobility and decreased position sense (proprioception). Lack of proprioception may cause balance problems. The aim of our study was to investigate how does joint hypermobility affect balance in patients with DS. Our study conducted with 13 DS patients age between 18 to 40 years. Demographic data were recorded. Beighton Hypermobility Score (BHS) was used to evaluate joint hypermobility. Balance score of participants was evaluated with Berg Balance Scale (BBS). Mean age of our participants was 29,8±3,57 year. Average score of body mass index and BHS were; 33,23 ±3,78 kg/m2 and 7,61±1,04, respectively. Out of a maximum possible score of 56 on the Berg Balance Scale, scores of participants with DS ranged from 36–51, with a mean of 43±4,45. Significant correlation was found between BHS and BBS (r: -,966, p=0.00). All of our participants have 6/9 or higher grade from BHS. As a conclusion of our study; joint hypermobility may affect balance score in patients with DS. The results suggest that people with DS have worse balance scores which affected by hypermobility. Further studies need larger population for more reliable results.

Keywords: adults, balance, Down's syndrome, joint hypermobility

Procedia PDF Downloads 330