Search results for: lithuanian adult population

Authors: Saman Javadi, Mohammad Hassan Mahmoudi, Fatemeh Jafari, Aminreza Neshat

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Urmia Lake’s water level has been dropped during the past decade. Although the most common reason in studies was declared climate change, but observation of adjacent lake (like Van in Turkey) is not the same as the common reason. Most of studies were focused on climate and land use change, but groundwater resource as one of the most important element is negligible. Due to population and agriculture activities growth, exploration of groundwater resource has been increased. In as much as continued decline of water levels can lead to saltwater intrusion, reduce stream discharge near outcrop regions and threaten groundwater quality, aquifers of this region were affected by saltwater intrusion of Urmia Lake. In this research comparison of saltwater intrusion into eastern and western coastal aquifer was studied. In conclusion eastern aquifers are in a critical situation; vice versa the western ones are in a better situation. Thus applying management of groundwater operation would be necessary for eastern aquifers.

Keywords: coastal aquifer, groundwater over-exploration, saltwater intrusion, Urmia Lake

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Authors: Gheorghe Braniste

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It is a matter of common knowledge the fact that the International Olympic Movement is characterized by dynamism and adaptability to the challenges of modern society. A significant proof of this is the establishment of the IOC Refugee Olympic Team in 2016, at the Olympic Games in Rio de Janeiro, a practice continued in Tokyo in 2020 and with a great chance to be successfully repeated in subsequent editions: Paris 2024 and Dakar 2026. This phenomenon is all the more welcome as, after the global refugee crisis of 2015, when the whole world has seen millions of people in the world displaced, we are now experiencing the negative effects of the war that started in February 2022 in Ukraine; which caused the exodus of the population to neighboring countries. Therefore, the international Olympic community must decide how to integrate Ukrainian athletes with refugee status into the Olympic system. Until the establishment of an internationally agreed policy, Romania and the Republic of Moldova, as countries directly involved in this process, must find urgent solutions to allow athletes to continue their Olympic careers. This article proposes a description of the strategies adopted both at the national level and at the level of sports clubs and an analysis of their impact on the performance of athletes.

Keywords: olympic movement, olympic games, refugees, performance, integration

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Authors: Amina Bayazid, Habiba Fetati, Houari Toumi

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Introduction: The clinical value of vitamin K antagonists (VKA) has been widely demonstrated in numerous indications. Unfortunately, VKA are not devoid of drawbacks and risk of serious bleeding. The iatrogenic induced by these drugs is a major public health problem. Patients & Methods: We conducted a retrospective study period extending from February 2012 to August 2013 in the pharmacovigilance service of EHUO (clinical pharmacology unit). The prescription of painkillers was analyzed in patients on VKA followed at our level. The influence of these analgesics on the evolution of the INR is an important component in our work. Results: We counted a total of 195 patients, of whom 32 (or 16.41% of the total population) had received analgesic treatment. The frequencies of different categories of analgesics administered were: • Analgesics opioids: 0% • Analgesics weak opioids: Tramadol: 21.87% • The non-opioid analgesics: -AINS: 71.87% (indomethacin: 68.75% ibuprofen: 3.12%) - Paracetamol: 6.25% -Salicyles (Acetylsalicylic acid): 0%. Conclusion: The management of pain in patients under vitamin K antagonists has special features, given their many drug interactions with analgesics and their influence on the evolution of the INR which can have dramatic consequences. As such, special attention must be paid to the use of analgesics in this type of patient.

Keywords: vitamin K antagonists, pain killers, interactions, INR

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Authors: Renny Wulandari

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This study aims to determine how the influence of Non Performing Financing, Financing Deposit Ratio, Operating Expenses and Operating Revenue and Net Income Margin on the disclosure of financial risk in Sharia banks. To achieve these objectives conducted associative research method with data source in the form of secondary data that is annual report data with period 2013-2016. The population in this study is the sharia banking industry in Indonesia and who issued the annual financial statements. A method of sampling use probability sampling. Analysis in this research is with SEM-PLS. The result is Net Income Margin has a significant effect on financial risk disclosure while Non Performing Financing (NPF) Financing to Deposit Ratio (FDR), Operating Expenses and Operating Revenue (OEOR) have no effect on the disclosure of financial risk in sharia bank.

Keywords: Sharia banks, disclosure of risk financial, non performing financing, financing deposit ratio, operating expenses and operating revenue, net income margin

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Authors: Hossein Mohammadi Rouzbahani, Hadis Karimipour, Evan Fraser, Ali Dehghantanha, Emily Duncan, Arthur Green, Conchobhair Russell

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Human population growth has driven rising demand for food that has, in turn, imposed huge impacts on the environment. In an effort to reconcile our need to produce more sustenance while also protecting the world’s ecosystems, farming is becoming more reliant on smart tools and communication technologies. Developing a smart farming framework allows farmers to make more efficient use of inputs, thus protecting water quality and biodiversity habitat. Internet of Things (IoT), which has revolutionized every sphere of the economy, is being applied to agriculture by connecting on-farm devices and providing real-time monitoring of everything from environmental conditions to market signals through to animal health data. However, utilizing IoT means farming networks are now vulnerable to malicious activities, mostly when wireless communications are highly employed. With that in mind, this research aims to review different utilized communication technologies in smart farming. Moreover, possible cyber-attacks are investigated to discover the vulnerabilities of communication technologies considering the most frequent cyber-attacks that have been happened.

Keywords: smart farming, Internet of Things, communication layer, cyber-attack

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Authors: Kadhim Alabady

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Background: Autism poses a particularly large public health challenge and an inspiring lifelong challenge for many families; it is a lifelong challenge of a different kind. Purpose: Therefore, it is important to understand what the key challenges are and how to improve the lives of children who are affected with autism in Dubai. Method: In order to carry out this research we have used a qualitative methodology. We performed structured in–depth interviews and focus groups with mental health professionals working at: Al Jalila hospital (AJH), Dubai Autism Centre (DAC), Dubai Rehabilitation Centre for Disabilities, Latifa hospital, Private Sector Healthcare (PSH). In addition to that, we conducted quantitative approach to estimate ASD prevalence or incidence data due to lack of registry. ASD estimates are based on research from national and international documents. This approach was applied to increase the validity of the findings by using a variety of data collection techniques in order to explore issues that might not be highlighted through one method alone. Key findings: Autism is the most common of the Pervasive Developmental Disorders. Dubai Autism Center estimates it affects 1 in 146 births (0.68%). If we apply these estimates to the total number of births in Dubai for 2014, it is predicted there would be approximately 199 children (of which 58 were Nationals and 141 were Non–Nationals) suffering from autism at some stage. 16.4% of children (through their families) seek help for ASD assessment between the age group 6–18+. It is critical to understand and address factors for seeking late–stage diagnosis, as ASD can be diagnosed much earlier and how many of these later presenters are actually diagnosed with ASD. Autism spectrum disorder (ASD) is a public health concern in Dubai. Families do not consult GPs for early diagnosis for a variety of reasons including cultural reasons. Recommendations: Effective school health strategies is needed and implemented by nurses who are qualified and experienced in identifying children with ASD. There is a need for the DAC to identify and develop a closer link with neurologists specializing in Autism, to work alongside and for referrals. Autism can be attributed to many factors, some of those are neurological. Currently, when families need their child to see a neurologist they have to go independently and search through the many that are available in Dubai and who are not necessarily specialists in Autism. Training of GP’s to aid early diagnosis of Autism and increase awareness. Since not all GP’s are trained to make such assessments increasing awareness about where to send families for a complete assessment and the necessary support. There is an urgent need for an adult autism center for when the children leave the safe environment of the school at 18 years. These individuals require a day center or suitable job training/placements where appropriate. There is a need for further studies to cover the needs of people with an Autism Spectrum Disorder (ASD).

Keywords: autism spectrum disorder, autism, pervasive developmental disorders, incidence

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Authors: Ali Arabkheradmand, Enayat A. Shabani, Shabnam Ranjbar Nikkhoo

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Historical and ancestral bonds of the countries in the Middle East have led to similarities in culture and context of their societies. In addition, economic resources, such as the oil industry, have generally been an integrative point in the region. Higher education of a country is influenced by different national and international factors and regarding the mentioned bonds, it is inviting to study the development of the countries of the Middle East in higher education and draw some practical implications which can be used in the educational policy-making of the region. This review includes a data analysis on the population of international students in the countries of the Middle East. As its second objective, a review study on the successful countries, that is those which host the highest number of international students and the strategies they have developed to reach this state among the countries of the region has been conducted. Suggestions are made as to the strategies in higher education systems of these countries which could prove useful and practical in the development of internationalization of higher education in the region, specifically with regard to the recruitment of international students.

Keywords: internationalization of higher education, international student recruitment, Middle East countries, educational policy making

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Authors: Jailan Mohamed El Demerdash

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In consideration of the challenges and the fierce global competition that have emerged in today’s hotel industry, it was important to shed light on the subject of strategic management. In addition, five-star hotels play a crucial role in supporting the tourism industry and investment in Egypt. Therefore, this study aims at exploring the scope of implementing strategic management practices in five-star hotels in Egypt and examining the differences between resorts and downtown hotels regarding the implementation of a strategic management process. The impact of the difference in hotel types on the implementation of the strategic management process will be examined. Simple random sampling technique will be employed to select the sample from the target population, including hotels from Sharm El- Sheikh, Cairo, and Hurghada cities. The data collection instrument employed in the current study is an interviewer-administered questionnaire. Eventually, combining the results of the study with the literature review helped to present a number of recommendations that have to be directed to hotel managers in the area of strategic management practices.

Keywords: strategic management, strategic tools, five-star hotels, resorts, downtown hotels, Egypt

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Authors: Ilham S. M. Elsayed

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The purpose of this study is to investigate Alahsa Governorate status and its vulnerability to generate urban heat islands. Alahsa Governorate is a famous oasis in the Arabic Peninsula including several oil centers. Extensive literature review was done to collect previous relative data on the urban heat island of Alahsa Governorate. Data used for the purpose of this research were collected from authorized bodies who control weather station networks over Alahsa Governorate, Eastern Province, Saudi Arabia. Although, the number of weather station networks within the region is very limited and the analysis using GIS software and its techniques is difficult and limited, the data analyzed confirm an increase in temperature for more than 2 °C from 2004 to 2014. Such increase is considerable whenever human health and comfort are the concern. The increase of temperature within one decade confirms the availability of urban heat islands. The study concludes that, Alahsa Governorate is vulnerable to create urban heat islands and more attention should be drawn to strategic planning of the governorate that is developing with a high pace and considerable increasing levels of urbanization.

Keywords: Alahsa Governorate, population density, Urban Heat Island, weather station

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Authors: Neil Singla, Derek Muse, Karen DiDonato, Pamela Palmer

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Introduction: Pain is the most common reason people visit emergency rooms. Studies indicate however, that Emergency Department (ED) physicians often do not provide adequate analgesia to their patients as a result of gender and age bias, opiophobia and insufficient knowledge of and formal training in acute pain management. Novel classes of analgesics have recently been introduced, but many patients suffer from acute pain in settings where the availability of intravenous (IV) access may be limited, so there remains a clinical need for rapid-acting, potent analgesics that do not require an invasive route of delivery. A sublingual sufentanil tablet (SST), dispensed using a single-dose applicator, is in development for treatment of moderate-to-severe acute pain in a medically-supervised setting. Objective: The primary objective of this study was to demonstrate the repeat-dose efficacy, safety and tolerability of sufentanil 20 mcg and 30 mcg sublingual tablets compared to placebo for the management of acute pain as determined by the time-weighted sum of pain intensity differences (SPID) to baseline over the 12-hour study period (SPID12). Key secondary efficacy variables included SPID over the first hour (SPID1), Total pain relief over the 12-hour study period (TOTPAR12), time to perceived pain relief (PR) and time to meaningful PR. Safety variables consisted of adverse events (AE), vital signs, oxygen saturation and early termination. Methods: In this Phase 2, double-blind, dose-finding study, an equal number of male and female patients were randomly assigned in a 2:2:1 ratio to SST 20 mcg, SS 30 mcg or placebo, respectively, following bunionectomy. Study drug was dosed as needed, but not more frequently than hourly. Rescue medication was available as needed. The primary endpoint was the Summed Pain Intensity Difference to baseline over 12h (SPIDI2). Safety was assessed by continuous oxygen saturation monitoring and adverse event reporting. Results: 101 patients (51 Male/50 Female) were randomized, 100 received study treatment (intent-to-treat [ITT] population), and 91 completed the study. Reasons for early discontinuation were lack of efficacy (6), adverse events (2) and drug-dosing error (1). Mean age was 42.5 years. For the ITT population, SST 30 mcg was superior to placebo (p=0.003) for the SPID12. SPID12 scores in the active groups were superior for both male (ANOVA overall p-value =0.038) and female (ANOVA overall p-value=0.005) patients. Statistically significant differences in favour of sublingual sufentanil were also observed between the SST 30mcg and placebo group for SPID1(p<0.001), TOTPAR12(p=0.002), time to perceived PR (p=0.023) and time to meaningful PR (p=0.010). Nausea, vomiting and somnolence were more frequent in the sufentanil groups but there were no significant differences between treatment arms for the proportion of patients who prematurely terminated due to AE or inadequate analgesia. Conclusions: Sufentanil tablets dispensed sublingually using a single-dose applicator is in development for treatment of patients with moderate-to-severe acute pain in a medically-supervised setting where immediate IV access is limited. When administered sublingually, sufentanil’s pharmacokinetic profile and non-invasive delivery makes it a useful alternative to IM or IV dosing.

Keywords: acute pain, pain management, sublingual, sufentanil

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Authors: Rania Ajmi, Faiza Allouche Khebour, Aude Nuscia Taibi, Sirine Essasi

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Urban green spaces (UGS) as an important contributor can be a significant part of sustainable development. A spatial method was employed to assess and map the spatial distribution of UGS in five districts in Sousse, Tunisia. Ecological management of UGS is an essential factor for the sustainable development of the city; hence the municipality of Sousse has decided to support the districts according to different green spaces characters. And to implement this policy, (1) a new GIS web application was developed, (2) then the implementation of the various green spaces was carried out, (3) a spatial mapping of UGS using Quantum GIS was realized, and (4) finally a data processing and statistical analysis with RStudio programming language was executed. The intersection of the results of the spatial and statistical analyzes highlighted the presence of an imbalance in terms of the spatial UGS distribution in the study area. The discontinuity between the coast and the city's green spaces was not designed in a spirit of network and connection, hence the lack of a greenway that connects these spaces to the city. Finally, this GIS support will be used to assess and monitor green spaces in the city of Sousse by decision-makers and will contribute to improve the well-being of the local population.

Keywords: distributions, GIS, green space, imbalance, spatial analysis

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Authors: Collins Augustine Ekpiwre

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Both the National Policy on Education (NPE) and the Teachers’ Registration Council of Nigeria (TRCN) gave the directive that all teachers in Nigerian schools should be trained teachers to enable them to be more effective in their teaching responsibilities. This applies to university teachers as well; they are required to acquire teacher qualifications such as Post Graduate Diploma in Education (PGDE) or Professional Diploma in Education (PDE) or Technical Teachers Certificate (TTC) or at least, National Certificate of Education (NCE) in addition to possessing academic qualifications in their specialized areas of study. It is on this ground that this study carried out an assessment of university teachers’ qualification status in Bayero University, Kano. The population of the study comprised all the teachers in the university. Data was collected through an examination of the documented official records of the qualification profile of all the teachers in the university obtained from its various faculties. The collected data was analyzed through descriptive statistic of simple percentage and frequency. Based on the findings of the study and in order to strengthen the teacher qualification status of teachers in the university, a few recommendations, for example, special salary scale should be made available to university teachers with appropriate teacher qualifications, were offered.

Keywords: Teacher, university teacher, teacher qualification, university education

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Authors: Marcio Emilio Dos Santos, Kelly C. F. Dos Santos

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Caregivers of patients diagnosed with ASD are subjected to high stress situations due to the complexity and multiple levels of daily activities that require the organization of events, behaviors and socioemotional situations, such as immediate decision making and in public spaces. The cognitive and emotional requirement needed to fulfill this caregiving role exceeds the regular cultural process that adults receive in their process of preparation for conjugal and parental life. Therefore, in many cases, caregivers present a high level of overload, poor capacity to organize and mediate the development process of the child or patient about their care. Aims: Improvement in the cognitive and emotional capacities related to the caregiver function, allowing the reduction of the overload, the feeling of incompetence and the characteristic level of stress, developing a more organized conduct and decision making more oriented towards the objectives and procedural gains necessary for the integral development of the patient with diagnosis of ASD. Method: The study was performed with 20 relatives, randomly selected from a total of 140 patients attended. The family members were submitted to the Wechsler Adult Intelligence Scale III intelligence test and the Family assessment Management Measure (FaMM) questionnaire as a previous evaluation. Therapeutic activity in a small group of family members or caregivers, with weekly frequency, with a minimum workload of two hours, using the Feuerstein Instrumental Enrichment Cognitive Development Program - Feuerstein Instrumental Enrichment for ten months. Reapplication of the previous tests to verify the gains obtained. Results and Discussion: There is a change in the level of caregiver overload, improvement in the results of the Family assessment Management Measure and highlight to the increase of performance in the cognitive aspects related to problem solving, planned behavior and management of behavioral crises. These results lead to the discussion of the need to invest in the integrated care of patients and their caregivers, mainly by enabling cognitively to deal with the complexity of Autism. This goes beyond the simple therapeutic orientation about adjustments in family and school routines. The study showed that when the caregiver improves his/her capacity of management, the results of the treatment are potentiated and there is a reduction of the level of the caregiver's overload. Importantly, the study was performed for only ten months and the number of family members attended in the study (n = 20) needs to be expanded to have statistical strength.

Keywords: caregiver overload, cognitive development program ASD caregivers, feuerstein instrumental enrichment, family assessment management measure

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Authors: Mitra JahangirRad, Sheida Sodagar, Maryam Bahrami Hidaji

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This study was conducted with the aim of comparing anxiety, stress, depression and attitude towards death among patients with breast cancer who have undergone mastectomy or breast-conserving surgery. The study method is causal-comparative. Statistical population was all patients with breast cancer referring to Medical Center of Panjom Azar Hospital in Gorgan or oncologists' offices in this city within eight months. They were selected using purposive sampling. Sample size of this study was 45 patients with breast cancer undergoing mastectomy and 70 patients under breast-conserving surgery. Measurement tools in this study were depression, anxiety, and stress scale (Dass-21) as well as Death Attitude Profile-Revised (DAPR). Results of this study in hypotheses investigation showed that anxiety, stress and depression among patients with breast cancer, undergoing mastectomy or breast-conserving surgery is significantly different. However, their attitudes towards death do not differ. From these findings, it can be concluded that although most patients with breast cancer encounter many psychological problems, patients undergoing mastectomy experience more anxiety, stress and depression relative to patients with breast-conserving surgery and it seems that they need more supportive therapy.

Keywords: anxiety, breast cancer, depression, death, mastectomy

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Authors: Cihan Cilbircioğlu

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Allium sativum L.(garlic) and Allium. cepa L. (onion) are the most common species of the Allium spp. and are produced at the very high rate all over the world. The yield loss caused by pests is the most important problem in the production of these crops. In the absence of control measures, yield loss would be around 35% on average. The yield loss sometimes depending on the pest species and population density can reach about 100%. Mites and nematodes are the most important pests of them. These pests that cause damage to A. sativum and A. cepa shows a wide range of taxonomic categories. The number of common pest mite and nematode species that cause damage to either A. sativum and A. cepa are over 20 species. In this study, detailed information on morphology, life cycle, management, and symptoms of the economically most important harmful important mite (acari) and nematode species of onion and garlic has been provided through careful survey of corresponding researches in Turkey and given information about new practices and approaches on their controls.

Keywords: onion, garlic, pest, acari, nematoda control methods, Turkey

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Authors: S. Moustafa El Shanawany, I. Labib Salem, F. Mohamed Magdy Badr El Dine, H. Tag El Deen Abd Allah

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Thermal injuries remain a global health problem and a common issue encountered in forensic pathology. They are a devastating cause of morbidity and mortality in children and adults especially in developing countries, causing permanent disfigurement, scarring and grievous hurt. Burns have always been a matter of legal concern in cases of suicidal burns, self-inflicted burns for false accusation and homicidal attempts. Assessment of burn injuries as well as rating permanent disabilities and disfigurement following thermal injuries for the benefit of compensation claims represents a challenging problem. This necessitates the development of reliable scoring systems to yield an expected likelihood of permanent disability or fatal outcome following burn injuries. The study was designed to identify the risk factors of mortality in acute burn patients and to evaluate the applicability of FLAMES (Fatality by Longevity, APACHE II score, Measured Extent of burn, and Sex) and BOBI (Belgian Outcome in Burn Injury) model scores in predicting the outcome. The study was conducted on 100 adult patients with acute burn injuries admitted to the Burn Unit of Alexandria Main University Hospital, Egypt from October 2014 to October 2015. Victims were examined after obtaining informed consent and the data were collected in specially designed sheets including demographic data, burn details and any associated inhalation injury. Each burn patient was assessed using both BOBI and FLAMES scoring systems. The results of the study show the mean age of patients was 35.54±12.32 years. Males outnumbered females (55% and 45%, respectively). Most patients were accidently burnt (95%), whereas suicidal burns accounted for the remaining 5%. Flame burn was recorded in 82% of cases. As well, 8% of patients sustained more than 60% of total burn surface area (TBSA) burns, 19% of patients needed mechanical ventilation, and 19% of burnt patients died either from wound sepsis, multi-organ failure or pulmonary embolism. The mean length of hospital stay was 24.91±25.08 days. The mean BOBI score was 1.07±1.27 and that of the FLAMES score was -4.76±2.92. The FLAMES score demonstrated an area under the receiver operating characteristic (ROC) curve of 0.95 which was significantly higher than that of the BOBI score (0.883). A statistically significant association was revealed between both predictive models and the outcome. The study concluded that both scoring systems were beneficial in predicting mortality in acutely burnt patients. However, the FLAMES score could be applied with a higher level of accuracy.

Keywords: BOBI, burns, FLAMES, scoring systems, outcome

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Authors: Mirim Kim, Won-Oak Oh

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Purpose: The purpose of this study was to identify hospitalized children's fall risk factors, fall prevention status and fall prevention strategies recognized by nurses and caregivers of hospitalized children and present an ecological model for fall preventive management in hospitalized children. Method: The participants of this study were 14 nurses working in medical institutions and having more than one year of child care experience and 14 adult caregivers of children under 6 years of age receiving inpatient treatment at a medical institution. One to one interview was attempted to identify their perception of fall preventive management. Transcribed data were analyzed through latent content analysis method. Results: Fall risk factors in hospitalized children were 'unpredictable behavior', 'instability', 'lack of awareness about danger', 'lack of awareness about falls', 'lack of child control ability', 'lack of awareness about the importance of fall prevention', 'lack of sensitivity to children', 'untidy environment around children', 'lack of personalized facilities for children', 'unsafe facility', 'lack of partnership between healthcare provider and caregiver', 'lack of human resources', 'inadequate fall prevention policy', 'lack of promotion about fall prevention', 'a performanceism oriented culture'. Fall preventive management status of hospitalized children were 'absence of fall prevention capability', 'efforts not to fall', 'blocking fall risk situation', 'limit the scope of children's activity when there is no caregiver', 'encourage caregivers' fall prevention activities', 'creating a safe environment surrounding hospitalized children', 'special management for fall high risk children', 'mutual cooperation between healthcare providers and caregivers', 'implementation of fall prevention policy', 'providing guide signs about fall risk'. Fall preventive management strategies of hospitalized children were 'restrain dangerous behavior', 'inspiring awareness about fall', 'providing fall preventive education considering the child's eye level', 'efforts to become an active subject of fall prevention activities', 'providing customed fall prevention education', 'open communication between healthcare providers and caregivers', 'infrastructure and personnel management to create safe hospital environment', 'expansion fall prevention campaign', 'development and application of a valid fall assessment instrument', 'conversion of awareness about safety'. Conclusion: In this study, the ecological model of fall preventive management for hospitalized children reflects various factors that directly or indirectly affect the fall prevention of hospitalized children. Therefore, these results can be considered as useful baseline data for developing systematic fall prevention programs and hospital policies to prevent fall accident in hospitalized children. Funding: This study was funded by the National Research Foundation of South Korea (grant number NRF-2016R1A2B1015455).

Keywords: fall down, safety culture, hospitalized children, risk factors

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Authors: Itee Chowdhury, Shikha Modi

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Introduction: Cancer is beginning to outpace cardiovascular disease as a cause of death affecting every major organ system with profound implications for perioperative management. Breast cancer is the most common cancer in women in India, accounting for 27% of all cancers. The small changes in analgesic management of cancer patients can greatly improve prognosis and reduce the risk of postsurgical cancer recurrence as opioid-based analgesia has a deleterious effect on cancer outcomes. Shortened postsurgical recovery time facilitates earlier return to intended oncological therapy maximising the chance of successful treatment. Literature reveals that the role of BIS since FDA approval has been assessed in various types of surgeries, but clinical data on its use in oncosurgical patients are scanty. Our study focuses on the role of BIS-guided anaesthesia for breast cancer surgery patients. Methods: A prospective randomized controlled study in patients aged 36-55years scheduled for modified radical mastectomy was conducted in 51 patients in each group who met the inclusion and exclusion criteria, and randomization was done by sealed envelope technique. In BIS guided anaesthesia group (B), sevoflurane was titrated to keep the BIS value 45-60, and thereafter if the patient showed hypertension/tachycardia, an opioid was given. In standard anaesthesia care (group C), sevoflurane was titrated to keep MAC in the range of 0.8-1, and fentanyl was given if the patient showed hypertension/tachycardia. Intraoperative opioid consumption was calculated. Postsurgery recovery characteristics, including Aldrete score, were assessed. Patients were questioned for pain, PONV, and recall of the intraoperative event. A comparison of age, BMI, ASA, recovery characteristics, opioid, and VAS score was made using the non-parametric Mann-Whitney U test. Categorical data like intraoperative awareness of surgery and PONV was studied using the Chi-square test. A comparison of heart rate and MAP was made by an independent sample t-test. #ggplot2 package was used to show the trend of the BIS index for all intraoperative time points for each patient. For a statistical test of significance, the cut-off p-value was set as <0.05. Conclusions: BIS monitoring led to reduced opioid consumption and early recovery from anaesthesia in breast cancer patients undergoing MRM resulting in less postoperative nausea and vomiting and less pain intensity in the immediate postoperative period without any recall of the intraoperative event. Thus, the use of a Bispectral index monitor allows for tailoring of anaesthesia administration with a good outcome.

Keywords: bispectral index, depth of anaesthesia, recovery, opioid consumption

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Authors: Seyyed Hossein Alavi, Soudabeh Mehri Talarposhti

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Quick development of urban population need for housing on the one hand and prevention of irregular urban extension for optimum usage of urban land, resolving problems of urban physiognomy, land using, and environmental issues and urban transport, on the other hand, proposed tall building as urban area extension requirement in developing and advanced countries. Beside the tall building, protection, and creation of green architecture is one the most important issues of today's architecture world. This research is about attending tall building with green architecture in Babolsar city 2015. For this, the issues that can make favorite conditions for green architecture has been discussed. The purpose of this discussion is skeleton extension and accessing interactions between architecture and related technologies. This discussion with using of qualitative research methods (Analytical Description) tried to studying designed performance models and also studying and analyzing the inside and foreign articles and books. Hope this research is useful in solving the existing problems in this issue.

Keywords: tall building, green architecture, skeleton extension, Babolsar city

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Authors: Leydi Noemi Peraza Gómez, Jose Álvarez Nemegyei, Damaris Francis Estrella Castillo

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In order to have an epidemiological tool to detect biomechanical stress (ERGO-Mex), which impose physical labor or recreational activities, a questionnaire is constructed in Spanish, validated and culturally adapted to the Mayan indigenous population of Yucatan. Through the seven steps proposed by Guillemin and Beaton the procedure was: initial translation, synthesis of the translations, feed back of the translation. After that review by a committee of experts, pre-test of the preliminary version, and presentation of the results to the committee of experts and members of the community. Finally the evaluation of its internal validity (Cronbach's α coefficient) and external (intraclass correlation coefficient). The results for the validation in Spanish indicated that 45% of the participants have biomechanical stress. The ERGO-Mex correlation was 0.69 (p <0.0001). Subjects with high biomechanical stress had a higher score than subjects with low biomechanical stress (17.4 ± 8.9 vs.9.8 ± 2.8, p = 0.003). The Cronbach's α coefficient was 0.92; and for validation in Cronbach's α maya it was 0.82 and CCI = 0.70 (95% CI: 0.58-0.79; p˂0.0001); ERGO-Mex is suitable for performing early detection of musculoskeletal diseases and helping to prevent disability.

Keywords: biomechanical stress, disability, musculoskeletal disorders, prevention

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Authors: Kripesh Adhikari, Hamid Bouchachia, Hammadi Nait-Charif

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Falls are one of the major causes of injury and death among elderly people aged 65 and above. A support system to identify such kind of abnormal activities have become extremely important with the increase in ageing population. Pose estimation is a challenging task and to add more to this, it is even more challenging when pose estimations are performed on challenging poses that may occur during fall. Location of the body provides a clue where the person is at the time of fall. This paper presents a vision-based tracking strategy where available joints are grouped into three different feature points depending upon the section they are located in the body. The three feature points derived from different joints combinations represents the upper region or head region, mid-region or torso and lower region or leg region. Tracking is always challenging when a motion is involved. Hence the idea is to locate the regions in the body in every frame and consider it as the tracking strategy. Grouping these joints can be beneficial to achieve a stable region for tracking. The location of the body parts provides a crucial information to distinguish normal activities from falls.

Keywords: fall detection, machine learning, deep learning, pose estimation, tracking

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Authors: António J. R. Neves, Rui Garcia, Paulo Dias, Alina Trifan

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With the aging of the world population and the continuous growth in technology, service robots are more and more explored nowadays as alternatives to healthcare givers or personal assistants for the elderly or disabled people. Any service robot should be capable of interacting with the human companion, receive commands, navigate through the environment, either known or unknown, and recognize objects. This paper proposes an approach for object recognition based on the use of depth information and color images for a service robot. We present a study on two of the most used methods for object detection, where 3D data is used to detect the position of objects to classify that are found on horizontal surfaces. Since most of the objects of interest accessible for service robots are on these surfaces, the proposed 3D segmentation reduces the processing time and simplifies the scene for object recognition. The first approach for object recognition is based on color histograms, while the second is based on the use of the SIFT and SURF feature descriptors. We present comparative experimental results obtained with a real service robot.

Keywords: object detection, feature, descriptors, SIFT, SURF, depth images, service robots

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Authors: Geovana Soncin, Larissa Berti

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Some aspects of prosody acquisition remain still unclear, especially regarding atypical speech development processes. This work deals with prosody acquisition and its implications for clinical purposes. Therefore, we analyze speech samples produced by adult speakers, children in typical language development, and children with phonological disorders. Phonological disorder comprises deviating manifestations characterized by inconsistencies in the phonological representation of a linguistic system under acquisition. The clinical assessment is performed mostly based on contrasts whose manifestations occur in the segmental level of a phonological system. Prosodic organization of spoken utterances is not included in the standard assessment. However, assuming that prosody is part of the phonological system, it was hypothesized that children with Phonological Disorders could present inconsistencies that also occur at a prosodic level. Based on this hypothesis, the paper aims to analyze contrastive focus marking in the speech of children with Phonological Disorders in comparison with the speech of children under Typical Language Development and adults. The participants of all groups were native speakers of Brazilian Portuguese. The investigation was designed in such a way as to identify differences and similarities among the groups that could be interpreted as clues of normal or deviant processes of prosody acquisition. Contrastive focus in Brazilian Portuguese is marked by increasing duration, f0, and intensity on the focused element as well as by a particular type of pitch accent (L*+H). Thirty-nine subjects participated, thirteen from each group. Acoustic analysis was performed, considering duration, intensity, and intonation as parameters. Children with PD were recruited in sessions from a service provided by Speech-Language Pathology Therapy; children in TD, paired in age and sex with the first group, were recruited in a regular school; and 20-24 years old adults were recruited from a University class. In a game prepared to elicit focused sentences, all of them produced the sentence “Girls love red dress,” marking focus on different syntactic positions: subject, verb, and object. Results showed that adults, children in typical language development, and children with Phonological Disorders marked contrastive focus differently: typical children used all parameters like adults do; however, in comparison with them, they exaggerated duration and, in the opposite direction, they did not increase f0 in a sufficient magnitude as adults; children with Phonological Disorder presented inconsistencies in duration, not increasing it in some syntactic positions, and also in intonation, not producing the representative pitch accent of contrastive focus. The results suggest prosody is also affected by phonological disorder and give clues of developmental processes of prosody acquisition.

Keywords: Brazilian Portuguese, contrastive focus, phonological disorder, prosody acquisition

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Authors: Shahadut Hossain

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Measurement errors in continuous covariates and/or misclassifications in categorical covariates are common in epidemiological studies. Regression analysis ignoring such mismeasurements seriously biases the estimated main and interaction effects of covariates on the outcome of interest. Thus, adjustments for such mismeasurements are necessary. In this research, we propose a Bayesian parametric framework for eliminating deleterious impacts of covariate mismeasurements in logistic regression. The proposed adjustment method is unified and thus can be applied to any generalized linear and non-linear regression models. Furthermore, adjustment for covariate mismeasurements requires validation data usually in the form of either gold standard measurements or replicates of the mismeasured covariates on a subset of the study population. Initial investigation shows that adequacy of such adjustment depends on the sizes of main and validation samples, especially when prevalences of the categorical covariates are low. Thus, we investigate the impact of main and validation sample sizes on the adjusted estimates, and provide a general guideline about these sample sizes based on simulation studies.

Keywords: measurement errors, misclassification, mismeasurement, validation sample, Bayesian adjustment

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Authors: Michael Ubale Cyril

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Challenges of embedding entrepreneurship in tertiary institutions in Nigeria requires a consistent policy for equipping schools with necessary facilities like establishing incubating technology centre, the right calibres of human resources, appropriate pedagogical tools for teaching entrepreneurship education and exhibition grounds where products and services will be delivered and patronised by the customers. With the death of facilities in public schools in Nigeria, educators are clamouring for a way out. This study investigated the challenges of embedding entrepreneurship education in Modibbo Adama University of Technology Yola, Nigeria. The population for the study was 201 comprising 34 industrial entrepreneurs, 76 technical teachers and 91 final year undergraduates. The data was analysed using means of 3 groups, standard deviation, and analysis of variance. The study found out, that technical teachers have not been trained to teach entrepreneurship education, approaches to teaching methodology, were not varied and lack of infrastructural facilities like building was not a factor. It was recommended that technical teachers be retrained to teach entrepreneurship education, textbooks in entrepreneurship should be published with Nigerian outlook.

Keywords: challenges, embedding, entrepreneurship pedagogical, technology incubating centres

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Authors: Nafisatul Ulfa, Elok Budi Retnani, R. P. Agus Lelana

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Emerging zoonotic parasite infection could originate in wildlife so its time very important to identify zoonotic agents in wild populations or maintained. According to the International Union Conservation of Nature (IUCN), Sumateran slow loris (Nycticebus coucang) was protected primate which have vulnerable status. Their population in wildlife decreased cause hunting for trade and destroy habitat. Helminthiasis can caused dead regularly and its so The study was conducted to know prevalence of gastrointestinal helminth infection of slow loris (Nycticebus coucang) in The Centre of Primate Rehabilitation of International Animal Rescue Indonesia (YIARI). Total of 13 fecal sampel from captive group of Nycticebus coucang were collected for 6 days and analysed from Februari-Mei 2014 by using McMaster, flotasion and Baermann technique. All fecal sampel was examined based on its fecal pool. Out of 13 fecal sampel examined, all of sampel (100%) was infected with five types of helminth Ascaris (84,61%), Hymenolepis (76,92%), Strongylid (61,54%), Oxyurid (15,38%) dan Trichuris (7,69%). The average number of egg per gram (EPG) was 11-1810.

Keywords: fecal, helminth, Nycticebus coucang, parasite, prevalence, slow loris

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Authors: Abdullah S. Alghamdi, Khaled Alghamdi, Richard O. Jenkins, Parvez I. Haris

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Background: Unhealthy diet is one of the modifiable risk factors for developing type 2 diabetes mellitus (T2DM). Improvement in diet can be beneficial for countering diabetes. For example, HbA1c, an important biomarker for diabetes, can be reduced by 1.1% through only alteration in diet. Ramadan fasting has been reported to provide positive health benefits. However, optimal benefits are not achieved, often due to poor dietary habits and lifestyle. There is a need to better understand the dietary habits of people fasting during Ramadan, so that necessary improvements can be made to develop this form of fasting as a non-pharmacological strategy for management and prevention of T2DM. Aim: This study aimed to assess the dietary patterns of Saudi adult patients with T2DM over three different periods (before, during, and after Ramadan) and relate this to HbA1c levels. Methods: This study recruited 82 Saudi with T2DM, who chose to fast during Ramadan, from the Endocrine and Diabetic Centre of Al Iman General Hospital, Riyadh, Saudi Arabia. Ethical approvals for the study were obtained from De Montfort University and Saudi Ministry of Health. Dietary patterns were assessed by a self-administered questionnaire in each period. This assessment included the diet type and frequency. Blood samples were collected in each period for determination of HbA1c. Results: The number of meals per day for the participants significantly decreased during Ramadan (P < 0.001). The consumption of fruit and vegetables significantly increased during Ramadan (P = 0.017). However, the consumption of sugary drinks significantly increased during and after Ramadan (P = 0.005). Approximately 60% of the patients indicated that they ate sugary foods at least once per week. The consumption of bread and rice was reported to be at least two times per week. The consumption of rice significantly reduced during Ramadan (P = 0.002). The mean HbA1c significantly varied between periods (P = 0.001), with lowest level during Ramadan compared to before and after Ramadan. The increase in the consumption of fruits and vegetables had a medium effect size on the reduction in HbA1c during Ramadan. There was a variance of 7.7% in the mean difference in HbA1c levels between groups (who changed their fruit and vegetable consumption) which can be accounted for by the increase in the consumption of fruits and vegetables. Likewise, 9.3% of the variance in the mean HbA1c difference between the groups was accounted for by a decrease in the consumption of rice. Conclusion: The increase in the frequency of fruit and vegetables intake, and especially the reduction in the frequency of rice consumption, during Ramadan produce beneficial effects in reducing HbA1c level. Therefore, further improving the dietary habits of patients with T2DM, such as reducing their sugary drinks intake, may help them to obtain greater benefits from Ramadan fasting in the management of their diabetes. It is recommended that dietary guidance is provided to the public to maximise health benefits through Ramadan fasting.

Keywords: Diabetes, Diet, Fasting, HbA1c, Ramadan

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Authors: Asad Ullah Khalid

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This paper encompasses the application of the concept of political economy of mass media in Pakistan. The media has developed at a massive pace and now is considered as one of the vital parts in having better administration furthermore helps in conveying the issues identified with the government to the public. Albeit Pakistani media has gained much independence after 2003 but there are many social, political and economy factors which influence the content of the media. The study employs triangulation of quantitative and qualitative methods. In terms of methods, content analysis and interview method both are used. The content of Pakistani media is analyzed quantitatively and qualitatively. Moreover, interviews with various journalists are conducted, and their findings are disclosed in this paper. Pakistan's communication landscape is neither well documented nor well understood, leaving its public off guard with regards to reviewing the role and impact of news inflow, correspondence and media in political, economic and social life. It has been found out that on particular issues some media channels have strong affiliations with certain political parties, moreover reporting and coverage have also been affected by the factors like terrorism, state policies(written and verbal), advertising/economic and demographic factors like the composition of the population.

Keywords: political economy, news media, Pakistan, electronic news media, journalism, mass media

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Authors: Ilham Zaidi, P. Sankara Sarma, Quazi Taufique Ahmed, V. Raman Kutty, Khalid Umer Khayyam, Gurpreet Singh, Abhishek Royal

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Introduction: Tuberculosis is a global public health emergency, but it is particularly acute in India, which has the world's highest tuberculosis burden. Due to overpopulation, lack of sanitation, malnutrition, low living standards, and poor socioeconomic status, among other factors, it is India's most common infectious disease. The long period of treatment is one of the main reasons for considering it as a public health emergency. Consequently, there is an increase in patient noncompliance, which leads to treatment failure, adverse treatment outcomes, and deaths. This could lead to the growth of anti-TB drug resistance. According to the WHO, approximately 558 thousand new cases of Multi-Drug Resistance Tuberculosis were diagnosed worldwide, with 8.5 percent developed Extensively Drug Resistance Tuberculosis. Methodology: This study is a program-based cross-sectional descriptive survey of adult tuberculosis patients enrolled in the Delhi-based Revised National Tuberculosis Program. The study setting was 27 NTEP districts of Delhi. (N=65,893) and Sample size- was 200; the sampling method which is used in the study was the systemic random sampling method. Results: Most of the demographic factors (age, gender, residence, and family type) were not significantly associated with adherence; marital status was found statistically significant with the treatment compliance. Hesitation while telling people about the disease and motivation to strictly follow drug schedule by healthcare workers were other factors where a significant association with drug adherence was observed. The study findings also suggest that provision of food, minimal financial and other moral support from family, counseling, discussion and politeness by healthcare providers might also facilitate adherence. Discussion and Conclusions: For TB treatment, adherence, age, sex, socioeconomic status, types of accommodations, malnutrition, and personal hygiene should all be considered; similar results were observed in previous studies. In the care of TB patients, DOTS services, health workers, and family support play a significant role. According to the country's National Strategic Plan, the Indian government has set a goal of eliminating tuberculosis by 2025 and patients' compliance with TB care and treatment adherence is very crucial to achieve this aim. A cohort study will be able to give a better understanding of factors associated with adherence since this study may have missed some defaulters who were absconding and could not be reached. Important Terms: RNTCP, NTEP, DOTS, DS-TB, DR-TB, RR-TB, MDR-TB, XDR-TB, Treatment failure, Treatment relapse, Treatment adherence.

Keywords: treatment adherence, treatment relapse, treatment failure, drug resistance tuberculosis

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Authors: Ntite Orji Kalu, Martina Kurowski

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Until recently, the Czech Republic had an educational system dominated by indigenous people, who accounted for 95% of the school population. With the increasing influx of migrants and foreign students, especially from outside European Union, came a great disparity among the quality of learners and their learning needs and consideration for the challenges associated with being a minority and living within a foreign culture. This has prompted the research into ways of tailoring the educational system to meet the rising demand of learning styles and needs for the diverse learners in the Czech classrooms. Literature is reviewed regarding the various ways to accommodate the international students considering racial differences, focusing on theoretical approach and pedagogical principles. This study examines the compulsory educational system of the Czech Republic and the position and responsibility of the teacher in fostering a culturally sensitive and inclusive learning environment. Descriptive and content analysis is relied upon for this study. Recommendations are made for stakeholders to imbibe a more responsive environment that enhances the cultural and social integration of all learners.

Keywords: culturally responsive teaching, cultural competence, diversity, learners, inclusive education, Czech schools

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