Search results for: ethnic group
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 8437

Search results for: ethnic group

5347 Effects of Clozapine and Risperidone Antipsychotic Drugs on the Expression of CACNA1C and Behavioral Changes in Rat ‘Ketamine Model of Schizophrenia

Authors: Mehrnoosh Azimi Sanavi, Hamed Ghazvini, Mehryar Zargari, Hossein Ghalehnoei, Zahra Hosseini-khah

Abstract:

Objectives: Calcium Voltage-Gated Channel Subunit Alpha1 C (CACNA1C) is one of the most important genes associated with schizophrenia. Methods: 45 male Wistar rats were divided into 5 groups: saline, control, ketamine, clozapine, and risperidone. Animals in ketamine, risperidone, and clozapine groups received ketamine (30 mg/ kg-i.p.) for 10 days. After the last injection of ketamine, we started injecting clozapine (7.5 mg/kg-i.p.) risperidone (1 mg/kg-i.p.) for up to 28 days. Twenty-four hours after the last injection, open field, social interaction, and elevated plus-maze tests, and gene expression in the hippocampus were performed. Results: The results of the social interaction test revealed a significant decrease in cumulative time with ketamine compared with the saline group and an increase with clozapine and risperidone compared with the ketamine group. Moreover, results from the elevated plus-maze test demonstrated a critical decrease in open-arm time and an increase in close-arm time with ketamine compared with saline, as well as an increase in open-arm time with risperidone compared with ketamine. Further results revealed a significant increase in rearing and grooming with ketamine compared to saline, as well as a decrease with risperidone and clozapine compared to ketamine. There were no significant differences in CACNA1C gene expression between groups in the rat hippocampus. In brief, the results of this study indicated that clozapine and risperidone could partially improve cognitive impairments in the rat. However, our findings demonstrated that this treatment is not related to CACNA1C gene expression.

Keywords: schizophrenia, ketamine, clozapine, risperidone

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5346 Risk Factors and Biomarkers for the Recurrence of Ovarian Endometrioma: About the Immunoreactivity of Progesterone Receptor Isoform B and Nuclear Factor Kappa B.

Authors: Ae Ra Han, Taek Hoo Lee, Sun Zoo Kim, Hwa Young Lee

Abstract:

Introduction: Ovarian endometrioma is one of the important causes of poor ovarian reserve and up to half of them have recurred. However, the treatment for recurrence prevention has limited efficiency and repeated surgical management makes worsen the ovarian reserve. To find better management for recurrence prevention, we investigated risk factors and biomarkers for the recurrence of ovarian endometrioma. Methods: The medical records of women with the history of surgical dissection for ovarian endometrioma were collected. After exclusion of the cases with concurrent hysterectomy, been menopaused during follow-up, incomplete medical record, and loss of follow-up, a total of 134 women were enrolled. Immunohistochemical staining for progesterone receptor isoform B (PR-B) and nuclear factor kappa B (NFκB) was done with the fixed tissue blocks of their endometriomas which were collected at the time of surgery. Results: Severity of dysmenorrhea and co-existence of adenomyosis had significant correlation with recurrence of endometrioma. Increased PR-B (P = .041) and decreased NFκB (P = .036) immunoreactivity were found in recurrent group. Serum CA-125 level at the time of recurrence was higher than the highest level of CA-125 during follow-up in unrecurred group (55.6 vs. 21.3 U/mL, P = .014). Conclusion: We found that the severity of dysmenorrhea and coexistence of adenomyosis are risk factors for recurrence of ovarian endometrioma, and serial follow-up of CA-125 is effective to detect and prevent the recurrence. However, to determine the possibility of immunoreactivity of PR-B and NFκB as biomarkers for ovarian endometrioma, further studies of various races and large numbers with prospective design are needed.

Keywords: endometriosis, recurrence, biomarker, risk factor

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5345 Action Research through Drama in Education on Adolescents’ Career Self-Efficacy and Decision-Making Skills Development

Authors: Christina Zourna, Ioanna Papavassiliou-Alexiou

Abstract:

The purpose of this multi-phased action research PhD study in Greece was to investigate if and how Drama in Education (DiE) – used as an innovative group counselling method – may have positive effects on secondary education students’career self-efficacy and career decision-making skills development. Using both quantitative and qualitative research tools, high quality data were gathered at various stages of the research and were analysed through multivariate methods and open-source computer aided data analysis software such as R Studio, QualCoder, and SPSS packages. After a five-month-long educational intervention based on DiE method, it was found that 9th, 10th, and 11th gradersameliorated their self-efficacy and learned the process of making an informed career decision – through targeted information gathering about themselves and possible study paths – thus, developing career problem-solving and career management skills. Gender differences were non statistically important, while differences in grades showed a minor influence on some of the measured factorssuch as general career indecisiveness and self-evaluation. Students in the 11th grade scored significantly higher than younger students in the career self-efficacy scale and have stronger faith in their abilities e.g., choosing general over vocational school and major study orientation. The study has shown that DiE can be effective in group career guidance, especially concerning the pillars of self-awareness, self-efficacy, and career decision-making processes.

Keywords: career decision-making skills, career self-efficacy, CDDQ scale, CDMSE-SF scale, drama in education method

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5344 Augmentation of Conventional Medicine for Post-concussion Syndrome with Cognitive Behavioral Therapy Accelerates Symptomatic Relief in Affected Individuals

Authors: Waqas Mehdi, Muhammad Umar Hassan, Khadeeja Mustafa

Abstract:

Objective: Post-concussion syndrome (PCS) is a medical term used to point out the complicated combination of physical, emotional, cognitive and behavioral signs and symptoms associated with Mild Traumatic Brain Injury(mTBI). This study was conducted to assess the improvement or debilitating effect of behavioral therapy in addition to the conventional treatment and to document these results for increasing the efficiency of treatment provided to such cases. Method: This was primarily an interventional prospective cohort study which was conducted in the Department of Neurosurgery, Mayo Hospital Lahore. The sample size was 200 patients who were randomly distributed into two groups. The interventional group with Cognitive behavioral therapy was added in addition to the conventional treatment regimen and the Control group receiving only conventional treatment. Results were noted initially as well as after two weeks of the follow-up period. Data were subsequently analyzed by Statistical Package for Social Sciences (SPSS) software and associations worked out. Result and conclusion: Among the patients that were given therapy sessions along with conventional medicine, there was a significant improvement in the symptoms and their overall quality of life. It is also important to notice that the time period taken for these effects to wane is cut down by psychiatric solutions too. So we can conclude that CBT sessions not only speed up recovery in patients with post-concussion syndrome they also aid in the efficiency improvement in functional capability and quality of life.

Keywords: neurosurgery, CBT, PCS, mTBI

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5343 Biodegradable Polymeric Composites of Polylactide and Epoxidized Natural Rubber

Authors: Masek A., Diakowska K., Zaborski M.

Abstract:

Polymeric materials have found their use almost in every branch of industry worldwide. Most of them constitute so-called “petropolymers" obtained from crude oil. However literature information sounds a warning that its global sources are running out. Thus, it seems that one should search for polymeric materials from renewable raw materials belonging to the group of green polymers. Therefore on account of environmental protection and the issue of sustainable technologies, nowadays greater and greater achievements have been observed in the field of green technology using engineering sciences to develop composite materials. The main aim of this study was to research what is the influence of biofillers on the properties. We used biofillers like : cellulose with different length of fiber, cellulose UFC100, silica and montmorillonite. In our research, we reported on biodegradable composites exhibitingspecificity properties by melt blending of polylactide (PLA), one of the commercially available biodegradable material, and epoxidized natural rubber (ENR) containing 50 mol.%epoxy group. Blending hydrophilic natural polymers and aliphatic polyesters is of significant interest, since it could lead to the development of a new range of biodegradable polymeric materials. We research the degradation of composites on the basis epoxidized natural rubber and poly(lactide). The addition of biofillers caused far-reaching degradation processes. The greatest resistance to biodegradation showed a montmorillonite-based mixtures, the smallest inflated cellulose fibers of varying length.The final aim in the present study is to use ENR and poly(lactide) to design composite from renewable resources with controlled degradation.

Keywords: renewable resources, biopolymer, degradation, polylactide

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5342 Improvement of Sleep Quality Through Manual and Non-Pharmacological Treatment

Authors: Andreas Aceranti, Sergio Romanò, Simonetta Vernocchi, Silvia Arnaboldi, Emilio Mazza

Abstract:

As a result of the Sars-Cov2 pandemic, the incidence of thymism disorders has significantly increased and, often, patients are reluctant to want to take drugs aimed at stabilizing mood. In order to provide an alternative approach to drug therapies, we have prepared a study in order to evaluate the possibility of improving the quality of life of these subjects through osteopathic treatment. Patients were divided into visceral and fascial manual treatment with the aim of increasing serotonin levels and stimulating the vagus nerve through validated techniques. The results were evaluated through the administration of targeted questionnaires in order to assess quality of life, mood, sleep and intestinal functioning. At a first endpoint we found, in patients undergoing fascial treatment, an increase in quality of life and sleep: in fact, they report a decrease in the number of nocturnal awakenings; a reduction in falling asleep times and greater rest upon waking. In contrast, patients undergoing visceral treatment, as well as those included in the control group, did not show significant improvements. Patients in the fascial group have, in fact, reported an improvement in thymism and subjective quality of life with a generalized improvement in function. Although the study is still ongoing, based on the results of the first endpoint we can hypothesize that fascial stimulation of the vagus nerve with manual and osteopathic techniques may be a valid alternative to pharmacological treatments in mood and sleep disorders.

Keywords: ostheopathy, insomnia, noctural awakening, thymism

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5341 The Role of Bridging Stakeholder in Water Management: Examining Social Networks in Working Groups and Co-Management

Authors: Fariba Ebrahimi, Mehdi Ghorbani

Abstract:

Comprehensive water management considers economic, environmental, technical and social sustainability of water resources for future generations. Integrated water management implies cooperative approach and involves all stakeholders and also introduces issues to managers and decision makers. Solving these issues needs integrated and system approach according to the recognition of actors or key persons in necessary to apply cooperative management of water resources. Therefore, social network analysis can be used to demonstrate the most effective actors for environmental base decisions. The linkage of diverse sets of actors and knowledge systems across management levels and institutional boundaries often poses one of the greatest challenges in adaptive water management. Bridging stakeholder can facilitate interactions among actors in management settings by lowering the transaction costs of collaboration. This research examines how network connections between group members affect in co- management. Cohesive network structures allow groups to more effectively achieve their goals and objectives Strong; centralized leadership is a better predictor of working group success in achieving goals and objectives. Finally, geometric position of each actor was illustrated in the network. The results of the research based on between centrality index have a key and bridging actor in recognition of cooperative management of water resources in Darbandsar village and also will help managers and planners of water in the case of recognition to organization and implementation of sustainable management of water resources and water security.

Keywords: co-management, water management, social network, bridging stakeholder, darbandsar village

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5340 Presuppositions and Implicatures in Four Selected Speeches of Osama Bin Laden's Legitimisation of 'Jihad'

Authors: Sawsan Al-Saaidi, Ghayth K. Shaker Al-Shaibani

Abstract:

This paper investigates certain linguistics properties of four selected speeches by Al-Qaeda’s former leader Osama bin Laden who legitimated the use of jihad by Muslims in various countries when he was alive. The researchers adopt van Dijk’s (2009; 1998) Socio-Cognitive approach and Ideological Square theory respectively. Socio-Cognitive approach revolves around various cognitive, socio-political, and discursive aspects that can be found in political discourse as in Osama bin Laden’s one. The political discourse can be defined in terms of textual properties and contextual models. Pertaining to the ideological square, it refers to positive self-presentation and negative other-presentation which help to enhance the textual and contextual analyses. Therefore, among the most significant properties in Osama bin Laden’s discourse are the use of presuppositions and implicatures which are based on background knowledge and contextual models as well. Thus, the paper concludes that Osama bin Laden used a number of manipulative strategies which augmented and embellished the use of ‘jihad’ in order to develop a more effective discourse for his audience. In addition, the findings have revealed that bin Laden used different implicit and embedded interpretations of different topics which have been accepted as taken-for-granted truths for him to legitimate Jihad against his enemies. There are many presuppositions in the speeches analysed that result in particular common-sense assumptions and a world-view about the selected speeches. More importantly, the assumptions in the analysed speeches help consolidate the ideological analysis in terms of in-group and out-group members.

Keywords: Al-Qaeda, cognition, critical discourse analysis, Osama Bin Laden, jihad, implicature, legitimisation, presupposition, political discourse

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5339 Building Resilience to El Nino Related Flood Events in Northern Peru Using a Structured Facilitation Approach to Interdisciplinary Problem Solving

Authors: Roger M. Wall, David G. Proverbs, Yamina Silva, Danny Scipion

Abstract:

This paper critically reviews the outcomes of a 4 day workshop focused on building resilience to El Niño related Flood Events in northern Perú. The workshop was run jointly by Birmingham City University (BCU) in partnership with Instituto Geofísico del Perú (IGP) and was hosted by the Universidad de Piura (UDEP). The event took place in August 2018 and was funded by the Newton-Paulet fund administered by the British Council. The workshop was a response to the severe flooding experienced in Piura during the El Niño event of March 2017 which damaged over 100,000 homes and destroyed much local infrastructure including around 100 bridges. El Niño is a recurrent event and there is concern that its frequency and intensity may change in the future as a consequence of climate change. A group of 40 early career researchers and practitioners from the UK and Perú were challenged with working together across disciplines to identify key cross-cutting themes and make recommendations for building resilience to similar future events. Key themes identified on day 1 of the workshop were governance; communities; risk information; river management; urban planning; health; and infrastructure. A field study visit took place on day 2 so that attendees could gain first-hand experience of affected and displaced communities. Each of the themes was then investigated in depth on day 3 by small interdisciplinary teams drawing on their own expertise, local knowledge and the experiences of the previous day’s field trip. Teams were responsible for developing frameworks for analysis of their chosen theme and presenting their findings to the whole group. At this point, teams worked together to develop links between the different themes so that an integrated approach could be developed and presented on day 4. This paper describes the approaches taken by each team and the way in which these were integrated to form an holistic picture of the whole system. The findings highlighted the importance of risk-related information and the need for strong governance structures to enforce planning regulations and development. The structured facilitation approach proved to be very effective and it is recommended that the process be repeated with a broader group of stakeholders from across the region.

Keywords: El Niño, integrated flood risk management, Perú, structured facilitation, systems approach, resilience

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5338 Nutritional Potential and Traditional Uses of High Altitude Wild Edible Plants in Eastern Himalayas, India

Authors: Hui Tag, Jambey Tsering, Pallabi Kalita Hui, Baikuntha Jyoti Gogoi, Vijay Veer

Abstract:

The food security issues and its relevance in High Mountain regions of the world have been often neglected. Wild edible plants have been playing a major role in livelihood security among the tribal Communities of East Himalayan Region of the world since time immemorial. The Eastern Himalayan Region of India is one of the mega diverse regions of world and rated as top 12th Global Biodiversity Hotspots by IUCN and recognized as one of the 200 significant eco-regions of the Globe. The region supports one of the world’s richest alpine floras and about one-third of them are endemic to the region. There are at least 7,500 flowering plants, 700 orchids, 58 bamboo species, 64 citrus species, 28 conifers, 500 mosses, 700 ferns and 728 lichens. The region is the home of more than three hundred different ethnic communities having diverse knowledge on traditional uses of flora and fauna as food, medicine and beverages. Monpa, Memba and Khamba are among the local communities residing in high altitude region of Eastern Himalaya with rich traditional knowledge related to utilization of wild edible plants. The Monpas, Memba and Khamba are the followers Mahayana sect of Himalayan Buddhism and they are mostly agrarian by primary occupation and also heavily relaying on wild edible plants for their livelihood security during famine since millennia. In the present study, we have reported traditional uses of 40 wild edible plant species and out of which 6 species were analysed at biochemical level for nutrients contents and free radical scavenging activities. The results have shown significant free radical scavenging (antioxidant) activity and nutritional potential of the selected 6 wild edible plants used by the local communities of Eastern Himalayan Region of India.

Keywords: East Himalaya, local community, wild edible plants, nutrition, food security

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5337 Community Based Psychosocial Intervention Reduces Maternal Depression and Infant Development in Bangladesh

Authors: S. Yesmin, N. F.Rahman, R. Akther, T. Begum, T. Tahmid, T. Chowdury, S. Afrin, J. D. Hamadani

Abstract:

Abstract: Maternal depression is one of the risk factors of developmental delay in young children in low-income countries. Maternal depressions during pregnancy are rarely reported in Bangladesh. Objectives: The purpose of the present study was to examine the efficacy of a community based psychosocial intervention on women with mild to moderate depressive illness during the perinatal period and on their children from birth to 12 months on mothers’ mental status and their infants’ growth and development. Methodology: The study followed a prospective longitudinal approach with a randomized controlled design. Total 250 pregnant women aged between 15 and 40 years were enrolled in their third trimester of pregnancy of which 125 women were in the intervention group and 125 in the control group. Women in the intervention group received the “Thinking Healthy (CBT based) program” at their home setting, from their last month of pregnancy till 10 months after delivery. Their children received psychosocial stimulation from birth till 12 months. The following instruments were applied to get the outcome information- Bangla version of Edinburgh Postnatal Depression Scale (BEPDS), Prenatal Attachment Inventory (PAI), Maternal Attachment Inventory (MAI), Bayley Scale of Infant Development-Third version (Bayley–III) and Family Care Indicator (FCI). In addition, sever morbidity; breastfeeding, immunization, socio-economic and demographic information were collected. Data were collected at three time points viz. baseline, midline (6 months after delivery) and endline (12 months after delivery). Results: There was no significant difference between any of the socioeconomic and demographic variables at baseline. A very preliminary analysis of the data shows an intervention effect on Socioemotional behaviour of children at endline (p<0.001), motor development at midline (p=0.016) and at endline (p=0.065), language development at midline (p=0.004) and at endline (p=0.023), cognitive development at midline (p=0.008) and at endline (p=0.002), and quality of psychosocial stimulation at midline (p=0.023) and at endline (p=0.010). EPDS at baseline was not different between the groups (p=0.419), but there was a significant improvement at midline (p=0.027) and at endline (p=0.024) between the groups following the intervention. Conclusion: Psychosocial intervention is found effective in reducing women’s low and moderate depressive illness to cope with mental health problem and improving development of young children in Bangladesh.

Keywords: mental health, maternal depression, infant development, CBT, EPDS

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5336 Synthesis of New Bio-Based Solid Polymer Electrolyte Polyurethane-Liclo4 via Prepolymerization Method: Effect of NCO/OH Ratio on Their Chemical, Thermal Properties and Ionic Conductivity

Authors: C. S. Wong, K. H. Badri, N. Ataollahi, K. P. Law, M. S. Su’ait, N. I. Hassan

Abstract:

Novel bio-based polymer electrolyte was synthesized with LiClO4 as the main source of charge carrier. Initially, polyurethane-LiClO4 polymer electrolytes were synthesized via polymerization method with different NCO/OH ratios and labelled as PU1, PU2, PU3, and PU4. Subsequently, the chemical, thermal properties and ionic conductivity of the films produced were determined. Fourier transform infrared (FTIR) analysis indicates the co-ordination between Li+ ion and polyurethane in PU1 due to the greatest amount of hard segment of polyurethane in PU1 as proven by soxhlet analysis. The structures of polyurethanes were confirmed by 13 nuclear magnetic resonance spectroscopy (13C NMR) and FTIR spectroscopy. Differential scanning calorimetry (DSC) analysis indicates PU 1 has the highest glass transition temperature (Tg) corresponds to the most abundant urethane group which is the hard segment in PU1. Scanning electron microscopy (SEM) of the PU-LiClO4 shows the good miscibility between lithium salt and the polymer. The study found that PU1 possessed the greatest ionic conductivity (1.19 × 10-7 S.cm-1 at 298 K and 5.01 × 10-5 S.cm-1 at 373 K) and the lowest activation energy, Ea (0.32 eV) due to the greatest amount of hard segment formed in PU 1 induces the coordination between lithium ion and oxygen atom of carbonyl group in polyurethane. All the polyurethanes exhibited linear Arrhenius variations indicating ion transport via simple lithium ion hopping in polyurethane. This research proves the NCO content in polyurethane plays an important role in affecting the ionic conductivity of this polymer electrolyte.

Keywords: ionic conductivity, palm kernel oil-based monoester-OH, polyurethane, solid polymer electrolyte

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5335 Study of Age-Dependent Changes of Peripheral Blood Leukocytes Apoptotic Properties

Authors: Anahit Hakobjanyan, Zdenka Navratilova, Gabriela Strakova, Martin Petrek

Abstract:

Aging has a suppressive influence on human immune cells. Apoptosis may play important role in age-dependent immunosuppression and lymphopenia. Prevention of apoptosis may be promoted by BCL2-dependent and BCL2-independent manner. BCL2 is an antiapoptotic factor that has an antioxidative role by locating the glutathione at mitochondria and repressing oxidative stress. STAT3 may suppress apoptosis in BCL2-independent manner and promote cell survival blocking cytochrome-c release and reducing ROS production. The aim of our study was to estimate the influence of aging on BCL2-dependent and BCL2-independent prevention of apoptosis via measurement of BCL2 and STAT3 mRNAs expressions. The study was done on Armenian population (2 groups: 37 healthy young (mean age±SE; min/max age, male/female: 37.6±1.1; 20/54, 15/22), 28 healthy aged (66.7±1.5; 57/85, 12/16)). mRNA expression in peripheral blood leukocytes (PBL) was determined by RT-PCR using PSMB2 as the reference gene. Statistical analysis was done with Graph-Pad Prism 5; P < 0.05 considered as significant. The expression of BCL2 mRNA was lower in aged group (0.199) compared with young ones (0.643)(p < 0.01). Decrease expression was also recorded for female and male subgroups (p < 0.01). The expression level of STAT3 mRNA was increased (young, 0.228; aged, 0.428) (p < 0.05) during aging (in the whole age group and male/female subgroups). Decreased level of BCL2 mRNA may indicate about the suppression of BCL2-dependent prevention of apoptosis during aging in peripheral blood leukocytes. At the same time increased the level of STAT3 may suggest about activation of BCL2-independent prevention of apoptosis during aging.

Keywords: BCL2, STAT3, aging, apoptosis

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5334 Physical Activity Patterns during Inpatient Rehabilitation in Patients with Recent Brain Injury

Authors: Nikita Pasricha, Karen Smith, Simone Marshall, Vincent DePaul, Jessica Trier

Abstract:

Understanding that physical activity in rehabilitation programs shapes outcomes in acquired brain injury (ABI) populations is not a new concept. However, there is a void in understanding the physical activity patterns of inpatients in ABI rehabilitation, the trajectory of physical activity recovery, and factors that contribute to the recovery of physical activity over the initial months post-ABI. The purpose of this study was to determine if physical activity patterns vary in people with recent ABI in inpatient rehabilitation. The study also investigated differences in physical activity patterns in ABI patients compared to age-related healthy participants. Results revealed that ABI patients spent approximately 6.7 times longer per day in sedentary postures than in active positions. In comparison, the control group spent only 2.8 times longer in sedentary postures compared to active positions. Patients with ABI took significantly fewer steps than age-matched health control participants. Within the ABI population, patients took 0.78 times fewer steps on weekends compared to weekdays. Participants with greater mobility limitations had a greater difference in WD to WE steps taken. Potential reasons could be from no structured weekend rehabilitation programs, lower availability of staff, or varying schedules. Given that the rehabilitation program is only structured on weekdays, further research to investigate the benefits of structured physical activities like group walking programs on weekends for ABI patients in inpatient rehabilitation programs is warranted.

Keywords: brain, ABI, TBI, rehabilitation

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5333 Virtual Simulation as a Teaching Method for Community Health Nursing: An Investigation of Student Performance

Authors: Omar Mayyas

Abstract:

Clinical decision-making (CDM) is essential to community health nursing (CHN) education. For this reason, nursing educators are responsible for developing these skills among nursing students because nursing students are exposed to highly critical conditions after graduation. However, due to limited exposure to real-world situations, many nursing students need help developing clinical decision-making skills in this area. Therefore, the impact of Virtual Simulation (VS) on community health nursing students' clinical decision-making in nursing education has to be investigated. This study aims to examine the difference in CDM ability among CHN students who received traditional education compared to those who received VS classes, to identify the factors that may influence CDM ability differences between CHN students who received a traditional education and VS classes, and to provide recommendations for educational programs that can enhance the CDM ability of CHN students and improve the quality of care provided in community settings. A mixed-method study will conduct. A randomized controlled trial will compare the CDM ability of CHN students who received 1hr traditional class with another group who received 1hr VS scenario about diabetic patient nursing care. Sixty-four students in each group will randomly select to be exposed to the intervention from undergraduate nursing students who completed the CHN course at York University. The participants will receive the same Clinical Decision Making in Nursing Scale (CDMNS) questionnaire. The study intervention will follow the Medical Research Council (MRC) approach. SPSS and content analysis will use for data analysis.

Keywords: clinical decision-making, virtual simulation, community health nursing students, community health nursing education

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5332 Effect of Relaxation Techniques in Reducing Stress Level among Mothers of Children with Autism Spectrum Disorder

Authors: R. N. Jay A. Ablog, M. N. Dyanne R. Del Carmen, Roma Rose A. Dela Cruz, Joselle Dara M. Estrada, Luke Clifferson M. Gagarin, Florence T. Lang-ay, Ma. Dayanara O. Mariñas, Maria Christina S. Nepa, Jahraine Chyle B. Ocampo, Mark Reynie Renz V. Silva, Jenny Lyn L. Soriano, Loreal Cloe M. Suva, Jackelyn R. Torres

Abstract:

Background: To date, there is dearth of literature as to the effect of relaxation techniques in lowering the stress level of mothers of children with autism spectrum disorder (ASD). Aim: To investigate the effectiveness of 4-week relaxation techniques in stress level reduction of mothers of children with ASD. Methods: Quasi experimental design. It included 25 mothers (10-experimental, 15-control) who were chosen via purposive sampling. The mothers were recruited in the different SPED centers in Baguio City and La Trinidad and in the community. Statistics used were T-test and Related T-Test. Results: The overall weighted mean score after 4-week training is 2.3, indicating that the relaxation techniques introduced were moderately effective in lowering stress level. Statistical analysis (T-test; CV=4.51>TV=2.26) shown a significant difference in the stress level reduction of mothers in the experimental group pre and post interventions. There is also a significant difference in the stress level reduction in the control and the experimental group (Related T-test; CV=2.08 >TV=2.07). The relaxation techniques introduced were favorable, cost-effective, and easy to perform interventions to decrease stress level.

Keywords: relaxation techniques, mindful eating, progressive muscle relaxation, breathing exercise, autism spectrum disorder

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5331 Building Resilient Communities: The Traumatic Effect of Wildfire on Mati, Greece

Authors: K. Vallianou, T. Alexopoulos, V. Plaka, M. K. Seleventi, V. Skanavis, C. Skanavis

Abstract:

The present research addresses the role of place attachment and emotions in community resiliency and recovery within the context of a disaster. Natural disasters represent a disruption in the normal functioning of a community, leading to a general feeling of disorientation. This study draws on the trauma caused by a natural hazard such as a forest fire. The changes of the sense of togetherness are being assessed. Finally this research determines how the place attachment of the inhabitants was affected during the reorientation process of the community. The case study area is Mati, a small coastal town in eastern Attica, Greece. The fire broke out on July 23rd, 2018. A quantitative research was conducted through questionnaires via phone interviews, one year after the disaster, to address community resiliency in the long-run. The sample was composed of 159 participants from the rural community of Mati plus 120 coming from Skyros Island that was used as a control group. Inhabitants were prompted to answer items gauging their emotions related to the event, group identification and emotional significance of their community, and place attachment before and a year after the fire took place. Importantly, the community recovery and reorientation were examined within the context of a relative absence of government backing and official support. Emotions related to the event were aggregated into 4 clusters related to: activation/vigilance, distress/disorientation, indignation, and helplessness. The findings revealed a decrease in the level of place attachment in the impacted area of Mati as compared to the control group of Skyros Island. Importantly, initial distress caused by the fire prompted the residents to identify more with their community and to report more positive feelings toward their community. Moreover, a mediation analysis indicated that the positive effect of community cohesion on place attachment one year after the disaster was mediated by the positive feelings toward the community. Finally, place attachment contributes to enhanced optimism and a more positive perspective concerning Mati’s future prospects. Despite an insufficient state support to this affected area, the findings suggest an important role of emotions and place attachment during the process of recovery. Implications concerning the role of emotions and social dynamics in meshing place attachment during the disaster recovery process as well as community resiliency are discussed.

Keywords: community resilience, natural disasters, place attachment, wildfire

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5330 Studies on Effect of Nano Size and Surface Coating on Enhancement of Bioavailability and Toxicity of Berberine Chloride; A p-gp Substrate

Authors: Sanjay Singh, Parameswara Rao Vuddanda

Abstract:

The aim of the present study is study the factual benefit of nano size and surface coating of p-gp efflux inhibitor on enhancement of bioavailability of Berberine chloride (BBR); a p-gp substrate. In addition, 28 days sub acute oral toxicity study was also conducted to assess the toxicity of the formulation on chronic administration. BBR loaded polymeric nanoparticles (BBR-NP) were prepared by nanoprecipitation method. BBR NP were surface coated (BBR-SCNP) with the 1 % w/v of vitamin E TPGS. For bioavailability study, total five groups (n=6) of rat were treated as follows first; pure BBR, second; physical mixture of BBR, carrier and vitamin E TPGS, third; BBR-NP, fourth; BBR-SCNP and fifth; BBR and verapamil (widely used p-gp inhibitor). Blood was withdrawn at pre-set timing points in 24 hrs study and drug was quantified by HPLC method. In oral chronic toxicity study, total four groups (n=6) were treated as follows first (control); water, second; pure BBR, third; BBR surface coated nanoparticles and fourth; placebo BBR surface coated nanoparticles. Biochemical levels of liver (AST, ALP and ALT) and kidney (serum urea and creatinine) along with their histopathological studies were also examined (0-28 days). The AUC of BBR-SCNP was significantly 3.5 folds higher compared to all other groups. The AUC of BBR-NP was 3.23 and 1.52 folds higher compared to BBR solution and BBR with verapamil group, respectively. The physical mixture treated group showed slightly higher AUC than BBR solution treated group but significantly low compared to other groups. It indicates that encapsulation of BBR in nanosize form can circumvent P-gp efflux effect. BBR-NP showed pharmacokinetic parameters (Cmax and AUC) which are near to BBR-SCNP. However, the difference in values of T1/2 and clearance indicate that surface coating with vitamin E TPGS not only avoids the P-gp efflux at its absorption site (intestine) but also at organs which are responsible for metabolism and excretion (kidney and liver). It may be the reason for observed decrease in clearance of BBR-SCNP. No toxicity signs were observed either in biochemical or histopathological examination of liver and kidney during toxicity studies. The results indicate that administration of BBR in surface coated nanoformulation would be beneficial for enhancement of its bioavailability and longer retention in systemic circulation. Further, sub acute oral dose toxicity studies for 28 days such as evaluation of intestine, liver and kidney histopathology and biochemical estimations indicated that BBR-SCNP developed were safe for long use.

Keywords: bioavailability, berberine nanoparticles, p-gp efflux inhibitor, nanoprecipitation method

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5329 Network Analysis of Genes Involved in the Biosynthesis of Medicinally Important Naphthodianthrone Derivatives of Hypericum perforatum

Authors: Nafiseh Noormohammadi, Ahmad Sobhani Najafabadi

Abstract:

Hypericins (hypericin and pseudohypericin) are natural napthodianthrone derivatives produced by Hypericum perforatum (St. John’s Wort), which have many medicinal properties such as antitumor, antineoplastic, antiviral, and antidepressant activities. Production and accumulation of hypericin in the plant are influenced by both genetic and environmental conditions. Despite the existence of different high-throughput data on the plant, genetic dimensions of hypericin biosynthesis have not yet been completely understood. In this research, 21 high-quality RNA-seq data on different parts of the plant were integrated into metabolic data to reconstruct a coexpression network. Results showed that a cluster of 30 transcripts was correlated with total hypericin. The identified transcripts were divided into three main groups based on their functions, including hypericin biosynthesis genes, transporters, detoxification genes, and transcription factors (TFs). In the biosynthetic group, different isoforms of polyketide synthase (PKSs) and phenolic oxidative coupling proteins (POCPs) were identified. Phylogenetic analysis of protein sequences integrated into gene expression analysis showed that some of the POCPs seem to be very important in the biosynthetic pathway of hypericin. In the TFs group, six TFs were correlated with total hypericin. qPCR analysis of these six TFs confirmed that three of them were highly correlated. The identified genes in this research are a rich resource for further studies on the molecular breeding of H. perforatum in order to obtain varieties with high hypericin production.

Keywords: hypericin, St. John’s Wort, data mining, transcription factors, secondary metabolites

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5328 An Electromyographic Study of Muscle Coordination during Dynamic Glenohumeral Joint Elevation

Authors: Omid Khaiyat, David Hawkes

Abstract:

Introduction: There remains a lack of information on sophisticated coordination patterns across shoulder girdle muscles. Considering the stability of the shoulder being heavily dependent on coordinated muscle activity during its wide-ranging movements, it is important that key intermuscular relationships are well-defined for a better understanding of underlying pathology. This study investigated shoulder intermuscular coordination during different planes of shoulder elevation. Materials and Methods: EMG was recorded from 14 shoulder muscles in 20 healthy participants during shoulder flexion, scapula plane elevation, abduction, and extension. Cross-correlation by means of Pearson Correlation Coefficient (PCC) was used to examine the coordination between different muscles and muscle groups. Results: Coordination between rotator cuff and deltoid muscle groups was significantly higher (p =0.020-0.035) during the initial (PCC) = 0.79) and final (PCC = 0.74) phases of elevation compared to the mid-range (PCC = 0.34). Furthermore, a high level of coordination (PCC = 0.89) was noted between the deltoid group and the adductor group (latissimus dorsi and teres major) during the initial stage of shoulder elevation. Conclusion: The destabilising force of the deltoid during the initial stage of shoulder elevation is balanced by coordinated activity of rotator cuff, latissimus dorsi, and teres major. This is also the case for the end-range of movement, where increased demand for stability again leads to higher coordination between the deltoid and rotator cuff muscle groups. Appreciation of the sophistication of normal shoulder function evidence-based rehabilitation strategies for conditions such as subacromial impingement syndrome or shoulder instability can be developed.

Keywords: shoulder, coordination, EMG, muscle activity, upper limb

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5327 Ovarian Hormones and Antioxidants Biomarkers in Dromedary Camels Synchronized with Controlled Intravaginal Drug Release/Ovsynch GPG Program during Breeding Season

Authors: Heba Hozyen, Ragab Mohamed, Amal Abd El Hameed, Amal Abo El-Maaty

Abstract:

This study aimed to investigate the effect of CIDR and ovsynch (Gonadotropin-prostaglandine-gonadotropin GPG) protocols for synchronization of follicular waves of dromedary camels on ovarian hormones, oxidative stress and conception during breeding season. Twelve dark colored dromedary camels were divided into two equal groups. The first group was subjected to CIDR insertion for 7 days and blood samples were collected each other day from the day of CIDR insertion (day 0) till day 21. The other group was subjected to GPG system (Ovsynch) and blood samples were collected daily for 11 days. Progesterone (P4) and estradiol were assayed using commercial ELISA diagnostic EIA kits. Catalase (CAT), total antioxidants capacity (TAC), glutathione reduced (GHD), lipid peroxide product (malondialdehyde, MDA) and nitric oxide (NO) were measured colorimetrically using spectrophotometer. Results revealed that CIDR treated camels had significantly high P4 (P= 0.0001), estradiol (P= 0.0001), CAT (P= 0.034), NO (P= 0.016) and TAC (P= 0.04) but significantly low MDA (P= 0.001) and GHD (P= 0.003) compared to GPG treated ones. Camels inserted with CIDR had higher conception rate (66.7%) compared to those treated with GPG (33%). In conclusion, camels treated with CIDR had higher hormonal response and antioxidant capacity than those synchronized with GPG which positively reflected on their conception rate. The better response of camels to CIDR and the higher conception compared to GPG protocol recommends its use for future reproductive management in camels.

Keywords: antioxidants, camel, CIDR, season, steroid hormones

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5326 Impact Evaluation and Technical Efficiency in Ethiopia: Correcting for Selectivity Bias in Stochastic Frontier Analysis

Authors: Tefera Kebede Leyu

Abstract:

The purpose of this study was to estimate the impact of LIVES project participation on the level of technical efficiency of farm households in three regions of Ethiopia. We used household-level data gathered by IRLI between February and April 2014 for the year 2013(retroactive). Data on 1,905 (754 intervention and 1, 151 control groups) sample households were analyzed using STATA software package version 14. Efforts were made to combine stochastic frontier modeling with impact evaluation methodology using the Heckman (1979) two-stage model to deal with possible selectivity bias arising from unobservable characteristics in the stochastic frontier model. Results indicate that farmers in the two groups are not efficient and operate below their potential frontiers i.e., there is a potential to increase crop productivity through efficiency improvements in both groups. In addition, the empirical results revealed selection bias in both groups of farmers confirming the justification for the use of selection bias corrected stochastic frontier model. It was also found that intervention farmers achieved higher technical efficiency scores than the control group of farmers. Furthermore, the selectivity bias-corrected model showed a different technical efficiency score for the intervention farmers while it more or less remained the same for that of control group farmers. However, the control group of farmers shows a higher dispersion as measured by the coefficient of variation compared to the intervention counterparts. Among the explanatory variables, the study found that farmer’s age (proxy to farm experience), land certification, frequency of visit to improved seed center, farmer’s education and row planting are important contributing factors for participation decisions and hence technical efficiency of farmers in the study areas. We recommend that policies targeting the design of development intervention programs in the agricultural sector focus more on providing farmers with on-farm visits by extension workers, provision of credit services, establishment of farmers’ training centers and adoption of modern farm technologies. Finally, we recommend further research to deal with this kind of methodological framework using a panel data set to test whether technical efficiency starts to increase or decrease with the length of time that farmers participate in development programs.

Keywords: impact evaluation, efficiency analysis and selection bias, stochastic frontier model, Heckman-two step

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5325 Seal and Heal Miracle Ointment: Effects of Cryopreserved and Lyophilized Amniotic Membrane on Experimentally Induced Diabetic Balb/C Mice

Authors: Elizalde D. Bana

Abstract:

Healing restores continuity and form through cell replication; hence, conserving structural integrity. In response to the worldwide pressing problem of chronic wounds in the healthcare delivery system, the researcher aims to provide effective intervention to preserve the structural integrity of the person. The wound healing effects of cryopreserved and lyophilized amniotic membrane (AM) of a term fetus embedded into two (2) concentrations (1.5 % and 1.0 %) of absorption-based ointment has been evaluated in vivo using the excision wound healing model 1x1 cm size. The total protein concentration in full term fetus was determined by the Biuret and Bradford methods, which are based on UV-visible spectroscopy. The percentages of protein presence in 9.5 mg (Mass total sample) of Amniotic membrane ranges between 14.77 – 14.46 % in Bradford method, while slightly lower to 13.78 – 13.80 % concentration in Biuret method, respectively. Bradford method evidently showed higher sensitivity for proteins than Biuret test. Overall, the amniotic membrane is composed principally of proteins in which a copious amount of literature substantially proved its healing abilities. After which, an area of 1 cm by 1 cm skin tissue was excised to its full thickness from the dorsolateral aspect of the isogenic mice and was applied twice a day with the ointment formulation having two (2) concentrations for the diabetic group and non-diabetic group. The wounds of each animal were left undressed and its area was measured every other day by a standard measurement formula from day 2,4,6,8,10,12 and 14. By the 14th day, the ointment containing 1.5 % of AM in absorption-based ointment applied to non-diabetic and diabetic group showed 100 % healing. The wound areas in the animals treated with the standard antibiotic, Mupirocin Ointment (Brand X) showed a 100% healing by the 14th day but with traces of scars, indicating that AM prepared from cryopreservation and lyophilization, at that given concentration, had a better wound healing property than the standard antibiotic. Four (4) multivariate tests were used which showed a significant interaction between days and treatments, meaning that the ointments prepared in two differing concentrations and induced in different groups of the mice had a significant effect on the percent of contraction over time. Furthermore, the evaluations of its effectiveness to wound healing were all significant although in differing degrees. It is observed that the higher the concentrations of amniotic membrane, the more effective are the results.

Keywords: wounds, healing, amniotic membrane ointments, biomedical, stem cell

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5324 Exploring the Knowledge from the Public on Technical and Vocational Education Training (TVET) in Ghana

Authors: Abubakar-Zagoon Adams, Emmanuel Intsiful, Haruna Zagoon-Sayeed

Abstract:

Within the Ghanaian context, the promotion of Technical and Vocational Education and Training (TVET) has been faced with many obstacles which are of great concern to national development. One of the obstacles that have been identified as having some negative impact on TVET promotion is the poor public perception of TVET. Poor public perception, as identified in the sub-sectors report in a number of Ghana Education Service reports, has received little attention in both research and the government’s effort to address the poor performance of the TVET sub-sector. This study investigated TVET stakeholders in the Ayawaso-West Municipality in the Greater Accra Region of Ghana to ascertain knowledge of technical and vocational education in Ghana. This study explored parents’ and students’ views and knowledge about technical and vocational education. The study adopted an exploratory research design and a qualitative research approach. Thirty-six (36) participants were selected by employing a purposive sampling technique. Twelve (ten parents and two school personnel) out of the total sample were engaged in key informant interviews, whereas three focus group discussions were conducted with students, eight in each group. The study found that the public has fair knowledge (positive) about TVET, and the other side of the coin knows that TVET is only meant for school dropouts, underprivileged students, and weak academic students. The study recommended that the government should intensify public education on TVET, deliberate investment should be made in TVET infrastructure, as well as proper regulation of the sub-sector.

Keywords: public perception, TVET promotion, socioeconomic, self-employment

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5323 Investigation of the Opinions and Recommendations of Participants Related to Operating Room Nursing Certified Course Program

Authors: Zehra Gencel Efe, Fatma Susam Ozsayın, Satı Tas

Abstract:

Background and Aim: It is not possible to teach all the knowledge related to operating room nursing in the nursing education process. Certified courses are organized by the Ministry of Health to compensate the lack of postgraduate training and the theoretical and practical training needs of working nurses. In this study; It is aimed to investigate the participants’ opinions and recommendations attending the certified course of operating room nursing that organized in İKCU AtaturkTraining and Research Hospital. Method: Two operating room nursing courses were organized in 2016. The 1st Operating Room Nursing Certified Course Program was organized between March 07, 2016 and April 6, 2016and the 2nd Operating Room Nursing Certified Course Program was organized between 07 November 2016 - 06 December 2016 at the İKCU Ataturk Training and Research Hospital. The first program was accepted for 29 participants, the second program was accepted for 30 participants. In the collection of the data, the 'Operating Room Nursing Certified Training Program Evaluation Form', 'Operating Room Nursing Certified Training Program Theoretical Training Evaluation Form' were used. Three point Likert-type scale is used for responses in the 'Operating Room Nursing Certified Training Program Evaluation Form’ (1=verygood, 2=good, 3=poor). Data is collected in five areas related to training program, operation room practice, communication, responsibility, experiences of learning. Four point Likert-type scale is used for responses in the 'Operating Room Nursing Certified Training Program Theoretical Training Evaluation Form' (1=verysatisfied, 2=quitesatisfied, 3=satisfied, 4=dissatisfied). Data is collected in two areas include presentation and content. Data were analyzed with SPSS 16 program. Findings and Conclusion: It was found that 93,22% of participants were female in addition, 62,7% had bachelor degree. It was seen that 33,87% of the work group had 1-5 years of experience in their field. It was found that; 88% of trainees participating in the first group to the operating room nursing-certified course program stated the training program was very good, 12% of them stated the training program was good. Nobody was signed the ‘poor’ choice. 81% of the trainees who participated in the 2nd group to the operating room nursing-certified course program stated the training program was very good, 19% of them stated the training program was good. Nobody was signed the ‘poor’ choice. It was found that there was no meaningful difference between the achievement ratios of the trainees and the learning status of the trainees when compared with the t test in the groups with success level of the operating room nursing certified course program according to the learning status of the participants (p ˃ 0,05). The trainees noted that the course was satisfied with theoretical and practical steps but the support services (lunch, coffee breaks etc.) were in adequate.

Keywords: certified courses, nursing certified courses, operating room nursing, training program

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5322 The Balancing of the Parental Responsibilities and Right and the Best Interest of the Child within the Parent-Child Relationship

Authors: R. Prinsloo

Abstract:

Amniotic fluid stem cells (AFSC) have been shown to contribute towards the amelioration of Acute Renal Failure (ARF), but the mechanisms underlying the renoprotective effect are largely unknown. Therefore, the main goal of the current study was to evaluate the therapeutic efficacy of AFSC in a cisplatin-induced rat model of ARF and to investigate the underlying mechanisms responsible for its renoprotective effect. To study the therapeutic efficacy of AFSC, ARF was induced in Wistar rats by an intra-peritoneal injection of cisplatin, and five days after administration, the rats were randomized into two groups and injected with either AFSC or normal saline intravenously. On day 8 and 12 after cisplatin injection, i.e., day 3 and day7 post-therapy respectively, the blood biochemical parameters, histopathological changes, apoptosis, and expression of pro-apoptotic, anti-apoptotic and autophagy-related proteins in renal tissues were studied in both groups of rats. Administration of AFSC in ARF rats resulted in improvement of renal function and attenuation of renal damage as reflected by significant decrease in blood urea nitrogen, serum creatinine levels, tubular cell apoptosis as assessed by Bax/Bcl2 ratio, and expression of the pro-apoptotic proteins viz. PUMA, Bax, cleaved caspase-3 and cleaved caspase-9 as compared to saline-treated group. Furthermore, in the AFSC-treated group as compared to saline-treated group, there was a significant increase in the activation of autophagy as evident by increased expression of LC3-II, ATG5, ATG7, Beclin1 and phospho-AMPK levels with a concomitant decrease in phospho-p70S6K and p62 expression levels. To further confirm whether the protective effects of AFSC on cisplatin-induced apoptosis were dependent on autophagy, chloroquine, an autophagy inhibitor was administered by the intra-peritoneal route. Chloroquine administration led to significant reduction in the anti-apoptotic effects of the AFSC therapy and further deterioration in the renal structure and function caused by cisplatin. Collectively, our results put forth that AFSC ameliorates cisplatin-induced ARF through induction of autophagy and inhibition of apoptosis. Furthermore, the protective effects of AFSC were blunted by chloroquine, highlighting that activation of autophagy is an important mechanism of action for the protective role of AFSC in cisplatin-induced renal injury.

Keywords: best interest of the child, children's rights, parent and child relationship, parental responsibilities and rights

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5321 The Effect of a 12 Week Rhythmic Movement Intervention on Selected Biomotor Abilities on Academy Rugby Players

Authors: Jocelyn Solomons, Kraak

Abstract:

Rhythmic movement, also referred to as “dance”, involves the execution of different motor skills as well as the integration and sequencing of actions between limbs, timing and spatial precision. The aim of this study was therefore to investigate and compare the effect of a 16-week rhythmic movement intervention on flexibility, dynamic balance, agility, power and local muscular endurance of academy rugby players in the Western Cape, according to positional groups. Players (N ¼ 54) (age 18.66 0.81 years; height 1.76 0.69 cm; weight 76.77 10.69 kg), were randomly divided into a treatment-control [TCA] (n ¼ 28) and a control-treatment [CTB] (n ¼ 26) group. In this crossover experimental design, the interaction effect of the treatment order and the treatment time between the TCA and CTB group, was determined. Results indicated a statistically significant improvement (p < 0.05) in agility2 (p ¼ 0.06), power2 (p ¼ 0.05), local muscular endurance1 (p ¼ 0.01) & 3 (p ¼ 0.01) and dynamic balance (p < 0.01). Likewise, forwards and backs also showed statistically significant improvements (p < 0.05) per positional groups. Therefore, a rhythmic movement intervention has the potential to improve rugby-specific bio-motor skills and furthermore, improve positional specific skills should it be designed with positional groups in mind. Future studies should investigate, not only the effect of rhythmic movement on improving specific rugby bio-motor skills, but the potential of its application as an alternative training method during off- season (or detraining phases) or as a recovery method.

Keywords: agility, dance, dynamic balance, flexibility, local muscular endurance, power, training

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5320 Management of Myofascial Temporomandibular Disorder in Secondary Care: A Quality Improvement Project

Authors: Rishana Bilimoria, Selina Tang, Sajni Shah, Marianne Henien, Christopher Sproat

Abstract:

Temporomandibular disorders (TMD) may affect up to a third of the general population, and there is evidence demonstrating the majority of Myofascial TMD cases improve after education and conservative measures. In 2015 our department implemented a modified care pathway for myofascial TMD patients in an attempt to improve the patient journey. This involved the use of an interactive group therapy approach to deliver education, reinforce conservative measures and promote self-management. Patient reported experience measures from the new group clinic revealed 71% patient satisfaction. This service is efficient in improving aspects of health status while reducing health-care costs and redistributing clinical time. Since its’ establishment, 52 hours of clinical time, resources and funding have been redirected effectively. This Quality Improvement Project was initiated because it was felt that this new service was being underutilised by our surgical teams. The ‘Plan-Do-Study-Act cycle’ (PDSA) framework was employed to analyse utilisation of the service: The ‘plan’ stage involved outlining our aims: to raise awareness amongst clinicians of the unified care pathway and to increase referral to this clinic. The ‘do’ stage involved collecting data from a sample of 96 patients over 4 month period to ascertain the proportion of Myofascial TMD patients who were correctly referred to the designated clinic. ‘Suitable’ patients who weren’t referred were identified. The ‘Study’ phase involved analysis of results, which revealed that 77% of suitable patients weren’t referred to the designated clinic. They were reviewed on other clinics, which are often overbooked, or managed by junior staff members. This correlated with our original prediction. Barriers to referral included: lack of awareness of the clinic, individual consultant treatment preferences and patient, reluctance to be referred to a ‘group’ clinic. The ‘Act’ stage involved presenting our findings to the team at a clinical governance meeting. This included demonstration of the clinical effectiveness of the care-pathway and explaining the referral route and criteria. In light of the evaluation results, it was decided to keep the group clinic and maximize utilisation. The second cycle of data collection following these changes revealed that of 66 Myofascial TMD patients over a 4 month period, only 9% of suitable patients were not seen via the designated pathway; therefore this QIP was successful in meeting the set objectives. Overall, employing the PDSA cycle in this QIP resulted in appropriate utilisation of the modified care pathway for patients with myofascial TMD in Guy’s Oral Surgery Department. In turn, this leads to high patient satisfaction with the service and effectively redirected 52 hours of clinical time. It permitted adoption of a collaborative working style with oral surgery colleagues to investigate problems, identify solutions, and collectively raise standards of clinical care to ensure we adopt a unified care pathway in secondary care management of Myofascial TMD patients.

Keywords: myofascial, quality Improvement, PDSA, TMD

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5319 Farmers’ Access to Agricultural Extension Services Delivery Systems: Evidence from a Field Study in India

Authors: Ankit Nagar, Dinesh Kumar Nauriyal, Sukhpal Singh

Abstract:

This paper examines the key determinants of farmers’ access to agricultural extension services, sources of agricultural extension services preferred and accessed by the farmers. An ordered logistic regression model was used to analyse the data of the 360 sample households based on a primary survey conducted in western Uttar Pradesh, India. The study finds that farmers' decision to engage in the agricultural extension programme is significantly influenced by factors such as education level, gender, farming experience, social group, group membership, farm size, credit access, awareness about the extension scheme, farmers' perception, and distance from extension sources. The most intriguing finding of this study is that the progressive farmers, which have long been regarded as a major source of knowledge diffusion, are the most distrusted sources of information as they are suspected of withholding vital information from potential beneficiaries. The positive relationship between farm size and ‘Access’ underlines that the extension services should revisit their strategies for targeting more marginal and small farmers constituting over 85 percent of the agricultural households by incorporating their priorities in their outreach programs. The study suggests that marginal and small farmers' productive potential could still be greatly augmented by the appropriate technology, advisory services, guidance, and improved market access. Also, the perception of poor quality of the public extension services can be corrected by initiatives aimed at building up extension workers' capacity.

Keywords: agriculture, access, extension services, ordered logistic regression

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5318 Environmental and Safety Studies for Advanced Fuel Cycle Fusion Energy Systems: The ESSENTIAL Approach

Authors: Massimo Zucchetti

Abstract:

In the US, the SPARC-ARC projects of compact tokamaks are being developed: both are aimed at the technological demonstration of fusion power reactors with cutting-edge technology but following different design approaches. However, they show more similarities than differences in the fuel cycle, safety, radiation protection, environmental, waste and decommissioning aspects: all reactors, either experimental or demonstration ones, have to fulfill certain "essential" requirements to pass from virtual to real machines, to be built in the real world. The paper will discuss these "essential" requirements. Some of the relevant activities in these fields, carried out by our research group (ESSENTIAL group), will be briefly reported, with the aim of showing some methodology aspects that have been developed and might be of wider interest. Also, a non-competitive comparison between our results for different projects will be included when useful. The question of advanced D-He3 fuel cycles to be used for those machines will be addressed briefly. In the past, the IGNITOR project of a compact high-magnetic field D-T ignition experiment was found to be able to sustain limited D-He3 plasmas, while the Candor project was a more decisive step toward D-He3 fusion reactors. The following topics will be treated: Waste management and radioactive safety studies for advanced fusion power plants; development of compact high-field advanced fusion reactors; behavior of nuclear materials under irradiation: neutron-induced radioactivity due to side DT reactions, radiation damage; accident analysis; reactor siting.

Keywords: advanced fuel fusion reactors, deuterium-helium3, high-field tokamaks, fusion safety

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