Search results for: multiple nonpharmacological interventions

Authors: Zenah Gheblawi, Susan Armijo-Olivo, Elisa B. Pelai, Vaishali Sharma, Musa Tashfeen, Angela Fung, Francisca Claveria

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Due to physiological differences between men and women, pain is experienced differently between the two sexes. Chronic pain disorders, notably temporomandibular disorders (TMDs), disproportionately affect women in diagnosis, and pain severity in opposition of their male counterparts. TMDs are a type of musculoskeletal disorder that target the masticatory muscles, temporalis muscle, and temporomandibular joints, causing considerable orofacial pain which can usually be referred to the neck and back. Therapeutic methods are scarce, and are not TMD-centered, with the latest research suggesting that subjects with chronic musculoskeletal pain disorders have abnormal alterations in the grey matter of their brains which can be remedied with exercise, and thus, decreasing the pain experienced. The aim of the study is to investigate the effects of exercise therapy in TMD female patients experiencing chronic jaw pain and to assess the consequential effects on brain activity. In a randomized controlled trial, the effectiveness of an exercise program to improve brain alterations and clinical outcomes in women with TMD pain will be tested. Women with chronic TMD pain will be randomized to either an intervention arm or a placebo control group. Women in the intervention arm will receive 8 weeks of progressive exercise of motor control training using visual feedback (MCTF) of the cervical muscles, twice per week. Women in the placebo arm will receive innocuous transcutaneous electrical nerve stimulation during 8 weeks as well. The primary outcomes will be changes in 1) pain, measured with the Visual Analogue Scale, 2) brain structure and networks, measured by fractional anisotropy (brain structure) and the blood-oxygen level dependent signal (brain networks). Outcomes will be measured at baseline, after 8 weeks of treatment, and 4 months after treatment ends and will determine effectiveness of MCTF in managing TMD, through improved clinical outcomes. Results will directly inform and guide clinicians in prescribing more effective interventions for women with TMD. This study is underway, and no results are available at this point. The results of this study will have substantial implications on the advancement in understanding the scope of plasticity the brain has in regards with pain, and how it can be used to improve the treatment and pain of women with TMD, and more generally, other musculoskeletal disorders.

Keywords: exercise therapy, musculoskeletal disorders, physical therapy, rehabilitation, tempomandibular disorders

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Authors: David A. Scott, Michelle G. Scott

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The problem of juvenile crime, school suspensions and oppositional behaviors indicates a need for a wide range of intervention programs for at-risk youth. Juvenile court systems and mental health agencies are examining alternative ways to deal with at-risk youth that will allow the adolescent to live within their home community. The previous trend that treatment away from home is more effective than treatment near one's community has shifted. Research now suggests that treatment be close to home for several reasons, such as increased treatment success, parental involvement, and reduced costs. Treatment options consist of a wide range of interventions, including outpatient, inpatient, and community-based services (therapeutic group homes, foster care and in-home preservation services). The juvenile justice system, families and other mental health agencies continue to seek the most effective treatment for at-risk youth in their communities. This research examines two possible treatment modalities, a multi-systemic outpatient program and a residential program. Research examining effective, evidence- based counseling will be discussed during this presentation. The presenter recently completed a three-year research grant examining effective treatment modalities for at-risk youth participating in a multi-systemic program. The presenter has also been involved in several research activities gathering data on effective techniques used in residential programs. The data and discussion will be broken down into two parts, each discussing one of the treatment modalities mentioned above. Data on the residential programs was collected on both a sample of 740 at- risk youth over a five-year period and also a sample of 63 participants during a one-year period residing in a residential programs. The effectiveness of these residential services was measured in three ways: services are evaluated by primary referral sources; follow-up data is obtained at various intervals after program participation to measure recidivism (what percentage got back into trouble with the Department of Juvenile Justice); and a more sensitive, "Offense Seriousness Score", has been computed and analyzed prior to, during and after treatment in the residential program. Data on the multi-systemic program was gathered over the past three years on 190 participants. Research will discuss pre and post test results, recidivism rates, academic performance, parental involvement, and effective counseling treatment modalities.

Keywords: at-risk youth, group homes, therapeutic group homes, recidivism rates

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Authors: Nor Kalsum M. Isa, Mohd Yazid M. Yunos, Anuar Alias, Mazdi Marzuki, Kamarul Ismail, Mohd H. Ibrahim

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Green building is an emerging concept with the ultimate target to achieve sustainable development by integrating sustainability goals and principles into project development. Basically, a green building is a building that is designed, constructed and operated to boost environmental, economic, health and productivity performance over conventional buildings. The buildings have been proven to be successful in contributing towards sustainability and project success. The purpose of this study was to determine the benefits of sustainability application in building projects, looking towards project success from the perspective of Malaysian key project stakeholders. The study also aimed to explore the establishment of sustainability goals in the green building projects in Malaysia. The Triple Bottom Line (TBL) Concept of Sustainability was used as the foundation theoretical framework. Surveys, interviews and multiple case study methods were employed. A sample of 188 Malaysian building project stakeholders was selected for questionnaire surveys, and 15 stakeholders from three award-winning green building projects in Malaysia were involved in the interviews. The study found that the majority of the respondents were less aware that the sustainability integration in the building project can significantly affect cost reduction, schedule effectiveness and stakeholders’ satisfaction with the performance of buildings as at the same level as the quality performance. Of the four sustainability goals, the environmental aspect was given more priority than others in the development of the green building projects.

Keywords: green building, sustainability, project stakeholders, Malaysia

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Authors: Najma Najam, Rukhsana Kausar, Rabia Hussain Kanwal, Saira Batool, Anum Javed

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In Pakistan, elderly population though increasing but it has been neglected by the researchers and policy makers which resulted in compromised quality of life of the ageing population. Two regions, Punjab and Gilgit-Baltistan (GB) were selected for comparison as Lahore and Multan (Punjab) are highly urbanized, large cities whereas Gilgit and Skardu are remote and mountain bounded valleys in GB. This study focuses on psychological and emotional functioning of elderly and a series of measures translated and adapted in Urdu language was used to assess quality of life, psychological and mental well-being, actual and perceived social support, attachment patterns, forgiveness, affects, geriatric depression, and emotional disturbance patterns (depression, anxiety, and stress) in elderly. A gender-equated sample of 201 elderly participants, 93 from GB (60 from Gilgit, 33 from Skardu) and 108 from Punjab (61 from Lahore, 47 from Multan) with over 60 years age was collected from the multiethnic community of Punjab and GB through purposive convenient sampling technique. Findings revealed that elderly from Multan have better psychological and emotional functioning, higher levels of social support, tendency to forgive, better mental wellbeing and quality of life and lower levels of stress, anxiety, depression, negative affect and attachment avoidance and anxiety related to partner as compared to the elderly from Lahore. Furthermore, both elderly male of Gilgit & Skardu have adequate mental well-being including subjective well-being and psychological functioning which showed positive aspects of mental health but elderly female are more attached to their home and neighbourhood which shows their social and environmental mastery. Gilgiti elderly male reported more degree of positive affect such as enthusiasm, active, alertness, excitement and strong whereas among elderly from Skardu shows more negative affect i.e. aversive mood states, irritability, hostility, and general distress. The need of psychosocial therapy and family counseling for the elderly in urban areas has been identified, which can facilitate in reducing or preventing the depressive and stressful tendencies. The findings are expected to have implications for improving quality of life of the elderly, designing interventions, support system and rehabilitation services to help them. However, findings may attract attention of policy makers and researchers as currently this is the most neglected population in Pakistan.

Keywords: psychological, emotional, aging, elderly, quality of life

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Authors: Dike Felix Okechukwu

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Studies and reports from authoritative sources such as the Intergovernmental Panel on Climate Change (IPCC) have stated that to effectively solve environmental sustainability challenges such as pollution, inappropriate waste disposal, and unsustainable consumption, there is a need for more research to seek solutions towards environmentally sustainable behavior. However, literature thus far reports only sporadic developments of TL in Environmental Sustainability because there are scarce reports showing the reliable process(es) to produce TL - for sustainability projects or otherwise. Nonetheless, a recently published article demonstrates how TL can be used to help young adults gain transformed mindsets and habits toward environmental sustainability behaviors and practices. This study, however, does not demonstrate, on a repeated basis, the dependability of the method or reliability of the procedures in using its proposed methodology to help young adults achieve transformed habits towards environmental sustainability behaviors, especially in diverse contexts. In this study, it is demonstrated, through repeated measures, a reliable process that can be used to achieve transformations in habits and mindsets toward environmental sustainability behaviors. To achieve this, the design adopted is multiple case studies and a thematic analysis techniques. Five cases in diverse contexts were used to analyze pieces of evidence of Transformative Learning Outcomes toward environmentally sustainable behaviors. Results from the study offer fresh perspectives on a reliable methodology that can be adopted to achieve Transformations in Habits and mindsets toward environmental sustainability behaviors.

Keywords: environmental sustainability, transformative learning, behaviour, learning, education

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Authors: Feng Yin

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Clouds are inevitable contaminants in optical satellite imagery, and prevent the satellite imaging systems from acquiring clear view of the earth surface. The presence of clouds in satellite imagery bring negative influences for remote sensing land resources investigation. As a consequence, detecting the locations of clouds in satellite imagery is an essential preprocessing step, and further remove the existing clouds is crucial for the application of imagery. In this paper, a multi-temporal based satellite imagery cloud detection and removal method is proposed, which will be used for large-scale land resource investigation. The proposed method is mainly composed of four steps. First, cloud masks are generated for cloud contaminated images by single temporal cloud detection based on multiple spectral features. Then, a cloud-free reference image of target areas is synthesized by weighted averaging time-series images in which cloud pixels are ignored. Thirdly, the refined cloud detection results are acquired by multi-temporal analysis based on the reference image. Finally, detected clouds are removed via multi-temporal linear regression. The results of a case application in Hubei province indicate that the proposed multi-temporal cloud detection and removal method is effective and promising for large-scale land resource investigation.

Keywords: cloud detection, cloud remove, multi-temporal imagery, land resources investigation

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Authors: Morteza Shayan Arani, Mohammadamin Esmailzadehazimi, Mohammadreza Moeini, Mohammad Toorani, Aouni A. Lakis

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This paper investigates the nonlinear response of thin, incompressible, hyperelastic cylindrical shells in the presence of a time-varying temperature field while considering initial geometric imperfections. The governing equations of motion are derived using an improved Donnell's shallow shell theory. The hyperelastic material is modeled using the Mooney-Rivlin model with two parameters, incorporating temperature-dependent terms. The Lagrangian method is applied to obtain the equation of motion. The resulting governing equation is addressed through the Lindstedt-Poincaré and Multiple Scale methods. The linear and nonlinear models presented in this study are verified against existing open literature, demonstrating the accuracy and reliability of the presented model. The study focuses on understanding the influence of temperature variations and geometrical imperfections on the natural frequency and amplitude-frequency response of the systems. Notably, the investigation reveals the coexistence of hardening and softening peaks in the amplitude-frequency response, which vary in magnitude depending on these parameters. Additionally, resonance peaks exhibit changes as a result of temperature and geometric imperfections.

Keywords: hyperelastic material, cylindrical shell, geometrical nonlinearity, material naolinearity, initial geometric imperfection, temperature gradient, hardening and softening

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Authors: Arati Inamdar, Siddharth Bhattacharyya, Kester Haye

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Collision tumors are rare entities characterized by neoplasms of two different cell populations with distinct separating boundaries. Such tumors could be benign, malignant, or a combination of both. The exact mechanism of origin for collision tumors is predicted to be tumor heterogeneity or concurrent occurrence of neoplasm in the same organ. We present two cases of plasmacytoma presenting as a collision tumor, one with a tumor of hematological origin and another with a non-hematological origin, namely Chronic Lymphocytic Leukemia and Adenocarcinoma of the colon, respectively. The immunohistochemical stains and flowcytometry analysis performed on the specimens aided incorrect diagnosis. Interestingly, neoplastic cells of plasmacytoma in the first case demonstrated strong cytokeratin along with weak Epithelial Specific Antigen/ Epithelial cell adhesion molecule Monoclonal Antibody (MOC31) positivity, indicating that the tumor may influence the microenvironment of the tumor in the vicinity. Furthermore, the next-generation sequencing studies performed on the specimen with plasmacytoma and chronic lymphocytic lymphoma demonstrated BReast CAncer gene (BRCA2) and Tumor Necrosis Factor Alpha Induced Protein 3 (TNFAIP3) as a disease associated variants suggestive of risk for multiple tumors including collision tumors. Our reports highlight the unique collision tumors involving plasmacytoma, which have never been reported previously, as well as provide necessary insights about the underline genetic aberrations and tumor heterogeneity through sequencing studies and allow clonality assessment for subsequent tumors.

Keywords: BRCA2, collision tumor, chronic lymphocytic leukemia, plasmacytoma

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Authors: Saradiya Mukherjee

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Background: Indian Muslims, compared to their counterparts in other religions, generally do not fare well on many yardsticks related to socio-economic progress and the same is true with maternal health care utilization. Due to low age at marriage a major percentage of child birth is ascribed to young (15-24 years) Muslim mothers in, which pose serious concerns on the maternal health care of Young Married Muslim women (YMMW). A thorough search of past literature on Muslim women’s health and health care reveals that studies in India have mainly focused on religious differences in fertility levels and contraceptive use while the research on the determinants of maternal health care utilization among Muslim women are lacking in India. Data and Methods: Retrieving data from the National Family Health Survey -3 (2005-06) this study attempts to assess the level of utilization and factors effecting three key maternal health indicators (full ANC, safe delivery and PNC) among YMMW (15-24 years) in India. The key socio-economic and demographic variables taken as independent or predictor variables in the study was guided by existing literature particularly for India. Bi-variate analysis and chi square test was applied and variables which were found to be significant were further included in binary logistic regression. Results: The findings of the study reveal abysmally low levels of utilization for all three indicators i.e. full ANC, safe delivery and PNC of maternal health care included in the study. Mother’s education, mass media exposure, women’s autonomy, birth order, economic status wanted status of child and region of residence were found to be significant variables effecting maternal health care utilization among YMMW. Multivariate analysis reveals that no mass media exposure, lower autonomy, education, poor economic background, higher birth order and unintended pregnancy are some of the reasons behind low maternal health care utilization. Conclusion: Considering the low level of safe maternal health care utilization and its proximate determinants among YMMW the study suggests educating Muslim girls, promoting family planning use, involving media and collaboration between religious leader and health care system could be some important policy level interventions to address the unmet need of maternity services among YMMW.

Keywords: young Muslim women, religion, socio-economic condition, antenatal care, delivery, post natal care

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Authors: Abeer M. Orabi

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Midwives are being seen as a key factor in returning birth care to a normal physiologic process that is woman-centered. On the other hand, more needs to be done to increase access for every woman to professional midwifery care. Because of the nature of the midwifery specialty, the magnitude of the effect that can result from a lack of knowledge if midwives make a mistake in their care has the potential to affect a large number of the birthing population. So, the development, running, and management of midwifery educational programs should follow international standards and come after a thorough community needs assessment. At the same time, the number of accredited midwifery educational programs needs to be increased so that larger numbers of midwives will be educated and qualified, as well as access to skilled midwifery care will be increased. Indeed, the selection of promising midwives is important for the successful completion of an educational program, achievement of the program goals, and retention of graduates in the field. Further, the number of schooled midwives in midwifery education programs, their background, and their experience constitute some concerns in the higher education industry. Basically, preceptors and clinical sites are major contributors to the midwifery education process, as educational programs rely on them to provide clinical practice opportunities. In this regard, the selection of clinical training sites should be based on certain criteria to ensure their readiness for the intended training experiences. After that, communication, collaboration, and liaison between teaching faculty and field staff should be maintained. However, the shortage of clinical preceptors and the massive reduction in the number of practicing midwives, in addition to unmanageable workloads, act as significant barriers to midwifery education. Moreover, the medicalized approach inherent in the hospital setting makes it difficult to practice the midwifery model of care, such as watchful waiting, non-interference in normal processes, and judicious use of interventions. Furthermore, creating a motivating study environment is crucial for avoiding unnecessary withdrawal and retention in any educational program. It is well understood that research is an essential component of any profession for achieving its optimal goal and providing a foundation and evidence for its practices, and midwifery is no exception. Midwives have been playing an important role in generating their own research. However, the selection of novel, researchable, and sustainable topics considering community health needs is also a challenge. In conclusion, ongoing education and research are the lifeblood of the midwifery profession to offer a highly competent and qualified workforce. However, many challenges are being faced, and barriers are hindering their improvement.

Keywords: barriers, challenges, midwifery education, educational programs

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Authors: Vallence Ngabo Maniragaba

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This study aimed at examining the variations of undernutrition among children below 5 years of age in Uganda. The approach of spatial and spatiotemporal analysis helped in identifying cluster patterns, hot spots and emerging hot spots. Data from the 6 Uganda Demographic and Health Surveys spanning from 1990 to 2016 were used with the main outcome variable being undernutrition among children <5 years of age. All data that were relevant to this study were retrieved from the survey datasets and combined with the 214 shape files for the districts of Uganda to enable spatial and spatiotemporal analysis. Spatial maps with the spatial distribution of the prevalence of undernutrition, both in space and time, were generated using ArcGIS Pro version 2.8. Moran’s I, an index of spatial autocorrelation, rules out doubts of spatial randomness in order to identify spatially clustered patterns of hot or cold spot areas. Furthermore, space-time cubes were generated to establish the trend in undernutrition as well as to mirror its variations over time and across Uganda. Moreover, emerging hot spot analysis was done to help identify the patterns of undernutrition over time. The results indicate a heterogeneous distribution of undernutrition across Uganda and the same variations were also evident over time. Moran’s I index confirmed spatial clustered patterns as opposed to random distributions of undernutrition prevalence. Four hot spot areas, namely; the Karamoja, the Sebei, the West Nile and the Toro regions were significantly evident, most of the central parts of Uganda were identified as cold spot clusters, while most of Western Uganda, the Acholi and the Lango regions had no statistically significant spatial patterns by the year 2016. The spatio-temporal analysis identified the Karamoja and Sebei regions as clusters of persistent, consecutive and intensifying hot spots, West Nile region was identified as a sporadic hot spot area while the Toro region was identified with both sporadic and emerging hotspots. In conclusion, undernutrition is a silent pandemic that needs to be handled with both hands. At 31.2 percent, the prevalence is still very high and unpleasant. The distribution across the country is nonuniform with some areas such as the Karamoja, the West Nile, the Sebei and the Toro regions being epicenters of undernutrition in Uganda. Over time, the same areas have experienced and exhibited high undernutrition prevalence. Policymakers, as well as the implementers, should bear in mind the spatial variations across the country and prioritize hot spot areas in order to have efficient, timely and region-specific interventions.

Keywords: undernutrition, spatial autocorrelation, hotspots analysis, geographically weighted regressions, emerging hotspots analysis, under-fives, Uganda

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Authors: Nguyen Ngoc Que Tran

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Purpose: The purpose of this paper is to investigate the relationship between internal market orientation, external market orientation, employee commitment and job satisfaction. Design/methodology/approach: This study collected data through a survey and utilized simple linear regression and multiple regression analysis to determine if there was any support for the research hypotheses as presented in the previous chapter. Findings: Using data from 256 employees of four leading joint stock banks in Vietnam, the empirical results indicates that employee commitment is positively related with external market orientation, job satisfaction is positively related to employee commitment, and employee commitment and job satisfaction are positively related to external market orientation. However, job satisfaction has no significant positive effect on external market orientation. Theoretical contribution: The primary contribution to marketing theory arising from this study is the integration of job satisfaction, employee commitment, and external market orientation in a single research model. Practical implications: The major contribution to practice is an external market oriented bank has to respond rapidly to the future needs and preferences of its customers. This could result in high levels of commitment to the service process and in doing so provide Vietnamese joint-stock commercial banks with a competitive advantage. The finding is important for the banking service sector in general and the Vietnamese banking industry in particular.

Keywords: employee commitment, job satisfaction and external market orientation, vietnam, bank

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Authors: Lilian Ijomah

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Restorative justice practices continue to gain recognition globally in the criminal and juvenile justice systems and schools. Despite considerable research, little is known about how juvenile detention center staff members’ knowledge, beliefs, and attitudes affect implementation. As with many interventions, effective implementation relies on the staff members who must do the daily work. This phenomenological study aimed to add to the existing literature by examining staff knowledge, beliefs, and attitudes on restorative justice practices, barriers to effective implementation, and potential differences in knowledge, beliefs, and attitudes between education staff and juvenile detention officers at the research site. The present study used semi-structured interviews and focus groups of both types of staff members who work with the youth in a juvenile justice facility to answer three research questions: (1) To what extent are staff members knowledgeable about the principles behind restorative approach to discipline and about how the approach should be carried out?; (2) What are staff member beliefs and attitudes toward the restorative justice program and its implementation in a juvenile justice setting?; and (3) What similarities and differences are there between (a) knowledge and (b) beliefs and attitudes of the educators and juvenile detention officers? A total of 28 staff members participated, nine educators, and 19 detention officers. The findings for the first research question indicated that both groups (educators and juvenile detention officers) were knowledgeable about two of the three principles of restorative justice: repairing the harm done by the offender and reducing risks for future occurrence; but did not show clear knowledge of one principle, active involvement from all stakeholders. For research question 2, staff beliefs and attitudes were categorized into two types, positive beliefs and attitudes (e.g., that restorative justice is more appropriate than the use of punitive measures) and negative beliefs and attitudes (e.g., that restorative justice is ‘just another program that creates extra work for staff’). When the two staff groups were compared to answer research question 3, both groups were found to have similar knowledge (showing knowledge of two of the three principles) and somewhat different beliefs and attitudes – both groups showed a mix of positive and negative, but the educators showed somewhat more on the positive side. Both groups also identified barriers to implementation such as the perception of restorative justice as ‘soft’, lack of knowledge and exposure to restorative justice, shortage of resources and staff, and difficulty sustaining the restorative justice approach. The findings of this study are largely consistent with current literature but also extend the literature by studying staff knowledge, attitudes, and beliefs in a juvenile detention center and comparing the two staff groups. Recommendations include assessing staff knowledge and attitudes toward restorative justice during the hiring process, ensuring adequate staff training, communicating clearly to build positive attitudes and beliefs, providing adequate staffing, and building a sense of community.

Keywords: juvenile justice, restorative justice, restorative practices, staff attitudes and beliefs

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Authors: Kalpana Poudel-Tandukar

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Background: Human Immunodeficiency Virus (HIV) infection has been frequently associated with vitamin D deficiency and depression. Vitamin D deficiency increases the risk of depression in people without HIV. We assessed the cross-sectional and prospective associations between serum concentrations of 25-hydroxyvitamin D (25[OH]D) and depression in a HIV-positive people. Methods: A survey was conducted among 316 HIV-positive people aged 20-60 years residing in Kathmandu, Nepal for a cross-sectional association at baseline, and among 184 participants without depressive symptoms at baseline who responded to both baseline (2010) and follow-up (2011) surveys for prospective association. The competitive protein-binding assay was used to measure 25(OH)D levels and the Beck Depression Inventory-Ia method was used to measure depression, with cut off score 20 or higher. Relationships were assessed using multiple logistic regression analysis with adjustment of potential confounders. Results: The proportion of participants with 25(OH)D level of <20ng/mL, 20-30ng/mL, and >30ng/mL were 83.2%, 15.5%, and 1.3%, respectively. Only four participants with 25(OH)D level of >30ng/mL were excluded in the further analysis. The mean 25(OH)D level in men and women were 15.0ng/mL and 14.4ng/mL, respectively. Twenty six percent of participants (men:23%; women:29%) were depressed. Participants with 25(OH)D level of < 20 ng/mL had a 1.4 fold higher odds of depression in a cross-sectional and 1.3 fold higher odds of depression after 18 months of baseline compared to those with 25(OH)D level of 20-30ng/mL (p=0.40 and p=0.78, respectively). Conclusion: Vitamin D may not have significant impact against depression among HIV-positive people with 25(OH)D level below normal ( > 30ng/mL).

Keywords: depression, HIV, Nepal, vitamin D

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Authors: Rafael Estrada, Cristian Ruiz Rueda

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Carbapenems are last-resort antibiotics used in clinical settings to treat antibiotic-resistant bacterial infections. Thus, the emergence and spread of resistance to carbapenems is a major public health concern. Here, we have studied a carbapenem-resistant Aeromonas veronii strain previously isolated from a water sample from Sam Simeon Creek (Hearst San Simeon State Park, CA). Analysis of this isolate using disk-diffusion, CarbaNP, eCIM and mCIM assays revealed that it was resistant to amoxicillin-clavulanic acid and all carbapenems tested and that this isolate produced a potentially novel carbapenemase of the Metallo-β-lactamase family. Whole genome sequencing analysis revealed that this A. veronii isolate carries a novel variant of the blacₚₕₐ class β-carbapenemase gene that was closely related to the blacₚₕₐ₇ gene of Aeromonas jandaei. This isolate also carried a novel variant of the blaₒₓₐ class D carbapenemase gene that was most closely related to the blaₒₓₐ-₉₁₂ gene found in other Aeromonas veronii isolates. Finally, we also identified a novel class C β-lactamase gene moderately related to the blaFₒₓ-₁₇ gene of Providencia stuartii and other blaFₒₓ variants identified in Klebsiella pneumoniae, Escherichia coli and other Enterobacteriaceae. Overall, our findings reveal that environmental isolates are an important reservoir of multiple carbapenemases and other β-lactamases of clinical significance.

Keywords: β-lactamases, carbapenem, antibiotic-resistant, aeromonas veronii

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Authors: Amnah Moghees, Saima Abbas Dar, Muniba Saeed

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Teaching a second language to deaf learners has always been a challenge in Pakistan. Different approaches and strategies have been followed, but they have been resulted into partial or complete failure. The study aims to investigate the language problems faced by adult deaf learners of English as second language in mainstream classrooms. Moreover, the study also determines the factors which are very much involved in language teaching and learning in mainstream classes. To investigate the language problems, data will be collected through writing samples of ten deaf adult learners and ten normal ESL learners of the same class; whereas, observation in inclusive language teaching classrooms and interviews from five ESL teachers in inclusive classes will be conducted to know the factors which are directly or indirectly involved in inclusive language education. Keeping in view this study, qualitative research paradigm will be applied to analyse the corpus. The study figures out that deaf ESL learners face severe language issues such as; odd sentence structures, subject and verb agreement violation, misappropriation of verb forms and tenses as compared to normal ESL learners. The study also predicts that in mainstream classrooms there are multiple factors which are affecting the smoothness of teaching and learning procedure; role of mediator, level of deaf learners, empathy of normal learners towards deaf learners and language teacher’s training.

Keywords: deaf English language learner, empathy, mainstream classrooms, previous language knowledge of learners, role of mediator, language teachers' training

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Authors: Mai Kaneda, Sarah Feeney

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This study examined the association between adult attachment security and career decision-making self-efficacy (CDMSE) among college students in the United States. Previous studies show that attachment security is associated with levels of CDMSE among college students. Given that a majority of studies examining career development variables have used parental attachment measures, this study adds to understanding of this phenomenon by utilizing a broader measure of attachment. The participants included 269 college students (76% female) between the ages of 19-29. An anonymous survey was distributed online via social media as well as in hard copy format in classrooms. Multiple regression analyses were conducted to determine the relationship between anxious and avoidant attachment and CDMSE. Results revealed anxious attachment was a significant predictor of CDMSE (B = -.13, p = .01), such that greater anxiety in attachment was associated with lower levels of CDMSE. When accounting for anxious attachment, avoidant attachment was no longer significant as a predictor of CDMSE (B = -.12, p = .10). The variance in college CDMSE explained by the model was 7%, F(2,267) = 9.51, p < .001. Results for anxious attachment are consistent with existing literature that finds insecure attachment to be related to lower levels of CDMSE, however the non-significant results for avoidant attachment as a predictor of CDMSE suggest not all types of attachment insecurity are equally related to CDMSE. Future research is needed to explore the nature of the relationship between different dimensions of attachment insecurity and CDMSE.

Keywords: attachment, career decision-making, college students, self-efficacy

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Authors: John Acire, Wilfred Lajul, Ogwang Tom

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Using a qualitative research technique, this study investigates the influence of Early Childhood Education (ECE) on learning outcomes in lower primary schools in Gulu City, Uganda. The study, which is based on Vygotsky's sociocultural theory of human learning, fills gaps in the current literature on the influence of ECE on learning outcomes. The aims of the study include analyzing the state of learning outcomes, investigating ECE practices, and determining the influence of these practices on learning outcomes in lower primary schools. The findings highlight the critical significance of ECE in promoting children's overall development. Nursery education helps children improve their handwriting, reading abilities, and general cognitive development. Children who have received nursery education have improved their abilities to handle pencils, form letters, and engage in social interactions, highlighting the significance of fine motor skills and socializing. Despite the good elements, difficulties in implementing ECE practices were found, such as differences in teaching styles, financial limits, and potential weariness due to prolonged school hours. The study suggests focused interventions to improve the effectiveness of ECE practices, ensure their connection with educational goals and maximize their influence on children's development. The study's findings show that respondents agree on the importance of nursery education in supporting holistic development, socialization, language competency, and conceptual comprehension. Challenges in nursery education, such as differences in teaching techniques and insufficient resources, highlight the need for comprehensive measures to address these challenges. Furthermore, parental engagement in home learning activities was revealed as an important factor affecting early education outcomes. Children who were engaged at home performed better in lower primary, emphasizing the value of a supportive family environment. Finally, the report suggests measures to enhance parental participation, changes in teaching methods through retraining, and age-appropriate enrolment. Future studies might concentrate on the involvement of parents, ECE policy practice, and the influence of ECE teachers on lower primary school learning results. These ideas are intended to help create a more favorable learning environment by encouraging holistic development and preparing children for success in succeeding academic levels.

Keywords: early childhood education, learning outcomes in lower primary schools, early childhood education practices, how ECE practices influence learning outcomes in lower primary schools

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Authors: Junwen Chen, Celina Feleppa, Tingyue Sun, Satoko Sasagawa, Michael Smithson

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School refusal behaviours refer to behaviours to avoid school attendance, chronic lateness in arriving at school, or regular early dismissal. Poor attendance in schools is highly correlated with anxiety, depression, suicide attempts, delinquency, violence, and substance use and abuse. Poor attendance is also a strong indicator of lower achievement in school, as well as problematic social-emotional development. Long-term consequences of school refusal behaviours include fewer opportunities for higher education, employment, and social difficulties, and high risks of later psychiatric illness. Given its negative impacts on youth educational outcomes and well-being, a thorough understanding of factors that are involved in the development of this phenomenon is warranted for developing effective management approaches. This study investigated parental and adolescent factors that may contribute to school refusal behaviours by specifically focusing on the role of parental and adolescents’ anxiety and depression, emotion dysregulation, and parental rearing style. Findings are expected to inform the identification of both parental and adolescents’ factors that may contribute to school refusal behaviours. This knowledge will enable novel and effective approaches that incorporate these factors to managing school refusal behaviours in adolescents, which in turn improve their school and daily functioning. Results are important for an integrative understanding of school refusal behaviours. Furthermore, findings will also provide information for policymakers to weigh the benefits of interventions targeting school refusal behaviours in adolescents. One-hundred-and-six adolescents aged 12-18 years (mean age = 14.79 years old, SD = 1.78, males = 44) and their parents (mean age = 47.49 years old, SD = 5.61, males = 27) completed an online questionnaire measuring both parental and adolescents’ anxiety, depression, emotion dysregulation, parental rearing styles, and adolescents’ school refusal behaviours. Adolescents with school refusal behaviours reported greater anxiety and depression, with their parents showing greater emotion dysregulation. Parental emotion dysregulation and adolescents’ anxiety and depression predicted school refusal behaviours independently. To date, only limited studies have investigated the interplay between parental and youth factors in relation to youth school refusal behaviours. Although parental emotion dysregulation has been investigated in relation to youth emotion dysregulation, little is known about its role in the context of school refusal. This study is one of the very few that investigated both parental and adolescent factors in relation to school refusal behaviours in adolescents. The findings support the theoretical models that emphasise the role of youth and parental psychopathology in school refusal behaviours. Future management of school refusal behaviours should target adolescents’ anxiety and depression while incorporating training for parental emotion regulation skills.

Keywords: adolescents, school refusal behaviors, parental factors, anxiety and depression, emotion dysregulation

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Authors: Mennatallah M. Hussein, Olivier de Weck

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The advancement of space exploration demands a robust space launch services program capable of reliably propelling payloads into orbit. Despite rigorous testing and quality assurance, launch failures still occur, leading to significant financial losses and jeopardizing mission objectives. Traditional failure prediction methods often lack the sophistication to account for multi-mode failure scenarios, as well as the predictive capability in complex dynamic systems. Traditional approaches also rely on expert judgment, leading to variability in risk prioritization and mitigation strategies. Hence, there is a pressing need for robust approaches that enhance launch vehicle reliability from lift-off until it reaches its parking orbit through comprehensive simulation techniques. In this study, the developed model proposes a multi-mode launch vehicle simulation framework for predicting failure scenarios when incorporating new technologies, such as new propulsion systems or advanced staging separation mechanisms in the launch system. To this end, the model combined a 6-DOF system dynamics with comprehensive data analysis to simulate multiple failure modes impacting launch performance. The simulator utilizes high-fidelity physics-based simulations to capture the complex interactions between different subsystems and environmental conditions.

Keywords: launch vehicle, failure prediction, propulsion anomalies, rocket launch simulation, rocket dynamics

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Authors: Roslina Kamaruddin

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The paddy farmer’s performance and ability to improve productivity for increased incomes is driven by their level of farm management practices. Knowledge on the nature and level of sustainable farm management (SFM) practice provides opportunities for supporting the competitive advantages of paddy farmers to sustainably break away from the poverty cycle. Little attention has been given to measuring the performance and impact of SFM for the improvement of paddy farmer's livelihood in Malaysia. Without understanding SFM, it is difficult to make policies and provide targeted, impactful support to paddy farmers. The objective of this study is to assess the level of SFM among paddy farmers by calculating the Sustainable Farm Management Index (SFMI) using the Rice Check (RC) guideline established by the Department of Agriculture. The structured questionnaire was designed to capture the nine elements of farming practices based on the RC and was then distributed to 788 paddy farmers in Malaysia's main granary areas, namely MADA, KADA, and BLS. Each practice was given a score to determine whether the guidelines were followed. The index ranges from 0 to 100, with 0 being unsustainable and 100 being highly sustainable. A multiple regression analysis was employed as well to estimate the effects of SFM adoption on farmer livelihoods. The findings show that adopting SFM has a positive and significant effect on farmers' livelihoods. The paper, therefore, recommends that farmers should be educated on the importance of sustainable farming practices as this is essential for the sustainable livelihood development of poor farmers who rely on government subsidies.

Keywords: sustainable farm management, paddy farming, rice check, granary areas, farmers livelihood

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Authors: Mai To

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Higher education institutions (HEIs) in Ontario, Canada have invested in social media presence for multiple purposes, such as branding, student’ engagement, and recruitment. To have a full picture of the social media strategy implemented by HEIs in Ontario, Canada, this study used a mixed-method approach to analyze Facebook posts’ characteristics and content. A total of 1789 Facebook posts from September 2019 to April 2020 of six selected HEIs were collected for analysis and coding based on five pre-determined branding positions: Elite, Nurturing, Campus, Outcome, and Commodity. Besides, the study also calculated the engagement rate for each social media practice to measure its effectiveness. The results show that there were not many differences in practices such as posting frequency, length, types, and timing among HEIs. However, the distribution of branding positions and content targeting future students versus current students was varied, although the HEIs employed all five branding positions and targeted the same lists of audiences. Some practices such as evening post for colleges and nurturing branding for universities attracted significantly higher engagement. This study provides a review of current social media practices and branding strategy, as well as informs the practices that can better engage the audiences.

Keywords: branding, higher education, social media, student engagement, student recruitment

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Authors: Amit Kumar Baghel, Sisir Kumar Nayak

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The proposed metamaterial design help to increase the radiation efficiency at 2.9 GHz by reducing the side and back lobes by making the phase difference of the waves emerging from the phase center of the horn antenna same after passing through metamaterial array. The unit cell of the metamaterial is having concentric ring structure made of copper of 0.035 mm thickness on both sides of FR4 sheet. The inner ring diameter is kept as 3 mm, and the outer ring diameters are changed according to the path and tramission phase difference of the unit cell from the phase center of the antenna in both the horizontal and vertical direction, i.e., in x- and y-axis. In this case, the ring radius varies from 3.19 mm to 6.99 mm with the respective S21 phase difference of -62.25° to -124.64°. The total phase difference can be calculated by adding the path difference of the respective unit cell in the array to the phase difference of S21. Taking one of the unit cell as the reference, the total phase difference between the reference unit cell and other cells must be integer multiple of 360°. The variation of transmission coefficient S21 with the ring radius is greater than -6 dB. The array having 5 x 5 unit cell is kept inside the pyramidal horn antenna (L X B X H = 295.451 x 384.233 x 298.66 mm3) at a distance of 36.68 mm from the waveguide throat. There is an improvement in side lobe level in E-plane by 14.6 dB when the array is used. The front to back lobe ration is increased by 1 dB by using the array. The proposed antenna with metamaterial array can be used in beam shaping for wireless power transfer applications.

Keywords: metamaterial, side lobe level, front to back ratio, beam forming

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Authors: Kristel Dame Bañez Sumagaysay, Marie Victoria Cruz-javier

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The current subject is a case of a 21 year-old woman at 29 1/7 weeks of gestation with Pre-B cell Acute Lymphoblastic Leukemia who was admitted to the coronary care unit (CCU) of the St. Luke’s Medical Center-Global City for Severe Acute Respiratory Distress Syndrome (ARDS) secondary to hospital-acquired pneumonia secondary to pneumocystis jiroveci; central line-associated bloodstream infection (E. aerogenes). She presented with chronic hypoxemia caused by Pulmonary edema, probably secondary to heart failure secondary to cardiomyopathy chemotherapy-induced. Due to worsening feto-maternal status, extracorporeal membrane oxygenation (ECMO) for respiratory support was instituted, and an elective cesarean section was done due to multiple maternal factors and deteriorating health status under total intravenous anesthesia assisted by veno-venous extracorporeal membrane oxygenation. She delivered a live preterm newborn male, APGAR Score: 1, 0, 0, birth weight 985 grams, birth length: 40.5cm, small for gestational age.

Keywords: extracorporeal membrane oxygenation, pre-b cell acute lymphoblastic leukemia, severe acute respiratory distress syndrome, ethical dilemmas

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Authors: B. M. M. D. Mendis, L. I. Rajapaksa, P. S. K. Gunathunga, R. C. Fernando, M. Jayalath

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Background / introduction: During the year 2011, 8511 males received services from the sexual health clinics island wide. At present there is only limited information on the risk behaviours of male attendees. Information on risk behaviours related to STI /HIV transmission is helpful in planning suitable prevention interventions. Aim(s)/objectives: The objectives were to determines the sexual partners (other than the marital partner and regular partners) responsible for transmitting STI( Sexually transmitted infections)/ HIV and to understand the practice of safer sex. Methods: Study was a clinic based prospective study conducted for a one year period using an interviewer administered questionnaire. Results: 983 attendees were interviewed. . Mean age was 34.02 years. 75% of the sample had completed GCE O/L (ordinary level examination). Skilled labourers, drivers and forces/police comprised 40% of the sample. 50% admitted sex with a casual female, 12% with a casual male, and 13% with CSW (commercial sex workers) while MSW (male sex workers) exposures were minimal. It was identified that younger males had more contacts with males, and regular female partners while more older males with CSW. Anal sex among males was reported by 11.5%. 20.5% used alcohol frequently and 5.9% used drugs and 1.4% injected. Common STI were genital herpes (7.9%), Non gonococcal urethritis (6.2%) and gonorrhoea (6.2%). Among those who had contacts with FSW 6.7% gonorrhoea (GC), 8.2% non gonococcal urethritis (NGU), 7.5% genital herpes and 0.7% HIV. Non regular partner exposures 3.7% had gonorrhoea, 8.3% NGU, 6.6% genital herpes and 0.8% HIV. Among MSM contacts 10.6% had GC, 4.5% NGU, 5.3% genital herpes, 5.3% secondary syphilis and 0.8% HIV. Only 9.0% used condoms correctly. Friends, doctors, newspapers, internet, and forces were important sources of information on condoms. Non use of condoms were due to worry about satisfaction (24.6%) and faith in the partner (25.6%). Discussion/conclusion: Casual partners for unsafe sex is a concern. MSM and CSW are remained as an important source of infection. Early Syphilis and gonorrhoea infections were mostly seen among MSM exposures. The findings indicate that the male population in the sample had satisfactory education. However, still the unsafe sexual contacts are common. . Newspapers, internet were more important sources of information on condoms. Low condom use remains another concern.. More males contracted STI through casual partners. Therefore strategies used for prevention need to be revisited also emphasizing on general population where casual partners represent. . Increasing awareness of men and women through mass media and primary health care teams may be important strategies that can be used to keep the HIV epidemic in a low level.

Keywords: STI, HIV, Males, safe sex practices

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Authors: Mei-Hui Liu

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This study examines the effectiveness of a blended professional development program on preservice EFL (English as a foreign language) teachers’ learning to teach speech acts with the advent of Information and Communication Technology, researchers and scholars underscore the significance of integrating online and face-to-face learning opportunities in the teacher education field. Yet, a paucity of evidence has been documented to investigate the extent to which such a blended professional learning model may impact real classroom practice and student learning outcome. This yearlong project involves various stakeholders, including 25 preservice teachers, 5 English professionals, and 45 secondary school students. Multiple data sources collected are surveys, interviews, reflection journals, online discussion messages, artifacts, and discourse completion tests. Relying on the theoretical lenses of Community of Inquiry, data analysis depicts the nature and process of preservice teachers’ professional development in this blended learning community, which triggers and fosters both face-to-face and synchronous/asynchronous online interactions among preservice teachers and English professionals (i.e., university faculty and in-service teachers). Also included is the student learning outcome after preservice teachers put what they learn from the support community into instructional practice. Pedagogical implications and research suggestions are further provided based on the research findings and limitations.

Keywords: blended professional development, preservice EFL teachers, speech act instruction, student learning outcome

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Authors: A. B. Robert, Adam Pramadia, Calvin Andika

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The main purpose of this study is to explore consumer loyalty characteristic of mobile phone category in Indonesia. Second, this research attempts to identify consumer segment and to explore their profile in each segment as the basis of marketing strategy formulation. This study used some tools of multivariate analysis such as discriminant analysis and cluster analysis. Discriminate analysis used to discriminate consumer loyal and not loyal by using particular variables. Cluster analysis used to reveal various segment in mobile phone category. In addition to having better customer understanding in each segment, this study used descriptive analysis and cross tab analysis in each segment defined by cluster analysis. This study expected several findings. First, consumer can be divided into two large group of loyal versus not loyal by set of variables. Second, this study identifies customer segment in mobile phone category. Third, exploring customer profile in each segment that has been identified. This study answer a call for additional empirical research into different product categories. Therefore, a replication research is advisable. By knowing the customer loyalty characteristic, and deep analysis of their consumption behavior and profile for each segment, this study is very advisable for high impact marketing strategy development. This study contributes body of knowledge by adding empirical study of consumer loyalty, segmentation analysis in mobile phone category by multiple brand analysis.

Keywords: customer loyalty, segmentation, marketing strategy, discriminant analysis, cluster analysis, mobile phone

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Authors: Papon Thamvasupong, Kwanchanok Viravaidya-Pasuwat

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Osteoarthritis affects a lot of people worldwide. Local injection of glucosamine is one of the alternative treatment methods to replenish the natural lubrication of cartilage. However, multiple injections can potentially lead to possible bacterial infection. Therefore, a drug delivery system is desired to reduce the frequencies of injections. A hydrogel is one of the delivery systems that can control the release of drugs. Thermo-reversible hydrogels can be beneficial to the drug delivery system especially in the local injection route because this formulation can change from liquid to gel after getting into human body. Once the gel is in the body, it will slowly release the drug in a controlled manner. In this study, various formulations of Pluronic-based hydrogels were synthesized for the controlled release of glucosamine. One of the challenges of the Pluronic controlled release system is its fast dissolution rate. To overcome this problem, alginate and calcium sulfate (CaSO₄) were added to the polymer solution. The characteristics of the hydrogels were investigated including the gelation temperature, gelation time, hydrogel dissolution and glucosamine release mechanism. Finally, a mathematical model of glucosamine release from Pluronic-alginate-hyaluronic acid hydrogel was developed. Our results have shown that crosslinking Pluronic gel with alginate did not significantly extend the dissolution rate of the gel. Moreover, the gel dissolution profiles and the glucosamine release mechanisms were best described using the zeroth-order kinetic model, indicating that the release of glucosamine was primarily governed by the gel dissolution.

Keywords: controlled release, drug delivery system, glucosamine, pluronic, thermoreversible hydrogel

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Authors: Sushish Baral, Pratibha Joshi, Yaman Maharjan

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Glaucoma is a chronic eye condition that causes vision loss that is irreversible. Early detection and treatment are critical to prevent vision loss because it can be asymptomatic. For the identification of glaucoma, multiple deep learning algorithms are used. Transformer-based architectures, which use the self-attention mechanism to encode long-range dependencies and acquire extremely expressive representations, have recently become popular. Convolutional architectures, on the other hand, lack knowledge of long-range dependencies in the image due to their intrinsic inductive biases. The aforementioned statements inspire this thesis to look at transformer-based solutions and investigate the viability of adopting transformer-based network designs for glaucoma detection. Using retinal fundus images of the optic nerve head to develop a viable algorithm to assess the severity of glaucoma necessitates a large number of well-curated images. Initially, data is generated by augmenting ocular pictures. After that, the ocular images are pre-processed to make them ready for further processing. The system is trained using pre-processed images, and it classifies the input images as normal or glaucoma based on the features retrieved during training. The Vision Transformer (ViT) architecture is well suited to this situation, as it allows the self-attention mechanism to utilise structural modeling. Extensive experiments are run on the common dataset, and the results are thoroughly validated and visualized.

Keywords: glaucoma, vision transformer, convolutional architectures, retinal fundus images, self-attention, deep learning

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Authors: Anjula Negi, Sanjay Gupta

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Paradigms studied inform inadequacies of financial resources, be it to finance metro rails for construction or to meet operational revenues or to derive profits in the long term. Funding sustainability is far and wide for much-needed public transport modes, like urban rail or metro rails, to be successfully operated. India embarks upon a sustainable transport journey and has proposed metro rail systems countrywide. As an emerging economic leader, its fiscal constraints are paramount, and the land value capture (LVC) mechanism provides necessary support and innovation toward development. India’s metro rail policy promotes multiple methods of financing, including private-sector investments and public-private-partnership. The critical question that remains to be addressed is what factors can make such mechanisms work. Globally, urban rail is a revolution noted by many researchers as future mobility. Researchers in this study deep dive by way of literature review and empirical assessments into factors that can lead to the adoption of LVC mechanisms. It is understood that the adoption of LVC methods is in the nascent stages in India. Research posits numerous challenges being faced by metro rail agencies in raising funding and for incremental value capture. A few issues pertaining to land-based financing, inter alia: are long-term financing, inter-institutional coordination, economic/ market suitability, dedicated metro funds, land ownership issues, piecemeal approach to real estate development, property development legal frameworks, etc. The question under probe is what are the parameters that can lead to success in the adoption of land value capture (LVC) as a financing mechanism. This research provides insights into key parameters crucial to the adoption of LVC in the context of Indian metro rails. Researchers have studied current forms of LVC mechanisms at various metro rails of the country. This study is significant as little research is available on the adoption of LVC, which is applicable to the Indian context. Transit agencies, State Government, Urban Local Bodies, Policy makers and think tanks, Academia, Developers, Funders, Researchers and Multi-lateral agencies may benefit from this research to take ahead LVC mechanisms in practice. The study deems it imperative to explore and understand key parameters that impact the adoption of LVC. Extensive literature review and ratification by experts working in the metro rails arena were undertaken to arrive at parameters for the study. Stakeholder consultations in the exploratory factor analysis (EFA) process were undertaken for principal component extraction. 43 seasoned and specialized experts participated in a semi-structured questionnaire to scale the maximum likelihood on each parameter, represented by various types of stakeholders. Empirical data was collected on chosen eighteen parameters, and significant correlation was extracted for output descriptives and inferential statistics. Study findings reveal these principal components as institutional governance framework, spatial planning features, legal frameworks, funding sustainability features and fiscal policy measures. In particular, funding sustainability features highlight sub-variables of beneficiaries to pay and use of multiple revenue options towards success in LVC adoption. Researchers recommend incorporation of these variables during early stage in design and project structuring for success in adoption of LVC. In turn leading to improvements in revenue sustainability of a public transport asset and help in undertaking informed transport policy decisions.

Keywords: Exploratory factor analysis, land value capture mechanism, financing metro rails, revenue sustainability, transport policy

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