Search results for: dialectical behaviour therapy

Authors: Gaye Demi̇rtaş Adli

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Research: It was conducted to determine the factors affecting the fear of self-injection and self-pricking of fingers of diabetic individuals.The study was conducted as a cross-sectional, relation-seeking, and descriptive study. The study was conducted on 122 patients who had just started insulin therapy. Data were obtained through The Descriptive Patient Form, The Diabetic Self-Injection, and the Fear of Testing Questionnaire Form (D-FISQ). Descriptive statistical methods used in the evaluation of data are the Mann-Whitney U test, Kruskal-Wallis H test, and the Spearman correlation. The factors affecting the scale scores were evaluated with multiple linear regression analysis. The value of P<0.05 was considered statistically significant. Study group: 56.6% of the patients are male patients. Fear of self-injection (injection), fear of self-testing (test), and total fear (total) scores of women were found to be statistically higher than men (p<0.001). Age, gender, and pain experience were important variables that affected patients' fear of injections. With a one-unit increase in age, the injection fear score decreased by 0.13 points, and the mean injection fear score of women was 2.11 points higher than that of men. It was determined that the patient's age, gender, living with whom, and blood donation history were important variables affecting the fear of self-testing. It is seen that the fear test score decreases by 0.18 points with an increase in age by one unit, and the fear test scores of women compared to men are on average 3,358 points, the fear test scores of those living alone are 4,711 points compared to those living with family members, and the fear test scores of those who do not donate blood are 2,572 compared to those who donate blood score, it was determined that those with more pain experience were 3,156 points higher on average than those with less fear of injection. As a result, it was seen that the most important factors affecting the fear of insulin injection and finger punching in individuals with diabetes were age, gender, pain experience, living with whom, and blood donation history.

Keywords: diabetes, needle phobia, fear of injection, insulin injection

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Authors: Swati Tomar, Sunil Kumar Gupta

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Anammox is a promising and cost effective alternative to conventional treatment systems that facilitates direct oxidation of ammonium nitrogen under anaerobic conditions with nitrite as an electron acceptor without addition of any external carbon sources. The present study investigates the process kinetics of laboratory scale anammox hybrid reactor (AHR) which combines the dual advantages of attached and suspended growth. The performance & behaviour of AHR was studied under varying hydraulic retention time (HRTs) and nitrogen loading rate (NLRs). The experimental unit consisted of 4 numbers of 5L capacity anammox hybrid reactor inoculated with mixed seed culture containing anoxic and activated sludge. Pseudo steady state (PSS) ammonium and nitrite removal efficiencies of 90.6% and 95.6%, respectively, were achieved during acclimation phase. After establishment of PSS, the performance of AHR was monitored at seven different HRTs of 3.0, 2.5, 2.0, 1.5, 1.0, 0.5 and 0.25 d with increasing NLR from 0.4 to 4.8 kg N/m3d. The results showed that with increase in NLR and decrease in HRT (3.0 to 0.25 d), AHR registered appreciable decline in nitrogen removal efficiency from 92.9% to 67.4 %, respectively. The HRT of 2.0 d was considered optimal to achieve substantial nitrogen removal of 89%, because on further decrease in HRT below 1.5 days, remarkable decline in the values of nitrogen removal efficiency were observed. Analysis of data indicated that attached growth system contributes an additional 15.4 % ammonium removal and reduced the sludge washout rate (additional 29% reduction). This enhanced performance may be attributed to 25% increase in sludge retention time due to the attached growth media. Three kinetic models, namely, first order, Monod and Modified Stover-Kincannon model were applied to assess the substrate removal kinetics of nitrogen removal in AHR. Validation of the models were carried out by comparing experimental set of data with the predicted values obtained from the respective models. For substrate removal kinetics, model validation revealed that Modified Stover-Kincannon is most precise (R2=0.943) and can be suitably applied to predict the kinetics of nitrogen removal in AHR. Lawrence and McCarty model described the kinetics of bacterial growth. The predicted value of yield coefficient and decay constant were in line with the experimentally observed values.

Keywords: anammox, kinetics, modelling, nitrogen removal, sludge wash out rate, AHR

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Authors: Seba Mohanty, Jitendra Mahakud

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Capital ratio is one of the major indicators of the stability of the commercial banks. Pertinent to its pervasive importance, over the years the regulators, policy makers focus on the maintenance of the particular level of capital ratio to minimize the solvency and liquidation risk. In this context, it is very much important to identify the relationship between capital and risk and find out the factors which determine the capital ratios of commercial banks. The study examines the relationship between capital and risk of the commercial banks operating in India. Other bank specific variables like bank size, deposit, profitability, non-performing assets, bank liquidity, net interest margin, loan loss reserves, deposits variability and regulatory pressure are also considered for the analysis. The period of study is 1997-2015 i.e. the period of post liberalization. To identify the impact of financial crisis and implementation of Basel II on capital ratio, we have divided the whole period into two sub-periods i.e. 1997-2008 and 2008-2015. This study considers all the three types of commercial banks, i.e. public sector, the private sector and foreign banks, which have continuous data for the whole period. The main sources of data are Prowess data base maintained by centre for monitoring Indian economy (CMIE) and Reserve Bank of India publications. We use simultaneous equation model and more specifically Two Stage Least Square method to find out the relationship between capital and risk. From the econometric analysis, we find that capital and risk affect each other simultaneously, and this is consistent across the time period and across the type of banks. Moreover, regulation has a positive significant impact on the ratio of capital to risk-weighted assets, but no significant impact on the banks risk taking behaviour. Our empirical findings also suggest that size has a negative impact on capital and risk, indicating that larger banks increase their capital less than the other banks supported by the too-big-to-fail hypothesis. This study contributes to the existing body of literature by predicting a strong relationship between capital and risk in an emerging economy, where banking sector plays a majority role for financial development. Further this study may be considered as a primary study to find out the macro economic factors which affecting risk and capital in India.

Keywords: capital, commercial bank, risk, simultaneous equation model

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Authors: Ibrahima Diallo

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The literature on teacher education foregrounds reflection as an important aspect of professional practice. Reflection for a teacher consists in critically analysing and evaluating retrospectively a lesson to see what worked, what did not work, and how to improve it for the future. Now, many teacher education programmes worldwide consider the ability to reflect as one of the hallmarks of an effective educator. However, in some context like Senegal, reflection has not been given due consideration in teacher education programmes. In contexts where it has been in the education landscape for some time now, reflection is mostly depicted as an individual written activity and many teacher trainees have become disenchanted by the repeated enactments of this task that is solely intended to satisfy course requirements. This has resulted in whitewashing weaknesses or even ‘faking’ reflection. Besides, the “one-size-fits-all” approach of reflection could not flourish because how reflection impacts on practice is still unproven. Therefore, reflective practice needs to be contextualised and made more thought-provoking through dialogue and by using classroom data. There is also a need to highlight change brought in teachers’ practice through reflection. So, this study introduces reflection in a new context and aims to show evidenced change in novice EFL teachers’ practice through dialogic data-led reflection. The purpose of this study is also to contribute to the scarce literature on reflection in sub-Saharan Africa by bringing new perspectives on contextualised teacher-led reflection. Eight novice EFL teachers participated in this qualitative longitudinal study, and data have been gathered online through post-lesson reflection recordings and lesson videos for a period of four months. Then, the data have been thematically analysed using NVivo to systematically organize and manage the large amount of data. The analysis followed the six steps approach to thematic analysis. Major themes related to teachers’ classroom practice and their conception of reflection emerged from the analysis of the data. The results showed that post-lesson reflection with a peer can help novice EFL teachers gained more awareness on their classroom practice. Dialogic reflection also helped them evaluate their lessons and seek for improvement. The analysis of the data also gave insight on teachers’ conception of reflection in an EFL context. It was found that teachers were more engaged in reflection when using their lesson video recordings. Change in teaching behaviour as a result of reflection was evidenced by the analysis of the lesson video recordings. This study has shown that video-stimulated reflection is practical form of professional development that can be embedded in teachers’ professional life.

Keywords: novice EFL teachers, practice, professional development, video-stimulated reflection

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Authors: L. Ebralidze, A. Tsertsvadze, D. Berashvili, A. Bakuridze

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Current cancer therapy strategies are based on surgery, radiotherapy and chemotherapy. The problems associated with chemotherapy are one of the biggest challenges for clinical medicine. These include: low specificity, broad spectrum of side effects, toxicity and development of cellular resistance. Therefore, anti-cance drugs need to be develop urgently. Particularly, in order to increase efficiency of anti-cancer drugs and reduce their side effects, scientists work on formulation of nano-drugs. The objective of this study was to develop composition and technology of vincristine nanoparticles using high-molecular carbohydrates of plant origin. Plant polysacharides, particularly, soy bean seed polysaccharides, flaxseed polysaccharides, citrus pectin, gum arabic, sodium alginate were used as objects. Based on biopharmaceutical research, vincristine containing nanoparticle formulations were prepared. High-energy emulsification and solvent evaporation methods were used for preparation of nanosystems. Polysorbat 80, polysorbat 60, sodium dodecyl sulfate, glycerol, polyvinyl alcohol were used in formulation as emulsifying agent and stabilizer of the system. The ratio of API and polysacharides, also the type of the stabilizing and emulsifying agents are very effective on the particle size of the final product. The influence of preparation technology, type and concentration of stabilizing agents on the properties of nanoparticles were evaluated. For the next stage of research, nanosystems were characterized. Physiochemical characterization of nanoparticles: their size, shape, distribution was performed using Atomic force microscope and Scanning electron microscope. The present study explored the possibility of production of NPs using plant polysaccharides. Optimal ratio of active pharmaceutical ingredient and plant polysacharids, the best stabilizer and emulsifying agent was determined. The average range of nanoparticles size and shape was visualized by SEM.

Keywords: nanoparticles, target delivery, natural high molecule carbohydrates, surfactants

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Authors: Christopher Benedikt Jakob

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In our current society, there is no need to take a look at the wristwatch to know the exact time. Smartphones, the watch in the car or the computer watch, inform us about the time too. Over hundreds of years, luxury watches have held a fascination for human beings. Consumers buy watches that cost thousands of euros, although they could buy much cheaper watches which also fulfill the function to indicate the correct time. This shows that the functional value has got a minor meaning with reference to the buying-reasons as regards luxury watches. For a few years, people have an increased demand to track data like their walking distance per day or to track their sleep for example. Smart watches enable consumers to get information about these data. There exists a trend that people intend to optimise parts of their social life, and thus they get the impression that they are able to optimise themselves as human beings. With the help of smart watches, they are able to optimise parts of their productivity and to realise their targets at the same time. These smart watches are also offered as luxury models, and the question is: how will customers of traditional luxury watches react? Therefore this study has the intention to give answers to the question why people are willing to spend an enormous amount of money on the consumption of luxury watches. The self-expression model, the relationship basis model, the functional benefit representation model and the means-end-theory are chosen as an appropriate methodology to find reasons why human beings purchase specific luxury watches and luxury smart watches. This evaluative approach further discusses these strategies concerning for example if consumers buy luxury watches/smart watches to express the current self or the ideal self and if human beings make decisions on expected results. The research critically evaluates that relationships are compared on the basis of their advantages. Luxury brands offer socio-emotional advantages like social functions of identification and that the strong brand personality of luxury watches and luxury smart watches helps customers to structure and retrieve brand awareness which simplifies the process of decision-making. One of the goals is to identify if customers know why they like specific luxury watches and dislike others although they are produced in the same country and cost comparable prices. It is very obvious that the market for luxury watches especially for luxury smart watches is changing way faster than it has been in the past. Therefore the research examines the market changing parameters in detail.

Keywords: buying-behaviour, brand management, consumer, luxury watch, smart watch

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Authors: Libor Zachoval, Daire O Broin, Oisin Cawley

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E-learning platforms, such as Blackboard have two major shortcomings: limited data capture as a result of the limitations of SCORM (Shareable Content Object Reference Model), and lack of incorporation of Artificial Intelligence (AI) and machine learning algorithms which could lead to better course adaptations. With the recent development of Experience Application Programming Interface (xAPI), a large amount of additional types of data can be captured and that opens a window of possibilities from which online education can benefit. In a corporate setting, where companies invest billions on the learning and development of their employees, some learner behaviours can be troublesome for they can hinder the knowledge development of a learner. Behaviours that hinder the knowledge development also raise ambiguity about learner’s knowledge mastery, specifically those related to gaming the system. Furthermore, a company receives little benefit from their investment if employees are passing courses without possessing the required knowledge and potential compliance risks may arise. Using xAPI and rules derived from a state-of-the-art review, we identified three learner behaviours, primarily related to guessing, in a corporate compliance course. The identified behaviours are: trying each option for a question, specifically for multiple-choice questions; selecting a single option for all the questions on the test; and continuously repeating tests upon failing as opposed to going over the learning material. These behaviours were detected on learners who repeated the test at least 4 times before passing the course. These findings suggest that gauging the mastery of a learner from multiple-choice questions test scores alone is a naive approach. Thus, next steps will consider the incorporation of additional data points, knowledge estimation models to model knowledge mastery of a learner more accurately, and analysis of the data for correlations between knowledge development and identified learner behaviours. Additional work could explore how learner behaviours could be utilised to make changes to a course. For example, course content may require modifications (certain sections of learning material may be shown to not be helpful to many learners to master the learning outcomes aimed at) or course design (such as the type and duration of feedback).

Keywords: artificial intelligence, corporate e-learning environment, knowledge maintenance, xAPI

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Authors: Daniel Aberdam

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Haploinsufficiency of PAX6 in humans is the main cause of congenital aniridia, a rare eye disease characterized by reduced visual acuity. Patients have also progressive disorders including cataract, glaucoma and corneal abnormalities making their condition very challenging to manage. Aniridia-related keratopathy (ARK), caused by a combination of factors including limbal stem-cell deficiency, impaired healing response, abnormal differentiation, and infiltration of conjunctival cells onto the corneal surface, affects up to 95% of patients. It usually begins in the first decade of life resulting in recurrent corneal erosions, sub-epithelial fibrosis with corneal decompensation and opacification. Unfortunately, current treatment options for aniridia patients are currently limited. Although animal models partially recapitulate this disease, there is no in vitro cellular model of AKT needed for drug/therapeutic tools screening and validation. We used genome editing (CRISPR/Cas9 technology) to introduce a nonsense mutation found in patients into one allele of the PAX6 gene into limbal stem cells. Resulting mutated clones, expressing half of the amount of PAX6 protein and thus representative of haploinsufficiency were further characterized. Sequencing analysis showed that no off-target mutations were induced. The mutated cells displayed reduced cell proliferation and cell migration but enhanced cell adhesion. Known PAX6 targets expression was also reduced. Remarkably, addition of soluble recombinant PAX6 protein into the culture medium was sufficient to activate endogenous PAX6 gene and, as a consequence, rescue the phenotype. It strongly suggests that our in vitro model recapitulates well the epithelial defect and becomes a powerful tool to identify drugs that could rescue the corneal defect in patients. Furthermore, we demonstrate that the homeotic transcription factor Pax6 is able to be uptake naturally by recipient cells to function into the nucleus.

Keywords: Pax6, crispr/cas9, limbal stem cells, aniridia, gene therapy

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Authors: Adeel Zulifqar, Hong Hu

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Auxetic fabrics are a special kind of textile materials which possess negative Poisson’s ratio. Opposite to most of the conventional fabrics, auxetic fabrics get bigger in the transversal direction when stretched or get smaller when compressed. Auxetic fabrics are superior to conventional fabrics because of their counterintuitive properties, such as enhanced porosity under the extension, excellent formability to a curved surface and high energy absorption ability. Up till today, auxetic fabrics have been produced based on two approaches. The first approach involves using auxetic fibre or yarn and weaving technology to fabricate auxetic fabrics. The other method to fabricate the auxetic fabrics is by using non-auxetic yarns. This method has gained extraordinary curiosity of researcher in recent years. This method is based on realizing auxetic geometries into the fabric structure. In the woven fabric structure auxetic geometries can be realized by creating a differential shrinkage phenomenon into the fabric structural unit cell. This phenomenon can be created by using loose and tight weave combinations within the unit cell of interlacement pattern along with elastic and non-elastic yarns. Upon relaxation, the unit cell of interlacement pattern acquires a non-uniform shrinkage profile due to different shrinkage properties of loose and tight weaves in designed pattern, and the auxetic geometry is realized. The development of uni-stretch auxetic woven fabrics and bi-stretch auxetic woven fabrics by using this method has already been reported. This study reports the development of another kind of bi-stretch auxetic woven fabric. The fabric is first designed by transforming the auxetic geometry into interlacement pattern and then fabricated, using the available conventional weaving technology and non-auxetic elastic and non-elastic yarns. The tensile tests confirmed that the developed bi-stretch auxetic woven fabrics exhibit negative Poisson’s ratio over a wide range of tensile strain. Therefore, it can be concluded that the auxetic geometry can be realized into the woven fabric structure by creating the phenomenon of differential shrinkage and bi-stretch woven fabrics made of non-auxetic yarns having auxetic behavior and stretchability are possible can be obtained. Acknowledgement: This work was supported by the Research Grants Council of Hong Kong Special Administrative Region Government (grant number 15205514).

Keywords: auxetic, differential shrinkage, negative Poisson's ratio, weaving, stretchable

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Authors: Mohamad Shamsuri Juhari

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Fathers who positively involve themselves in their children’s lives will have had a constructive influence on the latter’s social, behavioural, and psychological development. This paper will share the preliminary findings of an ongoing research project which investigates Singaporean fathers from the nation’s minority Malay-Muslim community who commit the reverse, that is, it intends to study the reasons behind these fathers’ non-involvement during the period of their children’s developing years be it through absence, disinterest or ignorance. For instance, children from homes with absentee fathers are more likely to develop deficiencies in attitude and conduct. A father’s negative show of parental skills can also cause setbacks in the child’s education, economic instability in the latter’s future family life, as well as the likelihood of an ensuing intergenerational transmission of criminal behaviour. In the context of the minority Singaporean Malay-Muslim community, the need to investigate the challenges faced by fathers from the ethnic group in carrying out their parental roles arose due to the perceptible rise in statistics reflecting delinquency among its youths. This has resulted in other associated issues such as teenage pregnancies (and the subsequent cyclical patterns of divorce and single motherhood), over-representation in the data for drug offences, and under-representation in statistics reflecting academic achievement. While other factors are known to be involved, these negative outcomes have also been attributed to the lack of fatherly guidance in the affected Malay families. This still-ongoing research project is being carried out in two phases: The first by means of secondary research as well as exploratory data collection via roundtable and focus group discussions with fathers from diverse socio-economic backgrounds. This sets the way for the second phase in which a survey will be undertaken, followed by a series of in-depth face-to-face interviews. The research findings will then be translated into intervention initiatives to overcome the identified challenges. Based on the results collated from Phase 1 of the research, this paper will share a ‘first look’ on the challenges to effective parenting faced by Malay-Muslim fathers in Singapore specifically those relating to the socio-cultural domains of attitude, knowledge, and practice.

Keywords: Malay fathers, socio-cultural domains, attitude, knowledge, practice

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Authors: Heeba A. Gurku

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Introduction: Cone Beam CT(CBCT) images play an integral part in proper patient positioning in cancer patients undergoing radiation therapy treatment. But these images are low in quality. The purpose of this study is to generate high-quality synthetic CT images from CBCT using generative models. Material and Methods: This study utilized two datasets from The Cancer Imaging Archive (TCIA) 1) Lung cancer dataset of 20 patients (with full view CBCT images) and 2) Pancreatic cancer dataset of 40 patients (only 27 patients having limited view images were included in the study). Cycle Generative Adversarial Networks (GAN) and its variant Attention Guided Generative Adversarial Networks (AGGAN) models were used to generate the synthetic CTs. Models were evaluated by visual evaluation and on four metrics, Structural Similarity Index Measure (SSIM), Peak Signal Noise Ratio (PSNR) Mean Absolute Error (MAE) and Root Mean Square Error (RMSE), to compare the synthetic CT and original CT images. Results: For pancreatic dataset with limited view CBCT images, our study showed that in Cycle GAN model, MAE, RMSE, PSNR improved from 12.57to 8.49, 20.94 to 15.29 and 21.85 to 24.63, respectively but structural similarity only marginally increased from 0.78 to 0.79. Similar, results were achieved with AGGAN with no improvement over Cycle GAN. However, for lung dataset with full view CBCT images Cycle GAN was able to reduce MAE significantly from 89.44 to 15.11 and AGGAN was able to reduce it to 19.77. Similarly, RMSE was also decreased from 92.68 to 23.50 in Cycle GAN and to 29.02 in AGGAN. SSIM and PSNR also improved significantly from 0.17 to 0.59 and from 8.81 to 21.06 in Cycle GAN respectively while in AGGAN SSIM increased to 0.52 and PSNR increased to 19.31. In both datasets, GAN models were able to reduce artifacts, reduce noise, have better resolution, and better contrast enhancement. Conclusion and Recommendation: Both Cycle GAN and AGGAN were significantly able to reduce MAE, RMSE and PSNR in both datasets. However, full view lung dataset showed more improvement in SSIM and image quality than limited view pancreatic dataset.

Keywords: CT images, CBCT images, cycle GAN, AGGAN

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Authors: Jingwen Ou

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Writing for academic purposes in a second or foreign language poses a significant challenge for non-native speakers, particularly at the tertiary level, where English academic writing for L2 students is often hindered by difficulties in academic discourse, including vocabulary, academic register, and organization. The past two decades have witnessed a rising popularity in the application of the data-driven learning (DDL) approach in EAP writing instruction. In light of such a trend, this study aims to enhance the integration of DDL into English for academic purposes (EAP) writing classrooms by investigating the perception of Chinese college students regarding the use of corpus tools for improving EAP writing. Additionally, the research explores their corpus consultation behaviors during training to provide insights into corpus-assisted EAP instruction for DDL practitioners. Given the uprising popularity of DDL, this research aims to investigate Chinese university students’ use of corpus tools with three main foci: 1) the influence of corpus tools on learning behaviours, 2) the influence of corpus tools on students’ academic writing performance outcomes, and 3) students’ perceptions and potential perceptional changes towards the use of such tools. Three corpus tools, CQPWeb, Sketch Engine, and LancsBox X, are selected for investigation due to the scarcity of empirical research on patterns of learners’ engagement with a combination of multiple corpora. The research adopts a pre-test / post-test design for the evaluation of students’ academic writing performance before and after the intervention. Twenty participants will be divided into two groups: an intervention and a non-intervention group. Three corpus training workshops will be delivered at the beginning, middle, and end of a semester. An online survey and three separate focus group interviews are designed to investigate students’ perceptions of the use of corpus tools for improving academic writing skills, particularly the rhetorical functions in different essay sections. Insights from students’ consultation sessions indicated difficulties with DDL practice, including insufficiency of time to complete all tasks, struggle with technical set-up, unfamiliarity with the DDL approach and difficulty with some advanced corpus functions. Findings from the main study aim to provide pedagogical insights and training resources for EAP practitioners and learners.

Keywords: corpus linguistics, data-driven learning, English for academic purposes, tertiary education in China

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Authors: Nyimas Annissa Mutiara Andini

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There are 325,000 children younger than age 15 in the U.S. have epilepsy. In Indonesia, 40% of 3,5 millions cases of epilepsy happens in children. The most common type of epilepsy, which affects 6 out of 10 people with the disorder, is called idiopathic epilepsy and which has no identifiable cause. One of the most commonly used medications in the treatment of this childhood epilepsy is sodium valproate. Administration of sodium valproat in children has a problem to fail. Nearly 60% of pediatric patients known were mildly, moderately, or severely non-adherent with therapy during the first six months of treatment. Many parents or caregiver took far less medication than prescribed, and the treatment-adherence pattern for the majority of patients was established during the first month of treatment. 42% of the patients were almost always given their medications as prescribed but 13% had very poor adherence even in the early weeks and months of treatment. About 7% of patients initially gave the medication correctly 90% of the time, but adherence dropped to around 20% within six months of starting treatment. Over the six months of observation, the total missing of administration is about four out of 14 doses in any given week. This fail can cause the epilepsy to relapse. Whereas, current reported epilepsy disorder were significantly more likely than those never diagnosed to experience depression (8% vs 2%), anxiety (17% vs 3%), attention-deficit/hyperactivity disorder (23% vs 6%), developmental delay (51% vs 3%), autism/autism spectrum disorder (16% vs 1%), and headaches (14% vs 5%) (all P< 0.05). They had a greater risk of limitation in the ability to do things (relative risk: 9.22; 95% CI: 7.56–11.24), repeating a school grade (relative risk: 2.59; CI: 1.52–4.40), and potentially having unmet medical and mental health needs. In the other side, technology can help to make our life easier. One of the technology, that we can use is a mobile application. A mobile app is a software program we can download and access directly using our phone. Indonesians are highly mobile centric. They use, on average, 6.7 applications over a 30 day period. This paper is aimed to describe an application that could help to control a sodium valproat administration in children; we call it as D-Epi app. D-Epi app is a downloadable application that can help parents or caregiver alert by a timer-related application to warn whether it is the time to administer the sodium valproat. It works not only as a standard alarm, but also inform important information about the drug and emergency stuffs to do to children with epilepsy. This application could help parents and caregiver to take care a child with epilepsy in Indonesia.

Keywords: application, children, D-Epi, epilepsy

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Authors: Christina Hagen, Pragathi Kamale Gurmurthy, Thorsten M. Buzug

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CFD simulations are performed in the upper airway of a patient suffering from obstructive sleep apnea (OSA) that is a sleep related breathing disorder characterized by repetitive partial or complete closures of the upper airways. The simulations are aimed at getting a better understanding of the pathophysiological flow patterns in an OSA patient. The simulation is compared to medical data of a sleep endoscopic examination under sedation. A digital model consisting of surface triangles of the upper airway is extracted from the MR images by a region growing segmentation process and is followed by a careful manual refinement. The computational domain includes the nasal cavity with the nostrils as the inlet areas and the pharyngeal volume with an outlet underneath the larynx. At the nostrils a flat inflow velocity profile is prescribed by choosing the velocity such that a volume flow rate of 150 ml/s is reached. Behind the larynx at the outlet a pressure of -10 Pa is prescribed. The stationary incompressible Navier-Stokes equations are numerically solved using finite elements. A grid convergence study has been performed. The results show an amplification of the maximal velocity of about 2.5 times the inlet velocity at a constriction of the pharyngeal volume in the area of the tongue. It is the same region that also shows the highest pressure drop from about 5 Pa. This is in agreement with the sleep endoscopic examinations of the same patient under sedation showing complete contractions in the area of the tongue. CFD simulations can become a useful tool in the diagnosis and therapy of obstructive sleep apnea by giving insight into the patient’s individual fluid dynamical situation in the upper airways giving a better understanding of the disease where experimental measurements are not feasible. Within this study, it could been shown on one hand that constriction areas within the upper airway lead to a significant pressure drop and on the other hand a good agreement of the area of pressure drop and the area of contraction could be shown.

Keywords: biomedical engineering, obstructive sleep apnea, pharynx, upper airways

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Authors: Garreth Kestell, Lukah Dykes, Danielle Zerk, Kyla Trewartha, Rhianon Marshall, Elena Rudnik

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Adolescent mental health is an international priority and the impact of innovative service models must be evaluated. Secondary school-based mental health services (SBMHS) involving private general practitioners and psychologists are a model of care being trialed in South Australia. Measures of depression, anxiety, and stress are routinely collected throughout psychotherapy sessions. This research set out to quantify the impact of psychotherapy for rural adolescents in a school setting and explore the importance of session frequency. Methods: Demographics, session date and DASS21 scores from students (n=65) seen in 2016 by three psychologists working at the SBMHS were recorded. Students were aged 13-18 years (M=15.43, SD= 1.24), mostly female (F=51, M=14), attended between 1 and 23 sessions with a median of 6 sessions (MAD 5.93) in one-year. The treating psychologist collected self-administered DASS21 scores. A mixed model analysis was used with age, sex, treating psychologist, months from first session, and session number as fixed effects, with response variables of DASS depression, anxiety, and stress scores. Results: 71.5% were classified as having extreme or severe anxiety and half had extreme or severe depression and/or stress scores. On average males had a greater increase in DASS scores over time but males attending more sessions benefited most from therapy. Discussion: Psychologists are treating rural adolescents in schools for severe anxiety, depression, and stress. This pilot study indicates that a predictive model combining demographics, session frequency, and DASS scores may help identify who is most likely to benefit from individual psychotherapy. Variations in DAS scores of individuals over time indicate the need for the collection of information such as living situation and exposure to alcohol. A larger sample size and additional data are currently being collected to allow for a more robust analysis.

Keywords: adolescent health, psychotherapy, school based mental health services, DAS21

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Authors: Nataša Todorović, Jovana Nikolov, Ivana Stojković, Milan Vraneš, Jovana Panić, Slobodan Gadžurić

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The detection of ²¹⁰Pb levels in aquatic environments evokes interest in various scientific studies. Its precise determination is important not only for the radiological assessment of drinking waters but also ²¹⁰Pb, and ²¹⁰Po distribution in the marine environment are significant for the assessment of the removal rates of particles from the ocean and particle fluxes during transport along the coast, as well as particulate organic carbon export in the upper ocean. Measurement techniques for ²¹⁰Pb determination, gamma spectrometry, alpha spectrometry, or liquid scintillation counting (LSC) are either time-consuming or demand expensive equipment or complicated chemical pre-treatments. However, one other possibility is to measure ²¹⁰Pb on an LS counter if it is in equilibrium with its progeny ²¹⁰Bi - through the Cherenkov counting method. It is unaffected by the chemical quenching and assumes easy sample preparation but has the drawback of lower counting efficiencies than standard LSC methods, typically from 10% up to 20%. The aim of the presented research in this paper is to investigate the possible increment of detection efficiency of Cherenkov counting during ²¹⁰Pb/²¹⁰Bi detection on an LS counter Quantulus 1220. Considering naturally low levels of ²¹⁰Pb in aqueous samples, the addition of ionic liquids to the counting vials with the analysed samples has the benefit of detection limit’s decrement during ²¹⁰Pb quantification. Our results demonstrated that ionic liquid, 1-butyl-3-methylimidazolium salicylate, is more efficient in Cherenkov counting efficiency increment than the previously explored 2-hydroxypropan-1-amminium salicylate. Consequently, the impact of a few other ionic liquids that were synthesized with the same cation group (1-butyl-3-methylimidazolium benzoate, 1-butyl-3-methylimidazolium 3-hydroxybenzoate, and 1-butyl-3-methylimidazolium 4-hydroxybenzoate) was explored in order to test their potential influence on Cherenkov counting efficiency. It was confirmed that, among the explored ones, only ionic liquids in the form of salicylates exhibit a wavelength shifting effect. Namely, the addition of small amounts (around 0.8 g) of 1-butyl-3-methylimidazolium salicylate increases the detection efficiency from 16% to >70%, consequently reducing the detection threshold by more than four times. Moreover, the addition of ionic liquids could find application in the quantification of other radionuclides besides ²¹⁰Pb/²¹⁰Bi via Cherenkov counting method.

Keywords: liquid scintillation counting, ionic liquids, Cherenkov counting, ²¹⁰PB/²¹⁰BI in water

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Authors: Muhammad Naeem, Juho Lee, Jin-Wook Yoo

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In this study, we hypothesized that prolonged gastrointestinal transit at the inflamed colon conferred by a pH-triggered mucoadhesive smart nanoparticulate drug delivery system aids in achieving selective and sustained levels of the drug within the inflamed colon for the treatment of ulcerative colitis. We developed budesonide-loaded pH-sensitive charge-reversal solid lipid nanoparticles (SLNs) using a hot homogenization method. Polyetylenimine (PEI) was used to render SLNs cationic (PEI-SLNs). Eudragit S100 (ES) was coated on PEI-SLNs for pH-trigger charge-reversal SLNs (ES-PEI-SLNs). Therapeutic potential of the prepared SNLs formulation was evaluated in ulcerative colitis in mice. The transmission electron microscopy, zeta size and zeta potential data showed the successful formation of SLNs formulations. SLNs and PEI-SLNs showed burst drug release in acidic pH condition mimicking stomach and early small intestine environment which limiting their application as oral delivery systems. However, ES-PEI-SLNs prevented a burst drug release in acidic pH conditions and showed sustained release at a colonic pH. Most importantly, the surface charge of ES-PEI-SLNs switched from negative to positive in colonic conditions by pH-triggered removal of ES coating and accumulated selectively in inflamed colon. Furthermore, a charge reversal ES-PEI-SLNs showed a superior mitigation of dextran sulfate sodium (DSS)-induced acute colitis in mice as compared to SLNs and PEI-SLNs treated groups. Moreover, histopathological analysis of distal colon sections stained with hematoxylin/eosin and E-cadherin immunostaining revealed attenuated inflammation in an ES-PEI-SLNs-treated group. We also found that ES-PEI-SLNs markedly reduced the myeloperoxidase level and expression of TNF-alpha in colon tissue. Our results suggest that the pH-triggered charge reversal SLNs presented in this study would be a promising approach for ulcerative colitis therapy.

Keywords: solid lipid nanoparticles, stimuli-triggered charge-reversal, ulcerative colitis, methacrylate copolymer, budesonide

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Authors: Lingling Li, Peng Zhao, Runze Guan, Alice Jones, Tao Yu

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Background: Shoulder pain and weakness are associated with complex pathologies and often precludes weightlifters from participation in training. The role and mode of exercise training in weightlifters with shoulder pathology remains unclear. Objectives: This case report described an exercise program in management of an elite weightlifter with primary complaint of right shoulder pain and weakness. Methods: A 22-year-old weightlifter presented with 2-year duration of right shoulder pain and weakness which was worsened by routine weightlifting training, and symptoms were not relieved with steroid injection, manual therapy nor usual physiotherapy. There was a limitation in all active range of motion especially horizontal extension (13ᵒ) and external rotation (41ᵒ) with pain intensity at 4/10 and 10/10 (numeric pain rating score) respectively. Muscle weakness was most significant at supraspinatus and teres minor, 38% and 27% respectively compared to his left shoulder (hand-held dynamometry, Micro FET2). An exercise training program focusing on improving mobility was designed for this athlete following a comprehensive physical assessment. Exercises included specific stretching, muscle activating and scapular stability training; once per day, and for 60 minutes each session. All exercises were completed under instruction as pain allowed. Quantitative assessment was conducted at the end of each week for 3 weeks. Outcomes: After the program, the athlete was pain-free in all movements except the O’Brien active compression internal rotation test, the pain was however reduced from 10/10 to 3/10. The horizontal extension and external rotation range increased to 79ᵒ to 120ᵒ respectively, and strength of all rotator cuff muscles returned to normal. At 1-month follow up, the athlete was totally pain-free and had returned to normal function and weightlifting training activities. The outcomes sustained through 6-month and one year. Conclusion: This case report supports the use of a mobility-focused exercise program for management of shoulder pain and weakness in an elite weightlifter athlete.

Keywords: exercise training, mobility, rehabilitation, shoulder pain, weightlifting

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Authors: Jayanta Kumar Mahato, Partha Sarathi De, Amrita Kundu, P. C. Chakraborti

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Ratcheting is one of the most important phenomena to be considered for design and safety assessment of structural components subjected to stress controlled asymmetric cyclic loading in the elasto-plastic domain. In the present study uniaxial ratcheting behavior of commercially pure annealed OFHC copper and aluminium with two different grain sizes has been investigated. Stress-controlled tests have been conducted at various combinations of stress amplitude and mean stress. These stresses were selected in such a way that the ratio of equivalent stress amplitude (σₐeq) to ultimate tensile strength (σUTS) of the selected materials remains constant. It is found that irrespective of grain size the ratcheting fatigue lives decrease with the increase of both stress amplitude and mean stress following power relationships. However, the effect of stress amplitude on ratcheting lives is observed higher as compared to mean stress for both the FCC metals. It is also found that for both FCC metals ratcheting fatigue lives at a constant ratio of equivalent stress amplitude (σ ₐeq) to ultimate tensile strength (σUTS) are more in case fine grain size. So far ratcheting strain rate is concerned, it decreases rapidly within first few cycles and then a steady state is reached. Finally, the ratcheting strain rate increases up to the complete failure of the specimens due to a very large increase of true stress for a substantial reduction in cross-sectional area. The steady state ratcheting strain rate increases with the increase in both stress amplitude and mean stress. Interestingly, a unique perfectly power relationship between steady state ratcheting strain rate and cycles to failure has been found irrespective of stress combination for both FCC metals. Similar to ratcheting strain rate, the strain energy density decreases rapidly within first few cycles followed by steady state and then increases up to a failure of the specimens irrespective of stress combinations for both FCC metals; but strain energy density at steady state decreases with increase in mean stress and increases with the increase of stress amplitude. From the fractography study, it is found that the void density increases with the increase of maximum stress, but the void size and void density are almost same for any combination of stress parameters considering constant maximum stress.

Keywords: ratcheting phenomena, grain size, stress parameter, ratcheting lives, ratcheting strain rate

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Authors: Maja Ruzic-Baf, Mirjana Radetic-Paic

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The use of computers by children has many positive aspects, including the development of memory, learning methods, problem-solving skills and the feeling of one’s own competence and self-confidence. Playing on line video games can encourage hanging out with peers having similar interests as well as communication; it develops coordination, spatial relations and presentation. On the other hand, the Internet enables quick access to different information and the exchange of experiences. How kids use computers and what the negative effects of this can be depends on various factors. ICT has improved and become easy to get for everyone. In the past 12 years so many video games has been made even to that level that some of them are free to play. Young people, even some adults, had simply start to forget about the real outside world because in that other, digital world, they have found something that makes them feal more worthy as a man. This article present the use of ICT, forms of behavior and addictions to on line video games. The use of computers by children has many positive aspects, including the development of memory, learning methods, problem-solving skills and the feeling of one’s own competence and self-confidence. Playing on line video games can encourage hanging out with peers having similar interests as well as communication; it develops coordination, spatial relations and presentation. On the other hand, the Internet enables quick access to different information and the exchange of experiences. How kids use computers and what the negative effects of this can be depends on various factors. ICT has improved and become easy to get for everyone. In the past 12 years so many video games has been made even to that level that some of them are free to play. Young people, even some adults, had simply start to forget about the real outside world because in that other, digital world, they have found something that makes them feal more worthy as a man. This article present the use of ICT, forms of behavior and addictions to on line video games.

Keywords: addiction to video games, behaviour, ICT, young people

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Authors: Sinisa Prvanov

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This research is an attempt to analyze the existing urban form of outdoor public space of Duhok city and to give proposals for their improvements in terms of urban seating. The aim of this research is to identify the main urban furniture elements and behaviour of users of three central parks of Duhok city, recognizing their functionality and the most common errors. Citizens needs, directly related to the physical characteristics of the environment, are categorized in terms of contact with nature. Parks as significant urban environments express their aesthetic preferences, as well as the need for recreation and play. Citizens around the world desire to contact with nature and places where they can socialize, play and practice different activities, but also participate in building their community and feeling the identity of their cities. The aim of this research is also to reintegrate these spaces in the wider urban context of the city of Duhok, to develop new functions by designing new seating patterns, more improved urban furniture, and necessary supporting facilities and equipment. Urban furniture is a product that uses an enormous number of people in public space. It has a high level of wear and damage due to intense use, exposure to sunlight and weather conditions. Iraq has a hot and dry climate characterized by long, warm, dry summers and short, cold winters. The climate is determined by the Iraq location at the crossroads of Arab desert areas and the subtropical humid climate of the Persian Gulf. The second part of this analysis will describe the possibilities of traditional and contemporary materials as well as their advantages in urban furniture production, providing users protection from extreme local climate conditions, but also taking into account solidities and unwelcome consequences, such as vandalism. In addition, this research represents a preliminary stage in the development of IND307 furniture design course for needs of the Department of Interior design, at the American University in Duhok. Based on results obtained in this research, the course would present a symbiosis between people and technology, promotion of new street furniture design that perceives pedestrian activities in an urban setting, and practical use of anthropometric measurements as a tool for technical innovations.

Keywords: Furniture design, Street furniture, Social interaction, Public space

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Authors: Sendy Ghirardi, Pau Rausell Köster

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The European Commission increasingly pushes cultural policies towards social outcomes and local and regional authorities also call for culture-driven strategies for local development and prosperity and therefore, the measurement of cultural participation becomes increasingly more significant for evidence-based policy-making processes. Cultural participation involves various kinds of social and economic spillovers that combine social and economic objectives of value creation, including social sustainability and respect for human values. Traditionally, from the economic perspective, cultural consumption is measured by the value of financial transactions in purchasing, subscribing to, or renting cultural equipment and content, addressing the market value of cultural products and services. The main sources of data are the household spending survey and merchandise trade survey, among others. However, what characterizes the cultural consumption is that it is linked with the hedonistic and affective dimension rather than the utilitarian one. In fact, nowadays, more and more attention is being paid to the social and psychological dimensions of culture. The aim of this work is to present a comprehensive approach to measure the impacts of cultural participation and cultural users’ behaviour, combining both socio-psychological and economic approaches. The model combines contingent evaluation techniques with the individual characteristic and perception analysis of the cultural experiences to evaluate the cognitive, aesthetic, emotive and social impacts of cultural participation. To investigate the comprehensive approach to measure the impact of the cultural events on individuals, the research has been designed on the basis of prior theoretical development. A deep literature methodology has been done to develop the theoretical model applied to the web platform to measure the impacts of cultural experience on individuals. The developed framework aims to become a democratic tool for evaluating the services that cultural or policy institutions can adopt through the use of an interacting platform that produces big data benefiting academia, cultural management and policies. The Au Culture is a prototype based on an application that can be used on mobile phones or any other digital platform. The development of the AU Culture Platform has been funded by the Valencian Innovation Agency (Government of the Region of Valencia) and it is part of the Horizon 2020 project MESOC.

Keywords: comprehensive approach, cultural participation, economic dimension, socio-psychological dimension

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Authors: Jane E. Souyave, Judith Bower

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This study is an ongoing collaborative project between the University of Central Lancashire and the Alzheimer’s Society to design and test the idea of using interactive tools for a person living with dementia and their carers. It is hoped that the tools will fulfill the possible needs of engagement and interaction as dementia progresses, therefore enhancing wellbeing and improving quality of life for the person with dementia and their carers. The project was informed by Kitwood’s five psychological needs for producing wellbeing and explored evidence that fidgeting is often seen as a form of agitation and a negative symptom of dementia. Although therapy for agitation may be well established, there is a lack of appropriate items aimed at people in the later stage of dementia, that are not childlike or medical in their aesthetic. Individuals may fidget in a particular way and the tools in the Fidget Widget Toolkit have been designed to encourage repetitive movements of the hand, specifically to address the abilities of people with relatively advanced dementia. As an intervention, these tools provided a new approach that had not been tested in dementia care. Prototypes were created through an iterative design process and tested with a number of people with dementia and their carers, using quantitative and qualitative methods. Dementia Care Mapping was used to evaluate the impact of the intervention in group settings. Cohen Mansfield’s Agitation Inventory was used to record the daily use and interest of the intervention for people in their usual place of residence. The results informed the design of a new set of devices to promote safe, stigma free fidgeting as a positive experience, meaningful activity and enhance wellbeing for people in the later stage of dementia. The outcomes addressed the needs of individuals by reducing agitation and restlessness through helping them to connect, engage and act independently, providing the means of doing something for themselves that they were able to do. The next stage will be to explore the commercial feasibility of the Fidget Widget Toolkit so that it can be introduced as good practice and innovation in dementia care. It could be used by care homes, with carers and their families to support wellbeing and lead the way in providing some positive experiences and person-centred approaches that are lacking in the later stage of dementia.

Keywords: dementia, design, fidgeting, healthcare, positive moments, quality of life, wellbeing

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Authors: Marta Moczulska

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One of the most important aspects of human management in an organization is the work engagement. In spite of the different perspectives of engagement, it is possible to see that it is expressed in the activity of the individual involved in the performance of tasks, the functioning of the organization. At the same time is considered not only in behavioural but also cognitive and emotional dimensions. Previous studies were related to sources, predictors of engagement and determinants, including organizational ones. Attention was paid to the importance of needs (including belonging, success, development, sense of work), values (such as trust, honesty, respect, justice) or interpersonal relationships, especially with the supervisor. Taking them into account and theories related to human acting, behaviour in the organization, interactions, it was recognized that engagement can be shaped through cooperation and competition. It was assumed that to shape the work engagement, it is necessary to simultaneously cooperate and compete in order to reduce the weaknesses of each of these activities and strengthen the strengths. Combining cooperation and competition is defined as 'coopetition'. However, research conducted in this field is primarily concerned with relations between companies. Intra-organizational coopetition is mainly considered as competing organizational branches or units (cross-functional coopetition). Less attention is paid to competing groups or individuals. It is worth noting the ambiguity of the concepts of cooperation and rivalry. Taking into account the terms used and their meaning, different levels of cooperation and forms of competition can be distinguished. Thus, several types of intra-organizational coopetition can be identified. The article aims at defining the potential for work engagement through intra-organizational coopetition. The aim of research was to know how levels of cooperation in competition conditions influence engagement. It is assumed that rivalry (positive competition) between teams (the highest level of cooperation) is a type of coopetition that contributes to working engagement. Qualitative research will be carried out among students of the University of Zielona Gora, realizing various types of projects. The first research groups will be students working in groups on one project for three months. The second research group will be composed of students working in groups on several projects in the same period (three months). Work engagement will be determined using the UWES questionnaire. Levels of cooperation will be determined using the author's research tool. Due to the fact that the research is ongoing, results will be presented in the final paper.

Keywords: competition, cooperation, intra-organizational coopetition, work engagement

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Authors: R. A. Shahmiri, O. Standard, J. Hart, C. C. Sorrell

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Yttrium stabilized tetragonal zirconium polycrystalline (Y-TZP) has been used as a dental biomaterial. The strength and toughness of zirconia can be accounted for by its toughening mechanisms, such as crack deflection, zone shielding, contact shielding, and crack bridging. Prevention of crack propagation is of critical importance in high-fatigue situations, such as those encountered in mastication and para-function. However, the poor translucency of Y-TZP means that it may not meet the aesthetic requirements due to its white/grey appearance in polycrystalline form. To improve optical property of the Zirconia, precise evaluation of its refractive index is of significance. Zirconia`s optical properties need to be studied more in depth. Number of studies assumed, scattered light is isotropically distributed over all angles from biological media when defining optical parameters. Nevertheless, optical behaviour of real biological material depends on angular scattering of light by anisotropy material. Therefore, the average cosine of the scattering angle (which represent recovery phase function in the scattering angular distribution) usually characterized by anisotropy material. It has been identified that yttrium anti-sites present in the space charge layer have no significant role in the absorption of light in the visible range. Addition of cation dopant to polycrystalline zirconia results in segregate to grain boundaries and grain growth. Intrinsic and extrinsic properties of ZrO2 and their effect on optical properties need to be investigated. Intrinsic properties such as chemical composition, defect structure (oxygen vacancy), phase configuration (porosity, second phase) and distribution of phase need to be studied to comprehend their effect on refraction index, absorption/reflection and scattering. Extrinsic properties such as surface structure, thickness, underlying tooth structure, cement layer (type, thickness), and light source (natural, curing, artificial) of ZrO2 need to be studied to understand their effect on colour and translucency of material. This research reviewed effect of stabilization of tetragonal zirconia on optical property of zirconia for dental application.

Keywords: optical properties, zirconia dental biomaterial, chemical composition, phase composition

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Authors: Ava Zarif Sanayei, Sedigheh Sina

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Interventional radiology (IR) uses imaging guidance, including X-rays and CT scans, to deliver therapy precisely. Most IR procedures are performed under local anesthesia and start with a small needle being inserted through the skin, which may be called pinhole surgery or image-guided surgery. There is increasing concern about radiation exposure during interventional radiology procedures due to procedure complexity. The basic aim of optimizing radiation protection as outlined in ICRP 139, is to strike a balance between image quality and radiation dose while maximizing benefits, ensuring that diagnostic interpretation is satisfactory. This study aims to estimate the equivalent doses to the main trunk of the body for the Interventional radiologist and Superintendent using LiF: Mg, Ti (TLD-100) chips at the IR department of a hospital in Shiraz, Iran. In the initial stage, the dosimeters were calibrated with the use of various phantoms. Afterward, a group of dosimeters was prepared, following which they were used for three months. To measure the personal equivalent dose to the body, three TLD chips were put in a tissue-equivalent batch and used under a protective lead apron. After the completion of the duration, TLDs were read out by a TLD reader. The results revealed that these individuals received equivalent doses of 387.39 and 145.11 µSv, respectively. The findings of this investigation revealed that the total radiation exposure to the staff was less than the annual limit of occupational exposure. However, it's imperative to implement appropriate radiation protection measures. Although the dose received by the interventional radiologist is a bit noticeable, it may be due to the reason for using conventional equipment with over-couch x-ray tubes for interventional procedures. It is therefore important to use dedicated equipment and protective means such as glasses and screens whenever compatible with the intervention when they are available or have them fitted to equipment if they are not present. Based on the results, the placement of staff in an appropriate location led to increasing the dose to the radiologist. Manufacturing and installation of moveable lead curtains with a thickness of 0.25 millimeters can effectively minimize the radiation dose to the body. Providing adequate training on radiation safety principles, particularly for technologists, can be an optimal approach to further decreasing exposure.

Keywords: interventional radiology, personal monitoring, radiation protection, thermoluminescence dosimetry

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Authors: K. Hariohm, V. Prakash, J. Saravana Kumar

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Introduction and Rationale: Increased scope of Physiotherapy (PT) practice also has contributed to research in the field of PT. It is essential to determine the production and quality of the clinical trials from India since, it may reflect the scientific growth of the profession. These trends can be taken as a baseline to measure our performance and also can be used as a guideline for the future trials. Objective: To quantify and analyze qualitatively the RCT’s from India from the period 2000-2013’ May, and classify data for the information process. Methods: Studies were searched in the Medline database using the key terms “India”, “Indian”, “Physiotherapy”. Clinical trials only with PT authors were included. Trials out of scope of PT practice and on animals were excluded. Retrieved valid articles were analyzed for published year, type of participants, area of study, PEDro score, outcome measure domains of impairment, activity, participation; ‘a priori’ sample size calculation, region, and explanation of the intervention. Result: 45 valid articles were retrieved from the year 2000-2013’ May. The majority of articles were done on symptomatic participants (81%). The frequencies of conditions repeated more were low back pain (n-7) and diabetes (n-4). PEDro score with mode 5 and upper limit of 8 and lower limit 4 was found. 97.2% of studies measure the outcome at the impairment level, 34% in activity level, and 27.8% in participation level. 29.7% of studies did ‘a priori’ sample size calculation. Correlation of year trend and PEDro score found to be not significant (p>.05). Individual PEDro item analysis showed, randomization (100%), concealment (33%) baseline (76%), blinding-subject, therapist, assessor (9.1%, 0%, 10%), follow-up (89%) ITT (15%), statistics between groups (100%), measures of variance (88 %). Conclusion: The trend shows an upward slope in terms of RCTs published from India which is a good indicator. The qualitative analysis showed some gaps in the clinical trial design, which can be expected to be, fulfilled by the future researchers.

Keywords: RCT, PEDro, physical therapy, rehabilitation

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Authors: Bela Siska Afrida, Wisnu Barlianto, Desy Wulandari, Ery Olivianto

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Background: Allergic asthma, caused by IgE-mediated allergic reactions, remains a global health issue with high morbidity and mortality rates. Immunotherapy is the only etiology-based approach to treating asthma, but no standard biomarkers have been established to evaluate the therapy’s effectiveness. This study aims to determine the correlation between the ratios of serum levels of HDM-specific IgE/total IgE and Asthma Control Test (ACT) score as a biomarker of the response to immunotherapy in pediatric allergic asthma patients. Patient and Methods: This retrospective cohort study involved 26 pediatric allergic asthma patients who underwent HDM-specific subcutaneous immunotherapy for 14 weeks at the Pediatric Allergy Immunology Outpatient Clinic at Saiful Anwar General Hospital, Malang. Serum levels of HDM-Specific IgE and Total IgE were measured before and after immunotherapy using Chemiluminescence Immunoassay and Enzyme-linked Immunosorbent Assay (ELISA) method. Changes in asthma control were assessed using the ACT score. The Wilcoxon Signed Ranked Test and Spearman correlation test were used for data analysis. Results: There were 14 boys and 12 girls with a mean age of 6.48 ± 2.54 years. The study showed a significant decrease in serum HMD-specific levels before immunotherapy [9.88 ± 5.74 kuA/L] compared to those of 14 weeks after immunotherapy [4.51 ± 3.98 kuA/L], p = 0.000. Serum Total IgE levels significant decrease before immunotherapy [207.6 ± 120.8IU/ml] compared to those of 14 weeks after immunotherapy [109.83 ± 189.39 IU/mL], p = 0.000. The ratios of serum HDM-specific IgE/total IgE levels significant decrease before immunotherapy [0.063 ± 0.05] compared to those of 14 weeks after immunotherapy [0.041 ± 0.039], p = 0.012. There was also a significant increase in ACT scores before and after immunotherapy (each 15.5 ± 1.79 and 20.96 ± 2.049, p = 0.000). The correlation test showed a weak negative correlation between the ratios of HDM-specific IgE/total IgE levels and ACT score (p = 0.034 and r = -0.29). Conclusion: In conclusion, this study showed that a decrease in HDM-specific IgE levels, total IgE levels, and HDM-specific IgE/total IgE ratios, and an increase in ACT score, was observed after 14 weeks of HDM-specific subcutaneous immunotherapy. The weak negative correlation between the HDM-specific IgE/total IgE ratio and the ACT score suggests that this ratio can serve as a potential biomarker of the effectiveness of immunotherapy in treating pediatric allergic asthma patients.

Keywords: HDM-specific IgE/total IgE ratio, ACT score, immunotherapy, allergic asthma

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Authors: Samuele Abagnato, Lucia Rigamonti

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Life-Cycle-Assessment (LCA) is an effective tool to quantify the environmental impacts of reuse models and recycling technologies for textiles. In this work, publications in the last ten years about LCA on textile waste are classified according to location, goal and scope, functional unit, waste composition, impact assessment method, impact categories, and sensitivity analysis. Twenty papers have been selected: 50% are focused only on recycling, 30% only on reuse, the 15% on both, while only one paper considers only the final disposal of the waste. It is found that reuse is generally the best way to decrease the environmental impacts of textiles waste management because of the avoided impacts of manufacturing a new item. In the comparison between a product made with recycled yarns and a product from virgin materials, in general, the first option is less impact, especially for the categories of climate change, water depletion, and land occupation, while for other categories, such as eutrophication or ecotoxicity, under certain conditions the impacts of the recycled fibres can be higher. Cultivation seems to have quite high impacts when natural fibres are involved, especially in the land use and water depletion categories, while manufacturing requires a remarkable amount of electricity, with its associated impact on climate change. In the analysis of the reuse processes, relevant importance is covered by the laundry phase, with water consumption and impacts related to the use of detergents. About the sensitivity analysis, it can be stated that one of the main variables that influence the LCA results and that needs to be further investigated in the modeling of the LCA system about this topic is the substitution rate between recycled and virgin fibres, that is the amount of recycled material that can be used in place of virgin one. Related to this, also the yield of the recycling processes has a strong influence on the results of the impact. The substitution rate is also important in the modeling of the reuse processes because it represents the number of avoided new items bought in place of the reused ones. Another aspect that appears to have a large influence on the impacts is consumer behaviour during the use phase (for example, the number of uses between two laundry cycles). In conclusion, to have a deeper knowledge of the impacts of a life-cycle approach of textile waste, further data and research are needed in the modeling of the substitution rate and of the use phase habits of the consumers.

Keywords: environmental impacts, life-cycle-assessment, textiles recycling, textiles reuse, textiles waste management

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Authors: Sasiwan Tassana-iem, Sumattana Glangkarn

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Diabetic nephropathy is a major complication in diabetic patients whom as the glomerular filtration rate falls. The affects their quality of life and results in loss of money for kidney replacement therapy costs. There is an existing intervention, but the prevalence remains high, thus this research aims to study lessons learned in implementing programs to delay diabetic nephropathy management in primary health care. Method: The target settings are, 24 sub-district health promoting hospital in Sakon Nakhon province. Participants included the health care professionals, head of the sub-district health promoting hospital and the person responsible for managing diabetic nephropathy in each hospital (n= 50). There are 400 patients with diabetes mellitus in an area. Data were collected using questionnaires, patient records data, interviews and focus groups and analyzed by statistics and content analysis. Result: Reflection of participants that the interventions to delay diabetic nephropathy management in each area, the Ministry of Public Health has a policy to screen and manage this disease. The implementing programs aimed to provide health education, innovative teaching media used in communication to educate. Patients and caregivers had misunderstanding about the actual causes and prevention of this disease and how to apply knowledge suitable for daily life. Conclusion: The obstacles to the success of the implementing programs to delay diabetic nephropathy management in primary health care were most importantly, the patient needs self-care and should be evaluated for health literacy. This is crucial to promote health literacy; to access and understand health information as well to decide their health-related choices based on health information which will promote and maintain a good health. This preliminary research confirms that situation of diabetic nephropathy still exists. The results of this study will lead to the development of delay in diabetic nephropathy implementation among patients in the province studied.

Keywords: diabetic nephropathy, chronic kidney disease, primary health care, implementation

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