Search results for: primary teeth

Authors: Mirna Febriani

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Statement of problem. Alginate impression material is an imported material and a dentist always used this material to make impression of teeth and oral cavity tissues. Purpose. The aim of this study was to compare about compressive strength and tear strength of alginate impression material and alginate impression material combined with cassava. Material and methods.Property measured included compressive strength and tear strength. Results.The compressive strength and tear strength of the impression materials tested of a comparable ANSI/ADA standard no.18.The compressive strength and tear strength alginate impression material combined with cassava have lower than the compressive strength and tear strength alginate impression material. The alginate impression material combined with cassava has more water and silica content more decrease than alginate impression material. Conclusions.We concluded that compressive strength and tear strength of alginate impression material combined with cassava has lower than alginate impression material without cassava starch.

Keywords: compressive strength, tear strength, Cassava starch, alginate

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Authors: Sneha Shankar, Orlando Buendia, Will Evans

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Alpha-1 antitrypsin deficiency (AATD) is a rare, genetic, and multisystemic condition. Underdiagnosis is common, leading to chronic pulmonary and hepatic complications, increased resource utilization, and additional costs to the healthcare system. Currently, there is limited evidence of the direct medical costs of AATD diagnosis in the UK. This study explores the economic impact of AATD patients during the 3 years before diagnosis and to identify the major cost drivers using primary and secondary care electronic health record (EHR) data. The 3 years before diagnosis time period was chosen based on the ability of our tool to identify patients earlier. The AATD algorithm was created using published disease criteria and applied to 148 known AATD patients’ EHR found in a primary care database of 936,148 patients (413,674 Biobank and 501,188 in a single primary care locality). Among 148 patients, 9 patients were flagged earlier by the tool and, on average, could save 3 (1-6) years per patient. We analysed 101 of the 148 AATD patients’ primary care journey and 20 patients’ Hospital Episode Statistics (HES) data, all of whom had at least 3 years of clinical history in their records before diagnosis. The codes related to laboratory tests, clinical visits, referrals, hospitalization days, day case, and inpatient admissions attributable to AATD were examined in this 3-year period before diagnosis. The average cost per patient was calculated, and the direct medical costs were modelled based on the mean prevalence of 100 AATD patients in a 500,000 population. A deterministic sensitivity analysis (DSA) of 20% was performed to determine the major cost drivers. Cost data was obtained from the NHS National tariff 2020/21, National Schedule of NHS Costs 2018/19, PSSRU 2018/19, and private care tariff. The total direct medical cost of one hundred AATD patients three years before diagnosis in primary and secondary care in the UK was £3,556,489, with an average direct cost per patient of £35,565. A vast majority of this total direct cost (95%) was associated with inpatient admissions (£3,378,229). The DSA determined that the costs associated with tier-2 laboratory tests and inpatient admissions were the greatest contributors to direct costs in primary and secondary care, respectively. This retrospective study shows the role of EHRs in calculating direct medical costs and the potential benefit of new technologies for the early identification of patients with AATD to reduce the economic burden in primary and secondary care in the UK.

Keywords: alpha-1 antitrypsin deficiency, costs, digital health, early diagnosis

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Authors: Puteri Zarina M. K., Haddi J. K., Zolkepli N., Shu M. H. B., Hosshan H., Saad M. A.

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This paper provides an overview of the current state of ESL instruction for children with autism in Malaysia. Equal rights, independence, and active participation are guaranteed by the 2006 Convention on the Rights of Persons with Disabilities. Every child is entitled to receive education in an inclusive atmosphere that embraces diversity and ensures equal opportunity for all. The primary objective of the research was to investigate if English as a Second Language (ESL) teachers employ distinct instructional methods and strategies while teaching children diagnosed with autism. Moreover, the objective was to assess the similarities in the challenges faced by teachers when teaching ESL to children with autism in Malaysia. The study aimed to increase understanding of the challenges faced by ESL teachers in teaching autistic students. The study was structured as a qualitative research endeavour. A total of twelve (12) ESL teachers from selected primary schools in Malaysia were involved in this study. The research findings accurately depict the actual state of teaching ESL to autistic children. They confirm the imperative need for additional support in order to facilitate the successful integration of these children into the educational system.

Keywords: autism spectrum disorder, ESL, inclusion, Malaysia, special educational needs

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Authors: Mehmet Bozca

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Singular value decomposition based optimisation of geometric design parameters of a 5-speed gearbox is studied. During the optimisation, a four-degree-of freedom torsional vibration model of the pinion gear-wheel gear system is obtained and the minimum singular value of the transfer matrix is considered as the objective functions. The computational cost of the associated singular value problems is quite low for the objective function, because it is only necessary to compute the largest and smallest singular values (µmax and µmin) that can be achieved by using selective eigenvalue solvers; the other singular values are not needed. The design parameters are optimised under several constraints that include bending stress, contact stress and constant distance between gear centres. Thus, by optimising the geometric parameters of the gearbox such as, the module, number of teeth and face width it is possible to obtain a light-weight-gearbox structure. It is concluded that the all optimised geometric design parameters also satisfy all constraints.

Keywords: Singular value, optimisation, gearbox, torsional vibration

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Authors: Cecilia Moreira, Rita Paiva, Daniela Macedo, Leonor Ribeiro, Isabel Fernandes, Luis Costa

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Background: Head and neck paragangliomas are a rare group of tumors with a large spectrum of clinical manifestations. The approach to evaluate and treat these lesions has evolved over the last years. Surgery was the standard for the approach of these patients, but nowadays new techniques of imaging and radiation therapy changed that paradigm. Despite advances in treating, the growth potential and clinical outcome of individual cases remain largely unpredictable. Objectives: Characterization of our institutional experience with clinical management of these tumors. Methods: This was a cross-sectional study of patients followed in our institution between 01 January and 31 December 2017 with paragangliomas of the head and neck and cranial base. Data on tumor location, catecholamine levels, and specific imaging modalities employed in diagnostic workup, treatment modality, tumor control and recurrence, complications of treatment and hereditary status were collected and summarized. Results: A total of four female patients were followed between 01 January and 31 December 2017 in our institution. The mean age of our cohort was 53 (± 16.1) years. The primary locations were at the level of the tympanic jug (n=2, 50%) and carotid body (n=2, 50%), and only one of the tumors of the carotid body presented pulmonary metastasis at the time of diagnosis. None of the lesions were catecholamine-secreting. Two patients underwent genetic testing, with no mutations identified. The initial clinical presentation was variable highlighting the decrease of visual acuity and headache as symptoms present in all patients. In one of the cases, loss of all teeth of the lower jaw was the presenting symptomatology. Observation with serial imaging, surgical extirpation, radiation, and stereotactic radiosurgery were employed as treatment approaches according to anatomical location and resectability of lesions. As post-therapeutic sequels the persistence of tinnitus and disabling pain stands out, presenting one of the patients neuralgia of the glossopharyngeal. Currently, all patients are under regular surveillance with a median follow up of 10 months. Conclusion: Ultimately, clinical management of these tumors remains challenging owing to heterogeneity in clinical presentation, the existence of multiple treatment alternatives, and potential to cause serious detriment to critical functions and consequently interference with the quality of life of the patients.

Keywords: clinical outcomes, head and neck, management, paragangliomas

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Authors: Lenka Hurtalová, Eva Tillová, Mária Chalupová, Juraj Belan, Milan Uhríčik

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The secondary alloy A226 is used for many automotive casting produced by mould casting and high pressure die-casting. This alloy has excellent castability, good mechanical properties and cost-effectiveness. Production of primary aluminium alloys belong to heavy source fouling of life environs. The European Union calls for the emission reduction and reduction in energy consumption, therefore, increase production of recycled (secondary) aluminium cast alloys. The contribution is deal with influence of recycling on the quality of the casting made from A226 in automotive industry. The properties of the casting made from secondary aluminium alloys were compared with the required properties of primary aluminium alloys. The effect of recycling on microstructure was observed using combination different analytical techniques (light microscopy upon black-white etching, scanning electron microscopy-SEM upon deep etching and energy dispersive X-ray analysis-EDX). These techniques were used for the identification of the various structure parameters, which was used to compare secondary alloy microstructure with primary alloy microstructure.

Keywords: A226 secondary aluminium alloy, deep etching, mechanical properties, recycling foundry aluminium alloy

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Authors: Sona Lorencova, Beata Hornickova

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Compulsory pre-school education in Slovakia will be established by the Education Act for all five-year-old children from September 2021. The implementation of this law will change pre-school education in our country from optional to compulsory, and children will be able to complete this education either in institutional form school facilities or in the form of individual education at the request of the parent. The primary purpose of this change is that all children achieve pre-school education before entering primary school, thus eliminating differences between children before entering primary school. The benefits of introducing compulsory pre-school education are obvious to the professional public. However, as this fundamental change in children's education is perceived by parents who have a prime position in the upbringing and education of their children, research pays minimal attention. The aim of the study is to interpret the findings of quantitatively oriented research, which was focused on finding out the attitudes of parents to the planned introduction of compulsory preschool education in Slovakia. The data were obtained through questionnaires primarily intended for parents of preschool children. In the distributed questionnaire, the degree of agreement or disagreement with individual items could be expressed on a 5-point Likert scale. The results of the research present how perceived compulsory pre-school education is perceived by the parental public in Slovakia and what perspectives and limitations parents anticipate after its introduction.

Keywords: compulsory pre-school education, education act, childs' learning and development, kindergarten, parents' perspectives

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Authors: H. H. Goh, K. C. Goh, W. N. Z. S. Wan Sukri, Q. S. Chua, S. W. Lee, B. C. Kok

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Endowed of renewable energy sources (RES) are the advantages of ASEAN, but they are using a low amount of RES only to generate electricity because their primary energy sources are fossil and coal. The cost of purchasing fossil and coal is cheaper now, but it might be expensive soon, as it will be depleted sooner and after. ASEAN showed that the RES are convenient to be implemented. Some country in ASEAN has huge renewable energy sources potential and use. The primary aim of this project is to assist ASEAN countries in preparing the renewable energy and to guide the policies for RES in the more upright direction. The Green-Y model will help ASEAN government to study and forecast the economic concept, including feed-in tariff.

Keywords: ASEAN RES, Renewable Energy, RES Policies, RES Potential, RES Utilization

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Authors: Achmad Buhori, Reza Imam Pratama, Tissa Wiraatmaja, Wanti Megawati

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Data from many countries indicates that there is a marked increase of dental caries. The increases in caries appear to occur in lower socioeconomic groups. It is possible that the benefits of prevention of dental caries are not reaching these groups. However, there is a way to decrease dental caries by adding 5% of bromelain and calcium as an active agent in toothpaste. Bromelain can break glutamine-alanine bond and arginine-alanine bond which is a constituent of amino acid that causes dental plague which is one of the factors of dental caries. Calcium help rebuilds the teeth by strengthening and repairing enamel. Bromelain can be found from the extraction of pineapple (Ananas comosus) cobs (88.86-94.22 % of bromelain recovery during extraction based on the enzyme unit) and calcium can be taken from eggshell (95% of dry eggshell consist of calcium). The aim of this experiment is to make a toothpaste which contains bromelain and calcium as an effective, cheap, and healthy way to decrease dental caries around the world.

Keywords: bromelain, calcium, dental caries, dental plague, toothpaste

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Authors: Reenu Yadav, S. K. Yadav

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Herbal therapy has been used for daily oral health care to prevent, treat or cure oral conditions from halitosis to periodontal diseases. The importance of mouth and teeth cleanliness has been recognized from the earliest days of civilization to the 21st century. In the present study, leaves and seeds of Cordia obliqua and barks and twigs of Beautea monosperma, which is used traditionally for oral diseases was evaluated for its antimicrobial activity. The antimicrobial activity tests indicated that the methanolic extract exhibited stronger activities against the commonly encountered oral bacterial and fungal pathogens. The mouthwash formulation prepared and it is compared with marketed formulation HiOra. The results indicated that the herbal mouthwash could inhibit the growth of oral pathogens and may prevent plaque and other periodontal diseases caused by dental pathogens.

Keywords: herbal mouthwash, bio medicine, life sciences, herbal extracts

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Authors: Yunos Zahri, Ab Hamid R. Susanty, Ahmad Mustaffa

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This paper explores the need for a national baseline study on understanding the level of cyber security situational awareness among primary and secondary school students in Malaysia. The online survey method was deployed to administer the data collection exercise. The target groups were divided into three categories: Group 1 (primary school aged 7-9 years old), Group 2 (primary school aged 10-12 years old), and Group 3 (secondary school aged 13-17 years old). A different questionnaire set was designed for each group. The survey topics/areas included Internet and digital citizenship knowledge. Respondents were randomly selected from rural and urban areas throughout all 14 states in Malaysia. A total of 9,158 respondents participated in the survey, with most states meeting the minimum sample size requirement to represent the country’s demographics. The findings and recommendations from this baseline study are fundamental to develop teaching modules required for children to understand the security risks and threats associated with the Internet throughout their years in school. Early exposure and education will help ensure healthy cyber habits among millennials in Malaysia.

Keywords: cyber security awareness, cyber security education, cyber security, school students

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Authors: N. A. D. P. Niwunhella, W. G. R. C. K. Sirisena

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Appendicitis is one of the most encountered abdominal emergencies worldwide. Proper clinical diagnosis and appendicectomy with minimal post operative complications are therefore priorities. Aim of this study was to ascertain the overall management of acute appendicitis in Sri Lanka in special preference to delayed primary suturing of the surgical site, comparing other local and international treatment outcomes. Data were collected prospectively from 155 patients who underwent appendicectomy following clinical and radiological diagnosis with ultrasonography. Histological assessment was done for all the specimens. All perforated appendices were managed with delayed primary closure. Patients were followed up for 28 days to assess complications. Mean age of patient presentation was 27 years; mean pre-operative waiting time following admission was 24 hours; average hospital stay was 72 hours; accuracy of clinical diagnosis of appendicitis as confirmed by histology was 87.1%; post operative wound infection rate was 8.3%, and among them 5% had perforated appendices; 4 patients had post operative complications managed without re-opening. There was no fistula formation or mortality reported. Current study was compared with previously published data: a comparison on management of acute appendicitis in Sri Lanka vs. United Kingdom (UK). The diagnosis of current study was equally accurate, but post operative complications were significantly reduced - (current study-9.6%, compared Sri Lankan study-16.4%; compared UK study-14.1%). During the recent years, there has been an exponential rise in the use of Computerised Tomography (CT) imaging in the assessment of patients with acute appendicitis. Even though, the diagnostic accuracy without using CT, and treatment outcome of acute appendicitis in this study match other local studies as well as with data compared to UK. Therefore CT usage has not increased the diagnostic accuracy of acute appendicitis significantly. Especially, delayed primary closure may have reduced post operative wound infection rate for ruptured appendices, therefore suggest this approach for further evaluation as a safer and an effective practice in other hospitals worldwide as well.

Keywords: acute appendicitis, computerised tomography, diagnostic accuracy, delayed primary closure

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Authors: K. Zhumadilov, P. Kazymbet, A. Ivannikov, M. Bakhtin, A. Akylbekov, K. Kadyrzhanov, A. Morzabayev, M. Hoshi

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The aim of the study is to evaluate the possible excess of dose received by uranium processing plant workers. The possible excess of dose of workers was evaluated with comparison with population pool (Stepnogorsk) and control pool (Astana city). The measured teeth samples were extracted according to medical indications. In total, twenty-seven tooth enamel samples were analyzed from the residents of Stepnogorsk city (180 km from Astana city, Kazakhstan). About 6 tooth samples were collected from the workers of uranium processing plant. The results of tooth enamel dose estimation show us small influence of working conditions to workers, the maximum excess dose is less than 100 mGy. This is pilot study of EPR dose estimation and for a final conclusion additional sample is required.

Keywords: EPR dose, workers, uranium mines, tooth samples

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Authors: Amani M. Al-Hussan

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The current study aimed to explore the effects of science teaching strategies course (CURR422) on developing academic self efficacy and motivation towards teaching it in female primary classroom teachers in College of Education in Princess Nora Bint AbdulRahman University. The study sample consisted (48) female student teachers. To achieve the study aims, the researcher designed two instruments: Academic Self Efficacy Scale & Motivation towards Teaching Science Scale while maintaining the validity and reliability of these instruments.. Several statistical procedures were conducted i.e. Independent Sample T-test, Eta Square, Cohen D effect size. The results reveal that there were statistically significant differences between means of pre and post test for the sample in favor of post test. For academic self efficacy scale, Eta square was 0.99 and the effect size was 27.26. While for the motivation towards teaching science scale, Eta was 0.99 and the effect size was 51.72. These results indicated high effects of independent variable on the dependent variable.

Keywords: academic self efficiency, achievement, motivation, primary classroom teacher, science teaching strategies course, evaluation

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Authors: Mehdi Ghatus

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Two simple apparatus based on the hammer and anvil principle have been constructed and used to study the microstructure and micro-hardness characteristics of some AL-base alloys. Foils with thicknesses arranging from 20 µm up to 600 µm have been obtained. The cooling rate was estimated to be in the range 10^4 - 10^5 K/sec. Microstructure study of rapidly quenched Al-30% Si foils indicated that with decreasing the foil thickness the size of primary Si crystallites decreases in the whole investigated range (0.64-0.15 mm). However, the volume fraction of the primary Si crystals in the structure remained constant down to thickness the primary Si volume fraction started to decrease. Rapid quenching of Al- 14-16% Cu showed single phase cell structure. In foils up to 0.55 mm with decreasing the foil thickness the cell size decreases and micro-hardness increases particularly in foils below 0.3 mm in thickness. Isochronal annealing of theses foils show that the highly supersaturated Al-14-16% Cu solid solution decomposes readily at relatively low temperature and short time intervals. The maximum hardness is obtained after annealing at 100 °C for 30 minutes. However with decreasing the Cu content of the foils the precipitation process is largely delayed. Eight hours of annealing at 100 °C was not enough to achieve the maximum hardness in Al-4% Cu thin foils. The achieved hardness value was more than twice of the maximum hardness obtained in articles of similar composition but conventionally aged.

Keywords: aluminum, hardness, alloys, quenched aluminum

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Authors: Mónika Garai-Fodor, Nikoett Huszak

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In the present study, we investigate the cognitive aspects of conscious consumer behaviour among Generation Z members. In our view, conscious consumption can greatly help to foster social responsibility, environmental and health-conscious behaviour, and ethical consumerism. We believe that it is an important educational task to promote and reinforce consumer behaviour among young people that increases and creates community value. In this study, we analysed the dimensions of young people's conscious consumer behaviour and its manifestation in concrete forms of behaviour, purchasing, and consumer decisions. As a result of a survey conducted through a snowball sampling procedure, the responses of 200 respondents who are members of Generation Z were analysed. The research analysed young people's perceptions and opinions of conscious living and their perceptions of self-conscious consumer behaviour. The primary research used a pre-tested standardised online questionnaire. Data were evaluated using bivariate and multivariate analyses in addition to descriptive statistics. The research presents results that are valid for the sample, and we plan to continue with a larger sample survey and extend it to other generations. Our main objective is to analyse what conscious living means to young people, what behavioural elements they associate with it, and what activities they themselves undertake in this context.

Keywords: generation Z, conscious consumption, primary research, sustainability

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Authors: Foo Kok, Varun Thangamani

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Rectangular cavities with a full-span or finite-width configuration have been the basis of much previous research on cavity flows. However, much less attention has been given to the influence of sidewalls, in particular, on low-speed cavity flows. In this study, the flow characteristics of two separate low-speed finite-width cavities with a Reynolds number of 𝑅𝑒𝐷 = 10⁴ are examined using large eddy simulations. Two different lateral boundary conditions are used to investigate the influence of sidewalls on the self-sustaining oscillations and the three-dimensional flow fields inside the cavities. The results show that the full-span finite width cavities are less sensitive to the sidewall effect at a low length-to-width ratio 𝐿/𝐷. The increase in 𝐿/𝐷 leads to a departure from two-dimensional instability and results in the loss of spanwise homogeneity. The analysis of the spanwise flow structures shows that these effects correspond closely to the declination of the centrifugal force from the primary recirculation zone. Such effects are also reflected in the distinct modulation of the secondary vortices in the primary recirculation zone, which suggests that the instabilities observed in the full-span finite-width cavity flows are predominantly dependent on the secondary motion from the primary recirculation zone.

Keywords: LES, cavity flows, unsteady shear layer, instability modes, secondary flow

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Authors: Salman Imran, Chris Healey

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Traditionally, medical care of children in England and Wales starts from primary care with a referral to secondary care paediatricians who may not investigate further. Many primary care doctors do not undergo a paediatric rotation/exposure in training. As a result, there are many who have not acquired the necessary skills to manage children hence increasing hospital referral. With the current demand on hospitals in the National Health Service managing more problems in the community is needed. One way of handling this is to set up clinics, meetings and huddles in GP surgeries where professionals involved (general practitioner, paediatrician, health visitor, community nurse, dietician, school nurse) come together and share information which can help improve communication and care. The increased awareness and education that paediatricians can impart in this way will help boost confidence for primary care professionals to be able to be more self-sufficient. This has been tried successfully in other regions e.g., St. Mary’s Hospital in London but is crucial for a more rural setting like ours. The primary aim of this project would be to educate specifically GP’s and generally all other health professionals involved. Additional benefits would be providing care nearer home, increasing patient’s confidence in their local surgery, improving communication and reducing unnecessary patient flow to already stretched hospital resources. Methods: This was done as a plan do study act cycle (PDSA). Three clinics were delivered in different practices over six months where feedback from staff and patients was collected. Designated time for teaching/discussion was used which involved some cases from the actual clinics. Both new and follow up patients were included. Two clinics were conducted by a paediatrician and nurse whilst the 3rd involved paediatrician and local doctor. The distance from hospital to clinics varied from two miles to 22 miles approximately. All equipment used was provided by primary care. Results: A total of 30 patients were seen. All patients found the location convenient as it was nearer than the hospital. 70-90% clearly understood the reason for a change in venue. 95% agreed to the importance of their local doctor being involved in their care. 20% needed to be seen in the hospital for further investigations. Patients felt this to be a more personalised, in-depth, friendly and polite experience. Local physicians felt this to be a more relaxed, familiar and local experience for their patients and they managed to get immediate feedback regarding their own clinical management. 90% felt they gained important learning from the discussion time and the paediatrician also learned about their understanding and gaps in knowledge/focus areas. 80% felt this time was valuable for targeted learning. Equipment, information technology, and office space could be improved for the smooth running of any future clinics. Conclusion: The acute paediatric outpatient clinic can be successfully established in primary care facilities. Careful patient selection and adequate facilities are important. We have demonstrated a further step in the reduction of patient flow to hospitals and upskilling primary care health professionals. This service is expected to become more efficient with experience.

Keywords: clinics, education, paediatricians, primary care

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Authors: Nipon Sasithornsaowapa

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This research aims to study the impact of personality and family status on women executives’ career success of the primary education department of Thailand. The independent variable includes three factors, namely family status, personality, and knowledge-skill-experience, while the dependent variable is the career success. The population of this study includes 2,179 female management officials in the department of primary education. A total of 400 female managers is interviewed and utilized as a sample group. A questionnaire is developed and used as a research tool for data collection. Content analysis is performed to get the quantitative data. Descriptive statistics in this research is conducted by SPSS program. The findings revealed that personality and family status of samples have an influence on the overall career success of women executives in terms of their objective career success. However, in terms of specific factors of personality or family status, it is found that there is no relevance of each factor on the women executives’ career success. It can be concluded that the factor affecting the women executives’ career success is subjective career success including the happiness and enjoyment with the job not factor concerning materials. Their success is the result of each individual working experience. However, their personal characteristics do not affect their success.

Keywords: career success, women executives, primary education, knowledge-skill-experience

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Authors: Rachael Andrews, Viktoria McMillan, Shuaib Nasser, Christopher M. Roberts

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Background and objective: The National Review of Asthma Deaths (NRAD) found that asthma management and care was inadequate in 26% of cases reviewed. Major shortfalls identified were adherence to national guidelines and standards and, particularly, the organisation of care, including supervision and monitoring in primary care, with 70% of cases reviewed having at least one avoidable factor in this area. 5.4 million people in the UK are diagnosed with and actively treated for asthma, and approximately 60,000 are admitted to hospital with acute exacerbations each year. The majority of people with asthma receive management and treatment solely in primary care. This has therefore created concern that many people within the UK are receiving sub-optimal asthma care resulting in unnecessary morbidity and risk of adverse outcome. NRAD concluded that a national asthma audit programme should be established to measure and improve processes, organisation, and outcomes of asthma care. Objective: To develop a primary care dataset enabling extraction of information from GP practices in Wales and providing robust data by which results and lessons could be drawn and drive service development and improvement. Methods: A multidisciplinary group of experts, including general practitioners, primary care organisation representatives, and asthma patients was formed and used as a source of governance and guidance. A review of asthma literature, guidance, and standards took place and was used to identify areas of asthma care which, if improved, would lead to better patient outcomes. Modified Delphi methodology was used to gain consensus from the expert group on which of the areas identified were to be prioritised, and an asthma patient and carer focus group held to seek views and feedback on areas of asthma care that were important to them. Areas of asthma care identified by both groups were mapped to asthma guidelines and standards to inform and develop primary and secondary care datasets covering both adult and pediatric care. Dataset development consisted of expert review and a targeted consultation process in order to seek broad stakeholder views and feedback. Results: Areas of asthma care identified as requiring prioritisation by the National Asthma Audit were: (i) Prescribing, (ii) Asthma diagnosis (iii) Asthma Reviews (iv) Personalised Asthma Action Plans (PAAPs) (v) Primary care follow-up after discharge from hospital (vi) Methodologies and primary care queries were developed to cover each of the areas of poor and variable asthma care identified and the queries designed to extract information directly from electronic patients’ records. Conclusion: This paper describes the methodological approach followed to develop primary care datasets for a National Asthma Audit. It sets out the principles behind the establishment of a National Asthma Audit programme in response to a national asthma mortality review and describes the development activities undertaken. Key process elements included: (i) mapping identified areas of poor and variable asthma care to national guidelines and standards, (ii) early engagement of experts, including clinicians and patients in the process, and (iii) targeted consultation of the queries to provide further insight into measures that were collectable, reproducible and relevant.

Keywords: asthma, primary care, general practice, dataset development

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Authors: Solomon Ngoako Mabapa, Selekane Ananias Motadi, Nteseng Mailula, Hlekani Vanessa Mbhatsani, Lindelani Fhumudzani Mushaphi

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Background: South Africa has indeed made good progress towards IDD elimination, as far as implementation of salt iodization and coverage of iodized salt are concerned, the education and promotion aspects of the iodized salt intervention are seriously lacking. Objective: To determine the iodine nutritional knowledge of food handlers at primary schools under the National School Nutrition Programme in Capricorn and Waterberg district. Design: This study included 300 food handlers recruited from 95 primary schools in Capricorn district and 105 primary schools in Waterberg district, Limpopo Province, South Africa. Primary schools and study participants where conveniently selected. The data was collected by means of a structured questionnaire. Information obtained was on the socio-demographic characteristics of the participants, general knowledge on salt fortification and knowledge test. Results: The iodine knowledge for the food handlers in two districts was poor with the entire population’s iodine nutritional knowledge of 12% on the Lickert scale. The mean score on the Lickert scale for Capricorn and Waterberg districts was 17% and 8.6% respectively indicated poor iodine nutritional knowledge. Conclusion: The two districts had poor iodine nutritional knowledge. Giving nutrition education to the public on the importance of iodine and the consequences of iodine deficiency disorder (IDD) and continue advocacy on mass media on the iodine fortification as an intervention strategy to combat the escalating problem of micronutrient malnutrition control.

Keywords: food handlers, nutritional knowledge, iodine, National School Nutrition Programme

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Authors: Young-Jun You, Youn-Ju Jeong, Min-Su Park, Du-Ho Lee

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Due to a lot of limited conditions, a large box type floating structure is inevitably constructed by connecting many pontoons. When a floating structure is made with concrete, concrete shear key with saw-teeth shape is often used to carry shear force. Match casting for the shear key and precise construction on a sea are very important for making separated two pontoons as one body but those are not easy work and may increase construction time and cost. To solve this problem, one-way shear key is studied in this paper for a connected part where there is some difference between upward and downward shear force. It has only one inclined plane and can resist shear force in one direction. Big shear force is resisted by concrete which forms an inclined plane and small shear force is resisted by steel bar. This system can reduce manufacturing cost of individual pontoon and construction time and cost for constructing a floating structure on a sea. In this paper, the feasibility study about one-way shear key system is performed by comparing with design example.

Keywords: connection, floating container terminal, pontoon, pre-stressing, shear key

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Authors: Madrine King'endo

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This study dealt with the influence of spelling errors on English language performance among learners with dysgraphia in public primary schools in West Embu, Embu County, Kenya. The study purposed to investigate the influence of spelling errors on the English language performance among the class three pupils with dysgraphia in public primary schools. The objectives of the study were to identify the spelling errors that learners with dysgraphia make when writing English words and classify the spelling errors they make. Further, the study will establish how the spelling errors affect the performance of the language among the study participants, and suggest the remediation strategies that teachers could use to address the errors. The study could provide the stakeholders with relevant information in writing skills that could help in developing a responsive curriculum to accommodate the teaching and learning needs of learners with dysgraphia, and probably ensure training of teachers in teacher training colleges is tailored within the writing needs of the pupils with dysgraphia. The study was carried out in Embu county because the researcher did not find any study in related literature review concerning the influence of spelling errors on English language performance among learners with dysgraphia in public primary schools done in the area. Moreover, besides being relatively populated enough for a sample population of the study, the area was fairly cosmopolitan to allow a generalization of the study findings. The study assumed the sampled schools will had class three pupils with dysgraphia who exhibited written spelling errors. The study was guided by two spelling approaches: the connectionist stimulation of spelling process and orthographic autonomy hypothesis with a view to explain how participants with learning disabilities spell written words. Data were collected through interviews, pupils’ exercise books, and progress records, and a spelling test made by the researcher based on the spelling scope set for class three pupils by the ministry of education in the primary education syllabus. The study relied on random sampling techniques in identifying general and specific participants. Since the study used children in schools as participants, voluntary consent was sought from themselves, their teachers and the school head teachers who were their caretakers in a school setting.

Keywords: dysgraphia, writing, language, performance

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Authors: Dawit Thomas Lambamo

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Conduct disorder has become a major health and social problem; it is the most common psychiatric problem diagnosed among students which affect the academic and social interaction of students. This intervention was conducted in Dil Betigil primary school. After identifying six students with conduct disorder in Dil Betigil primary school, the intervention was conducted using a true experimental research design specifically pretest and posttest control group design. Data from teachers and parents of the students with conduct disorder were collected using adapted conduct disorder scale and semi-structured interview. The independent sample t-test of Pretest results of both experimental and control group indicated that there is no statistically significant difference between experimental and control groups. Intervention is carried out to enhance their social interaction and to decrees aggressive, a serious violation of rules and theft behavior of students in collaboration with teachers and parents. After six intervention weeks the post-test result showed that there was statistically significant difference in aggression and serious violation between the experimental and control groups, but there was no statistically significant mean difference regarding deceitful or theft between the experimental and control group.

Keywords: conduct, disorder, social interaction, interaction

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Authors: T. S. Yang, J. H. Liang

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This study applies the finite element method (FEM) to predict maximum forging load, effective stress distribution, effective strain distribution, workpiece temperature temperature in spiral bevel gear forging of AISI 1015. Maximum forging load, effective stress, effective strain, workpiece temperature are determined for different process parameters, such as modules, number of teeth, helical angle and workpiece temperature of the spiral bevel gear hot forging, using the FEM. Finally, the prediction of the power requirement for the spiral bevel gear hot forging of AISI 1015 is determined.

Keywords: spiral bevel gear, hot forging, finite element method

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Authors: Eniola Akande

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Introduction: English vocabulary and reading comprehension are core to academic achievement in many school subjects. Deficiency in both accounts for dismal performance in internal and external examinations among primary school pupils in Ibadan Metropolis, Nigeria. Previous studies largely focused on factors influencing pupils’ achievement in English vocabulary and reading comprehension. In spite of what literature has shown, the problem still persists, implying the need for other kinds of intervention. This study was therefore carried out to determine the effect of two transactional strategies Picture Walk (PW) and Know-Want to Learn-Learnt (KWL) on primary four pupils’ achievement in English vocabulary and reading comprehension in Ibadan Metropolis. The moderating effects of gender and learning style were also examined. Methodology: The study was anchored on Rosenblatt’s Transactional Reading and Piaget’s Cognitive Development theories; pretest-posttest control group quasi-experimental design with 3x2x3 factorial matrix was adopted. Six public primary schools were purposively selected based on the availability of qualified English language teachers in Primary Education Studies. Six intact classes (one per school) with a total of 101 primary four pupils (48 males and 53 females) participated. The intact classes were randomly assigned to PW (27), KWL (44) and conventional (30) groups. Instruments used were English Vocabulary (r=0.83), Reading Comprehension (r=0.84) achievement tests, Pupils’ Learning Style Preference Scale (r=0.93) and instructional guides. Treatment lasted six weeks. Data were analysed using the Descriptive statistics, Analysis of Covariance and Bonferroni post-hoc test at 0.05 level of significance. The mean age was 8.86±0.84 years. Result: Treatment had a significant main effect on pupils’ reading comprehension (F(2,82)=3.17), but not on English vocabulary. Participants in KWL obtained the highest post achievement means score in reading comprehension (8.93), followed by PW (8.06) and control (7.21) groups. Pupils’ learning style had a significant main effect on pupils’ achievement in reading comprehension (F(2,82)=4.41), but not on English vocabulary. Pupils with preference for tactile learning style had the highest post achievement mean score in reading comprehension (9.40), followed by the auditory (7.43) and the visual learning style (7.37) groups. Gender had no significant main effect on English vocabulary and reading comprehension. There was no significant two-way interaction effect of treatment and gender on pupils’ achievement in English vocabulary and reading comprehension. The two-way interaction effect of treatment and learning style on pupils’ achievement in reading comprehension was significant (F(4,82)=3.37), in favour of pupils with tactile learning style in PW group. There was no significant two-way interaction effect of gender and learning style on pupils’ achievement in English vocabulary and reading comprehension. The three-way interaction effects were not significant on English vocabulary and reading comprehension. Conclusion: Picture Walk and Know-Want to learn-Learnt instructional strategies were effective in enhancing pupils’ achievement in reading comprehension but not on English vocabulary. Learning style contributed considerably to achievement in reading comprehension but not to English vocabulary. Primary school, English language teachers, should put into consideration pupils’ learning style when adopting both strategies in teaching reading comprehension for improved achievement in the subject.

Keywords: comprehension-based intervention, know-want to learn-learnt, learning style, picture walk, primary school pupils

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Authors: Chau-Kuang Chen, Juanita Buford, Colette Davis, Raisha Allen, John Hughes, James Tyus, Dexter Samuels

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During the post-Civil War era, the city of Nashville, Tennessee, had the highest mortality rate in the country. The elevated death and disease among ex-slaves were attributable to the unavailability of healthcare. To address the paucity of healthcare services, the College, an institution with the mission of educating minority professionals and serving the under served population, was established in 1876. This study was designed to assess if the College has accomplished its mission of serving under served communities and contributed to the elimination of health disparities in the United States. The study objective was to quantify the impact of socioeconomic status and adverse health outcomes on primary care professionals serving disadvantaged communities, which, in turn, was significantly associated with a health professional shortage score partly designated by the U.S. Department of Health and Human Services. Various statistical methods were used to analyze the alumni data in years 1975 – 2013. K-means cluster analysis was utilized to identify individual medical and dental graduates into the cluster groups of the practice communities (Disadvantaged or Non-disadvantaged Communities). Discriminant analysis was implemented to verify the classification accuracy of cluster analysis. The independent t test was performed to detect the significant mean differences for clustering and criterion variables between Disadvantaged and Non-disadvantaged Communities, which confirms the “content” validity of cluster analysis model. Chi-square test was used to assess if the proportion of cluster groups (Disadvantaged vs Non-disadvantaged Communities) were consistent with that of practicing specialties (primary care vs. non-primary care). Finally, the partial least squares (PLS) path model was constructed to explore the “construct” validity of analytics model by providing the magnitude effects of socioeconomic status and adverse health outcome on primary care professionals serving disadvantaged community. The social ecological theory along with statistical models mentioned was used to establish the relationship between medical and dental graduates (primary care professionals serving disadvantaged communities) and their social environments (socioeconomic status, adverse health outcome, health professional shortage score). Based on social ecological framework, it was hypothesized that the impact of socioeconomic status and adverse health outcomes on primary care professionals serving disadvantaged communities could be quantified. Also, primary care professionals serving disadvantaged communities related to a health professional shortage score can be measured. Adverse health outcome (adult obesity rate, age-adjusted premature mortality rate, and percent of people diagnosed with diabetes) could be affected by the latent variable, namely socioeconomic status (unemployment rate, poverty rate, percent of children who were in free lunch programs, and percent of uninsured adults). The study results indicated that approximately 83% (3,192/3,864) of the College’s medical and dental graduates from 1975 to 2013 were practicing in disadvantaged communities. In addition, the PLS path modeling demonstrated that primary care professionals serving disadvantaged community was significantly associated with socioeconomic status and adverse health outcome (p < .001). In summary, the majority of medical and dental graduates from the College provide primary care services to disadvantaged communities with low socioeconomic status and high adverse health outcomes, which demonstrate that the College has fulfilled its mission.

Keywords: disadvantaged community, K-means cluster analysis, PLS path modeling, primary care

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Authors: Mahmoodreza Tahamtan

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Malignant surface epithelial ovarian tumors(SEOT) account for approximately 90% of primary ovarian cancer. We evaluate the immunohistochemical expression of WT1 protein among different histologic subtypes of SEOT. Immunohistochemistry for WT1 was done on 35 serous cystadenocarcinomas, 9 borderline serous tumors. A tumor was considered negative if < 1% of tumor cells were stained.Positive reactions were graded as follows:1+,1%-24%; 2+,25%-49%; 3+,50%-74%; 4+,75%-100%. Of the 35 cases of ovarian serous cystadenocarcinoma 30(85.7%)were diffusely positive(3+,4+),4 showed reactivity of < 50% of the tumor cells(1+,2+) and one were negative. All 9 borderline serous tumors showed immunoreactivity with WT1. WT1 is a good marker to distinguish primary ovarian serous carcinomas from other surface epithelial tumors.

Keywords: WT1, ovary, malignant, epithelial tumors

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Authors: Priyanka Govender, S. Mtshali, Theresa Moonsamy, Zanele Mkwanazi, L. Mthembu

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Chemically enhanced primary treatment (CEPT) can be used at wastewater works to improve the quality of the final effluent discharge, provided that the plant has spare anaerobic digestion capacity. CEPT can transfer part of the organic load to the digesters thereby effectively relieving the hydraulic loading on the plant and in this way can allow the plant to continue operating long after the hydraulic capacity of the plant has been exceeded. This can allow a plant to continue operating well beyond its original design capacity, requiring only fairly simple and inexpensive modifications to the primary settling tanks as well as additional chemical costs, thereby delaying or even avoiding the need for expensive capital upgrades. CEPT can also be effective at plants where high organic loadings prevent the wastewater discharge from meeting discharge standards, especially in the case of COD, phosphates and suspended solids. By increasing removals of these pollutants in the primary settling tanks, CEPT can enable the plant to conform to specifications without the need for costly upgrades. Laboratory trials were carried out recently at the Umbilo WWTW in Durban and these were followed by a baseline assessment of the current plant performance and a subsequent full scale trial on the Conventional plant i.e. West Plant. The operating conditions of the plant are described and the improvements obtained in COD, phosphate and suspended solids, are discussed. The PST and plant overall suspended solids removal efficiency increased by approximately 6% during the trial. Details regarding the effect that CEPT had on sludge production and the digesters are also provided. The cost implications of CEPT are discussed in terms of capital costs as well as operation and maintenance costs and the impact of Ferric chloride on the infrastructure was also studied and found to be minimal. It was concluded that CEPT improves the final quality of the discharge effluent, thereby improving the compliance of this effluent with the discharge license. It could also allow for a delay in upgrades to the plant, allowing the plant to operate above its design capacity. This will be elaborated further upon presentation.

Keywords: chemically enhanced, ferric, wastewater, primary

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Authors: Pilar Cornejo Ulloa, Guy Willems, Steffen Fieuws, Kim Quintelier, Wim Van Neer, Patrick Thevissen

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Dental age estimation can be performed both in living and deceased individuals. In anthropology, few studies have tested the reliability of dental age estimation methods complementary to the usually applied osteological methods. Objectives: In this study, destructive and non-destructive dental age estimation methods were applied on an archeological sample in order to compare them with the previously obtained anthropological age estimates. Materials and Methods: One hundred and thirty-four teeth from 24 individuals were analyzed using Kvaal, Kvaal and Solheim, Bang and Ramm, Lamendin, Gustafson, Maples, Dalitz and Johanson’s methods. Results: A high variability and wider age ranges than the ones previously obtained by the anthropologist could be observed. Destructive methods had a slightly higher agreement than the non-destructive. Discussion: Due to the heterogeneity of the sample and the lack of the real age at death, the obtained results were not representative, and it was not possible to suggest one dental age estimation method over another.

Keywords: archeology, dental age estimation, forensic anthropology, forensic dentistry

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