Search results for: duration of internet usage

Authors: Farah Naja, Mohamad Alameddine

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Background: The difficulty of compliance to therapeutic and lifestyle management of type 2 diabetes mellitus (T2DM) encourages patients to use complementary and alternative medicine (CAM) therapies. Little is known about the prevalence and mode of CAM use among diabetics in the Eastern Mediterranean Region in general and Lebanon in particular. Objective: To assess the prevalence and modes of CAM use among patients with T2DM residing in Beirut, Lebanon. Methods: A cross-sectional survey of T2DM patients was conducted on patients recruited from two major referral centers - a public hospital and a private academic medical center in Beirut. In a face-to-face interview, participants completed a survey questionnaire comprised of three sections: socio-demographic, diabetes characteristics and types and modes of CAM use. Descriptive statistics, univariate and multivariate logistic regression analyses were utilized to assess the prevalence, mode and correlates of CAM use in the study population. The main outcome in this study (CAM use) was defined as using CAM at least once since diagnosis with T2DM. Results: A total of 333 T2DM patients completed the survey (response rate: 94.6%). Prevalence of CAM use in the study population was 38%, 95% CI (33.1-43.5). After adjustment, CAM use was significantly associated with a “married” status, a longer duration of T2DM, the presence of disease complications, and a positive family history of the disease. Folk foods and herbs were the most commonly used CAM followed by natural health products. One in five patients used CAM as an alternative to conventional treatment. Only 7 % of CAM users disclosed the CAM use to their treating physician. Health care practitioners were the least cited (7%) as influencing the choice of CAM among users. Conclusion: The use of CAM therapies among T2DM patients in Lebanon is prevalent. Decision makers and care providers must fully understand the potential risks and benefits of CAM therapies to appropriately advise their patients. Attention must be dedicated to educating T2DM patients on the importance of disclosing CAM use to their physicians especially patients with a family history of diabetes, and those using conventional therapy for a long time.

Keywords: nutritional supplements, type 2 diabetes mellitus, complementary and alternative medicine (CAM), conventional therapy

Procedia PDF Downloads 331

Authors: Ramzi Shawahna

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Background: Neonatal intensive care units are high-risk settings where medication errors can occur and cause harm to this fragile segment of patients. This multicenter qualitative study was conducted to describe medication errors that occurred in neonatal intensive care units in Palestine from the perspectives of healthcare providers. Methods: This exploratory multicenter qualitative study was conducted and reported in adherence to the consolidated criteria for reporting qualitative research checklist. Semi-structured in-depth interviews were conducted with healthcare professionals (4 pediatricians/neonatologists and 11 intensive care unit nurses) who provided care services for patients admitted to neonatal intensive care units in Palestine. An interview schedule guided the semi-structured in-depth interviews. The qualitative interpretive description approach was used to thematically analyze the data. Results: The total duration of the interviews was 282 min. The healthcare providers described their experiences with 41 different medication errors. These medication errors were categorized under 3 categories and 10 subcategories. Errors that occurred while preparing/diluting/storing medications were related to calculations, using a wrong solvent/diluent, dilution errors, failure to adhere to guidelines while preparing the medication, failure to adhere to storage/packaging guidelines, and failure to adhere to labeling guidelines. Errors that occurred while prescribing/administering medications were related to inappropriate medication for the neonate, using a different administration technique from the one that was intended and administering a different dose from the one that was intended. Errors that occurred after administering the medications were related to failure to adhere to monitoring guidelines. Conclusion: In this multicenter study, pediatricians/neonatologists and neonatal intensive care unit nurses described medication errors occurring in intensive care units in Palestine. Medication errors occur in different stages of the medication process: preparation/dilution/storage, prescription/administration, and monitoring. Further studies are still needed to quantify medication errors occurring in neonatal intensive care units and investigate if the designed strategies could be effective in minimizing medication errors.

Keywords: medication errors, pharmacist, pharmacology, neonates

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Authors: Y. Jeon, A. Bissessur, J. Lin, P. Ndungu

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Most transformers employ the usage of cellulose paper, which has been chemically modified through the Kraft process that acts as an effective insulator. Cellulose ageing and oil degradation are directly linked to fouling of the transformer and accumulation of large quantities of waste insulating paper. In addition to technical difficulties, this proves costly for power utilities to deal with. Currently there are no cost effective method for the rejuvenation of cellulose paper that has been documented nor proposed, since renewal of used insulating paper is implemented as the best option. This study proposes and contrasts different rejuvenation methods of accelerated aged cellulose insulating paper by chemical and bio-bleaching processes. Of the three bleaching methods investigated, two are, conventional chlorine-based sodium hypochlorite (m/v), and chlorine-free hydrogen peroxide (v/v), whilst the third is a bio-bleaching technique that uses a bacterium isolate, Acinetobacter strain V2. Through chemical bleaching, varying the strengths of the bleaching reagents at 0.3 %, 0.6 %, 0.9 %, 1.2 %, 1.5 % and 1.8 % over 4 hrs. were analyzed. Bio-bleaching implemented a bacterium isolate, Acinetobacter strain V2, to bleach the aged Kraft paper over 4 hrs. The determination of the amount of alpha cellulose, degree of polymerization and viscosity carried out on Kraft-cellulose insulating paper before and after bleaching. Overall the investigated techniques of chemical and bio-bleaching were successful and effective in treating degraded and accelerated aged Kraft-cellulose insulating paper, however, to varying extents. Optimum conditions for chemical bleaching were attained at bleaching strengths of 1.2 % (m/v) NaOCl and 1.5 % (v/v) H2O2 yielding alpha cellulose contents of 82.4 % and 80.7 % and degree of polymerizations of 613 and 616 respectively. Bio-bleaching using Acinetobacter strain V2 proved to be the superior technique with alpha cellulose levels of 89.0 % and a degree of polymerization of 620. Chemical bleaching techniques require careful and controlled clean-up treatments as it is chlorine and hydrogen peroxide based while bio-bleaching is an extremely eco-friendly technique.

Keywords: alpha cellulose, bio-bleaching, degree of polymerization, Kraft-cellulose insulating paper, transformer, viscosity

Procedia PDF Downloads 258

Authors: Peli̇n Yilmaz, Gi̇zemnur Yildiz Uysal, Emi̇ne Bi̇rci̇, Berk Özcan, Burak Koca, Ehsan Tuzcuoğlu, Fati̇h Kasap

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Development of Energy Efficient Programs (EEP) is one of the most significant trends in the wet appliance industry of the recent years. Thanks to the EEP, the energy consumption of a washing machine as one of the most energy-consuming home appliances can shrink considerably, while its washing performance and the textile hygiene should remain almost unchanged. Here in, the goal of the present study is to achieve an optimum EEP algorithm providing excellent textile hygiene results as well as cleaning performance in a domestic washing machine. In this regard, steam-pretreated cold wash approach with a combination of innovative algorithm solution in a relatively short washing cycle duration was implemented. For the parametric study, steam exposure time, washing load, total water consumption, main-washing time, and spinning rpm as the significant parameters affecting the textile hygiene and cleaning performance were investigated within a Design of Experiment study using Minitab 2021 statistical program. For the textile hygiene studies, specific loads containing the contaminated cotton carriers with Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa bacteria were washed. Then, the microbial removal performance of the designed programs was expressed as log reduction calculated as a difference of microbial count per ml of the liquids in which the cotton carriers before and after washing. For the cleaning performance studies, tests were carried out with various types of detergents and EMPA Standard Stain Strip. According to the results, the optimum EEP program provided an excellent hygiene performance of more than 2 log reduction of microorganism and a perfect Washing Efficiency Index (Iw) of 1.035, which is greater than the value specified by EU ecodesign regulation 2019/2023.

Keywords: washing machine, energy efficient programs, hygiene, washing efficiency index, microorganism, escherichia coli, staphylococcus aureus, pseudomonas aeruginosa, laundry

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Authors: Sarah Hebbouch

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Two decades ago, research on diasporic women’s participation within Sufi circles would have been inconceivable, not only because of a general lack of recognition of their contribution to Sufism but due to the intimacy of the rituals, often taking place in confined spaces, like zawiyas (Sufi lodges). Recent scholarly attention to female spiritual experience owes to a digital awareness and interest in exploring diasporic community reproduction of those experiences. Within a context where female disciples of a Sufi convent undergo a physical separation from the saint’s sanctuary -because of immigration from the homeland to the host country- technology becomes a social hub accounting for Sufis’ ritual commitment and preservation of cultural capital in the diaspora. This paper elucidates how female Sufi immigrants affiliating with the Boudchichi brotherhood (Morocco-based) maintain ‘a relational network’ and strong social online relationships with their female compatriots in Morocco through the use of online platforms. Sufi communities living in the diaspora find the internet an open interactive space that serves to kindle their distance of spiritual participation and corroborate their transnational belonging. The current paper explores the implications of the use of a digital baseline named “Tariqa Info,” the convent’s digital online platform, and how it mediates everyday ritual performance, the promotion of digital connection, and the communication of ideas and discourses. Such a platform serves the bolstering emotional bonds for transnational female disciples and inclusion within online communities in the homeland. Assisted by an ethnographic lens, this paper discusses the research findings of participatory field observation of Sufi women’s online communities, informed by the need to trace the many ostensible aspects of interconnectedness and divergences.

Keywords: digital connection, Sufi convent, social online relationship, transnational female disciples

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Authors: Marina Shurupova, Victor Anisimov, Alexander Latanov

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Background: The cerebellar lesions inevitably provoke oculomotor impairments in patients of different age. Symptoms of subtentorial tumors, particularly medulloblastomas, include static and dynamic coordination disorders (ataxia, asynergia, imbalance), hypo-muscle tonus, disruption of the cranial nerves, and within the oculomotor system - nystagmus (fine or gross). Subtentorial tumors can also affect the areas of cerebellum that control the oculomotor system. The noninvasive eye-tracking technology allows obtaining multiple oculomotor characteristics such as the number of fixations and their duration, amplitude, latency and velocity of saccades, trajectory and scan path of gaze during the process of the visual field navigation. Eye tracking could be very useful in clinical studies serving as convenient and effective tool for diagnostics. The aim: We studied the dynamics of oculomotor system functioning in patients undergoing remission from cerebellar tumors removal surgeries and following neurocognitive rehabilitation. Methods: 38 children (23 boys, 15 girls, 9-17 years old) that have recovered from the cerebellar tumor-removal surgeries, radiation therapy and chemotherapy and were undergoing course of neurocognitive rehabilitation participated in the study. Two tests were carried out to evaluate oculomotor performance - gaze stability test and counting test. The monocular eye movements were recorded with eye tracker ArringtonResearch (60 Hz). Two experimental sessions with both tests were conducted before and after rehabilitation courses. Results: Within the final session of both tests we observed remarkable improvement in oculomotor performance: 1) in the gaze stability test the spread of gaze positions significantly declined compared to the first session, and 2) the visual path in counting test significantly shortened both compared to the first session. Thus, neurocognitive rehabilitation improved the functioning of the oculomotor system in patients following the cerebellar tumor removal surgeries and subsequent therapy. Conclusions: The experimental data support the effectiveness of the utilization of the eye tracking technique as diagnostic tool in the field of neurooncology.

Keywords: eye tracking, rehabilitation, cerebellar tumors, oculomotor system

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Authors: Kevin Soubly, Kaysara Khatun

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This study applies the existing Middle-Out Perspective (MOP) as a complementing analytical alternative to the customary dichotomous options of top-down vs. bottom-up strategies of international development and commons governance. It expands the framework by applying it to a new context of land management and environmental change, enabling fresh understandings of decision making around land use. Using a case study approach in Central Kalimantan, Indonesia among a village of indigenous Dayak, this study explores influences from both internal and external middle actors, utilizing qualitative empirical evidence and incorporating responses across 25 village households and 11 key stakeholders. Applying the factors of 'agency' and 'capacity' specific to the MOP, this study demonstrates middle actors’ unique capabilities and criticality to change due to their influence across various levels of decision-making. Study results indicate that middle actors play a large role, both passively and actively, both directly and indirectly, across various levels of decision-making, perception-shaping, and commons governance. In addition, the prominence of novel 'passive' middle actors, such as the internet, can provide communities themselves with a level of agency beyond that provided by other middle actors such as NGOs and palm oil industry entities – which often operate at the behest of the 'top' or out of self-interest. Further, the study posits that existing development and decision-making frameworks may misidentify the 'bottom' as the 'middle,' raising questions about traditional development and livelihood discourse, strategies, and support, from agricultural production to forest management. In conclusion, this study provides recommendations including that current policy preconceptions be reevaluated to engage middle actors in locally-adapted, integrative manners in order to improve governance and rural development efforts more broadly.

Keywords: environmental management, governance, Indonesia, land use, middle actors, middle-out perspective

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Authors: Md, MCS, MPH Munyangi Wa Nkola Jerome

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The pandemic of COVID-19, a recently discovered contagious respiratory disease called SARS-CoV-2 (Severe Acute Respiratory Syndrome-Coronavirus 2 Majority of people infected with SARS-CoV-2: Asymptomatic or mildly ill 14% of patients will develop severe illness requiring hospitalization and oxygen support, and 5% of these will be transferred to an intensive care unit, Urgent need for new treatments that can be used quickly to avoid transfer of patients to intensive care and death. Objective: To evaluate the clinical activity (efficacy) of ArtiCovid Hypothesis: Administration of 3 times a teaspoon per day by COVID patients (symptomatic, mild, or moderate forms) results in the disappearance of symptoms and improvement of biological parameters (including viral suppression). Clinical efficacy: the disappearance of clinical signs after seven days of treatment; reduction in the rate of patients transferred to intensive care units for mechanical ventilation and a decrease in mortality related to this infection Paraclinical efficacy: improvement of biological parameters (mainly d-dimer, CRP) Virological efficacy: suppression of the viral load after seven days of treatment (control test on the seventh day is negative) Pilot study using a standardized solution based on Artemisia annua (ARTICOVID) Obtaining authorization from the health authorities of the province of Central Kongo Recruitment of volunteer patients, mainly in the Kinkanda HospitalCarrying out tests before and after treatment as well as analyses before and after treatment. The protocol obtained the approval of the ethics committee 50 patients who completed the treatment were aged between 2 and 70 years, with an average age of 36 yearsMore half were male (56%). One in four patients was a health professional (25%) Of the 12 health professionals, 4 were physicians. For those who reported the date of onset of the disease, the average duration between the appearance of the first symptoms and the medical consultation was 5 days. The 50 patients put on ARTICOVID were discharged alive with CRP levels substantially normalizedAfter seven to eight days, the control test came back negative. This pilot study suggests that ARTICOVID may be effective against COVID-19 infection.

Keywords: artiCovid, DRC, Covid-19, SARS_COV_2

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Authors: M. Parvez Alam, M. Bilal Khan

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Concrete is the material of choice where strength, performance, durability, impermeability, fire resistance, and abrasion resistance are required. The hunger for the higher strength leads to other materials to achieve the desired results and thus, emerged the contribution of cementitious material for the strength of concrete In present day constructions, concrete is chosen as one of the best choices by civil engineers in construction materials. The concept of sustainability is touching new heights and many pozzolonic materials are tried and tested as partial replacement for the cement. In this paper, comprehensive review of available literatures are studied to evaluate the performance of pozzolonic materials such as ceramic waste powder, copper slag, silica fume on the strength of concrete by the partial replacement of ordinary materials such as cement, fine aggregate and coarse aggregate at different percentage of composition. From the study, we conclude that ceramic wastes are suitable to be used in the construction industry, and more significantly on the making of concrete. Ceramic wastes are found to be suitable for usage as substitution for fine and coarse aggregates and partial substitution in cement production. They were found to be performing better than normal concrete, in properties such as density, durability, permeability, and compressive strength. Copper slag is the waste material of matte smelting and refining of copper such that each ton of copper generates approximately 2.5 tons of copper slag. Copper slag is one of the materials that is considered as a waste which could have a promising future in construction Industry as partial or full substitute of aggregates. Silica fume, also known as micro silica or condensed silica fume, is a relatively new material compared to fly ash, It is another material that is used as an artificial pozzolonic admixture. High strength concrete made with silica fume provides high abrasion/corrosion resistance.

Keywords: concrete, pozzolonic materials, ceramic waste powder, copper slag

Procedia PDF Downloads 299

Authors: Avani Jain, S. Shelley, M. Indirani, Shilpa Kalal, Jaykanth Amalachandran

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Aim: To evaluate the prevalence of gall bladder dysfunction in patients with dyspepsia using In-House fatty meal cholescintigraphy. Materials & Methods: This study is a prospective cohort study. 59 healthy volunteers with no dyspeptic complaints and negative ultrasound and endoscopy were recruited in study. 61 patients having complaint of dyspepsia for duration of more than 6 months were included. All of them underwent 99mTc-Mebrofenin fatty meal cholescintigraphy following a standard protocol. Dynamic acquisitions were acquired for 120 minutes with an In-House fatty meal being given at 45th minute. Gall bladder emptying kinetics was determined with gall bladder ejection fractions (GBEF) calculated at 30minutes, 45minutes and at 60 minutes (30min, 45min & 60 min). Standardization of fatty meal was done for volunteers. Receiver operating characteristic (ROC) analysis was used assess the diagnostic accuracy of 3 time points (30min, 45min & 60 min) used for measuring gall bladder emptying. On the basis of cut off derived from volunteers, the patients were assessed for gall bladder dysfunction. Results: In volunteers, the GBEF at 30 min was 74.42±8.26 % (mean ±SD), at 45 min was 82.61 ± 6.5 % and at 60 min was 89.37±4.48%, compared to patients where at 30min it was 33.73±22.87%, at 45 min it was 43.03±26.97% and at 60 min it was 51.85±29.60%. The lower limit of GBEF in volunteers at 30 min was 60%, 45 min was 69% and at 60 min was 81%. ROC analysis showed that area under curve was largest for 30 min GBEF (0.952; 95% CI = 0.914-0.989) and that all the 3 measures were statistically significant (p < 0.005). Majority of the volunteers had 74% of gall bladder emptying by 30 minutes; hence it was taken as an optimum cutoff time to assess gall bladder contraction. > 60% GBEF at 30 min post fatty meal was considered as normal and < 60% GBEF as indicative of gall bladder dysfunction. In patients, various causes for dyspepsia were identified: GB dysfunction (63.93%), Peptic ulcer (8.19 %), Gastroesophageal reflux disease (8.19%), Gastritis (4.91%). In 18.03% of cases GB dysfunction coexisted with other gastrointestinal conditions. The diagnosis of functional dyspepsia was made in 14.75% of cases. Conclusions: Gall bladder dysfunction contributes significantly to the causation of dyspepsia. It could coexist with various other gastrointestinal diseases. Fatty meal was well tolerated and devoid of any side effects. Many patients who are labeled as functional dyspeptics could actually have gall bladder dysfunction. Hence as an adjunct to ultrasound and endoscopy, fatty meal cholescintigraphy can also be used as a screening modality in characterization of dyspepsia.

Keywords: in-house fatty meal, choescintigraphy, dyspepsia, gall bladder ejection fraction, functional dyspepsia

Procedia PDF Downloads 488

Authors: Errol J. Haarhoff

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Housing in New Zealand, particularly in Auckland, is dominated by low-density suburbs. Over the past 20 years, housing intensification policies aimed to curb outward low-density sprawl and to concentrate development within an urban boundary have been implemented. This requires the greater deployment of attached housing typologies such apartments, duplexes and terrace housing. There has been strong market response and uptake for higher density development, with the number of building approvals received by the Auckland Council for attached housing units increasing from around 15 percent in 2012/13, to 54 percent in 2017/18. A key question about intensification and strong market uptake in a city where lower density has been the norm, is whether higher density neighborhoods will deliver necessary housing satisfaction? This paper reports on the findings to a questionnaire survey and focus group discussions probing resident perceptions to living at higher density in relation to their dwellings, the neighborhood and their sense of community. The findings reveal strong overall housing satisfaction, including key aspects such as privacy, noise and living in close proximity to neighbors. However, when residents are differentiated in terms of length of tenure, age or whether they are bringing up children, greater variation in satisfaction is detected. For example, residents in the 65-plus age cohort express much higher levels of satisfaction, when compared to the 18-44 year cohorts who more likely to be binging up children. This suggests greater design sensitivity to better accommodate the range of household types. Those who have live in the area longer express greater satisfaction than those with shorter duration, indicating time for adaption to living at higher density. Findings strongly underpin the instrumental role that the public amenities play in overall housing satisfaction and the emergence of a strong sense of community. This underscores the necessity for appropriate investment in the public amenities often lacking in market-led higher density housing development. We conclude with an evaluation of the PPP model, and its part in delivering housing satisfaction. The findings should be of interest to cities, housing developers and built environment professional pursuing housing policies promoting intensification and higher density.

Keywords: medium density, housing satisfaction, neighborhoods, sense of community

Procedia PDF Downloads 119

Authors: Rui Calejo Rodrigues

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Building Refurbishing and Maintenance is a major area of knowledge ultimately dispensed to user/occupant criteria. The optimization of the service life of a building needs a special background to be assessed as it is one of those concepts that needs proficiency to be implemented. ISO 15686-2 Buildings and constructed assets - Service life planning: Part 2, Service life prediction procedures, states a factorial method based on deterministic data for building components life span. Major consequences result on a deterministic approach because users/occupants are not sensible to understand the end of components life span and so simply act on deterministic periods and so costly and resources consuming solutions do not meet global targets of planet sustainability. The estimation of 2 thousand million conventional buildings in the world, if submitted to a probabilistic method for service life planning rather than a deterministic one provide an immense amount of resources savings. Since 1989 the research team nowadays stating for CEES–Center for Building in Service Studies developed a methodology based on Montecarlo method for probabilistic approach regarding life span of building components, cost and service life care time spans. The research question of this deals with the importance of probabilistic approach of buildings life planning compared with deterministic methods. It is presented the mathematic model developed for buildings probabilistic lifespan approach and experimental data is obtained to be compared with deterministic data. Assuming that buildings lifecycle depends a lot on component replacement this methodology allows to conclude on the global impact of fixed replacements methodologies such as those on result of deterministic models usage. Major conclusions based on conventional buildings estimate are presented and evaluated under a sustainable perspective.

Keywords: building components life cycle, building maintenance, building sustainability, Montecarlo Simulation

Procedia PDF Downloads 192

Authors: Antonio Lopez-Villegas, Rafael Bautista-Mesa, Emilio Robles-Musso, Daniel Catalan-Matamoros, Cesar Leal-Costa

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Objectives: The purpose of this trial was to evaluate the burden borne by and the costs to informal caregivers of users with telemonitoring of pacemakers. Methods: This is a controlled, non-randomised clinical trial, with data collected from informal caregivers, five years after implantation of pacemakers. The Spanish version of the Survey on Disabilities, Personal Autonomy, and Dependency Situations was used to get information on clinical and social characteristics, levels of professionalism, duration and types of care, difficulties in providing care, health status, economic and job aspects, impact on the family or leisure due to informal caregiving for patients with pacemakers. Results: After five years of follow-up, 55 users with pacemakers finished the study. Of which, 50 were helped by a caregiver, 18 were included in the telemonitoring group (TM) and 32 in the conventional follow-up group (HM). Overall, females represented 96.0% of the informal caregivers (88.89% in TM and 100.0% in HM group). The mean ages were 63.17 ± 15.92 and 63.13 ± 14.56 years, respectively (p = 0.83) in the groups. The majority (88.0%) of the caregivers declared that they had to provide their services between 6 and 7 days per week (83.33% in TM group versus 90.63% in HM group), without significant differences between both groups. The costs related to care provided by the informal caregivers were 47.04% higher in the conventional follow-up group than in the TM group. Conclusions: The results of this trial confirm that there were no significant differences between the informal caregivers regarding to baseline characteristics, workload and time worked in both groups of follow-up. The costs incurred by the informal caregivers providing care for users with pacemakers included in telemonitoring group are significantly lower than those in the conventional follow-up group. Trial registration: ClinicalTrials.gov NCT02234245. Funding: The PONIENTE study, has been funded by the General Secretariat for Research, Development and Innovation, Regional Government of Andalusia (Spain), project reference number PI/0256/2017, under the research call 'Development and Innovation Projects in the Field of Biomedicine and Health Sciences', 2017.

Keywords: costs, disease burden, informal caregiving, pacemaker follow-up, remote monitoring, telemedicine

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Authors: Ammal M. Metwally, Walaa A. Basha, Ghada A. Abdel-Latif, Amira S. El Rifay

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Introduction: Improving breastfeeding practices does not always link to interventions relying on improving nutrition awareness and education alone but needs cultural and behavioral insights. Aim: Our study provided educational intervention through the use of the social marketing (SM) approach, which was respectable to societal norms allowing more conscious choices by mothers to achieve the maximum potential of physical growth of their infants. This study evaluated the effectiveness of the used approach for improving breastfeeding practices and the physical growth of infants aged up to 2 years. Methodology: A quasi-experimental intervention design with a posttest-only control design was done over three years duration to motivate mothers’ voluntary behavioral change toward breastfeeding promotion using SM principles: product, price, place, and promotion. The interventions targeted 464 pregnant women in their last trimester, mothers of children up to 2 years, and 1454 women in their childbearing period. Results: Most mothers showed increased awareness about the benefits of breastfeeding and became interested in breastfeeding their children outside the house using the breastfeeding cover (Gawn). Breastfeeding initiation, exclusive breastfeeding under six months, frequency of breastfeeding per day, and percentage of children who continued breastfeeding till two years were significantly increased (from 30%, 23 %, 56%, and 32% to 62 %, 47.3 %, 69 %, and 43.5 %). With the attention of the nutritional educational sessions three or more times, the majority of indicators had the most significant improvement. The females who recorded underweight results over males during the first two years of life significantly improved after the intervention (from 53.8 % to 15.4%, respectively). At the same time, females that were found to be obese before the intervention (7.7 %) became no longer obese. Conclusions: Nutritional interventions that are based on the use SM approach showed improvement for the majority of the key performance indicators. Although they doubled their value before the intervention, the majority were still modest (below 50 %). With sustained use of the SM approach, infants will achieve their maximum potential for physical growth by providing economically disadvantaged mothers with breastfeeding support.

Keywords: social marketing approach, early breastfeeding initiation, exclusive breastfeeding, responsiveness to cues of hunger and satiety, physical growth of infants

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Authors: Mokgophana Ramasobana

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Background: At the core of the demand to utilize evidence-based approaches in the policy-making cycle, prioritization of limited financial resources and results driven initiatives is the urgency to develop a cohort of competent Monitoring and Evaluation (M&E) practitioners and public servants. The ongoing strides in the evaluation capacity building (ECB) initiatives are a direct response to produce the highly-sought after M&E skills. Notwithstanding the rapid growth of M&E short courses, participants perceived value and expectation of M&E short courses as a panacea for ECB have not been empirically quantified or measured. The objective of this article is to explicitly illustrate the importance of measuring ECB interventions and understanding what works in ECB and why it works. Objectives: This article illustrates the importance of establishing empirical ECB measurement tools to evaluate ECB interventions in order to ascertain its contribution to the broader evaluation practice. Method: The study was primarily a desktop review of existing literature, juxtaposed by a survey of the participants across the African continent based on the 43 M&E short courses hosted by the Centre for Learning on Evaluation and Results Anglophone Africa (CLEAR-AA) in collaboration with the Department of Planning Monitoring and Evaluation (DPME) Results: The article established that participants perceive short course training as a panacea to improve their M&E practical skill critical to executing their organizational duties. In tandem, participants are likely to demand customized training as opposed to general topics in Evaluation. However, the organizational environments constrain the application of the newly acquired skills. Conclusion: This article aims to contribute to the 'how to' measure ECB interventions discourse and contribute towards the improvement to evaluate ECB interventions. The study finds that participants prefer training courses with longer duration to cover more topics. At the same time, whilst organizations call for customization of programmes, the study found that individual participants demand knowledge of generic and popular evaluation topics.

Keywords: evaluation capacity building, effectiveness and training, monitoring and evaluation (M&E) short course training, perceptions and expectations

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Authors: Sila Akhan, Muge Toygar, Murat Sayan, Simge Fidan

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Chronic viral hepatitis B, C, and D can cause hepatocellular carcinoma (HCC), cirrhosis and death. The proper treatment reduce the risk of development of HCC importantly, but not to zero point. Materials and Methods: We analysed retrospectively our chronic viral hepatitis B, C and D patients who attended to our Infectious Diseases policlinic between 2004-2018. From 589 biopsy-proven chronic hepatitis patients 3 have hepatocellular carcinoma on our follow up. First case is 74 years old patient. His HCV infection diagnosis was made 8 years ago. First treatment was pegylated interferon plus ribavirin only 28 weeks, because of HCV RNA breakthrough under treatment. In 2013 he was retreated with telaprevir, pegylated interferon plus ribavirin 24 weeks. But at the end of the therapy HCV RNA was found 1.290.000 IU/mL. He has abdominal ultrasonography (US) controls and alpha-fetoprotein (AFP) at 6 months intervals. All seemed normal until 2015 then he has an abdominal magnetic resonance imaging (MRI) and found HCC by chance. His treatment began in Oncology Clinic after verified with biopsy of HCC. And then sofosbuvir/ledipasvir was given to him for HCV 24 weeks. Sustained virologic response (SVR) was obtained. He is on cure for HCV infection and under control of Oncology for HCC. Second patient is 36 years old man. He knows his HBV infection since 2008. HBsAg and HBeAg positive; HDV RNA negative. Liver biopsy revealed grade:4, stage 3-4 according modified Knodell scoring system. In 2010 tenofovir treatment was began. His abdominal US and AFP were normal. His controls took place at 6 months intervals and HBV DNA negative, US, and AFP were normal until 2016 continuously. AFP found 37 above the normal range and then HCC was found in MRI. Third patient is 57 years old man. As hepatitis B infection was first diagnosed; he has cirrhosis and was began tenofovir as treatment. In short time he has HCC despite normal AFP values. Conclusion: In Mediterranian countries including Turkey naturally occurring pre-S/S variants are more than 75% of all chronic hepatitis B patients. This variants may contribute to the development of progressive liver damage and hepatocarcinogenesis. HCV-induced development of HCC is a gradual process and is affected by the duration of disease and viral genotype. All the chronic viral hepatitis patients should be followed up in 6 months intervals not only with US and AFP for HCC. Despite they have proper treatment there is always the risk development of HCC. Chronic hepatitis patients cannot be dropped from follow up even treated well.

Keywords: HCC, HCV, HBV, DAA

Procedia PDF Downloads 121

Authors: Laura Hervai

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One of the most significant phenomena of the 2000s was the emergence of social media sites and web 2.0 that revolutionized communication processes. Social networking platforms have fundamentally changed social and political participation of the public, which require organisations in the public and non-profit sector not only to adapt to these new trends but also to actively engage their audiences. Opportunity for interaction, freer expression of opinion and the proliferation of user generated content are major changes brought by web 2.0 technologies. Furthermore, due to the wide penetration of mobile technologies, social media sites are capable of connecting underdeveloped regions to the global flow of information. Taking advantage of these characteristics, organisations have the opportunity to engage much wider audiences, exploit new ways to raise awareness or reach out to regions that are difficult to access. The early adopters of these new communication tools soon recognized the need of developing social media guidelines for their organisations as well as the increased workload that they require. While ten years ago communication officers could handle their organisation’s social media presence, today it is a separate profession. International organisations face several challenges related to their social media presence. Early adopters have contributed to the development of best practices among which the ethics of social media usage still remained problematic. Another challenge for international organisations is to adapt to country-specific social media trends while they have to comply with the requirements of their parent organisation as well. However in the 21st century social media presence can be crucial to the successful operation of international organisations, their importance is still not taken seriously enough. The measurement of the effects and influence of social networking on the organisations’ productivity is an unsolved problem thus further research should focus on this matter. Research methods included primary research of major IGOs’ and NGOs’ social media presence and guidelines along with secondary research of social media statistics and scientific articles in the topic.

Keywords: international organisations, non-profit sector, NGO, social media, social network

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Authors: R. M. W. Rajapakshe

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Sri Lanka, which is officially called the Democratic Socialist Republic of Sri Lanka is an island nation situated near India. It is a multi-lingual, multi- religious and multi – ethnic country, where Sinhalese form the majority and the Tamils form the largest ethnic minority. The composition of the population (ethnic basis) in Sri Lanka is as follows: Sinhalese: 74.5%, Tamil (Sri Lankan): 12.6%, Muslim: 7.5 %, Tamil (Indian): 5.5%, Malay: 0.3%, Burgher: 0.3 %, other: 0.2 %. The Tamil people use the Tamil language as their mother tongue and the Sinhala people use the Sinhala language as their mother tongue. A very few people in both communities use English as their mother tongue and however, a large number of people use English as a second language. The Sinhala Language was declared the only official language in Sri Lanka in 1959. However, it was not acceptable to Tamil politicians as well as to the common Tamil people and it was the beginning of long standing ethnic crisis which later became a military war where a lot of blood was shed. As a solution to the above ethnic crisis the thirteenth amendment to the constitution of Sri Lanka was introduced in 1987 and according to it both Sinhala and Tamil were declared official languages and English as the link language in Sri Lanka. Thus, a new programme namely, second language teaching programme under which Sinhala was taught to Tamil students and Tamil was taught to Sinhala students, was introduced at government schools. Language teaching includes knowledge of the culture of the target language. As all cultures are mixed and have common features students have reduced their enmity about the other community and learned to respect the other culture. On the other hand as all languages are mixed, students came to the understanding that there are no pure languages. Thus, they learned to respect the other language. In the case of Sri Lanka the Sinhala language is mixed with the Tamil language and vice versa. Thus, the development of second language teaching is the prominent way to solve the above ethnic problem and this study clearly shows it. However, the above programme suffers with lack of trained second language teachers, infrastructure facilities and insufficient funds and, they can be considered as the main obstacles to develop the second language teaching programme. Yet, there are no satisfactory answers to those problems. The data were collected from relevant books, articles and other documents based on research and forty five recordings, each with one hour duration, of natural conversations covering all factions of the Sinhala community.

Keywords: ethnic crisis, official language, second language teaching, Sinhala, Tami

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Authors: Tanya Keni

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Efforts to link culture and self, have been the focus, initially of Anthropology and later of Psychology in the first half of the 20th century. In doing so, cross-cultural researchers have endeavored to identify factors valuable for classifying cultures. One such central classification is that of individualism and collectivism which remains prominent. However, it overlooks certain other cultural dimensions that can be of interest and need attention. The current paper tries to move beyond this classic distinction, to cultures that are termed to be honor and dignity oriented. Both honor and dignity, refer to the worth of a person but bear different connotations and psychological consequences. While dignity is an independent concept of self-worth whose locus lies deep within the individual, honor is an interdependent concept that needs both personal as well as societal acknowledgment. This research takes an exploratory and qualitative approach to draw the individual, structural and contextual understanding of personal honor and dignity in broad cultures that are conceptualized as honor and dignity aimed. The aim is to understand the cultural influence on an individual’s self-worth, considering gender. 12 Focus group discussions were conducted across North India and Germany with four participants each. The research process was inspired by the approaches of social constructivism and critical realism. These discussions were transcribed and further analyzed using thematic analysis and the results have revealed differential themes for the concepts of honor and dignity. Certain dimensional similarities were also observed for both the cultural groups, however with differential usage of language. In particular, the North Indian group was seen using phrases that were oriented towards safeguarding against loss of honor or dignity. While the phrases of the German group were aligned towards worth-enhancement. The research also gives an illustration of how honor and dignity translate into behavioral practice that can exert an influence on important life decisions, especially about self and family for both males and females. In addition to these, the study also contributes to the literature on self-worth by developing the concept of ‘dignity’ for which there exists a dearth of research.

Keywords: culture, dignity, honor, self, self-worth

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Authors: Fedili Benamar, Belloulou Mohamed Lamine, Ouahes Hassane, Ghattas Samir

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Introduction: Perioperative blood loss is a frequent cause of complications in total hip replacement (THR). The present prospective study assessed the efficacy of tranexamic acid (Exacyl(®)) in reducing blood loss in primary THR. Hypothesis: Tranexamic acid reduces blood loss in THR. Material and method: -This is a prospective randomized study on the effectiveness of Exacyl (tranexamic acid) in total hip replacement surgery performed on a standardized technique between 2019 and September 2022. -It involved 154 patients, of which 84 received a single injection of Exacyl (group 1) at a dosage of 10 mg/kg over 20 minutes during the perioperative period. -All patients received postoperative thromboprophylaxis with enoxaparin 0.4 ml subcutaneously. -All patients were admitted to the post-interventional intensive care unit for a duration of 24 hours for monitoring and pain management as per the service protocol. Results: 154 patients, of which 84 received a single injection of Exacyl (group 1) and 70 patients patients who did not receive Exacyl perioperatively : (Group 2 ) The average age is 57 +/- 15 years The distribution by gender was nearly equal with 56% male and 44% female; "The distribution according to the ASA score was as follows: 20.2% ASA1, 82.3% ASA2, and 17.5% ASA3. "There was a significant difference in the average volume of intraoperative and postoperative bleeding during the 48 hours." The average bleeding volume for group 1 (received Exacyl) was 614 ml +/- 228, while the average bleeding volume for group 2 was 729 +/- 300, with a chi-square test of 6.35 and a p-value < 0.01, which is highly significant. The ANOVA test showed an F-statistic of 7.11 and a p-value of 0.008. A Bartlett test revealed a chi-square of 6.35 and a p-value < 0.01." "In Group 1 (patients who received Exacyl), 73% had bleeding less than 750 ml (Group A), and 26% had bleeding exceeding 750 ml (Group B). In Group 2 (patients who did not receive Exacyl perioperatively), 52% had bleeding less than 750 ml (Group A), and 47% had bleeding exceeding 750 ml (Group B). "Thus, the use of Exacyl reduced perioperative bleeding and specifically decreased the risk of severe bleeding exceeding 750 ml by 43% with a relative risk (RR) of 1.37 and a p-value < 0.01. The transfusion rate was 1.19% in the population of Group 1 (Exacyl), whereas it was 10% in the population of Group 2 (no Exacyl). It can be stated that the use of Exacyl resulted in a reduction in perioperative blood transfusion with an RR of 0.1 and a p-value of 0.02. Conclusions: The use of Exacyl significantly reduced perioperative bleeding in this type of surgery.

Keywords: acid tranexamic, blood loss, anesthesia, total hip replacement, surgery

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Authors: Roongtiwa Chobchuen, Siriporn Mongkholthawornchai, Boonsong Hatawaikarn, Uriwan Chaichangreet, Kobkaew Thongtid, Pusda Pukdeekumjorn, Panita Limpawattana

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Background: Age-friendly nursing service system in Srinagarind Hospital has been developed continuously based on the value and cultural background of Thailand which corporates with the modified WHO’s Age friendly Primary Care Service System. It consists of 3 issues; 1) development of staff training, 2) age-friendly service and 3) appropriate physical environment. Objective: To evaluate the efficacy of Age-friendly Nursing Service System: KKU (AFNS:KKU) model and to evaluate factors associated with nursing perception with AFN:KKU. Study design: Descriptive study Setting: 31 wards that served older patients in Srinagarind Hospital Populations: Nursing staff from 11 departments (31 wards) Instrument: Age-friendly nursing care scale as perceived by hospitalized older person Procedure and statistical analysis: All participants were asked questions using age-friendly nursing care scale as perceived by hospitalized older person questionnaires. Descriptive statistics and multiple logistic regression analyses were used to analyse the outcomes. Results: There were 337 participants recruited in this study. The majority of them were women (92%) with the mean ages of 29 years and 77.45% were nurse practitioners. They had average nursing experiences of 5 years. The average scores of age-friendly nursing care scale were high and highest in the area of attitude and communication. Age, sex, educational level, duration of work among, and having experience in aging training were not associated with nursing perception where type of department was an independent factor. Nurses from department of Surgery and Orthopedic, Eye and ENT, special ward and Obstetrics and Gynecological had significant greater perception than nurses from Internal Medicine Department (p < 0.05). Conclusion: Nurses had high scores in all dimensions of age-friendly concept. The result indicates that nurses have good attitude to aging care which can lead to improve quality of care. Organization should support other domains of ageing care to achieve greater effectiveness in geriatric care.

Keywords: age-friendly, nursing service system, excellence model, geriatric care

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Authors: Duy Nguyen Do, Bart Julien Dewancker

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Many Soviet-style collective housing complexes (also known as KTT) were built since the 1960s in Hanoi to support the post-war population growth. Those low-rise buildings have created well-knitted, robust communities, so much to the point that in most complexes, all families in one housing block would know each other, occasionally interact and provide supports in need. To understand how the community of collective housing complexes have developed and maintained in order to adapt their advantages into modern housing designs, the study is executed on the site of Nguyen Cong Tru KTT. This is one of the oldest KTT in Hanoi, completed in 1954. The complex also has an unique characteristic that is closely related to its community: the symbiotic relationship with Hom – a flea market that has been co-developing with Nguyen Cong Tru KTT since its beginning. The research consists of three phases: the first phase is a sociological investigation with Nguyen Cong Tru KTT’s current residents and a site survey on the complex’s economic and architectural characteristics. In the second phase, the collected data is analyzed to find out people’s opinions with the KTT’s concerning their satisfaction with the current housing status, floor plan organization, community, the relationship between the KTT’s dedicated public spaces with the flea market and their usage. Simultaneously, the master plan and gathered information regarding current architectural characteristics of the complex are also inspected. On the third phase, the analyses’ results will provide information regarding the issues, positive trends and significant historical features of the complex’s architecture in order to generate suitable proposals for the redesigning project of Nguyen Cong Tru KTT, a design focused on vitalizing modern apartments’ communities.

Keywords: collective house community, collective house public space, community-focused, redesigning Nguyen Cong Tru KTT, sociological investigation

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Authors: Sarah Elsayed Mohammed, Lamiaa Ahmed Ahmed, Mahmoud Mohammed Khattab

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Aim: The aim of the present study was to investigate whether combined nicorandil and bone marrow-derived mesenchymal stem cells (BMDMSC) treatment could offer an additional benefit in ameliorating isoproterenol (ISO)-induced heart failure in rats. Methods: ISO (85 and 170 mg/kg/day) was injected subcutaneously for 2 successive days, respectively. By day 3, electrocardiographic changes were recorded and serum was separated for determination of CK-MB level for confirmation of myocardial damage. Nicorandil (3 mg/kg/day) was then given orally with or without a single i.v. BMDMSC administration. Electrocardiography and echocardiography were recorded 2 weeks after beginning of treatment. Rats were then sacrificed and ventricles were isolated for estimation of vascular endothelial growth factor (VEGF), tumor necrosis factor-alpha (TNF-α) and transforming growth factor-beta (TGF-β) contents, caspase-3 activity as well as inducible nitric oxide synthase (iNOS) and connexin-43 protein expressions. Moreover, histological analysis of myocardial fibrosis was performed and cryosections were done for estimation of homing of BMDMSC. Results: ISO induced a significant increase in ventricles/body weight ratio, left ventricular end diastolic (LVEDD) and systolic dimensions (LVESD), ST segment and QRS duration. Moreover, myocardial fibrosis as well as VEGF, TNF-α and TGF-β contents were significantly increased. On the other hand, connexin-43 protein expression was significantly decreased, while caspase-3 and iNOS protein expressions were significantly increased. Combined therapy provided additional improvement compared to cell treatment alone towards reducing cardiac hypertrophy, fibrosis and inflammation. Furthermore, combined therapy induced significant increase in angiogenesis and BMDMSC homing and prevented ISO induced changes in iNOS, connexin-43 and caspase-3 protein expressions. Conclusion: Combined nicorandil/BMDMSC treatment was superior to BMDMSC alone towards preventing ISO-induced heart failure in rats.

Keywords: fibrosis, isoproterenol, mesenchymal stem cells, nicorandil

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Authors: Isaac Kofi Mensah

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E-government has been adopted and used by many governments/countries around the world including Ghana to provide citizens and businesses with more accurate, real-time, and high quality services and information. The objective of this paper is to present an overview of the Government of Ghana’s (GoG) adoption and implement of e-government and its usage by the Ministries, Departments and its agencies (MDAs) as well as other public sector institutions to deliver efficient public service to the general public i.e. citizens, business etc. Government implementation of e-government focused on facilitating effective delivery of government service to the public and ultimately to provide efficient government-wide electronic means of sharing information and knowledge through a network infrastructure developed to connect all major towns and cities, Ministries, Departments and Agencies and other public sector organizations in Ghana. One aim for the Government of Ghana use of ICT in public administration is to improve productivity in government administration and service by facilitating the exchange of information to enable better interaction and coordination of work among MDAs, citizens and private businesses. The study was prepared using secondary sources of data from government policy documents, national and international published reports, journal articles, and web sources. This study indicates that through the e-government initiative, currently citizens and businesses can access and pay for services such as renewal of driving license, business registration, payment of taxes, acquisition of marriage and birth certificates as well as application for passport through the GoG electronic service (eservice) and electronic payment (epay) portal. Further, this study shows that there is an enormous commitment from GoG to adopt and implement e-government as a tool not only to transform the business of government but also to bring efficiency in public services delivered by the MDAs. To ascertain this, a further study need to be carried out to determine if the use of e-government has brought about the anticipated improvements and efficiency in service delivery of MDAs and other state institutions in Ghana.

Keywords: electronic government, electronic services, electronic pay, MDAs

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Authors: Farzaneh Tahmoorian, Bijan Samali, John Yeaman

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Road networks are increasingly expanding all over the world. The construction and maintenance of the road pavements require large amounts of aggregates. Considerable usage of various natural aggregates for constructing roads as well as the increasing rate at which solid waste is generated have attracted the attention of many researchers in the pavement industry to investigate the feasibility of the application of some of the waste materials as alternative materials in pavement construction. Among various waste materials, construction and demolition wastes, including Recycled Construction Aggregate (RCA) constitute a major part of the municipal solid wastes in Australia. Creating opportunities for the application of RCA in civil and geotechnical engineering applications is an efficient way to increase the market value of RCA. However, in spite of such promising potentials, insufficient and inconclusive data and information on the engineering properties of RCA had limited the reliability and design specifications of RCA to date. In light of this, this paper, as a first step of a comprehensive research, aims to investigate the feasibility of the application of RCA obtained from construction and demolition wastes for the replacement of part of coarse aggregates in asphalt mixture. As the suitability of aggregates for using in asphalt mixtures is determined based on the aggregate characteristics, including physical and mechanical properties of the aggregates, an experimental program is set up to evaluate the physical and mechanical properties of RCA. This laboratory investigation included the measurement of compressive strength and workability of RCA, particle shape, water absorption, flakiness index, crushing value, deleterious materials and weak particles, wet/dry strength variation, and particle density. In addition, the comparison of RCA properties with virgin aggregates has been included as part of this investigation and this paper presents the results of these investigations on RCA, basalt, and the mix of RCA/basalt.

Keywords: asphalt, basalt, pavement, recycled aggregate

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Authors: Zehra Aybike Kılıç, Alpin Köknel Yener

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Daylight is a powerful driver in terms of improving human health, enhancing productivity and creating sustainable solutions by minimizing energy demand. A proper daylighting system allows not only a pleasant and attractive visual and thermal environment, but also reduces lighting energy consumption and heating/cooling energy load with the optimization of aperture size, glazing type and solar control strategy, which are the major design parameters of daylighting system design. Particularly, in high-rise buildings where large openings that allow maximum daylight and view out are preferred, evaluation of daylight performance by considering the major parameters of the building envelope design becomes crucial in terms of ensuring occupants’ comfort and improving energy efficiency. Moreover, it is increasingly necessary to examine the daylighting design of high-rise residential buildings, considering the share of residential buildings in the construction sector, the duration of occupation and the changing space requirements. This study aims to identify a proper daylighting design solution considering window area, glazing type and solar control strategy for a high-residential building in terms of visual comfort and lighting energy efficiency. The dynamic simulations are carried out/conducted by DIVA for Rhino version 4.1.0.12. The results are evaluated with Daylight Autonomy (DA) to demonstrate daylight availability in the space and Daylight Glare Probability (DGP) to describe the visual comfort conditions related to glare. Furthermore, it is also analyzed that the lighting energy consumption occurred in each scenario to determine the optimum solution reducing lighting energy consumption by optimizing daylight performance. The results revealed that it is only possible that reduction in lighting energy consumption as well as providing visual comfort conditions in buildings with the proper daylighting design decision regarding glazing type, transparency ratio and solar control device.

Keywords: daylighting , glazing type, lighting energy efficiency, residential building, solar control strategy, visual comfort

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Authors: Susan Marie R. De La Cruz, Bernadette F. De La Cruz, Georgia D. Demavibas

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This study determined the top 10 perceived students’ academic needs, personal needs, personal obstacles in achieving their academic goals, are as they need assistance, and their perceived feelings in math, reading and writing. The North Carolina State College, Student Support Services needs assessment survey was used. The respondents were the randomly chosen122Graduate school students. The top 10 academic needs are as follows: need to improve memory, communication skills, study habits, time management skills, career decisions, vocabulary, math skills, test taking skills, reading comprehension, and the need to reduce math anxiety. Top 10 personal needs are as follows: difficulty meeting deadline, difficulty managing money, inadequate computer skills, afraid of failing graduate school, difficulty participating in class/group discussions, absence from school, anxiety during exams, little or no experience with internet, personal counseling needs, and unsure of university academic procedures. Students’ top 10 perceived personal obstacles were as follows: issues surrounding sickness in family, lack of time management, lack of money, feeling tired, fears to speak in class, poor study habits, problems at home, late in class, too shy, and always feeling sick and easily distracted. Students felt need assistance in areas surrounding personal budget, stress management, motivation, anxiety, depressions, leadership development and goals/decision making. It is recommended that enrichment activities be provided to respond to students’ academic and personal needs. Also, Graduate School Guidance Counselor collaborates with other licensed Guidance Counselors in other colleges to have a well-coordinated and effective delivery of services responsive to students’ needs.

Keywords: academic needs, guidance counsellors, guidance service, needs assessment survey, personal needs, student services

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Authors: Masahiro Nochi

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This study explores the process in which a Japanese child with congenital blindness deepens understanding of the condition of being “unable to see” and develops the idea of “blind self,” despite having no direct experience of vision. The rehabilitation activities of a child with a congenital visual impairment that were video-recorded from 1 to 6 years old were analyzed qualitatively. The duration of the video was about 80 hours. The recordings were transcribed verbatim, and the episodes in which the child used the words related to the act of “looking” were extracted. Detailed transcripts were constructed referencing the notations of conversation analysis. Characteristics of interactions in those episodes were identified and compared longitudinally. Results showed that the child used the expression "look" under certain interaction patterns and her body expressions and interaction with adults developed in conjunction with the development of language use. Four stages were identified. At the age of 1, interactions involving “look” began to occur. The child said "Look" in the sequence: the child’s “Look,” an adult’s “I’m looking,” certain performances by the child, and the adult’s words of praise. At the age of 3, the child began to behave in accordance with the spatial attributes of the act of "looking," such as turning her face to the adult’s voice before saying, “Look.” She also began to use the expression “Keep looking,” which seemed to reflect her understanding of the temporality of the act of “looking.” At the age of 4, the use of “Look” or “Keep looking” became three times more frequent. She also started to refer to the act of looking in the future, such as “Come and look at my puppy someday.” At the age of 5, she moved her hands toward the adults when she was holding something she wanted to show them. She seemed to understand that people could see the object more clearly when it was in close priximity. About that time, she began to say “I cannot see” to her mother, which suggested a heightened understanding of her own blindness. The findings indicate that as she grew up, the child came to utilize nonverbal behavior before and after the order "Look" to make the progress of the interaction with adults even more certain. As a result, actions that reflect the characteristics of the sighted person's visual experience were incorporated into the interaction chain. The purpose of "Look," with which she intended to attract the adult's attention at first, changed and became something that requests a confirmation she was unable to make herself. It is considered that such a change in the use of the word as well as interaction with sighted adults reflected her heightened self-awareness as someone who could not do what sighted people could do easily. A blind child can gradually deepen their understanding of their own characteristics of blindness among sighted people around them. The child can also develop “blind self” by learning how to interact with others even without direct visual experiences.

Keywords: blindness, child development, conversation analysis, self-concept

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Authors: Avinash Nayak, Debopam Das

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The current work implements the variational principle to find the optimum initial perturbation that provides maximum growth in an impulsively blocked channel flow. The conventional method for studying temporal stability has always been through modal analysis. In most of the transient flows, this modal analysis is still followed with the quasi-steady assumption, i.e. change in base flow is much slower compared to perturbation growth rate. There are other studies where transient analysis on time dependent flows is done by formulating the growth of perturbation as an initial value problem. But the perturbation growth is sensitive to the initial condition. This study intends to find the initial perturbation that provides the maximum growth at a later time. Here, the expression of base flow for blocked channel is derived and the formulation is based on the two dimensional perturbation with stream function representing the perturbation quantity. Hence, the governing equation becomes the Orr-Sommerfeld equation. In the current context, the cost functional is defined as the ratio of disturbance energy at a terminal time 'T' to the initial energy, i.e. G(T) = ||q(T)||2/||q(0)||2 where q is the perturbation and ||.|| defines the norm chosen. The above cost functional needs to be maximized against the initial perturbation distribution. It is achieved with the constraint that perturbation follows the basic governing equation, i.e. Orr-Sommerfeld equation. The corresponding adjoint equation is derived and is solved along with the basic governing equation in an iterative manner to provide the initial spatial shape of the perturbation that provides the maximum growth G (T). The growth rate is plotted against time showing the development of perturbation which achieves an asymptotic shape. The effects of various parameters, e.g. Reynolds number, are studied in the process. Thus, the study emphasizes on the usage of optimal perturbation and its growth to understand the stability characteristics of time dependent flows. The assumption of quasi-steady analysis can be verified against these results for the transient flows like impulsive blocked channel flow.

Keywords: blocked channel flow, calculus of variation, hydrodynamic stability, optimal perturbation

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Authors: Faiz N. K. Yusufi, Aquil Ahmed, Jamal Ahmad

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Diabetes in India is growing at an alarming rate and the complications caused by it need to be controlled. Coronary heart disease (CHD) is one of the complications that will be discussed for prediction in this study. India has the second most number of diabetes patients in the world. To the best of our knowledge, there is no CHD risk score for Indian type 2 diabetes patients. Any form of CHD has been taken as the event of interest. A sample of 750 was determined and randomly collected from the Rajiv Gandhi Centre for Diabetes and Endocrinology, J.N.M.C., A.M.U., Aligarh, India. Collected variables include patients data such as sex, age, height, weight, body mass index (BMI), blood sugar fasting (BSF), post prandial sugar (PP), glycosylated haemoglobin (HbA1c), diastolic blood pressure (DBP), systolic blood pressure (SBP), smoking, alcohol habits, total cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), very low density lipoprotein (VLDL), physical activity, duration of diabetes, diet control, history of antihypertensive drug treatment, family history of diabetes, waist circumference, hip circumference, medications, central obesity and history of CHD. Predictive risk scores of CHD events are designed by cox proportional hazard regression. Model calibration and discrimination is assessed from Hosmer Lemeshow and area under receiver operating characteristic (ROC) curve. Overfitting and underfitting of the model is checked by applying regularization techniques and best method is selected between ridge, lasso and elastic net regression. Youden’s index is used to choose the optimal cut off point from the scores. Five year probability of CHD is predicted by both survival function and Markov chain two state model and the better technique is concluded. The risk scores for CHD developed can be calculated by doctors and patients for self-control of diabetes. Furthermore, the five-year probabilities can be implemented as well to forecast and maintain the condition of patients.

Keywords: coronary heart disease, cox proportional hazard regression, ROC curve, type 2 diabetes Mellitus

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