Search results for: m40 income group
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 9488

Search results for: m40 income group

6338 Associated Factors the Safety of the Patient in Hemodialysis Clinics of a Brazilian Municipality: Cross-Sectional Study

Authors: Magda Milleyde de Sousa Lima, Letícia Lima Aguiar, Marina Guerra Martins, Erika Veríssimo Dias Sousa, Lizandra Sampaio de Oliveira, Lívia Moreira Barros, Joselany Áfio Caetano

Abstract:

Patients with chronic kidney disease are vulnerable to episodes which make the safety of their health vulnerable, mainly due to the treatment process that exposes them to high rates of interventions during hemodialysis sessions. Some factors associated with health care contribute to the risk of death and complications. However, there are a small number of scientific studies evaluating the level of safety of hemodialysis clinics, and the sociodemographic characteristics of patients and professionals associated with this safety. Therefore, the present study aims to examine the level of patient safety in hemodialysis clinics in the Brazilian capital, to identify the sociodemographic and clinical factors of patients and nursing staff associated with the level of safety. This is an observational, descriptive and quantitative research conducted in three hemodialysis clinics placed in the city of Fortaleza-CE, Brazil, from September to November 2019. The sample was formed after a sample calculation for finite inhabitants of correlation with 200 chronic renal patients, 30 nursing technicians and seven nurses. Conventional sampling was used based on the inclusion criteria: being present at the hemodialysis session on the day the researcher performed the data collection and being 18 years of age or older. Participants who presented communication difficulties to listen to and/or answer the sociodemographic and clinical questionnaire were excluded. Two instruments were applied: sociodemographic and clinical characterization form and Chronic Renal Patient Safety Assessment Scale on Hemodialysis (EASPRCH). The data were analyzed using the Kruskal Walls Test for categorical variables and Spearman correlation coefficient for non-categorical variables, using the Statistical Package SPSS version 20.0. The present study respected the ethical and legal principles determined by resolution 466/2012 of the National Health Council, under the approval of the Ethics and Research Committee with an opinion number: 3,255,635. The results showed that a hemodialysis clinic presented unsafe care practices of 32 points in the EASPRCH (p=0.001). A statistical association was identified between the level of safety and the variables of the patients: level of education (p=0.018), family income (p=0.049), type of employment (p=0.012), venous access site (p=0.009), use of medication during the session (p=0.008) and time of hemodialysis (p=0.002). When evaluating the profile of nurses, a statistical association was evidenced between the level of safety with the variables: marital status (p=0.000), race (p=0.017), schooling (p= 0.000), income (p=0.013), age (p=0.000), clinic workload (p=0.000), time working with hemodialysis (p=0.000), time working in the clinic (p= 0.007) and clinic sizing (p=0.000). In order, the sociodemographic factors of nursing technicians associated with the level of patient safety were: race (p= 0.001) and weekly workload at (p=0.010). Therefore, it is concluded that there is a non-conformity in the level of patient safety in one of the clinics studied and, that sociodemographic and clinical factors of patients and health professionals corroborate the level of safety of the health unit.

Keywords: hemodialysis, nursing, patient safety, quality improvement

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6337 Morality in Actual Behavior: The Moderation Effect of Identification with the Ingroup and Religion on Norm Compliance

Authors: Shauma L. Tamba

Abstract:

This study examined whether morality is the most important aspect in actual behavior. The prediction was that people tend to behave in line with moral (as compared to competence) norms, especially when such norms are presented by their ingroup. The actual behavior that was tested was support for a military intervention without a mandate from the UN. In addition, this study also examined whether identification with the ingroup and religion moderated the effect of group and norm on support for the norm that was prescribed by their ingroup. The prediction was that those who identified themselves higher with the ingroup moral would show a higher support for the norm. Furthermore, the prediction was also that those who have religion would show a higher support for the norm in the ingroup moral rather than competence. In an online survey, participants were asked to read a scenario in which a military intervention without a mandate was framed as either the moral (but stupid) or smart (but immoral) thing to do by members of their own (ingroup) or another (outgroup) society. This study found that when people identified themselves with the smart (but immoral) norm, they showed a higher support for the norm. However, when people identified themselves with the moral (but stupid) norm, they tend to show a lesser support towards the norm. Most of the results in the study did not support the predictions. Possible explanations and implications are discussed.

Keywords: morality, competence, ingroup identification, religion, group norm

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6336 Personas Help Understand Users’ Needs, Goals and Desires in an Online Institutional Repository

Authors: Maha ALjohani, James Blustein

Abstract:

Communicating users' needs, goals and problems help designers and developers overcome challenges faced by end users. Personas are used to represent end users’ needs. In our research, creating personas allowed the following questions to be answered: Who are the potential user groups? What do they want to achieve by using the service? What are the problems that users face? What should the service provide to them? To develop realistic personas, we conducted a focus group discussion with undergraduate and graduate students and also interviewed a university librarian. The personas were created to help evaluating the Institutional Repository that is based on the DSpace system. The profiles helped to communicate users' needs, abilities, tasks, and problems, and the task scenarios used in the heuristic evaluation were based on these personas. Four personas resulted of a focus group discussion with undergraduate and graduate students and from interviewing a university librarian. We then used these personas to create focused task-scenarios for a heuristic evaluation on the system interface to ensure that it met users' needs, goals, problems and desires. In this paper, we present the process that we used to create the personas that led to devise the task scenarios used in the heuristic evaluation as a follow up study of the DSpace university repository.

Keywords: heuristic evaluation, institutional repositories, user experience, human computer interaction, user profiles, personas, task scenarios, heuristics

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6335 Auditory Function in MP3 Users and Association with Hidden Hearing Loss

Authors: Nana Saralidze, Nino Sharashenidze, Zurab Kevanishvili

Abstract:

Hidden hearing loss may occur in humans exposed to prolonged high-level sound. It is the loss of ability to hear high-level background noise while having normal hearing in quiet. We compared the hearing of people who regularly listen 3 hours and more to personal music players and those who do not. Forty participants aged 18-30 years were divided into two groups: regular users of music players and people who had never used them. And the third group – elders aged 50-55 years, had 15 participants. Pure-tone audiometry (125-16000 Hz), auditory brainstem response (ABR) (70dB SPL), and ability to identify speech in noise (4-talker babble with a 65-dB signal-to-noise ratio at 80 dB) were measured in all participants. All participants had normal pure-tone audiometry (all thresholds < 25 dB HL). A significant difference between groups was observed in that regular users of personal audio systems correctly identified 53% of words, whereas the non-users identified 74% and the elder group – 63%. This contributes evidence supporting the presence of a hidden hearing loss in humans and demonstrates that speech-in-noise audiometry is an effective method and can be considered as the GOLD standard for detecting hidden hearing loss.

Keywords: mp3 player, hidden hearing loss, speech audiometry, pure tone audiometry

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6334 Decomposing the Socio-Economic Inequalities in Utilization of Antenatal Care in South Asian Countries: Insight from Demographic and Health Survey

Authors: Jeetendra Yadav, Geetha Menon, Anita Pal, Rajkumar Verma

Abstract:

Even after encouraging maternal and child wellness programs at worldwide level, lower-middle income nations are not reached the goal set by the UN yet. This study quantified the contribution of socioeconomic determinants of inequality to the utilization of Antenatal Care in South Asian Countries. This study used data from Demographic Health Survey (DHS) of the selected countries were used, and Oaxaca decomposing were applied for socioeconomic inequalities in utilization of antenatal care. Finding from the multivariate analysis shows that mother’s age at the time of birth, birth order and interval, mother’s education, mass media exposure and economic status were significant determinants of the utilization of antenatal care services in South Asian countries. Considering, concentration index curve, the line of equity was greatest in Pakistan which followed by India and Nepal.

Keywords: antenatal care, decomposition, inequalities, South Asian countries

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6333 Standardized Black Ginseng Extract Improving a Suppressed Immunomodulatory Effect Induced by Heat Stress

Authors: Byung Wook Yang, Jong Dae Park, Wang Soo Shin, Ji-Hyeon Song, Seo-Yun Choi, Boo-Yong Lee, Young Tae Hahm

Abstract:

Korean ginseng (Panax ginseng C. A. Meyer) is frequently taken orally as a traditional herbal medicine with ginsenosides as the main pharmacological component in Asian countries, and its use is increasing worldwide. Recently, the increase in global temperature has been reported to cause various kinds of biological disorders induced by heat stress in human. The standardized black ginseng extract (SBGE; KGR-BG1) was developed in our biological screening experiment on the thermo-regulation, whose chemical characteristics were evaluated as ginsenoside Rg1, Rb1, Rg3(S), as well as Re, Rf, Rg2(S), Rh1(S), Rh2(S), and Rg5+Rk1. Heat stress responses such as body weight, food intake, water consumption have been measured when treated with Standardized Black Ginseng Extract (SBGE) in the animal experiment and also, biomarkers. SBGE treated group has been found to inhibit a decrease in body weight, a decrease in food intake and an increase in the water consumption when compared with non-treated group against environmental heat stress. These results suggest that SBGE might have a protective effect against environmental heat stress. And also, the several factors of stress response on the immune system need to be done for further studies and its evaluation is in progress.

Keywords: ginseng, ginsenoside, standardization, heat stress, immunomodulatory effect

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6332 An Alternative to Problem-Based Learning in a Post-Graduate Healthcare Professional Programme

Authors: Brogan Guest, Amy Donaldson-Perrott

Abstract:

The Master’s of Physician Associate Studies (MPAS) programme at St George’s, University of London (SGUL), is an intensive two-year course that trains students to become physician associates (PAs). PAs are generalized healthcare providers who work in primary and secondary care across the UK. PA programmes face the difficult task of preparing students to become safe medical providers in two short years. Our goal is to teach students to develop clinical reasoning early on in their studies and historically, this has been done predominantly though problem-based learning (PBL). We have had an increase concern about student engagement in PBL and difficulty recruiting facilitators to maintain the low student to facilitator ratio required in PBL. To address this issue, we created ‘Clinical Application of Anatomy and Physiology (CAAP)’. These peer-led, interactive, problem-based, small group sessions were designed to facilitate students’ clinical reasoning skills. The sessions were designed using the concept of Team-Based Learning (TBL). Students were divided into small groups and each completed a pre-session quiz consisting of difficult questions devised to assess students’ application of medical knowledge. The quiz was completed in small groups and they were not permitted access of external resources. After the quiz, students worked through a series of openended, clinical tasks using all available resources. They worked at their own pace and the session was peer-led, rather than facilitator-driven. For a group of 35 students, there were two facilitators who observed the sessions. The sessions utilised an infinite space whiteboard software. Each group member was encouraged to actively participate and work together to complete the 15-20 tasks. The session ran for 2 hours and concluded with a post-session quiz, identical to the pre-session quiz. We obtained subjective feedback from students on their experience with CAAP and evaluated the objective benefit of the sessions through the quiz results. Qualitative feedback from students was generally positive with students feeling the sessions increased engagement, clinical understanding, and confidence. They found the small group aspect beneficial and the technology easy to use and intuitive. They also liked the benefit of building a resource for their future revision, something unique to CAAP compared to PBL, which out students participate in weekly. Preliminary quiz results showed improvement from pre- and post- session; however, further statistical analysis will occur once all sessions are complete (final session to run December 2022) to determine significance. As a post-graduate healthcare professional programme, we have a strong focus on self-directed learning. Whilst PBL has been a mainstay in our curriculum since its inception, there are limitations and concerns about its future in view of student engagement and facilitator availability. Whilst CAAP is not TBL, it draws on the benefits of peer-led, small group work with pre- and post- team-based quizzes. The pilot of these sessions has shown that students are engaged by CAAP, and they can make significant progress in clinical reasoning in a short amount of time. This can be achieved with a high student to facilitator ratio.

Keywords: problem based learning, team based learning, active learning, peer-to-peer teaching, engagement

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6331 Public Perception on Child Street Hawking in Aba Urban, Abia State, Nigeria

Authors: Paul Anyaogu, E. U. M. Igbo

Abstract:

This study examines the public view on child street hawking in Aba Urban, Abia State, Nigeria, its causes and effect on the child participant and society at large. The study tends to investigate the influence of socioeconomic status on child street hawking. The current situation reflects a chronic urban poverty, which disposed of parents/guardians to send their children and wards of school age to income yielding activities. A social survey research design was employed to select the respondents. A total of 1,108 questionnaires were administered to the respondents of 18 years and above and 1,038 were retrieved. Also, 24 in-depth interviews were conducted in the study area. The findings revealed that child street hawking is on the increase and a serious threat to social cohesion and national security. The study also revealed that poverty is a major cause of child street hawking. The study recommends that government should create job opportunities for urban dwellers, as well as provide social amenities and also put up poverty alleviation/eradication programmes for the people.

Keywords: Aba Urban, child street hawking, dangers, disposition, poverty

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6330 Computational Studies of the Reactivity Descriptors and the Optoelectronic Properties on the Efficiency Free-Base- and Zn-Porphyrin-Sensitized Solar Cells

Authors: Soraya Abtouche, Zeyneb Ghoualem, Syrine Daoudi, Lina Ouldmohamed, Xavier Assfeld

Abstract:

This work reports density functional theory calculations of the optimized geometries, molecular reactivity, energy gap,and thermodynamic properties of the free base (H2P) and their Zn (II) metallated (ZnP), bearing one, two, or three carboxylic acid groups using the hybrid functional B3LYP, Cam-B3lYP, wb97xd with 6-31G(d,p) basis sets. When donating groups are attached to the molecular dye, the bond lengths are slightly decreased, which is important for the easy transfer of an electron from donating to the accepting group. For all dyes, the highest occupied molecular orbital/lowest occupied molecular orbital analysis results in positive outcomes upon electron injection to the semiconductor and subsequent dye regeneration by the electrolyte. The ionization potential increases with increasing conjugation; therefore, the compound dye attached to one carboxylic acid group has the highest ionization potential. The results show higher efficiencies of those sensitized with ZnP. These results have been explained, taking into account the electronic character of the metal ion, which acts as a mediator in the injection step, and, on the other hand, considering the number of anchoring groups to which it binds to the surface of TiO2.

Keywords: DSSC, porphyrin, TD-DFT, electronic properties, donor-acceptor groups

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6329 Trends in Endoscopic Versus Open Treatment of Carpal Tunnel Syndrome in Rheumatoid Arthritis Patients

Authors: Arman Kishan, Sanjay Kubsad, Steve Li, Mark Haft, Duc Nguyen, Dawn Laporte

Abstract:

Objective: Carpal tunnel syndrome can be managed surgically with endoscopic or open carpal tunnel release (CTR). Rheumatoid arthritis (RA) is a known risk factor for Carpal Tunnel Syndrome (CTS) and is believed to be related to compression of the median nerve secondary to inflammation. We aimed to analyze national trends, outcomes, and patient-specific comorbidities associated with ECTR and OCTR in patients with RA. Methods: A retrospective cohort study was conducted using the PearlDiver database, identifying 683 RA patients undergoing ECTR and 4234 undergoing OCTR between 2010 and 2014. Demographic data, comorbidities, and complication rates were analyzed. Univariate and multivariable analyses assessed differences between the treatment methods. Results:  Patients with RA undergoing ECTR in comparison to OCTR had no significant differences in medical comorbidities such as hypertension, obesity, chronic kidney disease, hypothyroidism and diabetes mellitus. Patients in the ECTR group reported a risk ratio of 1.44 (95%CI: 1.10-1.89, p=0.01) of requiring repeat procedures within 90 days of the initial procedure. Five-year trends in ECTR and OCTR procedures reported a combined annual growth rate of 5.6% and 13.15, respectively. Conclusion: Endoscopic and open approaches to CTR are important considerations in surgical planning. RA and ECTR have previously been identified as independent risk factors for revision CTR. Our study has identified the 90-day risk of repeat procedures to be elevated in the ECTR group in comparison to the OCTR group. Additionally, the growth of OCTR procedures has outpaced the growth of ECTR procedures in the same period, likely in response to the trend of ECTR leading to higher rates of repeat procedures. The need for revision following ECTR in patients with RA could be related to chronic inflammation leading to transverse carpal ligament thickening and concomitant tenosynovitis. Future directions could include further characterization of repeat procedures performed in this subset of patients. 

Keywords: endoscopic treatment of carpal tunnel syndrome, open treatment of carpal tunnel syndrome, rheumatoid arthritis, trends analysis, carpal tunnel syndrome

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6328 Risk Assessment Results in Biogas Production from Agriculture Biomass

Authors: Sandija Zeverte-Rivza, Irina Pilvere, Baiba Rivza

Abstract:

The use of renewable energy sources incl. biogas has become topical in accordance with the increasing demand for energy, decrease of fossil energy resources and the efforts to reduce greenhouse gas emissions as well as to increase energy independence from the territories where fossil energy resources are available. As the technologies of biogas production from agricultural biomass develop, risk assessment and risk management become necessary for farms producing such a renewable energy. The need for risk assessments has become particularly topical when discussions on changing the biogas policy in the EU take place, which may influence the development of the sector in the future, as well as the operation of existing biogas facilities and their income level. The current article describes results of the risk assessment for farms producing biomass from agriculture biomass in Latvia, the risk assessment system included 24 risks, that affect the whole biogas production process and the obtained results showed the high significance of political and production risks.

Keywords: biogas production, risks, risk assessment, biosystems engineering

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6327 Role of Interlukin-18 in Primary Knee Osteoarthritis: Clinical, Laboratory and Radiological Study

Authors: Ibrahim Khalil Ibrahim, Enas Mohamed Shahine, Abeer Shawky El Hadedy, Emmanuel Kamal Aziz Saba, Ghada Salah Attia Hussein

Abstract:

Osteoarthritis (OA) is a multifactorial disease characterized by a progressive degradation of articular cartilage and is the leading cause of disability in elderly persons. IL-18 contributes to the destruction of cartilage and bone in the disease process of arthritis. The aim of the study was to investigate the role of IL-18 in primary knee OA patients. Serum level of IL-18 was assessed by enzyme-linked immunosorbent assay in 30 primary knee OA patients and compared to 20 age and gender-matched healthy volunteers as a control group. Radiographic severity of OA was assessed by Kellgren and Lawrence (KL) global scale. Pain, stiffness and functional assessment were done using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). OA patients had significantly higher serum IL-18 level than in control group (420.93 ± 345.4 versus 151.03 ± 144.16 pg/ml, P=0.001). Serum level of IL-18 was positively correlated with KL global scale (P=0.001). There were no statistically significant correlations between serum level of IL-18 and pain, stiffness, function subscales and total WOMAC index scores among the studied patients. In conclusions, IL-18 has a role in the pathogenesis of OA and it is positively correlated with the radiographic damage of OA.

Keywords: Interlukin-18, knee osteoarthritis, primary osteoarthritis, WOMAC scale

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6326 Effect of Heavy Metals on the Life History Trait of Heterocephalobellus sp. and Cephalobus sp. (Nematode: Cephalobidae) Collected from a Small-Scale Mining Site, Davao de Oro, Philippines

Authors: Alissa Jane S. Mondejar, Florifern C. Paglinawan, Nanette Hope N. Sumaya, Joey Genevieve T. Martinez, Mylah Villacorte-Tabelin

Abstract:

Mining is associated with increased heavy metals in the environment, and heavy metal contamination disrupts the activities of soil fauna, such as nematodes, causing changes in the function of the soil ecosystem. Previous studies found that nematode community composition and diversity indices were strongly affected by heavy metals (e.g., Pb, Cu, and Zn). In this study, the influence of heavy metals on nematode survivability and reproduction were investigated. Life history analysis of the free-living nematodes, Heterocephalobellus sp. and Cephalobus sp. (Rhabditida: Cephalobidae) were assessed using the hanging drop technique, a technique often used in life history trait experiments. The nematodes were exposed to different temperatures, i.e.,20°C, 25°C, and 30°C, in different groups (control and heavy metal exposed) and fed with the same bacterial density of 1×109 Escherichia coli cells ml-1 for 30 days. Results showed that increasing temperature and exposure to heavy metals had a significant influence on the survivability and egg production of both species. Heterocephalobellus sp. and Cephalobus sp., when exposed to 20°C survived longer and produced few numbers of eggs but without subsequent hatching. Life history parameters of Heterocephalobellus sp. showed that the value of parameters was higher in the control group under net production rate (R0), fecundity (mx) which is also the same value for the total fertility rate (TFR), generation times (G0, G₁, and Gh) and Population doubling time (PDT). However, a lower rate of natural increase (rm) was observed since generation times were higher. Meanwhile, the life history parameters of Cephalobus sp. showed that the value of net production rate (R0) was higher in the exposed group. Fecundity (mx) which is also the same value for the TFR, G0, G1, Gh, and PDT, were higher in the control group. However, a lower rate of natural increase (rm) was observed since generation times were higher. In conclusion, temperature and exposure to heavy metals had a negative influence on the life history of the nematodes, however, further experiments should be considered.

Keywords: artisanal and small-scale gold mining (ASGM), hanging drop method, heavy metals, life history trait.

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6325 Examining the Attitudes of Pre-School Teachers towards Values Education in Terms of Gender, School Type, Professional Seniority and Location

Authors: Hatice Karakoyun, Mustafa Akdag

Abstract:

This study has been made to examine the attitudes of pre-school teachers towards values education. The study has been made as a general scanning model. The study’s working group contains 108 pre-school teachers who worked in Diyarbakır, Turkey. In this study Values Education Attitude Scale (VEAS), which developed by Yaşaroğlu (2014), was used. In order to analyze the data for sociodemographic structure, percentage and frequency values were examined. The Kolmogorov-Smirnov method was used in determination of the normal distribution of data. During analyzing the data, KolmogorovSimirnov test and the normal curved histograms were examined to determine which statistical analyzes would be applied on the scale and it was found that the distribution was not normal. Thus, the Mann Whitney U analysis technique which is one of the nonparametric statistical analysis techniques were used to test the difference of the scores obtained from the scale in terms of independent variables. According to the analyses, it seems that pre-school teachers’ attitudes toward values education are positive. According to the scale with the highest average, it points out that pre-school teachers think that values education is very important for students’ and children’s future. The variables included in the scale (gender, seniority, age group, education, school type, school place) seem to have no effect on the pre-school teachers’ attitude grades which joined to the study.

Keywords: attitude scale, pedagogy, pre-school teacher, values education

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6324 Supplementation of Mannan Oligosaccharides in Guinea Pigs: Mortality and Growth Performance

Authors: C. Minguez, J. Bueso-Rodenas, C. Ibanez, A. Calvo

Abstract:

Mannan oligosaccharides (MOS) is one of the prebiotic most used in livestock nutrition. In this research, the effect of MOS dietary supplementation on growth performance and mortality in meat guinea pigs were studied. Three different experimental groups were compared: Control group (no additives); MOS 1 (1.5 g kg−1); MOS 2 (2 g kg−1). Guinea pigs were housed in 15 collective cages (n = 50 animals in each trial; 10 animals per cage). The young guinea pigs were weaning at day 28 and individually identified by a little ear tag. The fattening period was 49 days. Guinea pigs in both groups were fed ad libitum, with a standard commercial pellet diet (10 MJ of digestible energy/kg, 17% crude protein, 11% crude fiber, and 4.5% crude fat) and alfalfa (Medicago sativa) as forage. Growth traits, including body weight (BW), average daily gain (ADG), feed intake (FI), and feed conversion ratio (FCR), were measured weekly. On day 74, the animals were slaughtered. Contrasts between groups were obtained by calculated generalized least squares values. Mortality were evaluated by Fisher's exact test. Between MOS groups no significant differences were observed for growth traits and mortality. However, significant differences against the control group were observed for traits studied (pvalue < 0.05). In conclusion, the use of MOS could be a good prebiotic supplement to raise guinea pigs because it MOS has shown positive effects in growth traits and immune response in animals.

Keywords: guinea pig, growth, mannan oligosaccharides, mortality

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6323 The Factors Affecting Customers’ Trust on Electronic Commerce Website of Retail Business in Bangkok

Authors: Supattra Kanchanopast

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The purpose of this research was to identify factors that influenced the trust of e-commerce within retail businesses. In order to achieve the objectives of this research, the researcher collected data from random e-commerce users in Bangkok. The data was comprised of the results of 382 questionnaires. The data was analyzed by using descriptive statistics, which included frequency, percentages, and the standard deviation of pertinent factors. Multiple regression analysis was also used. The findings of this research revealed that the majority of the respondents were female, 25-40 years old, and graduated a bachelor degree. The respondents mostly worked in private sectors and had monthly income between 15,000-25,000 baht. The findings also indicate that information quality factors, website design factors, service quality factor, security factor and advertising factors as significant factors effecting customer trust of e-commerce in online retail. The hypotheses testing revealed that these factors in e-commerce had an effect on customer’s trust in the same direction with high level.

Keywords: e-commerce, online retail, Retail business, trust, website

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6322 The Effect of Vitamin D Deficiency on Endothelial Function in Atherosclerosis Patients Living in Saudi Arabia

Authors: Wedad Azhar

Abstract:

Vitamin D is an essential fat-soluble vitamin that is required for the maintenance of good health. It is obtained either through exposure to sunlight (ultraviolet B radiation) or through dietary sources. The role of vitamin D is beyond bone health. Indeed, it plays a critical role in the immune system and a broad range of organ functions such as the cardiovascular system. Moreover, vitamin D plays a critical role in the endothelial function, which is one of the main indicators of atherosclerosis. This study is investigating the correlation between vitamin D status and endothelial function in preventing and treating atherosclerosis especially in country that has ample of sunshine but yet, Saudis from suffering from this issue vitamin D deficiency and insufficiency. Ninety participants from both genders and aged 40 to 60will be involved. The participants will be categorised into three groups: the control group will be healthy persons, patients at risk of developing atherosclerosis, patients formally diagnosed atherosclerosis. Half of the participants in each group should already have been taking vitamin D supplementations. Fasting blood samples will be taken from the participants for biochemical assays. Endothelial function will be assist by flow-mediated dilation of the brachial artery. Participants will be asked to complete a questionnaire on their social and economic status, education level, daily exposure to sunlight, smoking status, consumption of supplements and medication, and a food frequency of vitamin D intake. The data will be analysed using SPSS.

Keywords: atherosclerosis, endothelial function, nutrition, vitamin D

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6321 The Effect of Using Augmented Reality Technique in a Computer Course Unit on the Academic Achievement and Attitudes of High School Female Students

Authors: Maha A. Al-Hsayni

Abstract:

Title of the Study: The Effect of Using Augmented Reality Technique in a Computer Course Unit on the Academic Achievement and Attitudes of High School Female Students. This study aimed at identifying the effect of using the Augmented Reality technique on the academic achievement of computer course at the cognitive domains (Knowledge, comprehension and analysis) with third high school female students in Holy Makkah. The researcher used: The quasi-experimental approach. The sample of the study was comprised of (55) female students in the third high school level in Holy Makkah in the second semester of the academic year 1434/1435 H. These students were assigned to two groups: The experimental group of (28) students who were taught by using the Augmented Reality technology, and the control group of (27) students, who were taught by using the traditional method. The researcher prepared a set of tools and materials, which are represented in achievement test consisted of (30) clauses, direction instrument consisted of (25) clauses and the design of augmented reality for computer study unit. The study used the following statistical methods for data analysis: Cronbach's alpha coefficient, Pearson correlation coefficient, means, standard deviations, t-test and analysis of covariance test ANCOVA. The study reached the following results: 1- There are statistically significance difference at ( 0.05) among the adjusted means of the experimental and control groups in the posttest at the domains of (Knowledge, comprehension and analysis) of third high school graders after adjusting the pretest 2- There are statistically significance difference at ( 0.05) among the means of pre and post-test for female students of the experimental group in the scale of attitude towards using Augmented Reality Technique. In the light of the study results, the researcher recommends the followings: The necessity of using Augmented Reality Technique in teaching computer courses for high school students. Furthermore, emphasizing the need to provide schools with educational halls equipped with instruments and screens that enable teachers to use the Augmented Reality in teaching the other courses. Also, the researcher suggested conducting more studies in order to improve the process of teaching and learning.

Keywords: augmented reality technique, computer course unit, academic achievement, attitudes, high school female students

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6320 MusicTherapy for Actors: An Exploratory Study Applied to Students from University Theatre Faculty

Authors: Adriana De Serio, Adrian Korek

Abstract:

Aims: This experiential research work presents a Group-MusicTherapy-Theatre-Plan (MusThePlan) the authors have carried out to support the actors. The MusicTherapy gives rise to individual psychophysical feedback and influences the emotional centres of the brain and the subconsciousness. Therefore, the authors underline the effectiveness of the preventive, educational, and training goals of the MusThePlan to lead theatre students and actors to deal with anxiety and to overcome psychophysical weaknesses, shyness, emotional stress in stage performances, to increase flexibility, awareness of one's identity and resources for a positive self-development and psychophysical health, to develop and strengthen social bonds, increasing a network of subjects working for social inclusion and reduction of stigma. Materials-Methods: Thirty students from the University Theatre Faculty participated in weekly music therapy sessions for two months; each session lasted 120 minutes. MusThePlan: Each session began with a free group rhythmic-sonorous-musical-production by body-percussion, voice-canto, instruments, to stimulate communication. Then, a synchronized-structured bodily-rhythmic-sonorous-musical production also involved acting, dances, movements of hands and arms, hearing, and more sensorial perceptions and speech to balance motor skills and the muscular tone. Each student could be the director-leader of the group indicating a story to inspire the group's musical production. The third step involved the students in rhythmic speech and singing drills and in vocal exercises focusing on the musical pitch to improve the intonation and on the diction to improve the articulation and lead up it to an increased intelligibility. At the end of each musictherapy session and of the two months, the Musictherapy Assessment Document was drawn up by analysis of observation protocols and two Indices by the authors: Patient-Environment-Music-Index (time to - tn) to estimate the behavior evolution, Somatic Pattern Index to monitor subject’s eye and mouth and limb motility, perspiration, before, during and after musictherapy sessions. Results: After the first month, the students (non musicians) learned to play percussion instruments and formed a musical band that played classical/modern music on the percussion instruments with the musictherapist/pianist/conductor in a public concert. At the end of the second month, the students performed a public musical theatre show, acting, dancing, singing, and playing percussion instruments. The students highlighted the importance of the playful aspects of the group musical production in order to achieve emotional contact and harmony within the group. The students said they had improved kinetic and vocal and all the skills useful for acting activity and the nourishment of the bodily and emotional balance. Conclusions: The MusThePlan makes use of some specific MusicTherapy methodological models, techniques, and strategies useful for the actors. The MusThePlan can destroy the individual "mask" and can be useful when the verbal language is unable to undermine the defense mechanisms of the subject. The MusThePlan improves actor’s psychophysical activation, motivation, gratification, knowledge of one's own possibilities, and the quality of life. Therefore, the MusThePlan could be useful to carry out targeted interventions for the actors with characteristics of repeatability, objectivity, and predictability of results. Furthermore, it would be useful to plan a University course/master in “MusicTherapy for the Theatre”.

Keywords: musictherapy, sonorous-musical energy, quality of life, theatre

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6319 Safety and Efficacy of Recombinant Clostridium botulinum Types B Vaccine Candidate

Authors: Mi-Hye Hwang, Young Min Son, Kichan Lee, Bang-Hun Hyun, Byeong Yeal Jung

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Botulism is a paralytic disease of human beings and animals caused by neurotoxin produced by Clostridium botulinum. The neurotoxins are genetically distinguished into 8 types, A to H. Ingestion of performed toxin, usually types B, C, and D, have been shown to produce diseases in most cases of cattle botulism. Vaccination is the best measure to prevent cattle botulism. However, the commercially available toxoid-based vaccines are difficult and hazardous to produce. We produced recombinant protein using gene of heavy chain domain of botulinum toxin B of which binds to cellular receptor of neuron cells and used as immunogen. In this study, we evaluated the safety and efficacy of botulism vaccine composed of recombinant types B. Safety test was done by National Regulation for Veterinary Biologicals. For efficacy test, female ICR mice (5 weeks old) were subcutaneously injected, intraperitoneally challenged, and examined the survival rates compared with vaccination and non-vaccination group. Mouse survival rate of recombinant types B vaccine was above 80%, while one of non-vaccination group was 0%. A vaccine composed of recombinant types B was safe and efficacious in mouse. Our results suggest that recombinant heavy chain receptor binding domain can be used as an effective vaccine candidate for type B botulism.

Keywords: botulism, livestock, vaccine, recombinant protein, toxin

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6318 Intrinsic and Extrinsic Motivations in Organic Farming Practices and Farmers’ Subjective Well-Being: The Case of French Organic Farmers

Authors: Nguyen Thi Huong Nhai

Abstract:

This paper examines how different motivations to engage in organic farming may impact the farmers’ subjective well-being using a survey database from the French Agence Bio. Three measures representing the subjective well-being of farmers brought by their involvement in organic farming are used in this study: feelings of pride, satisfaction, and feeling of happiness. We focus on the effects of two different types of motivations: intrinsic motivations, such as preservation of human health and public health, concern about the environment, and autonomy in farming decisions; extrinsic motivations, such as fair price, income, and demand incentives. Results show that not all intrinsic motivations can increase farmers’s well-being. The intrinsic motivation relating to environment concern and aspiration seems to have the highest positive impact on the three proxies of SWB in our study. It is interesting to find out that the two extrinsic motivations (profitable price, satisfying the incentive of consumer and cooperative) are proven to have a negative influence. Some comparisons, explanations, and practical implications are also indicated in this research.

Keywords: intrinsic otivation, extrinsic motivation, subjective wellbeing, organic farmers

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6317 The Influence of Plyometric Exercises on Biomechanical Factor Front Crawl and Back Crawl Speed in Elite Swimmers

Authors: Gheimati Salar

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The objective of conducting this research was to study the influence of plyometric exercises on the biomechanical selected factor of elite teen swimmers and compare the influence of plyometric exercises on the speed of front crawl and back crawl in empirical and control groups of teens. In order to conduct these study 30 swimmers with minimum of 3 years' experience who were 11 or 12 were randomly chosen and divided into 2 groups of 15. The first group was empirical and the second was control group. The speed of the swimmer was analyzed after 25 meters of swimming and their speed were recorded in the last. The researcher was standing stable at the beginning and then started the chronometer and stopped it at the end of the swimming. He repeated the record taking two times and then the average was taken. Before conducting plyometric exercises, a speed test was taken from both groups in both types of swimming. The duration of plyometric exercises was 8 weeks, every week 3 sessions and 24 sessions in total. The exercises in this study were focused on 3 parts of the body. Upper limb part, the lower part of the body and trunk area. Upper limb exercises consisted of four parts. The lower limb exercises consisted of 5 parts, and the trunk exercises consisted of four sections. A Medicine ball, cone and different weights were used in these exercises.

Keywords: plyometric, exercises, front crawl and back crawl, speed

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6316 The Implementation of Social Responsibility with the Approach of Indonesian Realistic Mathematics Education in Teaching and Learning Mathematics on Students' Engagement and Learning

Authors: Nurwati Djaman, Suradi Tahmir, Nurdin Arsyad

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The major objective of this study was to implement and evaluate the use of the implementation of social responsibility with the approach of Indonesian Realistic Mathematics Education (PMRI) in teaching and learning mathematics on students’ engagement and learning. The research problems investigated in this research: 1) What were the effects of the implementation of social responsibility with PMRI approach to learning mathematics? 2) What were the effects of the approach to students’ engagement? An action research and grounded theory methodology were adopted for the study. This study used mixed methods to collect, describe, and interpret the data. The data were collected through focus group discussion, classroom observations, questionnaire, interview, and students’ work. The participants in this study consisted of 45 students. The study revealed that the approach has given students the opportunity to develop their understanding of concepts and procedures, problem-solving ability, and communication ability. Also, students’ involvement in the approach improved their engagement in learning mathematics in the three domains of cognitive engagement, effective engagement, and behavioral engagement. In particular, the data collection from the focus group, classroom observations, and interviews suggest that, during this study, the students became more active participants in the mathematics lessons.

Keywords: Indonesian Realistic Mathematics Education, PMRI, learning mathematics, social responsibility, students' engagement

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6315 Evaluation of Existence of Antithyroid Antibodies, Anti-Thyroid Peroxidase and Anti-Thyroglobulin in Patients with Hepatitis C Viral Infections

Authors: Junaid Mahmood Alam, Sana Anwar, Sarah Sughra Asghar

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Chronic hepatitis or Hepatitis C viral (HCV) infection has been identified as one of the factors that could elicit autoimmune disease resulting in the development of auto-antibodies. Furthermore, HCV is implicated in contravening of forbearance to antigens, therefore, inciting auto-reactivity. In this regard, several near and past studies noted the prevalence of thyroid dysfunction and production of anti-thyroid antibodies (ATAb) such as anti-thyroid peroxidase (AntiTPO) and anti-thyroglobulin (AntiTG) in patients with HCV. Likewise, one of the etiologies of augmentation of thyroid disease is basically interferon therapy for HCV infections, for which a number of autoimmune diseases have been noted including Grave’s disease, Hishimoto thyroiditis. A prospectively case-control study was therefore carried out at department of clinical biochemistry lab services and chemical pathology in collaboration with department of clinical microbiology, at Liaquat National Hospital and Medical College, Karachi Pakistan for the period January 2015 to December 2017. Two control groups were inducted for comparison purpose, control group 1 = without HCV infection and with thyroid disorders (n = 20), control group 2 = with HCV infection and without thyroid disorders (n = 20), whereas HCV infected were n = 40 where more than half were noted to be positive for either of HCV IgG and Ag. In HCV group, patients with existing sub-clinical hypothyroidism and clinical hyperthyroidism were less than 5%. Analysis showed the presence of AntiTG in 12 HCV patients (30%), AntiTPO in 15 (37.5%) and both AntiTG and antiTPO in 10 patients (25%). Only 3 patients were found with the history of anti-thyroid auto-antibodies (7.5%) and one with parents and relatives with auto-immune disorders (2.5%). Patients that remained untreated were 12 (30%), under treatment 18 (45%) and with complete-course of treatment 10 (25%). As per review of the literature, meta-analysis of evident data and cross-sectional studies of selective cohorts (as studied in presented research), thyroid connection is designated as one of the most recurrent endocrine ailment associated with chronic HCV infection. Moreover, it also represents an extrahepatic disease in the continuum of HCV syndrome. In conclusion, HCV patients were more likely to encompass thyroid disorders especially related to development of either of ATAb or both antiTG and AntiTPO.

Keywords: Hepatitis C viral (HCV) infection, anti-thyroid antibodies, anti-thyroid peroxidase antibodies, anti-thyroglobulin antibodies

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6314 Histological Evaluation of the Neuroprotective Roles of Trans Cinnamaldehyde against High Fat Diet and Streptozotozin Induced Neurodegeneration in Wistar Rats

Authors: Samson Ehindero, Oluwole Akinola

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Substantial evidence has shown an association between type 2 diabetes (T2D) and cognitive decline, Trans Cinnamaldehyde (TCA) has been shown to have many potent pharmacological properties. In this present study, we are currently investigating the effects of TCA on type II diabetes-induced neurodegeneration. Neurodegeneration was induced in forty (40) adult wistar rats using high fat diet (HFD) for 4 months followed by low dose of streptozotocin (STZ) (40 mg/kg, i.p.) administration. TCA was administered orally for 30 days at the doses of 40mg/kg and 60mg/kg body weight. Animals were randomized and divided into following groups; A- control group, B- diabetic group, C- TCA (high dose), D- diabetic + TCA (high dose), E- diabetic + TCA (high dose) with high fat diet, F- TCA Low dose, G- diabetic + TCA (low dose) and H- diabetic + TCA (low dose) with high fat diet. Animals were subjected to behavioral tests followed by histological studies of the hippocampus. Demented rats showed impaired behavior in Y- Maze test compared to treated and control groups. Trans Cinnamaldehyde restores the histo architecture of the hippocampus of demented rats. This present study demonstrates that treatment with trans- cinnamaldehyde improves behavioral deficits, restores cellular histo architecture in rat models of neurodegeneration.

Keywords: neurodegeneration, trans cinnamaldehyde, high fat diet, streptozotocin

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6313 The Influence of Argumentation Strategy on Student’s Web-Based Argumentation in Different Scientific Concepts

Authors: Xinyue Jiao, Yu-Ren Lin

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Argumentation is an essential aspect of scientific thinking which has been widely concerned in recent reform of science education. The purpose of the present studies was to explore the influences of two variables termed ‘the argumentation strategy’ and ‘the kind of science concept’ on student’s web-based argumentation. The first variable was divided into either monological (which refers to individual’s internal discourse and inner chain reasoning) or dialectical (which refers to dialogue interaction between/among people). The other one was also divided into either descriptive (i.e., macro-level concept, such as phenomenon can be observed and tested directly) or theoretical (i.e., micro-level concept which is abstract, and cannot be tested directly in nature). The present study applied the quasi-experimental design in which 138 7th grade students were invited and then assigned to either monological group (N=70) or dialectical group (N=68) randomly. An argumentation learning program called ‘the PWAL’ was developed to improve their scientific argumentation abilities, such as arguing from multiple perspectives and based on scientific evidence. There were two versions of PWAL created. For the individual version, students can propose argument only through knowledge recall and self-reflecting process. On the other hand, the students were allowed to construct arguments through peers’ communication in the collaborative version. The PWAL involved three descriptive science concept-based topics (unit 1, 3 and 5) and three theoretical concept-based topics (unit 2, 4 and 6). Three kinds of scaffoldings were embedded into the PWAL: a) argument template, which was used for constructing evidence-based argument; b) the model of the Toulmin’s TAP, which shows the structure and elements of a sound argument; c) the discussion block, which enabled the students to review what had been proposed during the argumentation. Both quantitative and qualitative data were collected and analyzed. An analytical framework for coding students’ arguments proposed in the PWAL was constructed. The results showed that the argumentation approach has a significant effect on argumentation only in theoretical topics (f(1, 136)=48.2, p < .001, η2=2.62). The post-hoc analysis showed the students in the collaborative group perform significantly better than the students in the individual group (mean difference=2.27). However, there is no significant difference between the two groups regarding their argumentation in descriptive topics. Secondly, the students made significant progress in the PWAL from the earlier descriptive or theoretical topic to the later one. The results enabled us to conclude that the PWAL was effective for students’ argumentation. And the students’ peers’ interaction was essential for students to argue scientifically especially for the theoretical topic. The follow-up qualitative analysis showed student tended to generate arguments through critical dialogue interactions in the theoretical topic which promoted them to use more critiques and to evaluate and co-construct each other’s arguments. More explanations regarding the students’ web-based argumentation and the suggestions for the development of web-based science learning were proposed in our discussions.

Keywords: argumentation, collaborative learning, scientific concepts, web-based learning

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6312 Haplotypes of the Human Leukocyte Antigen-G Different HIV-1 Groups from the Netherlands

Authors: A. Alyami, S. Christmas, K. Neeltje, G. Pollakis, B. Paxton, Z. Al-Bayati

Abstract:

The Human leukocyte antigen-G (HLA-G) molecule plays an important role in immunomodulation. To date, 16 untranslated regions (UTR) HLA-G haplotypes have been previously defined by sequenced SNPs in the coding region. From these, UTR-1, UTR-2, UTR-3, UTR-4, UTR-5, UTR-6 and UTR-7 are the most frequent 3’UTR haplotypes at the global level. UTR-1 is associated with higher levels of soluble HLA-G and HLA-G expression, whereas UTR-5 and UTR-7 are linked with low levels of soluble HLA-G and HLA-G expression. Human immunodeficiency virus type 1 (HIV-1) infection results in the progressive loss of immune function in infected individuals. The virus escape mechanism typically includes T lymphocytes and NK cell recognition and lyses by classical HLA-A and B down-regulation, which has been associated with non-classical HLA-G molecule up-regulation, respectively. We evaluated the haplotypes of the HLA-G 3′ untranslated region frequencies observed in three HIV-1 groups from the Netherlands and their susceptibility to develop infection. The three groups are made up of mainly men who have sex with men (MSM), injection drug users (IDU) and a high-risk-seronegative (HRSN) group. DNA samples were amplified with published primers prior sequencing. According to our results, the low expresser frequencies show higher in HRSN compared to other groups. This is indicating that 3’UTR polymorphisms may be identified as potential prognostic biomarkers to determine susceptibility to HIV.

Keywords: Human leukocyte antigen-G (HLA-G) , men who have sex with men (MSM), injection drug users (IDU), high-risk-seronegative (HRSN) group, high-untranslated region (UTR)

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6311 Efficacy of CAM Methods for Pain Reduction in Acute Non-specific Lower Back Pain

Authors: John Gaber

Abstract:

Objectives: Complementary and alternative medicine (CAM) is a medicine or health practice that is used alongside conventional practice. Nowadays, CAM is commonly used in North America and other countries, and there is a need for more scientific study to understand its efficacy in different clinical cases. This retrospective study explores the effectiveness and recovery time of CAMs such as cupping, acupuncture, and sotai to treat cases of non-specific low back pain (ANLBP). Methods: We assessed the effectiveness of acupuncture, cupping, and sotai methods on pain and for the treatment of ANLBP. We have compared the magnitude of pain relief using a pain scale assessment method to compare the efficacy of each treatment. The Face Pain Scale assessment was conducted before and 24 hours post-treatment. This retrospective study analyzed 40 patients and categorized them according to the treatment they received. The study included the control group, and the three intervention groups, each with ten patients. Each of the three intervention groups received one of the intervention methods. The first group received the cupping treatment, where cups were placed on the lower back of both sides on points: BL23, BL25, BL26, BL54, BL37, BL40, and BL57. After vacuuming, the cups will stay for 10-15 minutes under infrared light (IR) heating. IR heating is applied by an infrared heat lamp. The second group received the acupuncture treatment, placing needles on points: BL23, BL25, BL26, BL52BL54, GB30, BL37, BL40, BL57, BL59, BL60, and KI3. The needles will be simulated with IR light. The final group received the sotai treatment, a Japanese form of structural realignment that relieves pain, balance, and mobility -moving the body naturally and spontaneously towards a comfortable direction by focusing on the inner feeling and synchronizing with the patient’s breathing. The SPSS statistical software was used to analyze the data using repeated-measures ANOVA. The data collected demonstrates the change in the FPS assessment method value over the course of treatment. p<0.05 was considered statistically significant. Results: In the cupping, acupuncture, and sotai therapy groups, the mean of the FPS value reduced from 8.7±1.2, 8.8±1.2, 9.0±0.8 before the intervention to 3.5±1.4, 4.3±1.4, 3.3±1.3, 24 hours after the intervention, respectively. The data collected shows that the CAM methods included in this study all show improvements in pain relief 24 hours after treatment. Conclusion: Complementary and alternative medicine were developed to treat injuries and illnesses with the whole body in mind, designed to be used in addition to standard treatments. The data above shows that the use of these treatments can have a pain-relieving effect, but more research should be done on the matter, as finding CAM methods that are efficacious is crucial in the landscape of health sciences.

Keywords: acupuncture, cupping, alternative medicine, rehabilitation, acute injury

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6310 Influencing Factors of Residents’ Intention to Participate in the Governance of Old Community Renewal: A Case Study of Nanjing

Authors: Tiantian Gu, Dezhi Li, Mian Zhang, Ying Jiang

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Considering the characteristics of residents’ participation in the governance of old community renewal (OCR), a theoretical model of the determinant of residents’ intention to participate in the governance of OCR has been built based on the theory of planned behavior. Seven old communities in Nanjing have been chosen as cases to conduct empirical analysis. The result indicates that participation attitude, subjective norm and perceived behavioral control have significant positive effects on residents’ intention to participate in the governance of the OCR. Recognition of the community, cognition of the OCR and perceived behavioral control have indirect positive effects on residents’ intention to participate in the OCR. In addition, the education level and the length of residence have positive effects on their participation intention, while the gender, age, and monthly income have little effect on it. The research result provides suggestions for the improvement of residents’ participation in the OCR.

Keywords: old community renewal, residents’ participation in governance, intention, theory of planned behavior

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6309 Increase Women's Knowledge and Attitude about Breast Cancer and Screening: Using an Educational Intervention in Community

Authors: Mitra Savabi-Esfahani, Fariba Taleghani, Mahnaz Noroozi, Maryam Tabatabaeian, Elsebeth Lynge

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Breast cancer is a health concern in worldwide. All women have not adequate information about breast cancer, resulting in undetected some tumors until advanced stages. Therefore awareness of people was recommended as a strategy to control that. The aim of this study was to assess the effect of an educational intervention on women's knowledge and attitude about breast cancer and screening. This study was conducted in 2016 on 191 women. All women living in one of big cities were invited to enroll in training classes. Inclusion criteria consisted women who were 20 - 69 years and not participated in any educational intervention. The lecture with group discussion was used as educational methods. Data collection tool was a structured questionnaire which filled out before and after intervention. The reliability of the questionnaire was determined by Cronbach's alpha. The data were analyzed using SPSS software. The average age was 44/4 ± 11.5 and 42.6% of the women had obtained high school. Of the 191 women, 70(36.6%) and 76(39.8%) had low and medium level of knowledge respectively and half of them, 95(50%) had medium level of attitude in before intervention. There was significant difference between mean scores of knowledge and attitude before and after the intervention by Paired T test (p < 0/001). It seems applying effective educational interventions can increase knowledge and attitude women about breast cancer particularly in community that they have insufficient levels. Moreover, the lecture method along with group discussion can be proposed as effective and conventional methods for this purpose.

Keywords: attitude, breast cancer, educational intervention, knowledge

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