Search results for: local treatment

Authors: L. Abubakar, B. M. Sokoto, I. U. Mohammed, M. S. Na’allah, A. Mohammad, A. N. Garba, T. S. Bubuche

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Onion (Allium cepa var. cepa L.) is the most important species of the Allium group belonging to family Alliaceae and genus Allium. It can be regarded as the single important vegetable species in the world after tomatoes. Despite the similarities, which bring the species together, the genus is a strikingly diverse one, with more than five hundred species, which are perennial and mostly bulbous plants. Out of these, only seven species are in cultivation, and five are the most important species of the cultivated Allium. However, Allium cepa (onion) and Allium sativum (Garlic) are the two major cultivated species grown all over the world of which the onion crop is the most important. North Western Nigeria (Sokoto, Kebbi and Zamfara States) constitute the major onion producing zone in Nigeria, which is primarily during the dry season. However, onion production in the zone is seriously affected by two main factors i.e. diseases and storage losses, in addition to other constraints that limits the cultivation of the crop during the rainy season which include lack of prolonged rainy season to allow for proper maturation of the crop. The major onion disease in this zone is purple blotch caused by a fungus Alternaria porri and currently efforts are on to develop onion hybrids resistant to the disease. Genetic diversity plays an important role in plant breeding either to exploit heterosis or to generate productive recombinants. Assessment of a large number of genotypes for a genetic diversity is the first step in this direction. The objective of this research therefore is to evaluate the genetic potentials of the onion cultivars of North Western Nigeria, with a view of developing new cultivars that address the major production challenges to onion cultivation in North Western, Nigeria. Thirteen onion cultivars were collected during an expedition covering North western Nigeria and Southern part of Niger Republic during 2013, which are areas noted for onion production. The cultivars were evaluated at two locations; Sokoto, in Sokoto State and Jega in Kebbi State all in Nigeria during the 2013/14 onion season (dry season) under irrigation. The objective of the research was to determine the genetic potentials of onion cultivars of north western Nigeria as a basis for breeding purposes. Combined analysis of the results revealed highly significant variation between the cultivars across the locations with respect to plant height, number of leaves/plant, bolting %, bulb height, bulb weight, mean bulb yield and cured bulb weight, with significant variation in terms of bulb diameter. Tasa from Warra Local Government Area of Kebbi State (V4) recorded the greatest mean fresh bulb yield with Jar Albasa (V8) from Illela Local Government Area of Sokoto State recording the least. Similarly Marsa (V5) from Silame Local Government Area recorded the greatest mean cured bulb yield (marketable bulb)with Kiba (V11) from Goronyo Local Government of Sokoto State recording the least. Significant variation was recorded between the locations with respect to all characters, with Sokoto being better in terms of plant height, number of leaves/plant, bolting % and bulb diameter. Jega was better in terms of bulb height, bulb yield and cured bulb weight. Significant variation was therefore observed between the cultivars.

Keywords: evaluation, genetic, onions, North Western Nigeria

Procedia PDF Downloads 385

Authors: Calvince Okome Odeny

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There is a current action to increase radiotherapy services in Kenya. The National government of Kenya, in collaboration with the county governments, has embarked on building radiotherapy centers in all 47 regions of the country. As these new centers are established in Kenya, it has to be ensured that minimum radiation safety standards are in place prior to operation. For full implementation of this, it is imperative that more Research and training for regulators are done on radiation protection, and safety and national regulatory infrastructure is geared towards ensuring radiation protection and safety in all aspects of the use of external radiotherapy practices. The present work aims at reviewing the level of protection and safety for patients and staff during external beam radiotherapy using Linac in Kenya and provides relevant guidance to improve protection and safety. A retrospective evaluation was done to verify whether those occupationally exposed workers and patients are adequately protected from the harmful effect of radiation exposure during the treatment procedures using Linac. The project was experimental Research, also including an analysis of resource documents obtained from the literature and international organizations. The critical findings of the work revealed that the key elements of protection of occupationally exposed workers and patients include a comprehensive quality Management system governing all planned activities from siting, safety, and design of the Facility, construction, acceptance testing, commissioning, operation, and decommissioning of the Facility; Government empowering the Regulatory Authority to license Medical Linear facilities and to enforce the applicable regulations to ensure adequate protection; A comprehensive Radiation Protection and Safety program must be established to ensure adequate safety and protection of workers and patients during treatment planning and treatment delivery of patients and categories of staff associated with the Facility must be well educated and trained to perform professionally with a commitment to sound safety culture. Relevant recommendations from the findings are shared with the Medical Linear Accelerator facilities and the regulatory authority to provide guidance and continuous improvement of protection and safety to improve regulatory oversight.

Keywords: oncology, radiotherapy, protection, staff

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Authors: Srivilai Worametrachanon, Arunee Apichartsrangkoon, Jiranat Techarang, Boonrak Phanchaisri

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A human-digestive simulator consisted of four colon compartments, i.e., stomach, small intestine, proximal colon and distal colon used to harbor L. casei 01 plus either pasteurized ordinary-purple-rice drinks or germinated-purple-rice drinks. Accordingly, three treatment compositions had been set up and the effects of treatments on colon bacterial communities including their by-products were thoroughly examined. L. casei 01 plus purple-rice drinks gave rise to significantly high formation (P ≤ 0.05) of short-chain-fatty acids (SCFA) of which highest acetic acid was found followed by propionic and butyric acids, while the germinated-rice drink showed the greatest impact. Moreover, the effect was more pronounced upon prolonged fermentation. In addition, the influence of treatments on colon microbes was also demonstrated. Accordingly, desirable bacteria including colon Lactobacilli and Bifidobacteria were significantly increased (P ≤ 0.05) in both colons in comparison with the control and the effect was more prominent after adding purple-rice drink. On the other hand, undesirable Clostridia and coliforms were apparently diminished by the influence of treatment conditions, in which both compartments exhibited similar results.

Keywords: human-digestive simulator, Lactobacillus casei 01, Pasteurized-purple-rice drinks

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Authors: Orawan Vichiansan, J. Kraipoj, K.Phandech, P. Sirasaporn

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Generally, frozen shoulder will improve over time, although it may take a long time up to year. The symptoms of frozen shoulder present by pain around shoulder and consequently limit range of motions. The effect of frozen shoulder leads to limit activities daily living life and high medical care cost. Physiotherapy is well known treatment for frozen shoulder but there was no data about the treatment of physiotherapy in frozen shoulder and length of follow up. Thus the aim of this study was to investigate physiotherapy program for frozen shoulder on range of motion and length of follow up. A retrospective study design was conducted. 469 medical records of patients with frozen shoulder were reviewed. These frozen shoulders were treated at physiotherapy unit, department of Rehabilitation last 3 years (January, 2014- December, 2016). The data consist of range of motions and length of follow up was recorded. The medical record of 183 males and 286 females with average aged 57.82±12.32 years were reviewed in this study. There was a statistically significant increase in shoulder flexion [mean difference 30.24 with 95%CI were [24.37-36.12], shoulder abduction [mean difference 34.93 with 95%CI were 27.8-42.0], shoulder internal rotation [mean difference 17.25 with 95%CI were 12.55-21.95] and shoulder external rotation [mean difference 17.71 with 95%CI were [13.07-22.36] respectively. In addition, the length of follow up averaged 84 days. In summary, the retrospective study show physiotherapy program likely to be benefit for patients with frozen shoulder in term of range of motion and short length of follow up.

Keywords: frozen shoulder, physiotherapy, range of motions, length of follow up

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Authors: Mohammad Rahim Rahnama, Amir Ali Kharazmi, Safiye Rokni

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The tourism industry will be the most important unlimited, sustainable source of income after the oil and automotive industries by 2020 and not only countries, but cities are striving to apprehend its various facets. In line with this objective, the present descriptive-analytical study, through survey and using a questionnaire, seeks to evaluate the probability of tourists’ return and their recommendation to their countrymen to travel to Mashhad, Iran. The population under study is a sample of 384 foreign tourists who, in 2016, arrived at Mashhad, the second metropolis in Iran and its biggest religious city. The Kaplan-Meier estimator was used to analyze the data. Twenty-six percent of the tourists are female and 74% are male. On average, each tourist has had 3.02 trips abroad and 2.1 trips to Mashhad. Tourists from 14 different countries have arrived at Mashhad. Kuwait (15.9%), Armenia (15.6%), and Iraq (10.9%) were the countries where most tourists originated. Seventy-six percent of the tourists traveled with family and 90% of the tourists arrived at Mashhad via airplane. Major purposes of tourists’ trip include pilgrimage (27.9%), treatment (22.1%) followed by pilgrimage and treatment combined (35.4%). Major issues for tourists, in the order of priority, include quality of goods and services (30.2%), shopping (18%), and inhabitants’ treatment of foreigners (15.9%). Main tourist attractions, in addition to the Holy Shrine of Imam Reza, include Torqabeh and Shandiz (Torqabeh 40.9% and Shandiz 29.9%), Neyshabour (18.2%) followed by Kalat, 4.4%. The average willingness to return among tourists is 3.13, which is higher than the mean 3, indicating satisfaction with the stay in Mashhad. Similarly, the average for tourists’ recommending to their countrymen to visit Mashhad is 3.42, which is also an indicator of tourists’ satisfaction with their presence in Mashhad. According to the findings of the Kaplan-Meier estimator, an increase in the number of tourists’ trips to Mashhad, and an increase in the number of tourists’ foreign trips, reduces the probability of recommending a trip to Mashhad by tourists. Similarly, willingness to return is higher among those who stayed at a relatives’ home compared with other patterns of residence (hotels, self-catering accommodation, and pilgrim houses). Therefore, addressing the issues raised by tourists is essential for their return and their recommendation to others to travel to Mashhad.

Keywords: international tourist, probability of return, satisfaction, Mashhad

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Authors: Minji Seo

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Fashion stakeholders are becoming increasingly aware of technological innovation in manufacturing. In 2020, the COVID-19 pandemic caused transformations in working patterns, such as working remotely rather thancommuting. To enable smooth remote working, 3D fashion design software is being adoptedas the latest trend in design and production. The majority of fashion designers, however, are still resistantto this change. Previous studies on 3D fashion design software solely highlighted the beneficial and detrimental factors of adopting design innovations. They lacked research on the relationship between resistance factors and the adoption of innovation. These studies also fell short of exploringthe perspectives of users of these innovations. This paper aims to investigate the key drivers and barriers of employing 3D fashion design software as wellas to explore the challenges faced by designers.It also toucheson the governmental support for digital manufacturing in Seoul, South Korea, and London, the United Kingdom. By conceptualising local support, this study aims to provide a new path for industrial clusters to optimise digital apparel manufacturing. The study uses a mixture of quantitative and qualitative approaches. Initially, it reflects a survey of 350 samples, fashion designers, on innovation resistance factors of 3D fashion design software and the effectiveness of local support. In-depth interviews with 30 participants provide a better understanding of designers’ aspects of the benefits and obstacles of employing 3D fashion design software. The key findings of this research are the main barriers to employing 3D fashion design software in fashion production. The cultural characteristics and interviews resultsare used to interpret the survey results. The findings of quantitative data examine the main resistance factors to adopting design innovations. The dominant obstacles are: the cost of software and its complexity; lack of customers’ interest in innovation; lack of qualified personnel, and lack of knowledge. The main difference between Seoul and London is the attitudes towards government support. Compared to the UK’s fashion designers, South Korean designers emphasise that government support is highly relevant to employing 3D fashion design software. The top-down and bottom-up policy implementation approach distinguishes the perception of government support. Compared to top-down policy approaches in South Korea, British fashion designers based on employing bottom-up approaches are reluctant to receive government support. The findings of this research will contribute to generating solutions for local government and the optimisation of use of 3D fashion design software in fashion industrial clusters.

Keywords: digital apparel production, industrial clusters, innovation resistance, 3D fashion design software, manufacturing, innovation, technology, digital manufacturing, innovative fashion design process

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Authors: Daniela Gnarini

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This paper aims to contribute to the field of immigrants' entrepreneurial performance. The debate on immigrant entrepreneurship has been dominated by cultural explanations, which argue that immigrants’ entrepreneurial results are linked to groups’ characteristics. However, this approach does not consider important dimensions that influence entrepreneurial performances. Furthermore, cultural theories do not take into account the huge differences in performances also within the same ethnic group. For these reason, this study adopts a biographical approach, both at theoretical and at methodological level, which can allow to understand the main aspects that make the difference in immigrants' entrepreneurial performances, by exploring the narratives of immigrant entrepreneurs, who operate in the restaurant sector in two different Italian metropolitan areas: Milan and Rome. Through the qualitative method of biographical interviews, this study analyses four main dimensions and their combinations: a) individuals' entrepreneurial and migratory path: this aspect is particularly relevant to understand the biographical resources of immigrant entrepreneurs and their change and evolution during time; b) entrepreneurs' social capital, with a particular focus on their networks, through the adoption of a transnational perspective, that takes into account both the local level and the transnational connections. This study highlights that, though entrepreneurs’ connections are significant, especially as far as those with family members are concerned, often their entrepreneurial path assumes an individualised trajectory. c) Entrepreneurs' human capital, including both formal education and skills acquired through informal channels. The latter are particularly relevant since in the interviews and data collected the role of informal transmission emerges. d) Embeddedness within the social, political and economic context, to understand the main constraints and opportunities both at local and national level. The comparison between two different metropolitan areas within the same country helps to understand this dimension.

Keywords: biographies, immigrant entrepreneurs, life stories, performance

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Authors: Lina Liang, Kai Xu, Jing Zhang

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Purpose: Age-related macular degeneration (AMD) is a major leading cause of visual impairment and blindness with no cure currently established. Cell replacement is discussed as a potential therapy for AMD. Besides intravitreal injection and subretinal injection, intravenous administration has been explored as an alternative route. This study is to observe the effect of BSYJ, a traditional Chinese medicine on the homing and differentiation of mesenchymal stem cells transplanted via tail vein injection in an age-related macular degeneration mouse model. Methods: Four-week-old C57BL/6J mice were injected with 40 mg/kg NaIO₃ to induce age-related macular degeneration model. At the second day after NaIO₃ injection, 1×10⁷ GFP labeled bone marrow-derived mesenchymal stem cells (GFP-MSCs) were transplanted via tali vein injection into the experimental mice. Then the mice were randomly divided into two groups, gavaged with either BSYJ solution (BSYJ group, n=12) or distilled water (DW group, n=12). 12 age-matched healthy C57BL/6J mice were fed regularly as normal control. At day 7, day 14, and day 28 after treatment, retina flat mounting was used to detect the homing of mesenchymal stem cells at the retina. Double-labeling immunofluorescence was used to determine the differentiation of mesenchymal stem cells. Results: At 7, 14, 28 days after treatment, the numbers of GFP-MSCs detected by retina flatmount were 10.2 ± 2.5, 14.5 ± 3.4 and 18.7 ± 5.8, respectively in the distilled water group, while 15.7 ± 3.8, 32.3 ± 3.5 and 77.3 ± 6.4 in BSYJ group, the differences between the two groups were significant (p < 0.05). At 28 days after treatment, it was shown by double staining immunofluorescence that there were more GFP positive cells in the retina of BSYJ group than that of the DW group, but none of the cells expressed RPE specific genes such as RPE65 and CRALBP, or photoreceptor genes such as recoverin and rhodopsin either in BSYJ group or DW group. However, GFAP positive cells were found among the cells labeled with GFP, and the double labeling cells were much more in the BSYJ group than the distilled water group. Conclusion: BSYJ could promote homing of mesenchymal stem cells at the retina of age-related macular degeneration model mice induced by NaIO₃, and the differentiation towards to glial cells. Acknowledgement: National Natural Foundation of China (No: 81473736, 81674033,81973912).

Keywords: BSYJ, differentiation, homing, mesenchymal stem cells

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Authors: Ezaldin A. M. Mohammed, Youssef K. H. Abdalhafid, Masoud. M. Zatout

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The study aims to clarify the toxic effect of plant hormones, which are widely used in agriculture. One of these is the plant hormones (indole acetic acid); has been ٳata hormone to rats at 100 ppm salt solution of 0.2 per day after day for a period of forty days before conception until the fourteenth day or sixteenth or childbirth. Treatment brought about a marked shortage in the rate of increase in the weight of mice., And a percentage of the weight of the liver there was a distinct increase in the relative weight of the liver. As well as the increase in pathological changes and increase the size of the nuclei and Kupffer cell, as noted widespread and dense clusters of inflammatory cells accompanied by about the erosion of liver tissue and blood ٳrchah. Biochemical analyzes showed a marked decrease of the liver in antioxidant enzymes and an increase in the rate of free radicals. It was also noted an increase in cases of abortion. The owner of so many birth defects. It was also noted the lack of body weight in fetuses and increase the absorption rate of embryos in fetuses of mothers treatment compared to the control group. Showed microscopic examinations of the liver of mice born in the transaction and the decay in the presence of hepatic cells and edema, blood vessels and increase the rate of cell death.

Keywords: indol acetic acid, liver, pathological changes, albino rats

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Authors: A. Sunkar, A. Saraswati, Y. Santosa

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Controversies surrounding the impacts of oil palm plantations have resulted in some heated debates, especially concerning biodiversity loss and indigenous people well-being. The indigenous people of Dayak generally used wildlife to fulfill their daily needs thus were assumed to have experienced negative impacts due to oil palm developments within and surrounding their settlement areas. This study was conducted to identify the characteristics of the Dayak community settled around an oil palm plantation, to determine their perceptions of wildlife loss or gain as the results of the development of oil palm plantations, and to identify the determinant characteristic of the perceptions. The research was conducted on March 2018 in Nanga Tayap and Tajok Kayong Villages, which were located around the oil palm plantation of NTYE of Ketapang, West Kalimantan-Indonesia. Data were collected through in depth-structured interview, using closed and semi-open questionnaires and three-scale Likert statements. Interviews were conducted with 74 respondents using accidental sampling, and categorized into respondents who were dependent on oil palm for their livelihoods and those who were not. Data were analyzed using quantitative statistics method, Likert Scale, Chi-Square Test, Spearman Test, and Mann-Whitney Test. The research found that the indigenous Dayak people were aware of wildlife species loss and gain since the establishment of the plantation. Nevertheless, wildlife loss did not affect their social, economic, and cultural needs since they could find substitutions. It was found that prior to the plantation’s development, the local Dayak communities were already slowly experiencing some livelihood transitions through local village development. The only determinant characteristic of the community that influenced their perceptions of wildlife loss/gain was level of education.

Keywords: wildlife, oil palm plantations, indigenous Dayak, biodiversity loss and gain

Procedia PDF Downloads 155

Authors: Jeong-Min Son, Jeong-Hee Eum, Jin-Kyu Min, Uk-Je Sung, Ju-Eun Kim

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While various environmental problems are severe due to climate change, especially in cities where population and development are concentrated, urban thermal environment problems such as heat waves and tropical nights are particularly worsening. Accordingly, the Korean government provides basic data related to the urban thermal environment to support each local government in effectively establishing policies to cope with heat waves. However, the basic data related to the thermal environment provided by the government has limitations in establishing a regional thermal adaptation plan with a minimum unit of cities, counties, and districts. In addition, the urban heat environment perceived by people differs in each region and space. Therefore, it is necessary to prepare practical measures that can be used to establish regional-based policies for heat wave adaptation by identifying people’s heat perception in the entire city. This study aims to develop a mobile phone application (APP) to gather people’s thermal sensation information and create Korea’s first thermal map based on this information. In addition, through this APP, citizens directly propose thermal adaptation policies, and urban planners and policymakers accept citizens' opinions, so this study provides a tool to solve local thermal environment problems. To achieve this purpose, first, the composition and contents of the app were discussed by examining various existing apps and cases for citizen participation and collection of heat information. In addition, factors affecting human thermal comfort, such as spatial, meteorological, and demographic factors, were investigated to construct the APP system. Based on these results, the basic version of the APP was developed. Second, the living lab methodology was adopted to gather people’s heat perception using the developed app to conduct overall evaluation and feedback of people on the APP. The people participating in the living lab were selected as those living in Daegu Metropolitan City, which is located in South Korea and annually records high temperatures. The user interface was improved through the living lab to make the app easier to use and the thermal map was modified. This study expects to establish high-resolution thermal maps for effective policies and measures and to solve local thermal environmental problems using the APP. The collected information can be used to evaluate spatial, meteorological, and demographic characteristics that affect the perceived heat of citizens. In addition, it is expected that the research can be expanded by gathering thermal information perceived by citizens of foreign cities as well as other cities in South Korea through the APP developed in this study.

Keywords: mobile application, living lab, thermal map, climate change adaptation

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Authors: Marcin Dębowski, Mirosław Krzemieniewski, Marcin Zieliński

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This publication presents a device designed to depolymerise and structurally change organic substrate, for use in agricultural biogas plants or sewage treatment plants. The presented device consists of a heated tank equipped with an inlet valve for the crude substrate and an outlet valve for the treated substrate. The system also includes a gas conduit, which is at its tip equipped with a high-pressure solenoid valve and a vacuum relief solenoid valve. A conduit behind the high-pressure solenoid valve connects to the vacuum tank equipped with the outlet valve. The substrate introduced into the device is exposed to agents such as high temperature and cavitation produced by abrupt, short-term reduction of pressure within the heated tank. The combined effect of these processes is substrate destruction rate increase of about 20% when compared to using high temperature alone, and about 30% when compared to utilizing only cavitation. Energy consumption is greatly reduced, as the pressure increase is generated by heating the substrate. Thus, there is a 18% reduction of energy consumption when compared to a device designed to destroy substrate through high temperature alone, and a 35% reduction if compared to using cavitation as the only means of destruction.

Keywords: thermal depolymerisation, organic substrate, biogas, pre-treatment

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Authors: Emily Moore, Andrew Gaukroger, Matthew Solan, Lucy Bailey, Alexandra Boxall, Andrew Carne, Chintu Gadamsetty, Charlotte Morley, Katy Western, Iwona Kolodziejczyk

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Introduction: Rupture of the Achilles tendon is common and has a long recovery period. Most cases are managed non-operatively. Foot and Ankle Surgeons advise an ultrasound scan to check the gap between the torn ends. A large gap (with the ankle in equinus) is a relative indication for surgery. The definitive decision regarding surgical versus non-operative management can only be made once an ultrasound scan is undertaken and the patient is subsequently reviewed by a Foot and Ankle surgeon. To get to this point, the patient journey involves several hospital departments. In nearby trusts, patients reattend for a scan and go to the plaster room both before and after the ultrasound for removal and re-application of the cast. At a third visit to the hospital, the surgeon and patient discuss options for definitive treatment. It may take 2-3 weeks from the initial Emergency Department visit before the final treatment decision is made. This “wasted time” is ultimately added to the recovery period for the patient. In this hospital, Achilles rupture patients are seen in a weekly multidisciplinary OneStop Heel Pain clinic. This pathway was already efficient but subject to occasional frustrating delays if a key staff member was absent. A new pathway was introduced with the goal to reduce delays to a definitive treatment plan. Method: A retrospective series of Achilles tendon ruptures managed according to the 2019 protocol was identified. Time taken from the Emergency Department to have both an ultrasound scan and specialist Foot and Ankle surgical review were calculated. 30 consecutive patients were treated with our new pathway and prospectively followed. The time taken for a scan and for specialist review were compared to the 30 consecutive cases from the 2019 (pre-COVID) cohort. The new pathway includes 1. A new contoured splint applied to the front of the injured limb held with a bandage. This can be removed and replaced (unlike a plaster cast) in the ultrasound department, removing the need for plaster room visits. 2. Urgent triage to a Foot and Ankle specialist. 3. Ultrasound scan for assessment of rupture gap and deep vein thrombosis check. 4. Early decision regarding surgery. Transfer to weight bearing in a prosthetic boot in equinuswithout waiting for the once-a-week clinic. 5. Extended oral VTE prophylaxis. Results: The time taken for a patient to have both an ultrasound scan and specialist review fell > 50%. All patients in the new pathway reached a definitive treatment decision within one week. There were no significant differences in patient demographics or rates of surgical vs non-operative treatment. The mean time from Emergency Department visit to specialist review and ultrasound scan fell from 8.7 days (old protocol) to 2.9 days (new pathway). The maximum time for this fell from 23 days (old protocol) to 6 days (new pathway). Conclusion: Teamwork and innovation have improved the experience for patients with an Achilles tendon rupture. The new pathway brings many advantages - reduced time in the Emergency Department, fewer hospital visits, less time using crutches and reduced overall recovery time.

Keywords: orthopaedics, achilles rupture, ultrasound, innovation

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Authors: Ella Abaev, Shany Segal, Miri Gabay

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Background: Choking is a blockage of airways that prevents efficient breathing and air flow to the lungs. Choking may be partial or full and is an emergency situation. Complete or prolonged choking leads to apnea, lack of oxygen in the tissues of the body and brain, and can cause death. There are three mechanisms of choking: obstruction of internal respiratory tracts by food or object aspiration, any material that blocks or covers external air passages, external pressure on the neck or trapping between objects. Children's airways are narrower than that of adults and therefore the risk of choking is greater, due to the aspiration of food and other foreign bodies into the lungs. In the Child Development Center at Safra Children’s Hospital, Tel Hashomer in Israel are treated infants, toddlers, and children aged 0-18 years with various developmental disabilities. Due to the increase in reports of ‘almost an event’ of choking in the past year and the serious consequences of choking event, it was decided to give an emphasis to the issue. Incidence and methods: The number of reports of ‘almost an event’ or a choking event was examined at the center during the years 2013-2018 and a thorough research work was conducted on the subject in order to build a prevention program. Findings: Between 2013 and 2018 the center reported about ten cases of ‘almost choking events’. In the middle of 2018 alone three cases of ‘almost an event’ were reported. Objective: Providing knowledge leads to awareness raise, change of perception, change in behavior and prevention. The center employs more than 130 staff members from various sectors so that it is the work of multi-professional teams to promote the quality and safety of the treatment. The familiarity of the staff with risk factors, prevention guidelines, identification of choking signs, and treatment are most important and significant in determining the outcome of a choking event. Conclusions and recommendations: After in-depth research work was carried out in cooperation with the Risk Management Unit on the subject of choking, which include a description of the definitions, mechanisms, risk factors, treatment methods and extensive recommendations for prevention (e.g. using treatment and stimulation accessories with standards association stamps and adjustment of the type of food and the way it is served to match to the child's age and the ability to swallow). The expected stages of development and emphasis on the population of children with special needs were taken into account. The research findings will be published by the staff and parents of the patients, professional publications, and lectures and there is an expectation to decrease the number of choking events in the next years.

Keywords: children with special needs, choking, educational system, prevention guidelines

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Authors: Kiran Sharma, Viktor Kunder, Zerha Rizvi, Ricardo Soubelet

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Platelet rich plasma (PRP) has been recognized as a method of treatment in medicine since the 1980s. It primarily functions by releasing cytokines and growth factors that promote wound healing; these growth promoting factors released by PRP enact new processes such as angiogenesis, collagen deposition, and tissue formation that can change wound healing outcomes. Many studies recognize that PRP aids in chronic wound healing, which is advantageous for patients who suffer from chronic diabetic foot ulcers (DFUs). This scoping review aims to examine literature to identify the efficacy of PRP use in the healing of DFUs. Following PRISMA guidelines, we searched randomized-controlled trials involving PRP use in diabetic patients with foot ulcers using PubMed, Medline, CINAHL Complete, and Cochrane Database of Systematic Reviews. We restricted the search to articles published during 2005-2022, full texts in the English language, articles involving patients aged 19 years or older, articles that used PRP on specifically DFUs, articles that included a control group, articles on human subjects. The initial search yielded 119 articles after removing duplicates. Final analysis for relevance yielded 8 articles. In all cases except one, the PRP group showed either faster healing, more complete healing, or a larger percentage of healed participants. There were no situations in the included studies where the control group had a higher rate of healing or decreased wound size as compared to a group with isolated PRP-only use. Only one study did not show conclusive evidence that PRP caused accelerated healing in DFUs, and this study did not have an isolated PRP variable group. Application styles of PRP for treatment were shown to influence the level of healing in patients, with injected PRP appearing to achieve the best results as compared to topical PRP application. However, this was not conclusive due to the involvement of several other variables. Two studies additionally found PRP to be useful in healing refractory DFUs, and one study found that PRP use in patients with additional comorbidities was still more effective in healing DFUs than the standard control groups. The findings of this review suggest that PRP is a useful tool in reducing healing times and improving rates of complete wound healing in DFUs. There is room for further research in the application styles of PRP before conclusive statements can be made on the efficacy of injected versus topical PRP healing based on the findings in this study. The results of this review provide a baseline for further research in PRP use in diabetic patients and can be used by both physicians and public health experts to guide future treatment options for DFUs.

Keywords: diabetic foot ulcer, DFU, platelet rich plasma, PRP

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Authors: Ismatilla Mardanov

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There are three types of countries, the first of which is willing to attract foreign direct investment (FDI) in enormous amounts and do whatever it takes to make this happen. Therefore, FDI pours into such countries. In the second cluster of countries, even if the country is suffering tremendously from the shortage of investments, the governments are hesitant to attract investments because they are at the hands of local oligarchs/cartels. Therefore, FDI inflows are moderate to low in such countries. The third type is countries whose companies prefer investing in the most efficient locations globally and are hesitant to invest in the homeland. Sorting countries into such clusters, the present study examines the essential institutions and economic factors that make these countries different. Past literature has discussed various determinants of FDI in all kinds of countries. However, it did not classify countries based on government motivation, institutional setup, and economic factors. A specific approach to each target country is vital for corporate foreign direct investment risk analysis and decisions. The research questions are 1. What specific institutional and economic factors paint the pictures of the three clusters; 2. What specific institutional and economic factors are determinants of FDI; 3. Which of the determinants are endogenous and exogenous variables? 4. How can institutions and economic and political variables impact corporate investment decisions Hypothesis 1: In the first type, country institutions and economic factors will be favorable for FDI. Hypothesis 2: In the second type, even if country economic factors favor FDI, institutions will not. Hypothesis 3: In the third type, even if country institutions favorFDI, economic factors will not favor domestic investments. Therefore, FDI outflows occur in large amounts. Methods: Data come from open sources of the World Bank, the Fraser Institute, the Heritage Foundation, and other reliable sources. The dependent variable is FDI inflows. The independent variables are institutions (economic and political freedom indices) and economic factors (natural, material, and labor resources, government consumption, infrastructure, minimum wage, education, unemployment, tax rates, consumer price index, inflation, and others), the endogeneity or exogeneity of which are tested in the instrumental variable estimation. Political rights and civil liberties are used as instrumental variables. Results indicate that in the first type, both country institutions and economic factors, specifically labor and logistics/infrastructure/energy intensity, are favorable for potential investors. In the second category of countries, the risk of loss of assets is very high due to governmentshijacked by local oligarchs/cartels/special interest groups. In the third category of countries, the local economic factors are unfavorable for domestic investment even if the institutions are well acceptable. Cluster analysis and instrumental variable estimation were used to reveal cause-effect patterns in each of the clusters.

Keywords: foreign direct investment, economy, institutions, instrumental variable estimation

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Authors: Francine Morales Tavares, Jose Alberto Rio Fernandes

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The expanding concept of Heritage and the increased relevance of how heritage places relate to their surroundings is associated with an important shift in public heritage policies and how they consider the development of cities and communities, with an increasingly relevant role of management. Within the current discussions, management plans, mandatory since the year 2005 in areas classified by UNESCO as World Heritage, it is a tool for the reconciliation of cultural heritage demands with the needs of multiple users of a certain area, being especially critical in the case of urban areas with intense touristic pressure. Considering the transformations of the heritage policy management model, this paper discusses the practices on the integration of cultural heritage in urban policies through indicators which were selected from resource manual 'Managing Cultural World Heritage (2013)' and analyzed two case studies: The Management Plan of the Historic Centre of Porto (Portugal) and The Management Plan for the Historic Site of Olinda (Brazil). The empirical evidence concluded that for the historic centre of Porto the increase of tourism is the main aim driver in the management plan, with positive and negative aspects on the heritage management point of view, unlike Olinda, where the plan for the development of local urban policies was identified as essential. Plans also differ in form, content and process but coincide on being unaligned with committed local political leaders’ agendas, with the consequent misunderstandings between theory and practice, planning and management, and critically missing in the field integration of urban policies. Therefore, more debate about management plans, more efficient tools and also, appropriate methodologies to correlate cultural heritage and urban public policy are still lacking.

Keywords: world heritage, management plan, planning, urban policies

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Authors: Joshua N. Edokpayi, John O. Odiyo, Titus A. M. Msagati, Elizabeth O. Popoola

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Polycyclic aromatic hydrocarbons (PAHs) are very toxic and persistent environmental contaminants. This study was undertaken to assess the concentrations and possible sources of 16 PAHs classified by the United State Environmental Protection Agency as priority pollutants in Mvudi and Nzhelele Rivers and sediments. Effluents from Thohoyandou wastewater treatment plant and Siloam waste stabilization ponds were also investigated. Diagnostic ratios were used to evaluate the possible sources of PAHs. PAHs in the water samples were extracted using 1:1 dichloromethane and n-hexane mixtures, while those in the sediment samples were extracted with 1:1 acetone and dichloromethane using ultrasonication method. The extracts were purified using SPE technique and reconstituted in n-hexane before analyses with GC-TOF-MS. The results obtained indicate the prevalence of high molecular weight PAHs in all the samples. PAHs concentrations in water and sediment samples from all the sampling sites were in the range of 13.174-26.382 mg/L and 27.10-55.93 mg/kg, respectively. Combustion of biomass was identified as the major possible source of PAHs. Effluents from wastewater treatment facilities were also considered as major anthropogenic contributions to the levels of PAHs determined in both river waters and sediments. Mvudi and Nzhelele Rivers show moderate to high contamination level of PAHs.

Keywords: polycyclic aromatic hydrocarbon, rivers, sediments, wastewater effluents

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Authors: Chaimaan Benhsinat, Amal Tazi, Mohammed Azzi

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Synthetic azo-dyes are widely used in food industry, they product intense coloration, high toxicity and mutagenicity for wastewater; Causing serious damage to aquatic biota and risk factors for humans. The treatment of these effluents remains a major challenge especially for third world countries that have not yet all possibilities to integrate the concept of sustainable development. These aqueous effluents require specific treatment to preserve natural environments. For these reasons and in order to contribute to the fight against this danger, we were interested in this study to the degradation of the dye Ponceau Red E124 'C20H11N2Na3O10S3' 'used in a food industry Casablanca-Morocco, by the super iron ferrate (VI) K3FexMnyO8; Synthesized in our laboratory and known for its high oxidizing and flocculants. The degradation of Ponceau red is evaluated with the objectives of chemical oxygen demand (COD), total organic carbon (TOC) and discoloration reductions. The results are very satisfying. In fact, we achieved 90% reduction of COD and 99% of discoloration. The recovered floc are subject to various techniques for spectroscopic analysis (UV-visible and IR) to identify by-products formed after the degradation. Moreover, the results will then be compared with those obtained by the application of ferrous sulfate (FeSO4, 7H2O) used by the food industry for the degradation of P4R. The results will be later compared with those obtained by the application of ferrous sulfate (FeSO4, 7H2O) used by the food industry, in the degradation of the P4R.

Keywords: COD removal, color removal, dye ponceau 4R, oxydation by ferrate (VI)

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Authors: Hector Jose Velazquez-Gonzalez, Norma Maldonado-Santiago, Laura Pietri-Gomez

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Cancer is one of the first cause of death in the world, most of them are women. In Puerto Rico, there is a permanent controversy on the conceptuation of what really involves a disability, also in when a chronic illness, like cancer, should be considered a disability. The aim of the research was to identify functional limitation in 50 women survivors of cancer. In turn, to know the meanings that 6 women attributed to cancer with a focus on functionality. We conducted a mix method research based on surveys and narratives. We administered the World Health Organization Disability Assessment, version 2.0, which obtained a Cronbach’s alpha of .949 on the general scale, and from .773 to .956 on the six domains. The domain that obtained the highest average was social participation (M= 33.89, SD= 20.434), but it was not significant in the disability percentage. Also, there was no significance in the disability percentage in the other five domains. In a matter of meanings, we conduct a semistructured interview to 6 participants. All of them do not refer to cancer as a disability, either they do not know that in Puerto Rico cancer is considered as a disability by the law. However, participants agree that cancer at the time of treatment and subsequent to it, has significant effects on functional limitations (fatigue, pain, cognitive limitations, and weakness, among others. Psychooncologic practice should encourage the constant assessment of the functionality to identify the needs that emerge from oncological diagnosis. So that psychosocial intervention could be considered as critical in cancer treatment to promote a better quality of life and well-being in a person with cancer.

Keywords: cancer, Puerto Rico, disability, psychosocial approach

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Authors: Senthilkumar S, Vijayakumar R M , Soorianathasundaram K, Durga Devi D

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A study was conducted to assess the influence of brassinosteroid and other bioregulators as pre-harvest sprays on yield and quality of newly introduced Californian grape cv. Italia. The vines were exposed to standardized pruning level of pruning 50% of the canes to 5-6 bud level for fruiting and 50% of the canes to two bud level for vegetative growth. The influence of brassinosteroid was assessed using BR (1 ppm) alone and in combination with GA3 and CPPU, sprayed at three different stages over the control (water spray) were given as treatments. The results revealed that the bunches treated with Brassinosteroid (1 ppm) + GA3 (10 ppm) at pea stage i.e., 7-8 mm berry size, recorded the maximum values on yield characters like bunch weight (719.94 g), yield per vine (12.70 kg/vine) and yield per hectare (15.88 t). The berry characters and quality traits were also significantly influenced by the application of bioregulators. The maximum value for all those characters was registered under bunch sprays of Brassinosteroid (1 ppm) + GA3 (10 ppm) at pea stage. The economic feasibility indicated that the treatment combination Brassinosteroid (1 ppm) + GA3 (10 ppm) at pea stage (7-8 mm berry size) had registered the maximum benefit cost ratio of 3.13, as compared to 1.89 in control (water spray). Overall, it was observed that a combined bunch spray of Brassinosteroid (1 ppm) + GA3 (10 ppm) at pea stage (7-8 mm berry size) was adjudged as the best treatment for promoting the crop for better the bunch quality and yield.

Keywords: bioregulators, brassinosteroid, CPPU, GA3, Italia grape cultivar

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Authors: T. M. Agbede, A. O. Adekiya

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An experiment was carried out for three consecutive years at Owo, southwest Nigeria. The objective of the investigation was to determine the effect of Cocoa Pod Ash (CPA) and Poultry Manure (PM) applied solely and their combined form, as sources of fertilizers on soil properties, leaf nutrient composition, growth and yield of cocoyam. Three soil amendments: CPA, PM (sole forms), CPA and PM (mixture), were applied at 7.5 t ha-1 with an inorganic fertilizer (NPK 15-15-15) at 400 kg ha-1 as a reference and a natural soil fertility, NSF (control), arranged in a randomized complete block design with three replications. Results showed that soil amendments significantly increased (p = 0.05) corm and cormel weights and growth of cocoyam, soil and leaf N, P, K, Ca and Mg, soil pH and organic carbon (OC) concentrations compared with the NSF (control). The mixture of CPA+PM treatment increased corm and cormel weights, plant height and leaf area of cocoyam by 40, 39, 42, and 48%, respectively, compared with inorganic fertilizer (NPK) and 13, 12, 15 and 7%, respectively, compared with PM alone. Sole or mixed forms of soil amendments showed remarkable improvement in soil physical properties compared with NPK and the NSF (control). The mixture of CPA+PM applied at 7.5 t ha-1 was the most effective treatment in improving cocoyam yield and growth parameters, soil and leaf nutrient composition.

Keywords: Cocoa pod ash, cocoyam, poultry manure, soil and leaf nutrient composition.

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Authors: Fahimeh Helali Soltanahmadi, Alireza Nourabdi

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To investigate the effects of seed pretreatment on drought tolerance, an experimental Marigold (Calendula officinalis L) was tested in 2017-2018. A germination experiment was performed in the laboratory of Urmia University. The experiment was performed as a factorial experiment in a completely randomized design with three replications. The experimental treatments were dry levels of polyethylene glycol in four levels (control, -3, -6 and -9 bar) and treatments of Humic acid (72 mg / l), salicylic acid (2000 μmol) and ascorbic acid (200 ppm), and control were performed. The results of the germination experiment showed that with increasing drought levels caused by polyethylene glycol, germination indices were significantly reduced, so that the highest value obtained from the measured traits was observed in normal irrigation and in priming treatments, and the lowest amount of these traits was observed at the -9 bar drought level due to polyethylene glycol in the control treatment. The results of this study showed an increase in drought tolerance and improved Marigold germination under stress by applying seed priming with salicylic acid, which is recommended in sustainable and organic agriculture.

Keywords: Marigold, organic matter, seed pretreatment, drought stress, allometric coefficient

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Authors: Rashad Al-Gaashani, Viktor Kochkodan, Jenny Lawler

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Physico-chemical activation method wasused to produce high-quality activated carbon (AC) with a large surface area of about 2000 m2/g from low-cost and abundant biomasswastes in Qatar, namely date seeds. X-Ray diffraction (XRD), scanning electron spectroscopy (SEM), energy dispersive X-Ray spectroscopy (EDS), and Brunauer-Emmett-Teller (BET) surface area analysis were used to evaluate the AC samples. AC produced from date seeds have a wide range of the pores available, including micro- andnano-pores. This type of AC with a well-developed pore structure may be very attractive for different applications, including air and water purification from micro and nano pollutants. Heavy metalsiron (III) and copper (II) ions were removed from wastewater using the AC producedusinga batch adsorption technique. The AC produced from date seeds biomass wastes show high removal of heavy metals such as iron (III) ions (100%) and copper (II) ions (97.25%). The highest removal of copper (II) ions (100%) with AC produced from date seeds was found at pH 8, whereas the lowest removal (22.63%) occurred at pH 2. The effect of adsorption time, adsorbent dose, pH on the removal of heavy metalswere studied.

Keywords: activated carbon, date seeds, biomass, heavy metals removal, water treatment

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Authors: Rhaetian Bern D. Azaula

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The Philippines' indigenous population, estimated to be 10%-20%, is protected by the Indigenous Peoples Rights Act (IPRA), passed in 1997. However, due to their isolation and limited access to basic services such as health education or needs for health assistance, the law's implementation remains a challenge. As traditional medicine continues to play a significant role in society as the prevention and treatment of some illnesses, it is still customary and widely used to use plants in both traditional and modern ways; however, commercially prepared drugs are progressively advanced as time goes by. Therefore, the purpose of this quantitative study is to investigate the indigenous community at Barangay Magsikap General Nakar, Quezon, and analyze the factors that affect the respondent’s preferences in an indigenous community and reasons for patronizing traditional and commercially prepared medicines and proposes updated health education strategies and instructional materials. Slovin's formula was utilized to reduce the total population representation, followed by stratified sampling for proportional allocation of respondents. The study selects respondents (1) from an Indigenous Community in Barangay Magsikap, General Nakar, Quezon, (2) aged 60 and above, and (3) who are willing to participate. The researcher utilized a checklist-based questionnaire with a Tagalog version, and a Likert Scale was utilized to assess the respondent's choices on selected items. The researcher obtained informed consent from the indigenous community's regional and local office, the chieftain of the tribe, and the respondents, ensuring confidentiality in the collection and retrieval of data. The study revealed that respondents aged 60-69, males with no formal education, are unemployed and have no income source. They prefer traditional medicines due to their affordability, availability, and cultural practices but lack safe preparation, dosages, and contraindications of used medicines. Commercially prepared medications are acknowledged, but respondents are not fully aware of proper administration instructions and dosage labels. Recommendations include disseminating approved herbal medicines and ensuring proper preparation, indications, and contraindications.

Keywords: traditional medicine, commercially prepared medicine, indigenous community, elderly adult

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Authors: Zakieh Piri, Shahla Damanabi, Peyman Rezaii Hachesoo

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Introduction: Healthcare organizations like other organizations suffer from a number of disorders such as Business Sponsor Disorder, Business Acceptance Disorder, Cultural/Political Disorder, Data Disorder, etc. As quality in healthcare care mostly depends on the quality of data, we aimed to identify data disorders and its symptoms in two teaching hospitals. Methods: Using a self-constructed questionnaire, we asked 20 questions in related to quality and usability of patient data stored in patient records. Research population consisted of 150 managers, physicians, nurses, medical record staff who were working at the time of study. We also asked their views about the symptoms and treatments for any data disorders they mentioned in the questionnaire. Using qualitative methods we analyzed the answers. Results: After classifying the answers, we found six main data disorders: incomplete data, missed data, late data, blurred data, manipulated data, illegible data. The majority of participants believed in their important roles in treatment of data disorders while others believed in health system problems. Discussion: As clinicians have important roles in producing of data, they can easily identify symptoms and disorders of patient data. Health information managers can also play important roles in early detection of data disorders by proactively monitoring and periodic check-ups of data.

Keywords: data disorders, quality, healthcare, treatment

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Authors: Dijana Sulejmanović

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Cognitive-behavioral modification (CBM) is a combination of cognitive and behavioral learning principles to shape and encourage the desired behaviors. A crucial element of cognitive-behavioral modification is that a change the behavior precedes awareness of how it affects others. CBM is oriented toward changing inner speech and learning to control behaviors through self-regulation techniques. It aims to teach individuals how to develop the ability to recognize, monitor and modify their thoughts, feelings, and behaviors. The review of literature emphasizes the efficiency the CBM approach in the treatment of children's hyperactivity and negative emotions such as anger. The results of earlier research show how impulsive and hyperactive behavior, agitation, and aggression may slow down and block the child from being able to actively monitor and participate in regular classes, resulting in the disruption of the classroom and the teaching process, and the children may feel rejected, isolated and develop long-term poor image of themselves and others. In this article, we will provide how the use of CBM, adapted to child's age, can incorporate measures of cognitive and emotional functioning which can help us to better understand the children’s cognitive processes, their cognitive strengths, and weaknesses, and to identify factors that may influence their behavioral and emotional regulation. Such a comprehensive evaluation can also help identify cognitive and emotional risk factors associated with aggressive behavior, specifically the processes involved in modulating and regulating cognition and emotions.

Keywords: aggressive behavior, cognitive behavioral modification, cognitive behavioral theory, modification

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Authors: Jessy Abouarab

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For more than half a century, international norms related to refugee security and protection have proliferated, yet their role in alleviating war’s negative impacts on human life remains limited. The impact of refugee-security processes often manifests asymmetrically within populations. Many issues and people get silenced due to narrow security policies that focus either on abstract threat containment and refugee control or refugee protection and humanitarian aid. (In)security practices are gendered and experienced. Examining the case study of Syrian refugees in Lebanon, this study explores the gendered impact of refugee security mechanisms on local realities. A transnational feminist approach will be used to position this research in relation to existing studies in the field of security and the refugee-protection regime, highlighting the social, cultural, legal, and political barriers to gender equality in the areas of violence, rights, and social inclusion. Through Photovoice methodology, the Syrian refugees’ (in)securities in Lebanon were given visibility by enabling local volunteers to record and reflect their realities through pictures, at the same time voice the participants’ anxieties and recommendations to reach normative policy change. This Participatory Action Research approach helped participants observe the structural barriers and lack of culturally inclusive refugee services that hinder security, increase discrimination, stigma, and poverty. The findings have implications for a shift of the refugee protection mechanisms to a community-based approach in ways that extend beyond narrow security policies that hinder women empowerment and raise vulnerabilities such as gendered exploitation, abuse, and neglect.

Keywords: gender, (in)security, Lebanon, refugee, Syrian refugees, women

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Authors: Gulcin Yildiz

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Although drying is one of the most prevalent techniques applied to enhance food stability, it is a complicated method covering simultaneous coupled heat and mass transfer phenomena and the theoretical application of these phenomena to food products becomes challenging because of the complex structure and to the physical and chemical changes that happen at drying. Pretreatment of materials before drying has been shown to be effective in solving drying problems such as long drying times and poor product quality. The study was conducted to examine the effect of ultrasound (US) pre-treatment on physical and chemical/nutritional attributes of freeze-dried carrot slices. The carrots were washed, hand-peeled, and cut with dimensions of 1 cm (L) x 0.2 (W) cm x 1 cm (H). The carrot samples were treated in an ultrasonic bath in two different times, which were 15 and 30 minutes. Untreated and ultrasound pre-treated carrot samples were dried in a freeze dryer. Freeze-dried samples were analyzed in terms of bioactive compounds, including total phenols, ascorbic acid, and antioxidant capacity. Significant differences were found among dried carrot samples with and without ultrasound. The freeze-dried carrot slices treated with a US (especially 30 minutes - treatment) showed higher preservation of bioactive compounds. In overall, US pretreatment is a promising process, as demonstrated in current research by its capability to better retain freeze-dried carrot quality.

Keywords: bioactive compounds, carrot, freeze drying, ultrasound-pretreatment

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Authors: Made Kurnia Widiastuti Giri, Nyoman Kanca, Arie Swastini, Bambang Purwanto

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Aim: Waria transgenders are a phenomenon whose existence is undeniable. The sexual behaviours of waria transgenders belong to the groups of high-risk STDs infections, especially HIV/AIDS. The present study was aimed at finding out the general idea of the existence of waria transgenders in Singaraja, their sexual transactions, their sexual behaviours, and at exploring the factors affecting their sexual behaviours along with their participation in regular reproduction health control. Methods: The subjects of the present research were male-to-female transgenders living in the town of Singaraja. The research applied a qualitative approach. Data collection in this research was conducted through in-depth interview and observation. Results: The results of the study exposed 1) the existence of waria transgender community in Singaraja observed from their active participation in social events such as taking the roles of counsellors in the campaign of prevention and control of HIV/AIDS with the Local Commission of AIDS Control and other foundations; 2) the sexual services provided by waria transgenders which were performed in squeeze method, oral and anal sex which could be categorized as HIV/AIDS high-risk sexual behaviours, while the consistency in doing safe sex among the trangenders in Singaraja showed that most of the waria transgenders (80%) were aware of the urgency of using condoms during sexual intercourse; and 3) the low participation of the waria transgenders in Singaraja in regular reproduction health check up at the local Centre of Public Health Service was caused by their negative perception about being examined by female doctors. Conclucions: Waria in singaraja categorized as HIV/AIDS high-risk sexual behaviours but they do have consistency in doing safe sex by using condoms. They have a negative psychological perception about being examined by female doctors.

Keywords: waria transgenders, sexual behaviours, reproduction health, hiv/aids

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