Search results for: recommended summary plan for emergency care and treatment
Commenced in January 2007
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Edition: International
Paper Count: 15419

Search results for: recommended summary plan for emergency care and treatment

11939 Role of Sulforaphane on Alleviating Duchenne Muscular Dystrophy(DMD) through Activation of Nrf2

Authors: Chengcao Sun, Shujun Li, Dejia Li

Abstract:

Sulforaphane (SFN) possesses powerful chemo-preventive effects and plays a crucial role on oxidative stress and inflammatory. In our recent study, SFN treatment could relieve muscular dystrophy in mdx mice by activating Nrf2 (NF-E2 related factor 2). Moreover, our findings indicated that SFN-activated Nrf2 alleviated muscle inflammation in dystrophin-deficient mdx mice through suppressing NF-κB signaling pathway. Collectively, SFN-induced Nrf2 molecular pathway might be a promising approach for treatment of the patients with Duchenne muscular dystrophy.

Keywords: sulforaphane, Duchenne muscular dystrophy, Nrf2, inflammation, fibrosis, oxidative stress

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11938 Challenges and Pitfalls of Nutrition Labeling Policy in Iran: A Policy Analysis

Authors: Sareh Edalati, Nasrin Omidvar, Arezoo Haghighian Roudsari, Delaram Ghodsi, Azizollaah Zargaran

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Background and aim: Improving consumer’s food choices and providing a healthy food environment by governments is one of the essential approaches to prevent non-communicable diseases and to fulfill the sustainable development goals (SDGs). The present study aimed to provide an analysis of the nutrition labeling policy as one of the main components of the healthy food environment to provide learning lessons for the country and other low and middle-income countries. Methods: Data were collected by reviewing documents and conducting semi-structured interviews with stakeholders. Respondents were selected through purposive and snowball sampling and continued until data saturation. MAXQDA software was used to manage data analysis. A deductive content analysis was used by applying the Kingdon multiple streams and the policy triangulation framework. Results: Iran is the first country in the Middle East and North Africa region, which has implemented nutrition traffic light labeling. The implementation process has gone through two phases: voluntary and mandatory. In the voluntary labeling, volunteer food manufacturers who chose to have the labels would receive an honorary logo and this helped to reduce the food-sector resistance gradually. After this phase, the traffic light labeling became mandatory. Despite these efforts, there has been poor involvement of media for public awareness and sensitization. Also, the inconsistency of nutrition traffic light colors which are based on food standard guidelines, lack of consistency between nutrition traffic light colors, the healthy/unhealthy nature of some food products such as olive oil and diet cola and the absence of a comprehensive evaluation plan were among the pitfalls and policy challenges identified. Conclusions: Strengthening the governance through improving collaboration within health and non-health sectors for implementation, more transparency of truthfulness of nutrition traffic labeling initiating with real ingredients, and applying international and local scientific evidence or any further revision of the program is recommended. Also, developing public awareness campaigns and revising school curriculums to improve students’ skills on nutrition label applications should be highly emphasized.

Keywords: nutrition labeling, policy analysis, food environment, Iran

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11937 Exploring Digital Media’s Impact on Sports Sponsorship: A Global Perspective

Authors: Sylvia Chan-Olmsted, Lisa-Charlotte Wolter

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With the continuous proliferation of media platforms, there have been tremendous changes in media consumption behaviors. From the perspective of sports sponsorship, while there is now a multitude of platforms to create brand associations, the changing media landscape and shift of message control also mean that sports sponsors will have to take into account the nature of and consumer responses toward these emerging digital media to devise effective marketing strategies. Utilizing the personal interview methodology, this study is qualitative and exploratory in nature. A total of 18 experts from European and American academics, sports marketing industry, and sports leagues/teams were interviewed to address three main research questions: 1) What are the major changes in digital technologies that are relevant to sports sponsorship; 2) How have digital media influenced the channels and platforms of sports sponsorship; and 3) How have these technologies affected the goals, strategies, and measurement of sports sponsorship. The study found that sports sponsorship has moved from consumer engagement, engagement measurement, and consequences of engagement on brand behaviors to micro-targeting one on one, engagement by context, time, and space, and activation and leveraging based on tracking and databases. From the perspective of platforms and channels, the use of mobile devices is prominent during sports content consumption. Increasing multiscreen media consumption means that sports sponsors need to optimize their investment decisions in leagues, teams, or game-related content sources, as they need to go where the fans are most engaged in. The study observed an imbalanced strategic leveraging of technology and digital infrastructure. While sports leagues have had less emphasis on brand value management via technology, sports sponsors have been much more active in utilizing technologies like mobile/LBS tools, big data/user info, real-time marketing and programmatic, and social media activation. Regardless of the new media/platforms, the study found that integration and contextualization are the two essential means of improving sports sponsorship effectiveness through technology. That is, how sponsors effectively integrate social media/mobile/second screen into their existing legacy media sponsorship plan so technology works for the experience/message instead of distracting fans. Additionally, technological advancement and attention economy amplify the importance of consumer data gathering, but sports consumer data does not mean loyalty or engagement. This study also affirms the benefit of digital media as they offer viral and pre-event activations through storytelling way before the actual event, which is critical for leveraging brand association before and after. That is, sponsors now have multiple opportunities and platforms to tell stories about their brands for longer time period. In summary, digital media facilitate fan experience, access to the brand message, multiplatform/channel presentations, storytelling, and content sharing. Nevertheless, rather than focusing on technology and media, today’s sponsors need to define what they want to focus on in terms of content themes that connect with their brands and then identify the channels/platforms. The big challenge for sponsors is to play to the venues/media’s specificity and its fit with the target audience and not uniformly deliver the same message in the same format on different platforms/channels.

Keywords: digital media, mobile media, social media, technology, sports sponsorship

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11936 Use of Amaranthus Roxburghianus Root Extract in the Treatment of Ulcerative Colitis in Mice

Authors: S. A. Nirmal, J. M. Ingale, G. S. Asane, S. C. Pal, Subhash C. Mandal

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The present work was undertaken to determine the effects of Amaranthus roxburghianus Nevski. (Amaranthaceae) root alone and in combination with piperine in treating ulcerative colitis (UC) in mice. Swiss albino mice were divided into seven groups (n = 6). Standard group received prednisolone (5 mg/kg, i.p.). Treatment groups received hydroalcoholic extract of roots of A. roxburghianus (50 and 100 mg/kg, p.o.) and a combination of hydroalcoholic extract of roots of A. roxburghianus (50 and 100 mg/kg, p.o.) and piperine (5 mg/kg, p.o.). Ulcer index, colitis severity, myeloperoxidase (MPO), malondialdehyde and glutathione were estimated from blood and tissue. Column chromatography of the extract was done and purified fractions were analyzed by gas chromatography-mass spectroscopy (GC-MS). Treatment with the combination of hydroalcoholic extract of A. roxburghianus and piperine showed minimal ulceration, hemorrhage, necrosis and leucocyte infiltration by histopathological observation. Acetic acid increased MPO levels in blood and colon tissue to 355 U/mL and 385 U/mg, respectively. The combination of hydroalcoholic extract (100 mg/kg) and piperine (5 mg/kg) significantly decreased MPO in blood and tissue to 182 U/mL and 193 U/mg, respectively. Similarly, this combination significantly reduced MPO and increased glutathione levels in blood and tissue. Various phytoconstituents were detected by GC-MS. The combination of hydroalcoholic extract and piperine is effective in the treatment of UC and the effects are comparable with the standard drug prednisolone. 4H-pyran-4-one, 2,3-dihydro-3,5-dihydroxy-6-methyl, eugenol and benzene, and 1-(1,5-dimethyl-4-hexenyl)-4-methyl are reported having analgesic, anti-inflammatory, and antioxidant properties; they may play a role in the biological activity of A. roxburghianus root.

Keywords: Amaranthus roxburghianus, ulcerative colitis, anti-inflammatory, ulcerative colitis

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11935 Integrating Music on Construction Sites: Key Benefits and Cautions: A Literature Perspective

Authors: Oluwatayomi Daniel Fadumo, Chinyere Celestina Esimone

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The construction industry, as a massive human capital-related sector, requires an always motivated workforce. The inability to maintain this state has been found to hamper productivity which ultimately leads to poor project delivery, infrastructural development decline, and low morale among citizens. The need to develop an approach to keep this set of people inspired before, during, and after work becomes a necessity; this paper aims to evaluate the key benefits and cautions in integrating music on construction sites in Nigeria to improve effective project delivery. In attaining this, the study identified the advantages of music on construction sites, evaluated the key considerations in introducing music on construction sites, and recommended measures for the effective integration of music on construction sites in Nigeria. The study is a descriptive research through the use of secondary data gleaned from relevant literature, journals, and research sites. The study concluded that different forms of music genres can be implemented ranging from Pop music, rock, metal, and classical music. Introducing music has the advantage of industrial branding, improving workers` morale, setting the pace for working, helping in information retention, and improving mental health and happiness. The key consideration, however, is to provide the right volume and music that doesn’t pose health and safety challenges. The study finally recommended that for effective integration of music on construction sites in Nigeria, policies should be drafted regulating its use, specific radio customized for the site be introduced and that research-based music, proven to have previously helped, should be given to a group of workers.

Keywords: music, construction sites, workers, construction industry, construction management practice

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11934 A Possible Connection Between Taste Change and Zinc Deficiency after Bariatric Surgery: A Literature Review

Authors: Boshra Mozaffar, Iskandar Idris

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Taste change is a common complication after Bariatric surgery (BS). However, the cause of this is still not clear. Since zinc is important fortaste perception, zinc deficiency, which is common after BS, may play an important role for taste change after BS. In this review, we aimto collate evidence relating to taste change and zinc deficiencyin relation to BS; effects of zinc replacement on taste perception in general and thereafter discuss the possible role of zinc deficiency to induce taste change after BS. A literature search was conducted, using four electronic bibliographical databases—EMBASE, PubMed, AMED and MEDLINE. We identified all available and relevant articles published before 30th February 2021.In total, 33 studies were included. The total number of participants analysed was N= 3264. We showed that taste change is a frequent complication after BS, especially after Roux-en-Y gastric bypass RYGBP comparing to other types of procedures. Patients' taste sensitivity differs among studies, but the most important decline in taste preference was observed for sweet food. Twelve studies investigating zinc deficiency following BS showed a significant decrease in zinc levels at six months after surgery. Supplementation with 45–50 mg of zinc sulphate was effective in improving taste, except in cancer patients, who showed no improvement in taste following zinc supplementation. Zinc deficiency appears to be associated with taste change after BS. Supplementation with much higher levels of zinc, at 45–50 mg, was effective in taste change treatment for many cases of taste disorder. The currently recommended levels of zinc replacements currently prescribed to patients following BS were not effective for avoiding zinc deficiency after BS—and thus not effective for averting taste change. It is therefore suggested that taste change following BS is closely related to zinc deficiency induced by the surgery.

Keywords: taste change, taste disorder, bariatric surgery, zinc, zinc sulphate or Zn, deficiency, supplementation, and micro-nutrient deficiencies

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11933 Psychosocial Challenges of Multi-Drug Resistant Tuberculosis (MDR-TB) Patients at St. Peter TB Specialized Hospital in Addis Ababa

Authors: Tamrat Girma Biru

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Multidrug-resistant tuberculosis (MDR-TB) is defined as resistant to at least Refampicin and Isoniazed: the most two power full TB drugs. It is a leading cause of high rates of morbidity and mortality, and increasing psychosocial challenges to patients, especially when co-infected with Human Immunodeficiency Virus (HIV). Ethiopia faces the highest rates of MDR-TB infection in the world. Objectives: The main objective of this study was to identify the psychosocial challenges of MDR-TB patients, to investigate the extent of the psychosocial challenges on (self-esteem, depression, and stigma) that MDR-TB patients encounter, to examine whether there is a sex difference in experiencing psychosocial challenges and assess the counseling needs of MDR-TB patients. Methodology: A cross-sectional study was conducted at St. Peter TB Specialized Hospital, Addis Ababa on 40 patients (25 males and 15 females) who are hospitalized for treatment. The patients were identified by using purposive sampling and made fill a questionnaire measuring their level of self-esteem, depression and stigma. Besides, data were collected from 16 participants, 28 care providers and 8 guardians, using semi-structured interview. The obtained data were analyzed using SPSS statistical program, descriptive statistics, independent t-test, and qualitative description. Results and Discussion: The results of the study showed that the majority (80%) of the respondents had suffered psychological challenges and social discriminations. Thus, the significance of MDR-TB and its association with HIV/AIDS problems is considered. Besides the psychosocial challenges, various aggravating factors such as length of treatment, drug burden and insecurity in economy together highly challenges the life of patients. In addition, 60% of participants showed low level of self-esteem. The patients also reported that they experienced high self-stigma and stigma by other members of the society. The majority of the participants (75%) showed moderate and severe level of depression. In terms of sex there is no difference between the mean scores of males and females in the level of depression and stigmatization by others and by themselves. But females showed lower level of self-esteem than males. The analysis of the t-test also shows that there were no statistically significant sex difference on the level of depression and stigma. Based on the qualitative data MDR-TB patients face various challenges in their life sphere such as: Psychological (depression, low self value, lowliness, anxiety), social (stigma, isolation from social relations, self-stigmatization,) and medical (drug side effect, drug toxicity, drug burden, treatment length, hospital stays). Recommendations: Based on the findings of this study possible recommendations were forwarded: develop and extend MDR-TB disease awareness creation through by media (printing and electronic), school net TB clubs, and door to door community education. Strengthen psychological wellbeing and social relationship of MDR-TB patients using proper and consistent psychosocial support and counseling. Responsible bodies like Ministry of Health (MOH) and its stakeholders and Non Governmental Organizations (NGOs) need to assess the challenges of patients and take measures on this pressing issue.

Keywords: psychosocial challenges, counseling, multi-drug resistant tuberculosis (MDR-TB), tuberculosis therapy

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11932 The Organizational Justice-Citizenship Behavior Link in Hotels: Does Customer Orientation Matter?

Authors: Pablo Zoghbi-Manrique-de-Lara, Miguel A. Suárez-Acosta

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The goal of the present paper is to model two classic lines of research in which employees starred, organizational justice and citizenship behaviour (OCB), but that have never been studied together when targeting customers. The suggestion is made that a hotel’s fair treatment (in terms of distributive, procedural, and interactional justice) toward customers will be appreciated by the employees, who will reciprocate in kind by favouring the hotel with increased customer-oriented behaviours (COBs). Data were collected from 204 employees at eight upscale hotels in the Canary Islands (Spain). Unlike in the case of perceptions of distributive justice, results of structural equation modelling demonstrate that employees substantively react to interactional and procedural justice toward guests by engaging in customer-oriented behaviours (COBs). The findings offer new reasons why employees decide to engage in COBs, and they highlight potentially beneficial effects of fair treatment toward guests bring to hospitality through promoting COBs.

Keywords: hotel guests’ (mis) treatment, customer-oriented behaviours, employee citizenship, organizational justice, third-party observers, third-party intervention

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11931 Trajectory Generation Procedure for Unmanned Aerial Vehicles

Authors: Amor Jnifene, Cedric Cocaud

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One of the most constraining problems facing the development of autonomous vehicles is the limitations of current technologies. Guidance and navigation controllers need to be faster and more robust. Communication data links need to be more reliable and secure. For an Unmanned Aerial Vehicles (UAV) to be useful, and fully autonomous, one important feature that needs to be an integral part of the navigation system is autonomous trajectory planning. The work discussed in this paper presents a method for on-line trajectory planning for UAV’s. This method takes into account various constraints of different types including specific vectors of approach close to target points, multiple objectives, and other constraints related to speed, altitude, and obstacle avoidance. The trajectory produced by the proposed method ensures a smooth transition between different segments, satisfies the minimum curvature imposed by the dynamics of the UAV, and finds the optimum velocity based on available atmospheric conditions. Given a set of objective points and waypoints a skeleton of the trajectory is constructed first by linking all waypoints with straight segments based on the order in which they are encountered in the path. Secondly, vectors of approach (VoA) are assigned to objective waypoints and their preceding transitional waypoint if any. Thirdly, the straight segments are replaced by 3D curvilinear trajectories taking into account the aircraft dynamics. In summary, this work presents a method for on-line 3D trajectory generation (TG) of Unmanned Aerial Vehicles (UAVs). The method takes as inputs a series of waypoints and an optional vector of approach for each of the waypoints. Using a dynamic model based on the performance equations of fixed wing aircrafts, the TG computes a set of 3D parametric curves establishing a course between every pair of waypoints, and assembling these sets of curves to construct a complete trajectory. The algorithm ensures geometric continuity at each connection point between two sets of curves. The geometry of the trajectory is optimized according to the dynamic characteristics of the aircraft such that the result translates into a series of dynamically feasible maneuvers. In summary, this work presents a method for on-line 3D trajectory generation (TG) of Unmanned Aerial Vehicles (UAVs). The method takes as inputs a series of waypoints and an optional vector of approach for each of the waypoints. Using a dynamic model based on the performance equations of fixed wing aircraft, the TG computes a set of 3D parametric curves establishing a course between every pair of waypoints, and assembling these sets of curves to construct a complete trajectory. The algorithm ensures geometric continuity at each connection point between two sets of curves. The geometry of the trajectory is optimized according to the dynamic characteristics of the aircraft such that the result translates into a series of dynamically feasible maneuvers.

Keywords: trajectory planning, unmanned autonomous air vehicle, vector of approach, waypoints

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11930 A Polynomial Relationship for Prediction of COD Removal Efficiency of Cyanide-Inhibited Wastewater in Aerobic Systems

Authors: Eze R. Onukwugha

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The presence of cyanide in wastewater is known to inhibit the normal functioning of bio-reactors since it has the tendency to poison reactor micro-organisms. Bench scale models of activated sludge reactors with varying aspect ratios were operated for the treatment of cassava wastewater at several values of hydraulic retention time (HRT). The different values of HRT were achieved by the use of a peristaltic pump to vary the rate of introduction of the wastewater into the reactor. The main parameters monitored are the cyanide concentration and respective COD values of the influent and effluent. These observed values were then transformed into a mathematical model for the prediction of treatment efficiency.

Keywords: wastewater, aspect ratio, cyanide-inhibited wastewater, modeling

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11929 Call-Back Laterality and Bilaterality: Possible Screening Mammography Quality Metrics

Authors: Samson Munn, Virginia H. Kim, Huija Chen, Sean Maldonado, Michelle Kim, Paul Koscheski, Babak N. Kalantari, Gregory Eckel, Albert Lee

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In terms of screening mammography quality, neither the portion of reports that advise call-back imaging that should be bilateral versus unilateral nor how much the unilateral call-backs may appropriately diverge from 50–50 (left versus right) is known. Many factors may affect detection laterality: display arrangement, reflections preferentially striking one display location, hanging protocols, seating positions with respect to others and displays, visual field cuts, health, etc. The call-back bilateral fraction may reflect radiologist experience (not in our data) or confidence level. Thus, laterality and bilaterality of call-backs advised in screening mammography reports could be worthy quality metrics. Here, laterality data did not reveal a concern until drilling down to individuals. Bilateral screening mammogram report recommendations by five breast imaging, attending radiologists at Harbor-UCLA Medical Center (Torrance, California) 9/1/15--8/31/16 and 9/1/16--8/31/17 were retrospectively reviewed. Recommended call-backs for bilateral versus unilateral, and for left versus right, findings were counted. Chi-square (χ²) statistic was applied. Year 1: of 2,665 bilateral screening mammograms, reports of 556 (20.9%) recommended call-back, of which 99 (17.8% of the 556) were for bilateral findings. Of the 457 unilateral recommendations, 222 (48.6%) regarded the left breast. Year 2: of 2,106 bilateral screening mammograms, reports of 439 (20.8%) recommended call-back, of which 65 (14.8% of the 439) were for bilateral findings. Of the 374 unilateral recommendations, 182 (48.7%) regarded the left breast. Individual ranges of call-backs that were bilateral were 13.2–23.3%, 10.2–22.5%, and 13.6–17.9%, by year(s) 1, 2, and 1+2, respectively; these ranges were unrelated to experience level; the two-year mean was 15.8% (SD=1.9%). The lowest χ² p value of the group's sidedness disparities years 1, 2, and 1+2 was > 0.4. Regarding four individual radiologists, the lowest p value was 0.42. However, the fifth radiologist disfavored the left, with p values of 0.21, 0.19, and 0.07, respectively; that radiologist had the greatest number of years of experience. There was a concerning, 93% likelihood that bias against left breast findings evidenced by one of our radiologists was not random. Notably, very soon after the period under review, he retired, presented with leukemia, and died. We call for research to be done, particularly by large departments with many radiologists, of two possible, new, quality metrics in screening mammography: laterality and bilaterality. (Images, patient outcomes, report validity, and radiologist psychological confidence levels were not assessed. No intervention nor subsequent data collection was conducted. This uncomplicated collection of data and simple appraisal were not designed, nor had there been any intention to develop or contribute, to generalizable knowledge (per U.S. DHHS 45 CFR, part 46)).

Keywords: mammography, screening mammography, quality, quality metrics, laterality

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11928 Overview About Sludge Produced From Treatment Plant of Bahr El-Baqar Drain and Reusing It With Cement in Outdoor Paving

Authors: Khaled M.Naguib, Ahmed M.Noureldin

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This paper aims to achieve many goals such as knowing (quantities produced- main properties- characteristics) of sludge produced from Bahr EL-Baqar drains treatment plant. This prediction or projection was made by laboratory analysis and modelling of Model samples from sludge depending on many studies that have previously done, second check the feasibility and do a risk analysis to know the best alternatives for reuse in producing secondary products that add value to sludge. Also, to know alternatives that have no value to add. All recovery methods are relatively very expensive and challenging to be done in this mega plant, so the recommendation from this study is to use the sludge as a coagulant to reduce some compounds or in secondary products. The study utilized sludge-cement replacement percentages of 10%, 20%, 30%, 40% and 50%. Produced tiles were tested for water absorption and breaking (bending) strength. The study showed that all produced tiles exhibited a water absorption ratio of around 10%. The study concluded that produced tiles, except for 50% sludge-cement replacement, comply with the breaking strength requirements of 2.8 MPa for tiles for external use.

Keywords: cement, tiles, water treatment sludge, breaking strength, absorption, heavy metals, risk analysis

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11927 Individualized Emotion Recognition Through Dual-Representations and Ground-Established Ground Truth

Authors: Valentina Zhang

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While facial expression is a complex and individualized behavior, all facial emotion recognition (FER) systems known to us rely on a single facial representation and are trained on universal data. We conjecture that: (i) different facial representations can provide different, sometimes complementing views of emotions; (ii) when employed collectively in a discussion group setting, they enable more accurate emotion reading which is highly desirable in autism care and other applications context sensitive to errors. In this paper, we first study FER using pixel-based DL vs semantics-based DL in the context of deepfake videos. Our experiment indicates that while the semantics-trained model performs better with articulated facial feature changes, the pixel-trained model outperforms on subtle or rare facial expressions. Armed with these findings, we have constructed an adaptive FER system learning from both types of models for dyadic or small interacting groups and further leveraging the synthesized group emotions as the ground truth for individualized FER training. Using a collection of group conversation videos, we demonstrate that FER accuracy and personalization can benefit from such an approach.

Keywords: neurodivergence care, facial emotion recognition, deep learning, ground truth for supervised learning

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11926 Applying Failure Modes and Effect Analysis Concept in a Global Software Development Process

Authors: Camilo Souza, Lidia Melo, Fernanda Terra, Francisco Caio, Marcelo Reis

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SIDIA is a research and development (R&D) institute that belongs to Samsung’s global software development process. The SIDIA’s Model Team (MT) is a part of Samsung’s Mobile Division Area, which is responsible for the development of Android releases embedded in Samsung mobile devices. Basically, in this software development process, the kickoff occurs in some strategic countries (e.g., South Korea) where some software requirements are applied and the initial software tests are performed. When the software achieves a more mature level, a new branch is derived, and the development continues in subsidiaries from other strategic countries (e.g., SIDIA-Brazil). However, even in the newly created branches, there are several interactions between developers from different nationalities in order to fix bugs reported during test activities, apply some specific requirements from partners and develop new features as well. Despite the GSD strategy contributes to improving software development, some challenges are also introduced as well. In this paper, we share the initial results about the application of the failure modes and effect analysis (FMEA) concept in the software development process followed by the SIDIA’s model team. The main goal was to identify and mitigate the process potential failures through the application of recommended actions. The initial results show that the application of the FMEA concept allows us to identify the potential failures in our GSD process as well as to propose corrective actions to mitigate them. Finally, FMEA encouraged members of different teams to take actions that contribute to improving our GSD process.

Keywords: global software development, potential failures, FMEA, recommended actions

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11925 Assessment of the Radiation Absorbed Dose Produced by Lu-177, Ra-223, AC-225 for Metastatic Prostate Cancer in a Bone Model

Authors: Maryam Tajadod

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The treatment of cancer is one of the main challenges of nuclear medicine; while cancer begins in an organ, such as the breast or prostate, it spreads to the bone, resulting in metastatic bone. In the treatment of cancer with radiotherapy, the determination of the involved tissues’ dose is one of the important steps in the treatment protocol. Comparing absorbed doses for Lu-177 and Ra-223 and Ac-225 in the bone marrow and soft tissue of bone phantom with evaluating energetic emitted particles of these radionuclides is the important aim of this research. By the use of MCNPX computer code, a model for bone phantom was designed and the values of absorbed dose for Ra-223 and Ac-225, which are Alpha emitters & Lu-177, which is a beta emitter, were calculated. As a result of research, in comparing gamma radiation for three radionuclides, Lu-177 released the highest dose in the bone marrow and Ra-223 achieved the lowest level. On the other hand, the result showed that although the figures of absorbed dose for Ra and Ac in the bone marrow are near to each other, Ra spread more energy in cortical bone. Moreover, The alpha component of the Ra-223 and Ac-225 have very little effect on bone marrow and soft tissue than a beta component of the lu-177 and it leaves the highest absorbed dose in the bone where the source is located.

Keywords: bone metastases, lutetium-177, radium-223, actinium-225, absorbed dose

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11924 The Diffusion of Telehealth: System-Level Conditions for Successful Adoption

Authors: Danika Tynes

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Telehealth is a promising advancement in health care, though there are certain conditions under which telehealth has a greater chance of success. This research sought to further the understanding of what conditions compel the success of telehealth adoption at the systems level applying Diffusion of Innovations (DoI) theory (Rogers, 1962). System-level indicators were selected to represent four components of DoI theory (relative advantage, compatibility, complexity, and observability) and regressed on 5 types of telehealth (teleradiology, teledermatology, telepathology, telepsychology, and remote monitoring) using multiple logistic regression. The analyses supported relative advantage and compatibility as the strongest influencers of telehealth adoption, remote monitoring in particular. These findings help to quantitatively clarify the factors influencing the adoption of innovation and advance the ability to make recommendations on the viability of state telehealth adoption. In addition, results indicate when DoI theory is most applicable to the understanding of telehealth diffusion. Ultimately, this research may contribute to more focused allocation of scarce health care resources through consideration of existing state conditions available foster innovation.

Keywords: adoption, diffusion of innovation theory, remote monitoring, system-level indicators

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11923 Feedback in the Language Class: An Action Research Process

Authors: Arash Golzari Koloor

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Feedback seems to be an inseparable part of teaching a second/foreign language. One type of feedback is corrective feedback which is one type of error treatment in second language classrooms. This study is a report on the types of corrective feedback employed in an IELTS preparation course. The types of feedback, their frequencies, and their effectiveness are enlisted, enumerated, and interpreted. The results showed that explicit correction and recast were the most frequent types of feedback while repetition and elicitation were the least. The results also revealed that metalinguistic feedback, elicitation, and explicit correction were the most effective types of feedback and affected learners performance greatly.

Keywords: classroom interaction, corrective feedback, error treatment, oral performance

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11922 Group Attachment Based Intervention® Reduces Toddlers' Fearfulness

Authors: Kristin Lewis, Howard Steele, Anne Murphy, Miriam Steele, Karen Bonuck, Paul Meissner

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The present study examines data collected during the randomized control trial (RCT) of the Group Attachment-Based Intervention (GABI©), a trauma-informed, attachment-based intervention aimed at promoting healthy parent-child relationships that support child development. Families received treatment at Treatment Center and were randomly assigned to either the GABI condition or the treatment as usual condition, a parenting class called Systematic Training for Effective Parenting (STEP). Significant improvements in the parent-child relationship have been reported for families participating in GABI, but not in the STEP control group relying on Coding Interactive Behavior (CIB) as applied to 5-minute video-films of mothers and their toddlers in a free play context. This report considers five additional attachment-relevant 'clinical codes' that were also applied to the 5-minute free play sessions. Seventy-two parent-child dyads (38 in GABI and 34 in STEP) were compared to one another at intake and end-of-treatment, on these five-point dimensions: two-parent codes—the dissociation and ignoring; two child codes—simultaneous display of contradictory behavior and fear; and one parent-child code, i.e., role reversal. Overall, scores were low for these clinical codes; thus, a binary measure was computed contrasting no evidence with some evidence of each clinical code. Crosstab analyses indicate that child fear at end-of-treatment was significantly lower among children who participated in GABI (7% or 3 children) as compared to those whose mothers participated in STEP (29% or 10 children) Chi Sq= 6.57 (1), p < .01. Discussion focuses on the potential for GABI to reduce childhood fearfulness and so enhance the child's health.

Keywords: coding interactive behavior, clinical codes, group attachment based intervention, GABI, attachment, fear

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11921 Molecular Docking of Marrubiin in Candida Rugosa Lipase

Authors: Benarous Khedidja, Yousfi Mohamed

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Infections caused by Candida species manifest in a number of diseases, including candidemia, vulvovaginal candidiasis, endocarditis, and peritonitis. These Candida species have been reported to have lipolytic activity by secretion of lipolytic enzymes such as esterases, lipases and phospholipases. These Extracellular hydrolytic enzymes seem to play an important role in Candida overgrowth. Candidiasis is commonly treated with antimycotics such as clotrimazole and nystatin, which bind to a major component of the fungal cell membrane (ergosterol). This binding forms pores in the membrane that lead to death of the fungus. Due to their secondary effects, scientists have thought of another treatment basing on lipase inhibition but we haven’t found any lipase inhibitors used as candidiasis treatment. In this work, we are interested to lipases inhibitors such as alkaloids as another candidiasis treatment. In the first part, we have proceeded to optimize the alkaloid structures and protein 3D structure using Hyperchem software. Secondly, we have docked inhibitors using Genetic algorithm with GOLD software. The results have shown ten possibilities of binding inhibitor to Candida rugosa lipase (CRL) but only one possibility has been accepted depending on the weakest binding energy.

Keywords: marrubiin, candida rugosa lipase, docking, gold

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11920 Risk Factors of Hospital Acquired Infection Mortality in a Tunisian Intensive Care Unit

Authors: Ben Cheikh Asma, Bouafia Nabiha, Ammar Asma, Ezzi Olfa, Meddeb Khaoula, Chouchène Imed, Boussarsar Hamadi, Njah Mansour

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Background: Hospital Acquired Infection (HAI) constitutes an important worldwide health problem. It was associated with high mortality rate in intensive care units (ICU). This study aimed to determine HAI mortality rate in Tunisian intensive care units and identify its risk factors. Methods: We conducted a prospective observational cohort study over a 12 months period (September 15th 2015 to September 15 th 2016) in the adult medical ICU of University Hospital-Farhat Hached (Sousse-Tunisia). All patients admitted in the ICU for more than 48 hours were included in the study. We used an anonymous standardized survey record form to collect data by a medical hygienist assisted by an intensivist. We adopted definitions of Center for Diseases Control and prevention of Atlanta to detect HAI, Kaplan Meier survival analysis and Cox proportional hazard regression to identify independent risk factor of HAI mortality. Results: Of 171 patients, 67 developed ICU-acquired infection (global incidence rate=39.2%). The mean age of patients was 59 ± 21.2 years and 60.8% were male. The most frequently identified infections were pulmonary acquired infection (ventilator associated pneumonia (VAP) and infected atelectasis with density rates 21.4 VAP/1000 days of mechanical ventilation and 9.4 infected atelectasis /1000 days of mechanical ventilation; respectively) and central venous catheter associated infection (CVC - AI) with density rate 28.4 CVC-AI / 1000 CVC-days). HAI mortality rate was 66.7% (n=44). The median survival was 20 days 3.36, 95% Confidential Interval [13.39 – 26.60]. Specific mortality rates according to infectious site were 65.5%, 36.4% and 4.5% respectively for VAP, CVC associated infection and infected atelectasis. In univariate analysis, a significant associations between mortality and cardiovascular history (p=0.04) tracheotomy (p=0.00), peripheral venous catheterization (p=0.04), VAP (p=0.04) and infected atelectasis (p=0.04) were detected. Independent risk factors for HAI mortality were VAP with Hazard Ratio = 3.14, 95% Confidential Interval [1.63 – 6.05] (p=0.001) and tracheotomy (Hazard Ratio=0.22, 95% Confidential Interval [0.10 – 0.44], p=0.000). Conclusions: In the present study, hospital acquired infection mortality rate was relatively high. We need to intensify the fight against these infections especially ventilator-associated pneumonia that is associated with higher risk of mortality in many studies. Thus, more effective infection control interventions were necessary in our hospital.

Keywords: hospital acquired infection, intensive care unit, mortality, risk factors

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11919 Development of Ready Reckoner Charts for Easy, Convenient, and Widespread Use of Horrock’s Apparatus by Field Level Health Functionaries in India

Authors: Gumashta Raghvendra, Gumashta Jyotsna

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Aim and Objective of Study : The use of Horrock’s Apparatus by health care worker requires onsite mathematical calculations for estimation of ‘volume of water’ and ‘amount of bleaching powder’ necessary as per the serial number of first cup showing blue coloration after adding freshly prepared starch-iodide indicator solution. In view of the difficulties of two simultaneous calculations required to be done, the use of Horrock’s Apparatus is not routinely done by health care workers because it is impractical and inconvenient Material and Methods: Arbitrary use of bleaching powder in wells results in hyper-chlorination or hypo-chlorination of well defying the purpose of adequate chlorination or non-usage of well water due to hyper-chlorination. Keeping this in mind two nomograms have been developed, one to assess the volume of well using depth and diameter of well and the other to know the quantity of bleaching powder to b added using the number of the cup of Horrock’s apparatus which shows the colour indication. Result & Conclusion: Out of thus developed two self-speaking interlinked easy charts, first chart will facilitate bypassing requirement of formulae ‘πr2h’ for water volume (ready reckoner table with depth of water shown on ‘X’ axis and ‘diameter of well’ on ‘Y’ axis) and second chart will facilitate bypassing requirement formulae ‘2ab/455’ (where ‘a’ is for ‘serial number of cup’ and ‘b’ is for ‘water volume’, while ready reckoner table showing ‘water volume’ shown on ‘X’ axis and ‘serial number of cup’ on ‘Y’ axis). The use of these two charts will help health care worker to immediately known, by referring the two charts, about the exact requirement of bleaching powder. Thus, developed ready reckoner charts will be easy and convenient to use for ensuring prevention of water-borne diseases occurring due to hypo-chlorination, especially in rural India and other developing countries.

Keywords: apparatus, bleaching, chlorination, Horrock’s, nomogram

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11918 Research on Key Technologies on Initial Installation of Ultra-Deep-Water Dynamic Umbilical

Authors: Weiwei Xie, Yichao Li

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The initial installation of the umbilical can affect the subsequent installation process and final installation. Meanwhile, the design of both ends of the ultra-deep water dynamic umbilical (UDWDU), as well as the design of the surface unit and the subsea production system connected by UDWDU,], varies in different oil and gas fields. To optimize the installation process of UDWDU, on the basis of the summary and analysis of the surface-end and the subsea-end design of UDWDU and the mainstream construction resources, the method of initial installation from the surface unit side or the subsea production system side of UDWDU is studied, and each initiation installation method is pointed out if some difficulties that may be encountered.

Keywords: dynamic umbilical, ultra-deep-water, initial installation, installation process

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11917 As a Little-Known Side a Passionate Statistician: Florence Nightingale

Authors: Gülcan Taşkıran, Ayla Bayık Temel

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Background: Florence Nightingale, the modern founder of the nursing, is most famous for her role as a nurse. But not so much known about her contributions as a mathematician and statistician. Aim: In this conceptual article it is aimed to examine Florence Nightingale's statistics education, how she used her passion for statistics and applied statistical data in nursing care and her scientific contributions to statistical science. Design: Literature review method was used in the study. The databases of Istanbul University Library Search Engine, Turkish Medical Directory, Thesis Scanning Center of Higher Education Council, PubMed, Google Scholar, EBSCO Host, Web of Science were scanned to reach the studies. The keywords 'statistics' and 'Florence Nightingale' have been used in Turkish and English while being screened. As a result of the screening, totally 41 studies were examined from the national and international literature. Results: Florence Nightingale has interested in mathematics and statistics at her early ages and has received various training in these subjects. Lessons learned by Nightingale in a cultured family environment, her talent in mathematics and numbers, and her religious beliefs played a crucial role in the direction of the statistics. She was influenced by Quetelet's ideas in the formation of the statistical philosophy and received support from William Farr in her statistical studies. During the Crimean War, she applied statistical knowledge to nursing care, developed many statistical methods and graphics, so that she made revolutionary reforms in the health field. Conclusions: Nightingale's interest in statistics, her broad vision, the statistical ideas fused with religious beliefs, the innovative graphics she has developed and the extraordinary statistical projects that she carried out has been influential on the basis of her professional achievements. Florence Nightingale has also become a model for women in statistics. Today, using and teaching of statistics and research in nursing care practices and education programs continues with the light she gave.

Keywords: Crimean war, Florence Nightingale, nursing, statistics

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11916 Effect of Prophylactic Oxytocin Therapy on Duration of Retained Fetal Membrane (RFM) in Periparturient Dairy Cows

Authors: Hamid Ghasemzadeh- Nava, Maziar Kaveh Baghbadorani, Amin Tamadon

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Considering response of uterus to ecbolic effect of oxytocin near the time of parturition, this study was done for investigating the effect of prophylactic administration of this hormone on duration of fetal membrane retention, time interval to first detectable estrus, time interval to first service, and conception rate at first service in cases of both normal parturition and dystocia. For this reason cows with (n=18) and without (n=18) dystocia assigned randomly to treatment (n=12) or control (n=6) groups and received intramuscular injection of 100 IU of oxytocin or 10 mL of normal saline respectively. Further observations and investigations indicate that duration of fetal retention is significantly shorter in treatment group cows compared to control groups, regardless of having dystocia (P=0.002) or normal spontaneous calving (P=0.001). The same trend exists for conception rate at first service in which cows in treatment groups had significantly higher conception rate (CR) in comparison to cows in control groups with (P=0.0003) or without dystocia (P=0.017). The time interval to first detected heat and first service didn’t show any difference between groups.

Keywords: conception rate, oxytocin, RFM, time to first service

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11915 Effects of Planned Pre-laboratory Discussion on Physics Students’ Acquisition of Science Process Skills in Kontagora, Niger State

Authors: Akano Benedict Ubawuike

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This study investigated the effects of pre-laboratory discussion on physics students’ acquisition of science process skills. The study design was quasi-experimental and purposive sampling technique was applied in selecting two schools in Kontagora Town for the research based on the availability of a good physics laboratory. Intact classes already grouped by the school for the sake of small laboratory space and equipment, comprising Thirty (30) students, 15 for experimental group in School A and 15 for control in school B were the subjects for the research. The instrument used for data collection was the lesson prepared for pre – practical discussion and researcher made Science Process Skill Test (SPST ) and two (2) research questions, and two (2) research hypotheses were developed to guide the study. The data collected were analyzed using means and t-Test statistics at 0.05 level of significance. The study revealed that pre-laboratory discussion was found to be more efficacious in enhancing students’ acquisition of science process skills. It also revealed that gender, had no significant effect on students’ acquisition of science process skills. Based on the findings, it was recommended among others that teachers should encourage students to develop interest in practical activities by engaging them in pre-laboratory discussion and providing instructional materials that will challenge them to be actively involved during practical lessons. It is also recommended that Ministries of Education and professional organizations like Science Teachers' Association of Nigeria (STAN) should organize workshops, seminars and conferences for physics teachers and Physics concepts should be taught with practical activity so that the students will do science instead of learning about science.

Keywords: physics, laboratory, discussion, students, acquisition, science process skills

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11914 The Effect of a 12 Week Rhythmic Movement Intervention on Selected Biomotor Abilities on Academy Rugby Players

Authors: Jocelyn Solomons, Kraak

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

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

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11913 Involvement in Health Policy and Political Efficacy among Hospital Nurses in Jordan: A Descriptive Survey

Authors: Raeda F. Abualrub, Amani Abdulnabi

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Aim: The aims of this study were to (a) examine the levels of nurses' political efficacy and involvement in health policy; and (b) explore the relationships between political efficacy, involvement in health policy, and participants’ background variables. Background: Nurses as citizens and health care providers have the right to express their opinions and beliefs in regard to issues that are concerned with the health care system or the public health domain. Methods: A descriptive, cross-sectional design using was utilized. A self-administered questionnaire (Political Efficacy Scale & Involvement in Health Policy Scale) was completed by a convenience sample of 302 nurses. Results: The results of this study showed low levels of involvement in health policy and political efficacy and a positive weak correlation between political efficacy and involvement in health policy. The perceived level of political efficacy was associated positively with nurses’ age and experience. Conclusions: Nurse administrators and managers may empower, support, and encourage nurses to enhance their involvement in health policy. Implications for Nursing Management: The findings have implications for nursing leaders and administrators to design appropriate strategies to enhance nurses’ involvement in health policy development.

Keywords: health policy, Jordan, nurses, political efficacy

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11912 Comparison of Sports Massage and Stretching along the Cold on Pain Intensity in Elite Female Volleyball Players with Trigger Points in Shoulder Girdle Region

Authors: Sahar Mohammadyari Ghareh Bolagh, Behnaz Seyedi Aghdam, Jalal Shamlou

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This study was done to compare the effects of sports massage and stretching along the cold on pain intensity in elite female volleyball players with trigger points in shoulder girdle region. This study was conducted on 32 female volleyball players with latent trigger points in shoulder girdle region. Patients were randomly assigned to three groups: sports massage (n=11) stretching along the cold (n=11) and control group (n=10). One session treatment program during 15 minutes was performed. Pain intensity with VAS + algometer was assessed before and after intervention and improved in both of massage and cold groups. After treatment there were no significant difference between two treatment groups (P < 0. 050). Results of present research showed sports massage and stretching along the cold were effective on pain intensity of myofascial trigger points.

Keywords: sports massage، stretching along the cold، pain intensity، trigger points, elite, volleyball players, shoulder girdle region

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11911 Case Study on Exploration of Pediatric Cardiopulmonary Resuscitation among Involved Team Members in Pediatric Intensive Care Unit Institut Jantung Negara

Authors: Farah Syazwani Hilmy Zaki

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Background: Compared to adult cardiopulmonary resuscitation (CPR), high-quality research and evidence on pediatric CPR remain relatively scarce. This knowledge gap hinders the development of optimal guidelines and best practices for resuscitating children. Objectives: To explore pediatric intensive care unit (PICU) CPR current practices in PICU of Institut Jantung Negara (IJN) Malaysia. Method: The research employed a qualitative approach, utilising case study research design. The data collection process involved in-depth interviews and reviewing the Resuscitation Feedback Form. Purposive sampling was used to select two cases consisting of 14 participants. The study participants comprised a cardiologist, one anaesthetist, and twelve nurses. The data collected were transcribed and entered into NVivo software to facilitate theme development. Subsequently, thematic analysis was conducted to analyse the data. Findings: The study yielded key findings regarding the enhancement of PICU CPR practices. These findings are categorised into four themes, namely routine procedures, resuscitation techniques, team dynamics, and individual contributions. Establishment of cohesive team is crucial in facilitating the effectiveness of resuscitation. According to participants, lack of confidence, skills and knowledge presents significant obstacles to effective PICU CPR. Conclusion: The findings of this study indicate that the participants express satisfaction with the current practices of PICU CPR. However, the research also highlights the need for enhancements in various areas, including routine procedures, resuscitation techniques, as well as team and individual factors. Furthermore, it was suggested that additional training be conducted on the resuscitation process to enhance the preparedness of the medical team.

Keywords: cardiopulmonary resuscitation, feedback, nurses, pediatric intensive care unit

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11910 Assessment of Occupational Health and Safety Conditions of Health Care Workers in Barangay Health Centers in a Selected City in Metro Manila

Authors: Deinzel R. Uezono, Vivien Fe F. Fadrilan-Camacho, Bianca Margarita L. Medina, Antonio Domingo R. Reario, Trisha M. Salcedo, Luke Wesley P. Borromeo

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The environment of health care workers is considered one of the most hazardous settings due to the nature of their work. In developing countries especially, the Philippines, this continues to be overlooked in terms of programs and services on occupational health and safety (OHS). One possible reason for this is the existing information gap on OHS which limits data comparability and impairs effective monitoring and assessment of interventions. To address this gap, there is a need to determine the current conditions of Filipino health care workers in their workplace. This descriptive cross-sectional study assessed the occupational health and safety conditions of health care workers in barangay health centers in a selected city in Metro Manila, Philippines by: (1) determining the hazards present in the workplace; (2) determining the most common self-reported medical problems; and (3) describing the elements of an OHS system based on the six building blocks of health system. Assessment was done through walkthrough survey, self-administered questionnaire, and key informant interview. Data analysis was done using Epi Info 7 and NVivo 11. Results revealed different health hazards present in the workplace particularly biological hazards (exposure to sick patients and infectious specimens), physical hazards (inadequate space and/or lighting), chemical hazards (toxic reagents and flammable chemicals), and ergonomic hazards (activities requiring repetitive motion and awkward posture). Additionally, safety hazards (improper capping of syringe and lack of fire safety provisions) were also observed. Meanwhile, the most commonly self-reported chronic diseases among health care workers (N=336) were hypertension (20.24%, n=68) and diabetes (12.50%, n=42). Top commonly self-reported symptoms were colds (66.07%, n=222), coughs (63.10%, n=212), headache (55.65%, n=187), and muscle pain (50.60%, n=170) while other diseases were influenza (16.96%, n=57) and UTI (15.48%, n=52). In terms of the elements of the OHS system, a general policy on occupational health and safety was found to be lacking and in effect, an absence of health and safety committee overseeing the implementing and monitoring of the policy. No separate budget specific for OHS programs and services was also found to be a limitation. As a result, no OHS personnel and trainings/seminar were identified. No established information system for OHS was in place. In conclusion, health and safety hazards were observed to be present across the barangay health centers visited in a selected city in Metro Manila. Medical conditions identified as most commonly self-reported were hypertension and diabetes for chronic diseases; colds, coughs, headache, and muscle pain for medical symptoms; and influenza and UTI for other diseases. As for the elements of the occupational health and safety system, there was a lack in the general components of the six building blocks of the health system.

Keywords: health hazards, occupational health and safety, occupational health and safety system, safety hazards

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