Search results for: outcomes that matter

Authors: Mirzashahi Babak, Mansouri Pejman, Najafi Arvin, Farzan Mahmoud

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Introduction: There are several surgical treatment choices for cervical spondylotic myelopathy (CSM). The aim of this study is to evaluate clinical outcomes and surgical complications in patients with cervical disk degeneration (CDD) undergoing either anterior cervical discectomy with or without fusion or cervical laminectomy and fusion. Methods: This prospective case series study included 45 consecutive patients with cervical spondylotic myelopathy between January 2010 and November 2014. There were 28 males and 17 females, with a mean age of 47 (range 37-68) years. The mean clinical follow-up was 14 months (range 3-24 months). The Neck Disability Index (NDI), visual analog scale (VAS) neck and arm pain, Short Form-36 (SF-36) were used as the functional outcome measurements. All of the complications in our patients were recorded. Results: In our study group, 26 patients underwent only one or two level anterior cervical discectomy. Ten patients underwent anterior cervical discectomy and fusion (ACDF) and nine cases underwent posterior laminectomy and fusion. We have found a statistically significant improvement between mean preoperative (29, range 19-43) and postoperative (7, range 0-12) NDI scores following surgery (P < 0.05). Also, there was a statistically significant difference between pre and post-operative VAS and SF-36 score (p < 0.05). There was a 7% overall complication rate (n = 3). The only complication in our patients was surgical site cellulitis which has been managed with oral antibiotic therapy. Conclusion: Both anterior cervical discectomy with or without fusion or posterior laminectomy and fusion are safe and efficacious treatment options for the management of CSM. The clinical outcomes seem to be fairly reproducible.

Keywords: cervical, myelopathy, discectomy, fusion, laminectomy

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Authors: Franklin Chu Buh, Irene Ule Ngole Sumbele, Andrew I. R. Maas, Mathieu Motah, Jogi V. Pattisapu, Eric Youm, Basil Kum Meh, Firas H. Kobeissy, Kevin W. Wang, Peter J. A. Hutchinson, Germain Sotoing Taiwe

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Introduction: Studying TBI characteristics and their relation to outcomes can identify initiatives to improve TBI prevention and care. The objective of this study was to define the features and outcomes of TBI patients seen over a 1-year period in a level-I trauma center in Cameroon. Methods: Data on demographics, causes, injury mechanisms, clinical aspects, and discharge status were prospectively collected over a period of 12 months. The Glasgow Outcome Scale-Extended (GOSE) and the Quality of Life Questionnaire after Brain Injury (QoLIBRI) were used to evaluate outcomes 6-months after TBI. Categorical variables were described as frequencies and percentages. Comparisons between 2 categorical variables were done using Pearson's Chi-square test or Fisher's exact test. Results: A total of 160 TBI patients participated in the study. The age group 15-45 years (78%; 125) was most represented. Males were more affected (90%; 144). Low educational level was recorded in 122 (76%) cases. Road traffic incidents (RTI) were the main cause of TBI (85%), with professional bike riders being frequently involved (27%, 43/160). Assaults (7.5%) and falls (2.5%) represent the second and third most common causes of TBI in Cameroon, respectively. Only 15 patients were transported to the hospital by ambulance, and 14 of these were from a referring hospital. CT-imaging was performed in 78% (125/160) of cases intracranial traumatic abnormality was identified in 77/125 (64%) cases. Financial constraints were the main reason for not performing a CT scan on 35 patients. A total of 46 (33%) patients were discharged against medical advice (DAMA) due to financial constraints. Mortality was 14% (22/160) but disproportionately high in patients with severe TBI (46%). DAMA had poor outcomes with QoLIBRI. Only 4 patients received post-injury physiotherapy services. Conclusion: TBI in Cameroon mainly results from RTIs and commonly affects young adult males, and low educational or socioeconomic status and commercial bike riding appear to be predisposing factors. Lack of pre-hospital care, financial constraints limiting both CT-scanning and medical care, and lack of acute physiotherapy services likely influenced care and outcomes adversely.

Keywords: characteristics, traumatic brain injury, outcome, disparities in care, prospective study

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Authors: Noor-ul-Ain, Muhammad Tahir Khan, Kashif Khan, Adeela Ajmal, Hamid Mustafa

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The objective of this study was to evaluate the preservative and upgrading potential of urea (70g/kg DM) added to high moisture oat silage at laboratory scale trial and urea was hydrolysed 95%. Microbial activity measured by pH and volatile fatty acids (VFA) and lactate production was reduced (p<0.001) by the urea addition. The pH of oat silage (without treated) was measured 5.7 and increased up to 8.00 on average while; volatile fatty acids (VFA) concentration was decreased. Relative proportions of fermentation acids changed after urea addition, increasing the acetate and butyrate and decreasing the propionate and lactate proportions. The addition of urea to oat silages increased (P<0.001) water soluble and ammonium nitrogen of the forage. These nitrogen fractions represented more than 40% of total nitrogen. After urea addition, total nitrogen content of oat silages increased from 21.0 g/kg DM to 28 g/kg DM. Application of urea at a rate of 70 g/kg DM significantly increased (P<0.001) the in situ degradation of neutral-detergent fibre after 48h of rumen incubation (NDF-situ). The NDF-situ was 200 g/kg NDF higher on oat forages ensiled with urea than on oat forages ensiled without urea. Oat silages can be effectively preserved and upgraded by ensiling with 70 g urea/kg dry matter. Further studies are required to evaluate voluntary intake of this forage.

Keywords: oat, silage, urea, pH, forage

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Authors: Benyapa Thitimapong

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Teenage pregnancy and adolescent mothers have become a matter of increasing concern in Thailand. Since adolescent mothers have been a big problem for two main consequences; health outcomes and socio-economic impacts. Adolescent mothers often endure poor living conditions; limited financial resources while also experience high stress, family instability, and limited educational opportunities. These disadvantages are negative and have long-term effects on adolescent mothers, their families, and the community. The majority of pregnant students and adolescent mothers dropped out of school after becoming pregnant, and some of them return to study again after they gave birth. This research aimed to explain the meaning of adolescent mothers who had undergone with childrearing and studying simultaneously after childbirth. A phenomenological qualitative approach was undertaken to investigate this study. The participants were 20 adolescent mothers each of whom became a mother and a student concurrently within less than 2 years after giving birth to a healthy baby and had also undergone the experience of childrearing and studying in non-formal education. In-depth interview was carried out for data collection, and the data were analyzed using content analysis method. ‘Learning to move forward’ was the meaning of adolescent mothers who experienced with childrearing and studying simultaneously. Their expressions were classified into two categories 1) having more responsibility, and 2) conceding and going on. The result of this study can be used as evidence for health care providers, especially nurses to facilitate and support pregnant adolescents and adolescent mothers to continue their education. Also, it can be used to guide policy to promote in all educational system to enable these groups to remain in school for their life-long success in the future.

Keywords: adolescent mothers, childrearing, studying, teenage pregnancy

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Authors: Daniel Phillip Svozil, Eileen Petrie, Kristy Robson, Lee Baumgartner, Max Finlayson

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Recreational angling is recognized for its potential to improve health and wellbeing which has translated into policy initiatives to increase participation in the sport. However, these benefits have been examined mostly among voluntary participants. Thus, there is an assumption that recreational angling is perceived equally and that these benefits may be evident even to non-anglers. This paper reviews the published benefits to health and wellbeing of recreational angling and proposes an approach to systemically analyze interactions among the perceptions, socio-economic barriers, and knowledge of these benefits among people at different levels of participation (including non-participants). The outcomes of this study will assist in identifying the feasibility of recreational angling for improving health and wellbeing outcomes among participants (i.e., fishing may not be for everyone) and designing interventions that address the perceptions and socio-economic barriers among individuals that may benefit from participation in recreational angling.

Keywords: angling, health, wellbeing, connecting with nature

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Authors: Wium de Villiers

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Section 106(1)(h) of the South African Criminal Procedure Act 51 of 1977 provides that an accused may enter a special plea that the prosecutor does not have title to prosecute. In a seminal matter (S v Mousa 2021 2 SACR 378 (GJ)) regarding section 106(1)(h), certain interesting legal aspects emerged. The first aspect concerned the meaning of the term “prosecutor”. More specifically, the question arose whether the term included a prosecutor who was previously involved with the matter, as well as the relevant Deputy Director of Public Prosecutions (DDPP) who instituted the prosecution and oversaw the prosecution on behalf of the state. The meaning of the term “title”, and with regard to the conduct of the “prosecutor”, the term “abuse of process,” were also raised and decided. In the paper, the facts, and the arguments in, and the decisions of the court, are discussed critically. The author argue that the intended objection in section 106(1)(h) is not to cure the abuse inflicted by a previous prosecutor or by the DDPP. I point out that the term “title” includes a lack of authority, non-compliance with jurisdictional requirements or absence of locus standi. I also point out that an abuse of process takes place if the process is used for an improper, ulterior or collateral purpose. I also argue that the accused should, instead of relying on section 106(1)(h), have relied on the prior agreement and applied for a permanent stay of prosecution.

Keywords: special plea, prosecutor, title, abuse of process

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Authors: Roslina Che Soh

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Best interest of the child has been the prevailing principle of the custody legislations of most nations in the world. The tremendous shift from parental rights to parental responsibilities throughout the centuries had made the principle of best interests of the child as the utmost matter which parents must uphold in child upbringing. Despite the commitment to this principle is significantly enshrined in the United Nation Convention on Rights of the Child, the content and application of the principle differs across borders. Differences persist notwithstanding many countries have experienced a substantial shift over the last several decades in the types of custodial arrangements that are thought to best serve children’s interests. The laws in Malaysia similarly uphold this principle but do not provide further deliberation on the principle itself. The principle is entirely developed by the courts through decided cases. Thus, this paper seeks to discuss the extent of the application of best interest of the child principle in custody disputes. In doing so, it attempts to provide an overview of the current laws and the approach of the Civil and the Shariah courts in Malaysia in applying the principle in determining custody disputes. For purposes of comparison, it briefly examines the legislations and the courts practices in Australia and England on this matter. The purpose is to determine the best standard to be adopted by Malaysia and to propose improvement to the laws whenever appropriate.

Keywords: child custody, best interest, Malaysian law, bioinformatics, biomedicine

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Authors: Cathy T. Mpanga Kowet, Aghaegbuna Obinna U. Ozumba

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This study examined and identified the inconsistencies, relationships, gaps and recurring themes in literature regarding the relationship between procurement strategies employed in the construction projects for sustainable buildings and realization of sustainability goals. A systematic literature review of studies on the relationship between various procurement strategies and attainment of sustainability outcomes was conducted. Using specific terms, papers published between 2002 and 2018 were identified and screened according to an inclusion and exclusion criteria. Current findings reveal that, although the attainment of sustainability goals is achievable with both traditional and contemporary procurement strategies, only projects delivered using modern procurement strategies are capable of meeting and exceeding targeted sustainability objectives. However, traditional procurement strategy remains the preferred method for most green building construction projects. The results suggest implications for decision makers in considering the impact of selected procurement strategies on targeted sustainability goals, in the early stages of sustainable building construction projects. The study shows that there is a gap between the reported appropriate procurement strategies and what is being practiced currently. Theoretically, the study expands on the literature on adoption and diffusion of contemporary procurement strategies, by consolidating existing studies to highlight the current gaps. While the study is at the literature review stage, deductions will serve as basis for field work involving empirical data.

Keywords: green buildings construction, procurement method, procurement strategy, sustainability objectives, sustainability outcomes

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Authors: CarlyWill Sloan

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Racial disparities in criminal justice outcomes are well-documented. However, there is little evidence on the extent to which racial bias by prosecutors is responsible for these disparities. This paper tests for racial bias in conviction by prosecutors. To identify effects, this paper leverages as good as random variation in prosecutor race using detailed administrative data on the case assignment process and case outcomes in New York County, New York. This paper shows that the assignment of an opposite-race prosecutor leads to a 5 percentage point (~ 8 percent) increase in the likelihood of conviction for property crimes. There is no evidence of effects for other types of crimes. Additional results indicate decreased dismissals by opposite-race prosecutors likely drive my property crime estimates.

Keywords: criminal justice, discrimination, prosecutors, racial disparities

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Authors: Y. Vásquez, F. Reyes, P. Oyola, M. Rubio, J. Muñoz, E. Lissi

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In several cities in Chile, there is significant urban pollution, particularly in Santiago and in cities in the south where biomass is used as fuel in heating and cooking in a large proportion of homes. This has generated interest in knowing what factors can be modulated to control the level of pollution. In this project was conditioned and set up a photochemical chamber (14m3) equipped with gas monitors e.g. CO, NOX, O3, others and PM monitors e.g. dustrack, DMPS, Harvard impactors, etc. This volume could be exposed to UVA lamps, producing a spectrum similar to that generated by the sun. In this chamber, PM and gas emissions associated with biomass burning were studied in the presence and absence of radiation. From the comparative analysis of wood stove (eucalyptus globulus) and pellet (radiata pine), it can be concluded that, in the first approximation, 9-nitroanthracene, 4-nitropyrene, levoglucosan, water soluble potassium and CO present characteristics of the tracers. However, some of them show properties that interfere with this possibility. For example, levoglucosan is decomposed by radiation. The 9-nitroanthracene, 4-nitropyrene are emitted and formed under radiation. The 9-nitroanthracene has a vapor pressure that involves a partition involving the gas phase and particulate matter. From this analysis, it can be concluded that K+ is compound that meets the properties known to be tracer. The PM2.5 emission measured in the automatic pellet stove that was used in this thesis project was two orders of magnitude smaller than that registered by the manual wood stove. This has led to encouraging the use of pellet stoves in indoor heating, particularly in south-central Chile. However, it should be considered, while the use of pellet is not without problems, due to pellet stove generate high concentrations of Nitro-HAP's (secondary organic contaminants). In particular, 4-nitropyrene, compound of high toxicity, also primary and secondary particulate matter, associated with pellet burning produce a decrease in the size distribution of the PM, which leads to a depth penetration of the particles and their toxic components in the respiratory system.

Keywords: biomass burning, photochemical chamber, particulate matter, tracers

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Authors: Mathieu Hemono, Sophie Puig-Malet, Patrick Zylberman, Avner Bar-Hen, Rainer Sauerborn, Stefanie Schütte, Niamh Herlihi, Antoine Flahault et Anneliese Depoux

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Since the IPCC released its first report in 1990, an increasing number of peer-reviewed publications have reported the health risks associated with climate change. Although there is a large body of evidence supporting the association between climate change and poor health outcomes, the media is inconsistent in the attention it pays to the subject matter. This study aims to analyze the modalities and rhetoric in the media concerning the impact of climate change on health in order to better understand its role in information dissemination. A review was conducted of articles published between 1990 and 2015 in the francophone newspapers Le Monde and Jeune Afrique. A detailed search strategy including specific climate and health terminology was used to search the newspapers’ online databases. 1202 articles were identified as having referenced the terms climate change and health. Inclusion and exclusion criteria were applied to narrow the search to articles referencing the effects of climate change on human health and 160 articles were included in the final analysis. Data was extracted and categorized to create a structured database allowing for further investigation and analysis. The review indicated that although 66% of the selected newspaper articles reference scientific evidence of the impact of climate change on human health, the focus on the topic is limited major political events or is circumstances relating to public health crises. Main findings also include that among the many direct and indirect health outcomes, infectious diseases are the main health outcome highlighted in association with climate change. Lastly, the articles suggest that while developed countries have caused most of the greenhouse effect, the global south is more immediately affected. Overall, the reviewed articles reinforce the need for international cooperation in finding a solution to mitigate the effects of climate change on health. The manner in which scientific results are communicated and disseminated, impact individual and collective perceptions of the topic in the public sphere and affect political will to shape policy. The results of this analysis will underline the modalities of the rhetoric of transparency and provide the basis for a perception study of media discourses. This study is part of an interdisciplinary project called 4CHealth that confronts results of the research done on scientific, political and press literature to better understand how the knowledge on climate changes and health circulates within those different fields and whether and how it is translated to real world change.

Keywords: climate change, health, health impacts, communication, media, rhetoric, awareness, Global South, Africa

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Authors: Michael Graz, Natasha Hurril, Andrew Shearer

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Research on feed supplementation with natural compounds is currently being intensively pursued with a view to improving energy utilisation in ruminants and mitigating the production of methane by these animals. Towards this end, a novel combination of extracts from garlic and bitter orange was therefore selected for trials on the basis of their previously published in vitro anti-methanogenic potential. Three separate in vitro experiments were conducted to determine energy utilisation and greenhouse gas production. These included use of rumen fluid from fistulated cows and sheep in batch culture, the Hohenheim gas test, and the Rusitec technique. Experimental and control arms were utilised, with 5g extracts per kilogram of total dietary dry matter (0.05g/kg active compounds) being used to supplement or not supplement the in vitro systems. Respiratory measurements were conducted on experimental day 1 for the batch culture and Hohenheim gas test and on day 14-21 for the Rusitec Technique (in a 21-day trial). Measurements included methane (CH4) production, total volatile fatty acid (VFA) concentration, molar proportions of acetate, propionate and butyrate and degradation of organic matter (Rusitec). CH4 production was reduced by 82% (±16%), 68% (±11%) and 37% (±4%) in the batch culture, Hohenheim gas test and Rusitec, respectively. Total VFA production was reduced by 13% (±2%) and 2% (±0.1%) in the batch culture and Hohenheim gas test whilst it was increased by 8% (±2%) in the Rusitec. Total VFA production was reduced in all tests between 2 and 10%, whilst acetate production was reduced between 10% and 29%. Propionate production which is an indicator of weight gain was increased in all cases between 16% and 30%. Butyrate production which is considered an indicator of potential milk yield was increased by between 6 and 11%. Degradation of organic matter in the Rusitec experiments was improved by 10% (±0.1%). In conclusion, the study demonstrated the potential of the combination of garlic and citrus extracts to improve digestion, enhance body energy retention and limit CH4 formation in relation to feed intake.

Keywords: citrus, garlic, methane, ruminants

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Authors: A. Kulprasutidilok

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In order to address the social factors of elderly health care, researcher and community members have turned to more inclusive and participatory approaches to research and interventions. One such approach, community-based participatory research (CBPR) in public health, has received increased attention as the academic and public health communities struggle to address the persistent problems of disparities in the use of health care and health outcomes for several over the past decade. As Thailand becomes an ageing society, health services and proper care systems specifically for the elderly group need to be prepared and well established. The purpose of this assignment was to study the health problems and was to explore the process of community participation in elderly health care. Participants in this study were member of elderly group of Paisanee Ramintra 65 community in Bangkok, Thailand. The results indicated two important components of community participation process in elderly health care: 1) a process to develop community participation in elderly health care, and 2) outcomes resulting from such process. The development of community participation consisted of four processes. As for the outcomes of the community participation development process, they consisted of elderly in the community got jointly and formulated a group, which strengthened the project because of collaborative supervision among themselves. Moreover, inactive health care services have changed to being energetic and focus on health promotion rather than medical achievement and elderly association of community can perform health care activities for chronically illness through the achievement of this development; consequently, they increasingly gained access to physical, cognitive, and social activity.

Keywords: community-based participatory research, elderly, heath care, Thailand.

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Authors: Urwah Ali

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The aim of this study is to carry out a meta-analysis in order to establish an overall international figure and to summarize the evidence relating to the possible relationship between child sexual abuse and subsequent mental and physical health outcomes. A systematic review was conducted using the HEC Digital Library, Pub Med, PsycINFO and SAHIL databases published after 2010 containing empirical data pertaining to CSA. Out of 124 articles assessed for eligibility, 32 studies provided evidence of a relationship between sexual child maltreatment and various health outcomes for use in subsequent meta-analyses. Statistical significance associations were observed between childhood sexual victimization and psychological problems in their adulthood [odds ratio (OR) = 1.5; 95%Cl 3.07–4.43]. For most studies included for meta-analysis, the odds ratio falls above 1.00, indicating that patients having history of childhood sexual victimization were more likely to develop psychological disorders.

Keywords: abuse, sexual abuse, childhood sexual abuse, mental health

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Authors: Emily Injete Amondo, Alisher Mirzabaev, Emmanuel Rukundo

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Children in rural farming households are often vulnerable to a multitude of risks, including health risks associated with climate change and variability. Cognizant of this, this study empirically traced the relationship between climate variability and nutritional health outcomes in rural children while identifying the cause-and-effect transmission mechanisms. We combined four waves of the rich Uganda National Panel Survey (UNPS), part of the World Bank Living Standards Measurement Studies (LSMS) for the period 2009-2014, with long-term and high-frequency rainfall and temperature datasets. Self-reported drought and flood shock variables were further used in separate regressions for triangulation purposes and robustness checks. Panel fixed effects regressions were applied in the empirical analysis, accounting for a variety of causal identification issues. The results showed significant negative outcomes for children’s anthropometric measurements due to the impacts of moderate and extreme droughts, extreme wet spells, and heatwaves. On the contrary, moderate wet spells were positively linked with nutritional measures. Agricultural production and child diarrhea were the main transmission channels, with heatwaves, droughts, and high rainfall variability negatively affecting crop output. The probability of diarrhea was positively related to increases in temperature and dry spells. Results further revealed that children in households who engaged in ex-ante or anticipatory risk-reducing strategies such as savings had better health outcomes as opposed to those engaged in ex-post coping such as involuntary change of diet. These results highlight the importance of adaptation in smoothing the harmful effects of climate variability on the health of rural households and children in Uganda.

Keywords: extreme weather events, undernutrition, diarrhea, agricultural production, gridded weather data

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Authors: Zouhaier Nasr, Mohamed Nouri

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The increase in greenhouse gases since the pre-industrial period is a real threat to disrupting the balance of marine and terrestrial ecosystems. Along with the oceans, forest soils are considered to be the planet's second-largest carbon sink. North African forests have been subject to alarming degradation for several decades. The objective of this investigation is to determine and quantify the effect of thinning practiced in pine forests in northern Tunisia on the storage of organic carbon in the trees and in the soil. The plot planted in 1989 underwent thinning in 2005 on to plots; the density is therefore 1600 trees/ha in control and 400 trees/ha in thinning. Direct dendrometric measurements (diameter, height, branches, stem) were taken. In the soil part, six profiles of 1m / 1m / 1m were used for soil and root samples and biomass and organic matter measurements. The measurements obtained were statistically processed by appropriate software. The results clearly indicate that thinning improves tree growth, so the diameter increased from 24.3 cm to 30.1 cm. Carbon storage in the trunks was 35% more and 25% for the whole tree. At ground level, the thinned plot shows a slight increase in soil organic matter and quantity of carbon per tree, exceeding the control by 10 to 25%.

Keywords: forest, soil, carbon, climate change, Tunisia

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Authors: Nicholas Sehube, Rosemary Kelebemang, Pogisego Dinake

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The extent of Pb contamination of shooting range soils has never been ascertained in Botswana, this was the first attempt in evaluating the deposition of Pb into the soils emanating from munitions. A total of 8 military shooting ranges were used for this study. Soil samples were collected at each of the 8 shooting ranges at the berm (stop butt), target line, 50 and 100 m from the berm. In all of the shooting ranges investigated the highest concentrations were found in the berm soils. The highest Pb concentrations of 38 406.87 mg/Kg were found in the berm soils of Thebephatshwa shooting range which is enclosed within a military camp with staff residential dwelling only a kilometre away. Most of the shooting ranges soils contained elevated levels of Pb in the ranges above 2000 mg/kg far exceeding the United States Environmental Protection Agency (USEPA) critical value of 400 mg/Kg. Mobilization of lead at high pH is attributed to low organic matter and such was the case with Thebephatshwa shooting range with a percept organic matter of 0.35±0.08. The predominant weathering products in these shooting ranges were cerussite (PbCO3), hydrocerussite (Pb(CO3)2(OH)2 and massicot (PbO). The detailed examination and characterization of the extent of pollution will help in the development and implementation of scientifically sound remediation and restoration of shooting ranges soils.

Keywords: ammunition, Botswana, Pb, pollution, soil

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Authors: M. Fertouna Bellakhal, M. Bellakhal, A. Dhib, A. Fathalli, S. Turki, L. Aleya

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Study of dinoflagellate cysts is a precious tool to get information about environment and water quality in many aquatic ecosystems. The distribution of Alexandrium pacificum cysts, in Bizerta lagoon located in North of Tunisia, was made based on sediment samples analysis from 123 equidistant stations delimiting 125 km² surfaces. Sediment characteristics such as percentage of water, organic matter, and particle size were analyzed to determine the factors that influence the distribution of this dinoflagellate. In addition, morphological examination and ribotyping of vegetative forms from microalgal cultures made from cyst germination confirmed the identity of the species attributed to A. pacificum. A correlation between the abundance of A. pacificum cysts and the percentage of water and sediment organic matter was recorded. In addition, the sedimentary fraction < 63μm was found to be potentially favorable for the installation and initiation of the Alexandrium pacificum efflorescence at the Bizerte lagoon. The mapping of cysts in this aquatic ecosystem has also allowed us to define distinct areas with specific abundance with closed relationship with shellfish aquaculture stations located within the lagoon.

Keywords: Alexandrium pacificum, cysts, Dinoflagellate, microalgal culture

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Authors: Rabeab Khunpukdee, Aranya Sukchoui, Nonluk Somgit, Chitima Bunnaul

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Endotracheal displacement is a major risk of life threatening among critically ill patients. Standard nursing protocol is needed to minimize this risk and to improve clinical outcomes. To evaluate the effectiveness of the endothacheal care nursing guideline. The incidence rates of endochacheal displacement, oxygen deficiency after extubation, re-intubation, and nurse’s satisfaction on the utilization of the endotracheal care nursing guideline. An evidence-based nursing practice framework was used to develop the endotracheal care nursing guideline. The guideline valid content was review by a 3 panel of experts. The index of item objective (IOC) of the guideline was 0.93. The guideline was implemented in 130 patients (guideline group) and 19 registered nurses at a medicine ward, Had Yai hospital, Thailand. Patient’s outcomes were evaluated by comparison with those 155 patients who received the routine nursing care (routine care group). Descriptive statistics, frequency, percentage, mean, standard deviation and Mann Whitney U-test was analyzed using the computer program. All significantly and better outcomes were found in the guideline group compared to the routine care group. The guideline group has less incidence rates of endotracheal displacement (1.54 % vs 9.03 %, p < 0.05), and none of the guideline group had oxygen deficiency after extubation (0 % vs 83.33%) compared to the routine care group. All of the 2 patients in the guideline group, compared to 6 of 14 patients in the routine care group were re-intubation. The overall rate of re-intubation in the total group (n = 130 vs 155) was seen less in the guideline group than the routine care group (1.54 % vs 3.87). Overall, nurses satisfaction was at high-level (89.50%) on the utilization of the guideline.

Keywords: endotracheal care, nursing guideline, re-intubation, satisfaction

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Authors: Ilona Krone

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Maternal smoking during pregnancy increases the risk of perinatal/postnatal negative health outcomes; however, only 1 in 5 pregnant smokers quit smoking. That is a clinical and public health problem. Pregnant smokers have negative paternal support, and higher levels of perceived stress than non-smokers and quitters return to smoking in a stressful situation. A crisis like the COVID-19 outbreak causes significant uncertainty and stress. For pregnant women, additional stress may increase due to concerns for their fetus. Strategies targeting maternal stress and isolation may be particularly useful to prevent negative outcomes for women and their fetuses. Within the post-doctoral study, cooperating with leading specialists, an innovative program for pregnant smokers will be developed. Feasibility for reducing craving, distress intolerance, Covid 19 related stress, and fear in pregnant women in Latvia will be assessed.

Keywords: COVID 19, mindfulness, motivation, pregnancy, smoking cessation

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Authors: Nir Wittenberg, Moshe Farhi

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This mixed-methods study examines the integration of artificial intelligence (AI) tools in a first-year social work course to assess their potential for enhancing professional knowledge and skills. The incorporation of digital technologies, such as AI, in social work interventions, training, and research has increased, with the expectation that AI will become as commonplace as email and mobile phones. However, policies and ethical guidelines regarding AI, as well as empirical evaluations of its usefulness, are lacking. As AI is gradually being adopted in the field, it is prudent to explore AI thoughtfully in alignment with pedagogical goals. The outcomes assessed include professional identity, course satisfaction, and motivation. AI offers unique reflective learning opportunities through personalized simulations, feedback, and queries to complement face-to-face lessons. For instance, AI simulations provide low-risk practices for situations such as client interactions, enabling students to build skills with less stress. However, it is essential to recognize that AI alone cannot ensure real-world competence or cultural sensitivity. Outcomes related to student learning, experience, and perceptions will help to elucidate the best practices for AI integration, guiding faculty, and advancing pedagogical innovation. This strategic integration of selected AI technologies is expected to diversify course methodology, improve learning outcomes, and generate new evidence on AI’s educational utility. The findings will inform faculty seeking to thoughtfully incorporate AI into teaching and learning.

Keywords: artificial intelligence (AI), social work education, students, developing a professional identity, ethical considerations

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Authors: Sonia Arradaza-Pajaron

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College students are expected to engage in an on-the-job training or internship for completion of a course requirement prior to graduation. In this scenario, they are exposed to the real world of work outside their training institution. To find out their readiness both emotionally and academically, this study has been conducted. A descriptive-correlational research design was employed and random sampling technique method was utilized among 265 randomly selected third year college students of PIT, SY 2014-15. A questionnaire on Emotional Intelligence (bearing the four components namely; emotional literacy, emotional quotient competence, values and beliefs and emotional quotient outcomes) was fielded to the respondents and GWA was extracted from the school automate. Data collected were statistically treated using percentage, weighted mean and Pearson-r for correlation. Results revealed that respondents’ emotional intelligence level is moderately high while their academic performance is good. A high significant relationship was found between the EI component; Emotional Literacy and their academic performance while only significant relationship was found between Emotional Quotient Outcomes and their academic performance. Therefore, if EI influences academic performance significantly when correlated, a possibility that their OJT performance can also be affected either positively or negatively. Thus, EI can be considered predictor of their academic and academic-related performance. Based on the result, it is then recommended that the institution would try to look deeply into the consideration of embedding emotional intelligence as part of the (especially on Emotional Literacy and Emotional Quotient Outcomes of the students) college curriculum. It can be done if the school shall have an effective Emotional Intelligence framework or program manned by qualified and competent teachers, guidance counselors in different colleges in its implementation.

Keywords: academic performance, emotional intelligence, college students, academic success

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Authors: H. Khomri, A. Bentellis

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Since century of the Development Activities extraction and a dispersed mineral processing Toxic metals and much more contaminated vast areas occupied by what they natural outcrops. New types of metalliferous habitats are so appeared. A species that is Lygeum spartum attracted our curiosity because apart from its valuable role in desertification, it is apparently able to exclude antimony and other metals can be. This species, green leaf blades which are provided as cattle feed, would be a good subject for phytoremediation of mineral soils. The study of absorption and translocation of chromium by the Lygeum spartum in the mining region of Djebel Hamimat and the interaction soil-plant, revealed that soils of this species living in this region are alkaline, calcareous majority in their fine texture medium and saline in their minority. They have normal levels of organic matter. They are moderately rich in nitrogen. They contain total chromium content reaches a maximum of 66,80 mg Kg^(-1) and a total absence of soluble chromium. The results of the analysis of variance of the difference between bare soils and soils appear Lygeum spartum made a significant difference only for the silt and organic matter. But for the other variables analyzed this difference is not significant. Thus, this plant has only one action on the amendment, only the levels of silt and organic matter in soils. The results of the multiple regression of the chromium content of the roots according to all soil variables studied did appear that among the studied variables included in the model, only the electrical conductivity and clay occur in the explanation of contents chromium in roots. The chromium content of the aerial parts analyzed by regression based on all studied soil variables allows us to see only the variables: electrical conductivity and content of chromium in the root portion involved in the explanation of the content chromium in the aerial part.

Keywords: absorption, translocation, analysis of variance, chrome, Lygeum spartum, multiple regression, the soil variables

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Authors: Anne-Loes K. Warps, Rob A. E. M. Tollenaar, Pieter J. Tanis, Jan Willem T. Dekker

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Anastomotic leakage after colorectal cancer surgery remains a severe complication. Early diagnosis and treatment are essential to prevent further adverse outcomes. In the literature, it has been suggested that earlier reintervention is associated with better survival, but anastomotic leakage can occur with a highly variable time interval to index surgery. This study aims to evaluate the time-interval between rectal cancer resection with primary anastomosis creation and reoperation, in relation to short-term outcomes, stratified for the use of a defunctioning stoma. Methods: Data of all primary rectal cancer patients that underwent elective resection with primary anastomosis during 2013-2019 were extracted from the Dutch ColoRectal Audit. Analyses were stratified for defunctioning stoma. Anastomotic leakage was defined as a defect of the intestinal wall or abscess at the site of the colorectal anastomosis for which a reintervention was required within 30 days. Primary outcomes were new stoma construction, mortality, ICU admission, prolonged hospital stay and readmission. The association between time to reoperation and outcome was evaluated in three ways: Per 2 days, before versus on or after postoperative day 5 and during primary versus readmission. Results: In total 10,772 rectal cancer patients underwent resection with primary anastomosis. A defunctioning stoma was made in 46.6% of patients. These patients had a lower anastomotic leakage rate (8.2% vs. 11.6%, p < 0.001) and less often underwent a reoperation (45.3% vs. 88.7%, p < 0.001). Early reoperations (< 5 days) had the highest complication and mortality rate. Thereafter the distribution of adverse outcomes was more spread over the 30-day postoperative period for patients with a defunctioning stoma. Median time-interval from primary resection to reoperation for defunctioning stoma patients was 7 days (IQR 4-14) versus 5 days (IQR 3-13 days) for no-defunctioning stoma patients. The mortality rate after primary resection and reoperation were comparable (resp. for defunctioning vs. no-defunctioning stoma 1.0% vs. 0.7%, P=0.106 and 5.0% vs. 2.3%, P=0.107). Conclusion: This study demonstrated that early reinterventions after anastomotic leakage are associated with worse outcomes (i.e. mortality). Maybe the combination of a physiological dip in the cellular immune response and release of cytokines following surgery, as well as a release of endotoxins caused by the bacteremia originating from the leakage, leads to a more profound sepsis. Another explanation might be that early leaks are not contained to the pelvis, leading to a more profound sepsis requiring early reoperations. Leakage with or without defunctioning stoma resulted in a different type of reinterventions and time-interval between surgery and reoperation.

Keywords: rectal cancer surgery, defunctioning stoma, anastomotic leakage, time-interval to reoperation

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Authors: Jared R. Chapman

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This study introduces a type of motivational information system called an educational engagement information system (EEIS). An EEIS draws on principles of behavioral economics, motivation theory, and learning cognition theory to design information systems that help students want to improve their performance. This study compares academic outcomes for course sections taught by part- and full-time instructors both with and without an EEIS. Without an EEIS, students in the part-time instructor's course sections demonstrated significantly higher failure rates (a 143.8% increase) and dropout rates (a 110.4% increase) with significantly fewer students scoring a B- or higher (39.8% decrease) when compared to students in the course sections taught by a full-time instructor. It is concerning that students in the part-time instructor’s course without an EEIS had significantly lower academic outcomes, suggesting less understanding of the course content. This could impact retention and continuation in a major. With an EEIS, when comparing part- and full-time instructors, there was no significant difference in failure and dropout rates or in the number of students scoring a B- or higher in the course. In fact, with an EEIS, the failure and dropout rates were statistically identical for part- and full-time instructor courses. When using an EEIS (compared with not using an EEIS), the part-time instructor showed a 62.1% decrease in failures, a 61.4% decrease in dropouts, and a 41.7% increase in the number of students scoring a B- or higher in the course. We are unaware of other interventions that yield such large improvements in academic performance. This suggests that using an EEIS such as Delphinium may compensate for part-time instructors’ limitations of expertise, time, or rewards that can have a negative impact on students’ academic outcomes. The EEIS had only a minimal impact on failure rates (7.7% decrease) and dropout rates (18.8% decrease) for the full-time instructor. This suggests there is a ceiling effect for the improvements that an EEIS can make in student performance. This may be because experienced instructors are already doing the kinds of things that an EEIS does, such as motivating students, tracking grades, and providing feedback about progress. Additionally, full-time instructors have more time to dedicate to students outside of class than part-time instructors and more rewards for doing so. Using adjunct and other types of part-time instructors will likely remain a prevalent practice in higher education management courses. Given that using part-time instructors can have a negative impact on student graduation and persistence in a field of study, it is important to identify ways we can augment part-time instructors’ performance. We demonstrated that when part-time instructors use an EEIS, it can result in significantly lower students’ failure and dropout rates and an increase in the rate of students earning a B- or above; and bring their students’ performance to parity with the performance of students taught by a full-time instructor.

Keywords: gamification, engagement, motivation, academic outcomes

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Authors: F. Arıkan, Z. Karakus

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Cancer is a widespread disease in the world and is the third reason of deaths among the chronic diseases. Educating patients and caregivers has a vital role for empowering them in managing disease and treatment's symptoms. Informing of the patients about their disease and treatment process decreases patient's distress and decisional conflicts, improves wellbeing of them, increase success of the treatment and survival. In this era, technological education methods are used for patients that have different chronic disease. Many studies indicated that especially web based patient education such as chronic obstructive lung disease; heart failure is more effective than printed materials. Web based education provide easiness to patients while they are reaching health services. It also has more advantages because of it decreases health cost and requirement of staff. It is thought that web based education may be beneficial method for cancer patient's empowerment in coping with the disease's symptoms. The aim of the study is evaluate the effectiveness of web based education for cancer patients' clinical outcomes.

Keywords: cancer patients, e-learning, nursing, web based education

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Authors: Adeyemi Adeyinka, Yemisi Ilesanmi

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This study investigated parental involvement and motivation as predictors of students’ learning outcomes in value concepts in Yoruba language in Ibadan, Nigeria. Value concepts in Yoruba language aimed at teaching moral lessons and transmitting Yoruba culture. However, feelers from schools and the society reported students’ poor achievement in examinations and negative attitude to the subject. Previous interventions focused on teaching strategies with little consideration for student-related factors. The study was anchored on psychosocial learning theory. The respondents were senior secondary II students with mean age of 15.50 ± 2.25 from 20 public schools in Ibadan, Oyo-State. In all, 1000 students were selected (486 males and 514 females) through proportionate to sample size technique. Instruments used were Students’ Motivation (r=0.79), Parental Involvement (r=0.87), and Attitude to Yoruba Value Concepts (r=0.94) scales and Yoruba Value Concepts Achievement Test (r=0.86). Data were analyzed using descriptive statistics, Pearson product moment correlation and Multiple regressions at 0.05 level of significance. Findings revealed a significant relationship between parental involvement (r=0.54) and students’ achievement in and attitude to (r=0.229) value concepts in Yoruba. The composite contribution of parental involvement and motivation to students’ achievement and attitude was significant, contributing 20.3% and 5.1% respectively. The relative contributions of parental involvement to students’ achievement (β = 0.073; t = 1.551) and attitude (β = 0.228; t = 7.313) to value concepts in Yoruba were significant. Parental involvement was the independent variable that strongly predicts students’ achievement in and attitude to Yoruba value concepts. Parents should inculcate indigenous knowledge in their children and support its learning at school.

Keywords: parental involvement, motivation, predictors, learning outcomes, value concepts in Yoruba

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Authors: Hee-Young Song

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Background and objectives: In 2011, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommendations proposed a multidimensional assessment of patients’ conditions that included both functional parameters and patient-reported outcomes, with the aim to provide a comprehensive assessment of the disease, thus meeting both the needs of the patient and the role of the physician. However, few studies have evaluated patient-reported outcomes as well as objective functional assessments among individuals with chronic obstructive pulmonary disease (COPD) in clinical practice in Korea. This study was undertaken to explore the relationship between functional status assessed by the 6-minute walking distance (MWD) test and subjective health status reported by stable patients with COPD residing in community. Methods: A cross-sectional descriptive study was conducted with 118 stable COPD patients aged 69.4 years old and selected by a convenient sampling from an outpatient department of pulmonology in a tertiaryhospitals. The 6-MWD test was conducted according to standardized instructions. Participants also completed a constructed questionnaire including general characteristics, smoking history, dyspnea by modified medical research council (mMRC) scale, and health status by COPD assessment test (CAT). Anthropometric measurements were performed for body mass index (BMI). Medical records were reviewed to obtain disease-related characteristics including duration of the disease and forced expiratory volume in 1 second (FEV1). Data were analyzed using PASW statistics 20.0. Results: Mean FEV1% of participants was 63.51% and mean 6-MWD and CAT scores were 297.54m and 17.7, respectively. The 6-MWD and CAT showed significant negative correlations (r= -.280, p=.002); FEV1 and CAT did as well correlations (r= -.347, p < .001). Conclusions: Findings suggest that the better functional status an individual with COPD has, the better subjective health status is, and provide the support for using patient-reported outcomes along with functional parameters to facilitate comprehensive assessment of COPD patients in real clinical practices.

Keywords: chronic obstructive pulmonary disease, COPD assessment test, functional status, patient-reported outcomes

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Authors: Joel Mintz, Kyle Huntley, Waseem Wahood, Samuel Raine, Farzanna Haffizulla

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The effect of different state government interventions on COVID-19 health outcomes is currently unknown. Stay at home (SAH) orders, all non-essential business closures and school closures in the Northeastern US were examined. A linear correlation between the peak number of new daily COVID-19 positive tests, hospitalizations and deaths per capita and the elapsed time between government issued guidance and a fixed number of COVID-19 deaths in each state was performed. Earlier government interventions were correlated with lower peak healthcare burden. Statewide closures of schools and non-essential businesses showed significantly greater (p<.001) correlation to peak COVID-19 disease burden as compared to a statewide SAH. The implications of these findings require further study to determine the effectiveness of these interventions.

Keywords: Coronavirus, epidemiology, government intervention, public health, social distancing

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Authors: Sharon Millen, Sarah Miller, Laura Dunne, Clare McGeady, Laura Neeson

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This paper presents the findings from a randomised controlled trial (RCT) and process evaluation of the Lifestart parenting programme. Lifestart is a structured child-centred programme of information and practical activity for parents of children aged from birth to five years of age. It is delivered to parents in their own homes by trained, paid family visitors and it is offered to parents regardless of their social, economic or other circumstances. The RCT evaluated the effectiveness of the programme and the process evaluation documented programme delivery and included a qualitative exploration of parent and child outcomes. 424 parents and children participated in the RCT: 216 in the intervention group and 208 in the control group across the island of Ireland. Parent outcomes included: parental knowledge of child development, parental efficacy, stress, social support, parenting skills and embeddedness in the community. Child outcomes included cognitive, language and motor development and social-emotional and behavioural development. Both groups were tested at baseline (when children were less than 1 year old), mid-point (aged 3) and at post-test (aged 5). Data were collected during a home visit, which took two hours. The process evaluation consisted of interviews with parents (n=16 at baseline and end-point), and focus groups with Lifestart Coordinators (n=9) and Family Visitors (n=24). Quantitative findings from the RCT indicated that, compared to the control group, parents who received the Lifestart programme reported reduced parenting-related stress, increased knowledge of their child’s development, and improved confidence in their parenting role. These changes were statistically significant and consistent with the hypothesised pathway of change depicted in the logic model. There was no evidence of any change in parents’ embeddedness in the community. Although four of the five child outcomes showed small positive change for children who took part in the programme, these were not statistically significant and there is no evidence that the programme improves child cognitive and non-cognitive skills by immediate post-test. The qualitative process evaluation highlighted important challenges related to conducting trials of this magnitude and design in the general population. Parents reported that a key incentive to take part in study was receiving feedback from the developmental assessment, which formed part of the data collection. This highlights the potential importance of appropriate incentives in relation to recruitment and retention of participants. The interviews with intervention parents indicated that one of the first changes they experienced as a result of the Lifestart programme was increased knowledge and confidence in their parenting ability. The outcomes and pathways perceived by parents and described in the interviews are also consistent with the findings of the RCT and the theory of change underpinning the programme. This hypothesises that improvement in parental outcomes, arising as a consequence of the programme, mediate the change in child outcomes. Parents receiving the Lifestart programme reported great satisfaction with and commitment to the programme, with the role of the Family Visitor being identified as one of the key components of the programme.

Keywords: parent-child relationship, parental self-efficacy, parental stress, school readiness

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