Search results for: discharging period

Authors: Ahmed Hamid Nassr

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The significant of the old stone ages in the Sudan, seems from the longest times and the large differentiation in antiquities, so many Neolithic cemeteries have been discovered in the Sudan, which the studies revealed costumes’ funerary from the Form of grave and the contents has been contrasted in some elements and constant in the others. Many interpretations of the late Neolithic cemeteries tradition written from the earlier studies, most of them focus of the development and change in the burial from society’s development and ideas of afterlife beginnings. Another emphasis undertaken is the relationship between societies cultural aspects and the environmental conditions of the period; it has been considered that it hyper-affected the development of farming in one way or another. The site of Qalaat Shanan noted in earlier 1990 and excavated by the Author from 2011-2013, the site located north of Khartoum about 170 km in Shendi town. Site setting lies amongst a group of Neolithic sites in the Shendi area, it reflected a succession of various Neolithic activities from the early to the late horizons. Excavation revealed many late Neolithic graves, the adult and child graves show large funerary content, different in quality and quantity, which indicates of societies development and related to religion and ideas about the afterlife. This presentation discusses the variations of the Late Neolithic cemeteries in Galaat Shanan site from the grave form, content and differentiation of the sex and age and compared with other late Neolithic discoveries in Sudan and the Nile valley. The study shows many changes in the graves related to the societies changes in late Neolithic in Sudan, climate and economic subsistence's are well reasons, but also the idea change is the main reason for the changes. That is clear from the variations of grave shape and content in age and sex and might be society’s status and levels.

Keywords: Sudan, Shendi town, Qalaat Shanan, late neolithic, cemeteries, funerary, tradition

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Authors: Vasishtha Avadhani Upadrasta, Mradul Kumar Daga, Smita Kaushik

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Background: Caffeine consumption has skyrocketed in the recent decades as we try to match pace with the machines. Studies have been conducted on animals and a few on humans, mainly on the acute effects of high-dose caffeine intake. Almost none have been conducted on the chronic effects of caffeine consumption. This study involved Medical professionals as case subjects, who consumed caffeine daily. Methods: This study, over a period of 3 months, involved 96 volunteers (chosen randomly w.r.t. gender and field in medical fraternity), including people who drank >500mg of caffeine a day to people who consumed none. People with any co-morbidities at all were excluded straight away. Two sets of blood samples were drawn and assessed. Three groups were created, Group 1 (>200mg caffeine/day) and Group 2 (15-200 mg caffeine/day) and Group 3 (<200mg Caffeine/day). Results: The result of the study found that exposure to caffeine at doses >200mg/day for more than 6 months leads to a significant difference in circulating free T3 [(-0.96 pmol/L ± 0.07) = (-18.5%), CI 95%, p = .000024] and Cortisol [(-123 nmol/L ± 9.8) = (-46.8%), CI 95%, p = .00029] hormones but shows an insignificant effect on circulating TSH [0.4 mIU/L, CI 95%, p=.37] and ACTH [(-3.2 pg/ml ± 0.3), CI 95%, p = .53) hormones, which stay within normal physiological ranges, irrespective of the daily dose of consumption. Results also highlight that women are more susceptible to decrement in fT3 than men (Relative Risk =1.58, ANOVA F-static = 7.15, p = 0.0105). Conclusions: Caffeine consumption in excess of 200mg/day, for more than or equal to 6 months, causes significant derangement in basal fT3 and Cortisol hormone levels, without affecting the TSH and ACTH (regulatory) hormone levels, indicating disturbance of action at the peripheral and/or cellular levels, possibly via the Paraventricular Nucleus –Leptin-CAR-Adenosine interactions. Women are more susceptible to decrement in fT3 levels than men (at same dose of caffeine).

Keywords: ACTH, adrenals, caffeine, cortisol, thyroid, thyroxin, TSH

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Authors: Mahmoud S. Zaghloul, Mohammed M. Khalaf, Wael N. Thabet, Haidy N. Asham

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Background. Hypertrophic scarring is a difficult problem for burn patients, and scar management is an essential aspect of outpatient burn therapy. Post-burn pathologic scars involve functional and aesthetic limitations that have a dramatic influence on the patient’s quality of life. The aim was to investigate the use of extracorporeal shock wave therapy (ESWT), which targets the fibroblasts in scar tissue, as an effective modality for scar treatment in burn patients. Subjects and methods: forty patients with post-burn scars were assigned randomly into two equal groups; their ages ranged from 20-45 years. The study group received ESWT and traditional physical therapy program (deep friction massage, stretching exercises). The control group received traditional physical therapy program (deep friction massage, stretching exercises). All groups received two sessions per week for six successful weeks. The data were collected before and after the same period of treatment for both groups. Evaluation procedures were carried out to measure scar thickness using ultrasonography and Vancouver Scar Scale (VSS) was completed before and after treatment. Results: Post-treatment results showed that there was a significant improvement difference in scar thickness in both groups in favor of the study group. Percentage of improvement in scar thickness in the study group was 42.55%, while it was 12.15% in the control group. There was also a significant improvement difference between results obtained using VSS in both groups in favor of the study group. Conclusion: ESWT is effective in management of pathologic post burn scars.

Keywords: extracorporeal shock wave therapy, post-burn scars, ultrasonography, Vancouver scar scale

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Authors: Ipek Sensu

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Comorbid Axis I disorders are highly common for suicidal borderline personality disorder (BPD) patients, especially substance use disorder and anxiety disorders. Since interpersonal dysfunction is one of the core symptoms in BPD, the purpose of the current study is to examine perceived criticism and anxiety disorders and also substance abuse disorders (SUD) for women with borderline personality disorder (BPD) who attempt suicide at least once in their lifetime. In the current study, it was suggested that the perceived criticism from others and being upset by criticism differ between suicidal women with BPD with comorbidity of anxiety disorders and SUD (separately) and suicidal women with BPD without anxiety disorders and without SUD (separately). The participants in this study included ninety-nine women who have already been diagnosed with borderline personality disorder and also have had at least two episodes of deliberate self-harm, in other words, suicide attempts and/or non-suicidal self-injury (NSSI) in the last five years and at least one episode in the 8-week period before joining the research study and at least one suicide attempt in the previous year. Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) and Social History Interview (SHI) were conducted to determine the comorbid axis I disorders and level of perceived criticism. As a result of the independent sample t-tests, the first hypothesis was rejected, in other words, women with BPD and a comorbid anxiety disorder did not show significantly higher levels of ‘criticized by others’, compared to women with BPD alone. However, the levels of ‘upset at criticism’ were significantly different between suicidal women with BPD with or without any anxiety disorders, which is the second hypothesis. In addition, the third hypothesis was also accepted; this means, women with BPD who had any substance use dependence would show significantly higher levels of 'criticized by others' compared to women with BPD alone. Finally, the fourth hypothesis was partly accepted: that is, women with BPD with alcohol dependence had significantly higher levels of ‘how upset when they expose to criticism’, compared to those without alcohol dependence. Limitations, implications, and directions for future research are discussed.

Keywords: anxiety disorders, borderline personality disorders, perceived criticism, substance use disorders

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Authors: Oluwasaanmi Lawrence Adesuyi, Igbekoyi Kayode Emmanuel

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This study examined vote - commercialization during elections among the voters in Nigeria, a series of elections in Ekiti State, Southwestern Nigeria. Democracy in Nigeria that came to replace the unwanted ruling and dictating mission of the military government has been facing a societal terror “crime of votes commercialization” that stands in jeopardy against its sustainability in Nigeria. Social exchange and action-bound theories were employed as the theoretical framework. Forty-Eight in-depth interviews, key informant interviews, and case studies were conducted with purposively selected respondents in the three senatorial districts that captured the sixteen local governments of the state. The results show that really commercialization of votes has become the order of the day in all series of electioneering among Ekiti people. Also, it was recorded that true democracy is no longer allowed to triumph as a result of vote buying that allows the highest bidder to be the winner. The result also shows that this attitude is not limited to only one political party or one candidate but involved all the political parties that participated in Election. It has become a frequent idea among the electorates during every festive period of election in Ekiti State. The tyrannical attitude has been given a nickname to suit the conditional situation of votes commercialization - (Diboki o se obe), which means vote and have a pot of soup, this implies that you will get money to take care of yourself and the family when you vote and collect money on the vote you cast, notwithstanding the money is being collected from all candidates that participated in the election, but the highest bidder has the day. The main challenge this has on democracy is that the contestants challenge the result of the election results based on the act of vote commercialization. Also, those that bought people’s votes with a huge amount of money relent on their democratic promises. The study showed that the crime of vote commercialization that threatens democracy must be addressed for sustainability.

Keywords: crime, democracy, jeopardy, military, sustainability, votes-commercialization

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Authors: Lakhoua Najeh

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Aims of the work: The aim of this paper is to improve the reliability and the availability of a Packer production line of cigarettes based on two methods: The SADT method (Structured Analysis Design Technique) and the FMECA approach (Failure Mode Effects and Critically Analysis). The first method enables us to describe the functionality of the Packer production line of cigarettes and the second method enables us to establish an FMECA analysis. Methods: The methodology adopted in order to contribute to the improvement of the reliability and the availability of a Packer production line of cigarettes has been proposed in this paper, and it is based on the use of Structured Analysis Design Technique (SADT) and Failure mode, effects, and criticality analysis (FMECA) methods. This methodology consists of using a diagnosis of the existing of all of the equipment of a production line of a factory in order to determine the most critical machine. In fact, we use, on the one hand, a functional analysis based on the SADT method of the production line and on the other hand, a diagnosis and classification of mechanical and electrical failures of the line production by their criticality analysis based on the FMECA approach. Results: Based on the methodology adopted in this paper, the results are the creation and the launch of a preventive maintenance plan. They contain the different elements of a Packer production line of cigarettes; the list of the intervention preventive activities and their period of realization. Conclusion: The diagnosis of the existing state helped us to found that the machine of cigarettes used in the Packer production line of cigarettes is the most critical machine in the factory. Then this enables us in the one hand, to describe the functionality of the production line of cigarettes by SADT method and on the other hand, to study the FMECA machine in order to improve the availability and the performance of this machine.

Keywords: production system, diagnosis, SADT method, FMECA method

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Authors: Nassima Elyebdri, Asma Boumediou, Soumia Addoun

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Traditional medicine has been part of the Algerian culture for decades. In particular, the city of Tlemcen still retains practices based on phytotherapy to the present day, as this kind of medicine fulfills the needs of its followers among the local population. The toxic plants contain diverse natural substances which supplied a lot of medicine in the pharmaceutical industry. In order to explore new medicinal sources among toxic plants, an ethnobotanical study was carried out on the use of these plants by the population, at Emir Abdelkader Square of the city of Tlemcen, a rather busy place with a high number of traditional health practitioners and herbalists. This is a descriptive and transversal study aimed at estimating the frequency of using toxic plants among the studied population, for a period of 4 months. The information was collected, using self-anonymous questionnaires, and analyzed by the IBM SPSS Statistics software used for statistical analysis. A sample of 200 people, including 120 women and 80 men, were interviewed. The mean age was 41 ± 16 years. Among those questioned, 83.5% used plants; 8% of them used toxic plants and 35% used plants that can be toxic under certain conditions. Some improvements were observed in 88% of the cases where toxic plants were used. 80 medicinal plants, belonging to 36 botanical families, were listed, identified and classified. The most frequent indications for these plants were for respiratory diseases in 64.7% of cases, and for digestive disorders in 51.5% of cases. 11% of these plants are toxic, 26% could be toxic under certain conditions. Among toxics plants, the most common ones are Berberis vulgaris with 5.4%, indicated in the treatment of uterine fibroids and thyroid, Rhamnus alaternus with 4.8% for hepatic jaundice, Nerium oleander with 3% for hemorrhoids, Ruta chalepensis with 1.2%, indicated for digestive disorders and dysmenorrhea, and Viscum album with 1.2%, indicated for respiratory diseases. The most common plants that could be toxic are Mentha pulegium (15.6%), Eucalyptus globulus (11.4%), and Pimpinella anisum (10.2%). This study revealed interesting results on the use of toxic plants, which are likely to serve as a basis for further ethno-pharmacological investigations in order to get new drug sources.

Keywords: ethnobotany, phytotherapy, Tlemcen, toxic plants

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Authors: Arun Prasad, Abhishek Tiwari, Rekha Jaiswal, Vivek Chaudhary

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Background: Robotic Roux en Y gastric bypass is being done for some time but is technically difficult, requiring operating in both the sub diaphragmatic and infracolic compartments of the abdomen. This can mean a dual docking of the robot or a hybrid partial laparoscopic and partial robotic surgery. The Mini /One anastomosis /omega loop gastric bypass (MGB) has the advantage of having all dissection and anastomosis in the supracolic compartment and is therefore suitable technically for robotic surgery. Methods: We have done 208 robotic mini gastric bypass surgeries. The robot is docked above the head of the patient in the midline. Camera port is placed supra umbilically. Two ports are placed on the left side of the patient and one port on the right side of the patient. An assistant port is placed between the camera port and right sided robotic port for use of stapler. Distal stomach is stapled from the lesser curve followed by a vertical sleeve upwards leading to a long sleeve pouch. Jejunum is taken at 200 cm from the duodenojejunal junction and brought up to do a side to side gastrojejunostomy. Results: All patients had a successful robotic procedure. Mean time taken was 85 minutes. There were major intraoperative or post operative complications. No patient needed conversion or re-explorative surgery. Mean excess weight loss over a period of 2 year was about 75%. There was no mortality. Patient satisfaction score was high and was attributed to the good weight loss and minimal dietary modifications that were needed after the procedure. Long term side effects were anemia and bile reflux in a small number of patients. Conclusions: MGB / OAGB is gaining worldwide interest as a short simple procedure that has been shown to very effective and safe bariatric surgery. The purpose of this study was to report on the safety and efficacy of robotic surgery for this procedure. This is the first report of totally robotic mini gastric bypass.

Keywords: MGB, mini gastric bypass, OAGB, robotic bariatric surgery

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Authors: Jiří Vágner, Dana Fialová

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The Covid-19 pandemic and its effects have triggered significant changes in travel behavior. On the contrary to a deep decline in international tourism, domestic tourism has recovered. It has not fully replaced the total volume of national tourism so far. However, from a regional point of view, and especially according to the type of destinations, regional targeting has changed significantly compared to the previous period. Urban destinations, which used to be the domain of foreign tourists, have been relatively orphaned, in contrast to destinations tied to natural attractions, which have seen seasonal increases. Even here, at a lower hierarchical geographic level, we can observe the differentiation resulting from the existing localization and infrastructure. The case study is focused on the three largest water reservoirs of the Vltava Cascade in Czechia– Lipno, Orlík, and Slapy. Based on a detailed field survey, in the periods before and during the pandemic, as well as available statistical data (Tourdata; Czech Statistical Office, Czech Cadaster and Ordnance Survey), different trends in the exploitation of these destinations with regard to existing or planned infrastructure are documented, analyzed and explained. This gives us the opportunity to discuss on concrete examples of generally known phenomena that are usually neglected in tourism: slum, brownfield, greenfield. Changes in travel behavior – especially the focus on spending leisure time individually in naturally attractive destinations – can affect the use of sites, which can be defined as a tourist or recreational slum, brownfield, but also as a tourist greenfield development. Sociocultural changes and perception of destinations by tourists and other actors represent, besides environmental changes, major trends in current tourism.

Keywords: Covid-19 pandemic, czechia, sociocultural and environmental impacts, tourist infrastructure, travel behavior, the Vltava Cascade water reservoirs

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Authors: Dibakar Sahoo, Sridevi Gummadi

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The focus of the study is to empirically analyse the climatic impacts on foodgrain yield and its variability across seasons and altitudes in Odisha, one of the most vulnerable states in India. The study uses Just-Pope Stochastic Production function by using two-step Feasible Generalized Least Square (FGLS): mean equation estimation and variance equation estimation. The study uses the panel data on foodgrain yield, rainfall and temperature for 13 districts during the period 1984-2013. The study considers four seasons: winter (December-February), summer (March-May), Rainy (June-September) and autumn (October-November). The districts under consideration have been categorized under three altitude regions such as low (< 70 masl), middle (153-305 masl) and high (>305 masl) altitudes. The results show that an increase in the standard deviations of monthly rainfall during rainy and autumn seasons have an adversely significant impact on the mean yield of foodgrains in Odisha. The summer temperature has beneficial effects by significantly increasing mean yield as the summer season is associated with harvesting stage of Rabi crops. The changing pattern of temperature has increasing effect on the yield variability of foodgrains during the summer season, whereas it has a decreasing effect on yield variability of foodgrains during the Rainy season. Moreover, the positive expected signs of trend variable in both mean and variance equation suggests that foodgrain yield and its variability increases with time. On the other hand, a change in mean levels of rainfall and temperature during different seasons has heterogeneous impacts either harmful or beneficial depending on the altitudes. These findings imply that adaptation strategies should be tailor-made to minimize the adverse impacts of climate change and variability for sustainable development across seasons and altitudes in Odisha agriculture.

Keywords: altitude, adaptation strategies, climate change, foodgrain

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Authors: A. L. I. Prasanna, E. Liyanage, S. A. Rajaratne, K. P. A. P. Kariyawasam, A. A. J. Rajaratne

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Maintaining or improving the muscle strength of the injured body part is essential to optimize performance among disabled athletes. General conditioning and strengthening exercises might be ineffective if not sufficiently intense enough or targeted for each participant’s specific impairment. Specific strengthening programme, targeted to the affected body part, are essential to improve the strength of impaired muscles and increase in strength will help reducing the impact of disability. Methods: The muscle strength of hip, knee and ankle joints was assessed in a group of randomly selected disabled athletes, using the Medical Research Council (MRC) grading. Those having muscle strength of grade 4 or less were selected for this study (24 in number) and were given and a custom made exercise program designed to strengthen their hip, knee or ankle joint musculature, according to the muscle or group of muscles affected. Effectiveness of the strengthening program was assessed after a period of 3 months. Results: Statistical analysis was done using the Minitab 16 statistical software. A Mann-Whitney U test was used to compare the strength of muscle group before and after exercise programme. A significant difference was observed after the three month strengthening program for knee flexors (Left and Right) (P =0.0889, 0.0312) hip flexors (left and right) (P=0.0312, 0.0466), hip extensors (Left and Right) (P=0.0478, 0.0513), ankle plantar flexors (Left and Right) (P=0.0466, 0.0423) and right ankle dorsiflexors (P= 0.0337). No significant difference of strength was observed after the strengthening program in the knee extensors (left and right), hip abductors (left and right) and left ankle dorsiflexors. Conclusion: Impairment specific exercise programme appear to be beneficial for disabled athletes to significantly improve the muscle strength of the affected joints.

Keywords: muscle strengthening programme, disabled athletes, physiotherapy, rehabilitation sciences

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Authors: Kubra Sultan Yuzuncuyil, Aytekin İsman, Berkay Bulus

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With the developments of information and communication technologies, the forms of molding public opinion have changed. In the presence of Internet, the notion of activism has been endowed with digital codes. Activists have engaged the use of Internet into their campaigns and the process of creating collective identity. Activist movements have been incorporating the relevance of new communication technologies for their goals and opposition. Creating and managing activism through Internet is called Online Activism. In this main, Slow Food Movement which was emerged within the philosophy of defending regional, fair and sustainable food has been engaging Internet into their activist campaign. This movement supports the idea that a new food system which allows strong connections between plate and planet is possible. In order to make their voices heard, it has utilized social networks and develop particular skills in the framework online activism. This study analyzes online activist skills of Slow Food Movement (SFM) develop and attempts to measure its effectiveness. To achieve this aim, it adopts the model proposed by Sivitandies and Shah and conduct both qualitiative and quantiative content analysis on social network use of Slow Food Movement. In this regard, the sample is chosen as the official profile and analyzed between in a three month period respectively March-May 2017. It was found that SFM develops particular techniques that appeal to the model of Sivitandies and Shah. The prominent skill in this regard was found as hyperlink abbreviation and use of multimedia elements. On the other hand, there are inadequacies in hashtag and interactivity use. The importance of this study is that it highlights and discusses how online activism can be engaged into a social movement. It also reveals current online activism skills of SFM and their effectiveness. Furthermore, it makes suggestions to enhance the related abilities and strengthen its voice on social networks.

Keywords: slow food movement, Twitter, internet, online activism

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Authors: Michael Luc Andre, Célia Maintenant

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Theory of mind is a milestone in child development which allows children to understand that others could have different mental states than theirs. Understanding the developmental stages of theory of mind in children leaded researchers on two Connected research problems. In one hand, the link between executive function and theory of mind, and on the other hand, the relationship of theory of mind and syntax processing. These two lines of research involved a great literature, full of important results, despite certain level of disagreement between researchers. For a long time, these two research perspectives continue to grow up separately despite research conclusion suggesting that the three variables should implicate same developmental period. Indeed, our goal was to study the relation between theory of mind, executive function, and language via a unique research question. It supposed that between executive function and language, one of the two variables could play a critical role in the relationship between theory of mind and the other variable. Thus, 112 children aged between three and six years old were recruited for completing a receptive and an expressive vocabulary task, a syntax understanding task, a theory of mind task, and three executive function tasks (inhibition, cognitive flexibility and working memory). The results showed significant correlations between performance on theory of mind task and performance on executive function domain tasks, except for cognitive flexibility task. We also found significant correlations between success on theory of mind task and performance in all language tasks. Multiple regression analysis justified only syntax and general abilities of language as possible predictors of theory of mind performance in our preschool age children sample. The results were discussed in the perspective of a great role of language abilities in theory of mind development. We also discussed possible reasons that could explain the non-significance of executive domains in predicting theory of mind performance, and the meaning of our results for the literature.

Keywords: child development, executive function, general language, syntax, theory of mind

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Authors: Mariem Meddeb Sidhom, Souhayel Hedfi, Rjaibia Houda, Mehdi Dridi, Mohamed Ali Yousfi, Sâadia Gargouri

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Considering the important increase in costs of caspofungin treatments and ahead the evolution of its indication, pharmacy department was prompted to realize a review of the adequacy of prescriptions in the medical intensive care units (ICU). A retrospective observational study was conducted in Tunis military hospital concerning ICU prescriptions of caspofungin from 2008 until 2013. A pharmacist had returned to the patient’s medical records to collect data and to the microbiology department for parasitological results. The adequacy of prescriptions was evaluated by a pharmacist and an infectiologist parasitologist, referring to predefined scale of criteria resuming the indications of the marketing authorization (MA) and grade AI-AII of the guidelines of the Infectious Diseases Society of America (IDSA). Sixty two ICU patients have been treated with caspofungin during the period of study; however, 8 files were lost. Thus, 54 patients were included in the study having received 55 prescriptions of caspofungin. Males were a majority with 64.8% of the population. Mean age was 51 years. Caspofungin was indicated in accordance with the IDSA recommendations in 43.6% of the cases. The most case of non respect to the guidelines was the indication of caspofungin as empirical treatment in non neutropenic patients. Caspofungin was utilized as a first line treatment in 9 cases where it was possible to give fluconazole first, as germs were fluconazole- sensitive. Caspofungin was indicated in 2 patients with good renal function and in which nor amphotericin B, liposomal ampho B neither itraconazole had been previously used, as indicates the MA. The posology of caspofungin was respected in all prescriptions with a loading dose of 70 mg in the first day and a maintenance dose of 50 mg daily. Seven patients had received a daily dose of 70 mg, the recommended dose for people weighing more than 80 Kg. Caspofungin prescriptions are far to be adequately done. There is a clear need of optimization in indicating this molecule and that must be done in collaboration between the pharmacy department, the ICUs and parasitology department.

Keywords: caspofungin, prescription, intensive care units, marketing authorization, Tunisian hospital cohort

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Authors: A. O. Oluwajobi, O. A. Falusi, N. A. Zubbair, T. Owoeye, F. Ladejobi, M. C. Dangana, A. Abubakar

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The technology of mobile telephony has positively enhanced human life and reports on the bio safety of the radiation from their antennae have been contradictory, leading to serious litigations and violent protests by residents in several parts of the world. The crave for more information, as requested by WHO in order to resolve this issue, formed the basis for this study on the effect of the radiation from 900 MHz GSM antenna on the DNA of Hibiscus sabdariffa. Seeds of H. sabdariffa were raised in pots placed in three replicates at 100, 200, 300 and 400 metres from the GSM antennae in three selected test locations and a control where there was no GSM signal. Temperature (˚C) and the relative humidity (%) of study sites were measured for the period of study (24 weeks). Fresh young leaves were harvested from each plant at two, eight and twenty-four weeks after sowing and the DNA extracts were subjected to RAPD-PCR analyses. There were no significant differences between the weather conditions (temperature and relative humidity) in all the study locations. However, significant differences were observed in the intensities of radiations between the control (less than 0.02 V/m) and the test (0.40-1.01 V/m) locations. Data obtained showed that DNA of samples exposed to rays from GSM antenna had various levels of distortions, estimated at 91.67%. Distortions occurred in 58.33% of the samples between 2-8 weeks of exposure while 33.33% of the samples were distorted between 8-24 weeks exposure. Approximately 8.33% of the samples did not show distortions in DNA while 33.33% of the samples had their DNA damaged twice, both at 8 and at 24 weeks of exposure. The study showed that radiation from the 900 MHz GSM antenna is potent enough to cause distortions to DNA of H. sabdariffa even within 2-8 weeks of exposure. DNA damage was also independent of the distance from the antenna. These observations would qualify emissions from GSM mast as environmental hazard to the existence of plant biodiversities and all life forms in general. These results will trigger efforts to prevent further erosion of plant genetic resources which have been threatening food security and also the risks posed to living organisms, thereby making our environment very safe for our existence while we still continue to enjoy the benefits of the GSM technology.

Keywords: damage, DNA, GSM antenna, radiation

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Authors: Alison Brown

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Through stories, children make sense of their world, see themselves through the eyes of another, and process emotions and lived experiences in a non-threatening and indirect manner. Building on research around the use of narrative techniques with adults and families, this research looked directly at the use of narratives as a therapeutic technique with children in counseling. Based on individual therapy sessions with children over a six-year period, this work of collective case studies tells the story of a practice incorporating children’s narratives, of children’s experiences in writing and sharing their narratives, and of the clinical impact of the use of narratives with children. Not all stories were narratives of success or happiness. Children documented their fears and anger as well as their achievements and hope for the future. What emerged through this study was an awareness of recurring themes in the way children responded to the narrative process and in the benefits and limitations of story writing with children. Consistent with previous studies focusing on narrative work with adults and families, the use of narratives with children provided opportunities for healing, acceptance, developing greater understanding, externalizing, and re-authoring a preferred future. In terms of the children’s experiences in writing and sharing their narratives, consistent themes emerged again, with many children finding the experience cathartic and liberating, empowering and hopeful, but most importantly, an opportunity that allowed them to feel and understand that they were not alone. Whilst a small collection of case studies tells the stories of a limited number of children, it is hoped that this research provides both a model and inspiration for others to explore similar uses of narratives with children. As a greater number of children’s narratives are created, the potential to share and benefit from the many rich stories and experiences of other children becomes more of a reality. Across cultures, economic and social settings, rural and urban environments, and varying family structures, it is important that we hear the voices of our children – ‘In their own words’.

Keywords: narrative therapy children counselling, social, emotional, zone of proximal development, scaffolding

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Authors: Oleg Sapelnikov, Ruslan Latypov, Darina Ardus, Samvel Aivazian, Andrey Shiryaev, Renat Akchurin

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OBJECTIVE: MAZE procedure is one of the most effective surgical methods in atrial fibrillation (AF) treatment. Nowadays we are all aware of its modifications. In our study we conducted clinical analysis of “Box lesion+” approach during MAZE procedure in two-year follow-up. METHODS: We studied the results of the open-heart on-pump procedures performed in our hospital from 2017 to 2018 years. Thirty-two (32) patients with atrial fibrillation (AF) were included in this study. Fifteen (15) patients had concomitant coronary bypass grafting and seventeen (17) patients had mitral valve repair. Mean age was 62.3±8.7 years; prevalence of men was admitted (56.1%). Mean duration of AF was 4.75±5.44 and 7.07±8.14 years. In all cases, we performed endocardial Cryo-MAZE procedure with one-time myocardium revascularization or mitral-valve surgery. All patients of this study underwent pulmonary vein (PV) isolation and ablation of mitral isthmus with additional isolation of LA posterior wall (Box-lesion+ procedure). Mean follow-up was 2 years. RESULTS: All cases were performed without any complications. Additional isolation of posterior wall did not prolong the operative time and artificial circulation significantly. Cryo-MAZE procedure directly lasted 20±2.1 min, the whole operation time was 192±24 min and artificial circulation time was 103±12 min. According to design of the study, we performed clinical investigation of the patients in 12 months and in 2 years from the initial procedure. In 12 months, the number of AF free patients 81.8% and 75.8% in two years of follow-up. CONCLUSIONS: Isolation of the left atrial posterior wall and perimitral area may considerably improve the efficacy of surgical treatment, which was demonstrated in significant decrease of AF recurrences during the whole period of follow-up.

Keywords: atrial fibrillation, cryoablation, left atrium isolation, open heart procedure

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Authors: Hien Thi Dieu Truong, Mahmoud Al-Sarayreh, Pullanagari Reddy, Marlon M. Reis, Richard Archer

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New Zealand mānuka honey is a honeybee product derived mainly from Leptospermum scoparium nectar. The potent antibacterial activity of mānuka honey derives principally from methylglyoxal (MGO), in addition to the hydrogen peroxide and other lesser activities present in all honey. MGO is formed from dihydroxyacetone (DHA) unique to L. scoparium nectar. Mānuka honey also has an idiosyncratic phenolic profile that is useful as a chemical maker. Authentic mānuka honey is highly valuable, but almost all honey is formed from natural mixtures of nectars harvested by a hive over a time period. Once diluted by other nectars, mānuka honey irrevocably loses value. We aimed to apply hyperspectral imaging to honey frames before bulk extraction to minimise the dilution of genuine mānuka by other honey and ensure authenticity at the source. This technology is non-destructive and suitable for an industrial setting. Chemometrics using linear Partial Least Squares (PLS) and Support Vector Machine (SVM) showed limited efficacy in interpreting chemical footprints due to large non-linear relationships between predictor and predictand in a large sample set, likely due to honey quality variability across geographic regions. Therefore, an advanced modelling approach, one-dimensional convolutional neural networks (1D-CNN), was investigated for analysing hyperspectral data for extraction of biochemical information from honey. The 1D-CNN model showed superior prediction of honey quality (R² = 0.73, RMSE = 2.346, RPD= 2.56) to PLS (R² = 0.66, RMSE = 2.607, RPD= 1.91) and SVM (R² = 0.67, RMSE = 2.559, RPD=1.98). Classification of mono-floral manuka honey from multi-floral and non-manuka honey exceeded 90% accuracy for all models tried. Overall, this study reveals the potential of HSI and deep learning modelling for automating the evaluation of honey quality in frames.

Keywords: mānuka honey, quality, purity, potency, deep learning, 1D-CNN, chemometrics

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Authors: Pius Borona, Cheikh Mbow, Issa Ouedraogo

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In the Sahel, climate variability has been associated with a complex web of direct and indirect impacts. This natural phenomenon has been an impediment to agro-pastoral communities who experience uncertainty while involving in farming activities which is also their key source of livelihood. In this scenario, the role of climate variability in influencing the performance, quantity and quality of staple cereals yields, vital for food and nutrition security has been a topic of importance. This response of crops and subsequent yield variability is also a subject of immense debate due to the complexity of crop development at different stages. This complexity is further compounded by influence of slowly changing non-climatic factors. With these challenges in mind, the present paper initially explores the occurrence of climate variability at an inter annual and inter decadal level in South Burkina Faso. This is evidenced by variation of the total annual rainfall and the number of rainy days among other climatic descriptors. Further, it is shown how district-scale cereal yields in the study area including maize, sorghum and millet casually associate variably to the inter-annual variation of selected climate variables. Statistical models show that the three cereals widely depict sensitivity to the length of the growing period and total dry days in the growing season. Maize yields on the other hand relate strongly to the rainfall amount variation (R2=51.8%) showing high moisture dependence during critical growth stages. Our conclusions emphasize on adoption of efficient water utilization platforms especially those that have evidently increased yields and strengthening of forecasts dissemination.

Keywords: climate variability, cereal yields, seasonality, rain fed farming, Burkina Faso, rainfall

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Authors: Pham Minh Duc, Tran Thi Thanh Hien, David A. Bengtson

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Laboratory feeding trial: the study was conducted to find out the optimal dietary vitamin C, or ascorbic acid (AA) levels in terms of the growth performance of snakehead. The growth trial included six treatments with five replications. Each treatment contained 0, 125, 250, 500, 1000 and 2000 mg AA equivalent kg⁻¹ diet which included six iso-nitrogenous (45% protein), iso-lipid (9% lipid) and isocaloric (4.2 Kcal.g¹). Eighty snakehead fingerlings (6.24 ± 0.17 g.fish¹) were assigned randomly in 0.5 m³ composite tanks. Fish were fed twice daily on demand for 8 weeks. The result showed that growth rates increased, protein efficiency ratio increased and the feed conversion ratio decreased in treatments with AA supplementation compared with control treatment. The survival rate of fish tends to increase with increase AA level. The number of RBCs, lysozyme in treatments with AA supplementation tended to rise significantly proportional to the concentration of AA. The number of WBCs of snakehead in treatments with AA supplementation was higher 2.1-3.6 times. In general, supplementation of AA in the diets for snakehead improved growth rate, feed efficiency and immune response. Hapa on-farm trial: based on the results of the laboratory feeding trial, the effects of AA on snakehead in hapas to simulate farm conditions, was tested using the following treatments: commercial feed; commercial feed plus hand mixed AA at 500; 750 and 1000 mg AA.kg⁻¹; SBM diet without AA; SBM diet plus 500; 750 and 1000 mg AA.kg⁻¹. The experiment was conducted in two experimental ponds (only SBM diet without AA placed in one pond and the rest in the other pond) with four replicate hapa each. Stocking density was 150 fish.m² and culture period was 5 months until market size was attained. The growth performance of snakehead and economic aspects were examined in this research.

Keywords: fish health, growth rate, snakehead, Vitamin C

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Authors: Ahmad Ammar, Umar Khan Khattak, Muhammad Majid

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Empirically based lumped hydrologic models have an extensive track record of use for various watershed managements and flood related studies. This study focuses on the impacts of LULC change for 10 year period on the discharge in watershed using lumped model HEC-HMS. The Indus above Tarbela region acts as a source of the main flood events in the middle and lower portions of Indus because of the amount of rainfall and topographic setting of the region. The discharge pattern of the region is influenced by the LULC associated with it. In this study the Landsat TM images were used to do LULC analysis of the watershed. Satellite daily precipitation TRMM data was used as input rainfall. The input variables for model building in HEC-HMS were then calculated based on the GIS data collected and pre-processed in HEC-GeoHMS. SCS-CN was used as transform model, SCS unit hydrograph method was used as loss model and Muskingum was used as routing model. For discharge simulation years 2000 and 2010 were taken. HEC-HMS was calibrated for the year 2000 and then validated for 2010.The performance of the model was assessed through calibration and validation process and resulted R2=0.92 during calibration and validation. Relative Bias for the years 2000 was -9% and for2010 was -14%. The result shows that in 10 years the impact of LULC change on discharge has been negligible in the study area overall. One reason is that, the proportion of built-up area in the watershed, which is the main causative factor of change in discharge, is less than 1% of the total area. However, locally, the impact of development was found significant in built up area of Mansehra city. The analysis was done on Mansehra city sub-watershed with an area of about 16 km2 and has more than 13% built up area in 2010. The results showed that with an increase of 40% built-up area in the city from 2000 to 2010 the discharge values increased about 33 percent, indicating the impact of LULC change on discharge value.

Keywords: LULC change, HEC-HMS, Indus Above Tarbela, SCS-CN

Procedia PDF Downloads 513

Authors: Boce Zhang, Yaguang Luo

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Ripening of climacteric fruits, such as bananas and avocados, are usually initiated days prior to the retail marketing. However, upon the onset of irreversible ripening, they undergo rapid spoilage if not consumed within a narrow climacteric time window. Controlled ripening of climacteric fruits is a critical step to provide consumers with high-quality products while reducing postharvest losses and food waste. There is a high demand for technologies that can retard the ripening process or enable accelerated ripening immediately before consumption. In this work, metal−organic framework (MOF) was developed as a solid porous matrix to encapsulate gaseous hormone, including ethylene, for subsequent application. The feasibility of the on-demand stimulated ripening of bananas and avocados is also evaluated. MOF was synthesized and loaded with ethylene gas. The MOF−ethylene was placed inside sealed containers with preclimacteric bananas and avocados and stored at 16 °C. The fruits were treated for 24-48 hours, and evaluated for ripening progress. Results indicate that MOF−ethylene treatment significantly accelerated the ripening-related changes of color and textural properties in treated bananas and avocados. The average ripening period for both avocados and bananas were reduced in half by using this method. No significant differences of quality characteristics at respective ripening stages were observed between produce ripened via MOF-ethylene versus exogenously supplied ethylene gas or endogenously produced ethylene. Solid MOF matrices could have multiple advantages compared to existing systems, including easy to transport and safe to use by minimally trained produce handlers and consumers. We envision that this technology can help tackle food waste challenges at the critical retail and consumer stages in the food supply chain.

Keywords: climacteric produce, controllable ripening, food waste challenge, metal organic framework

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Authors: Nazim Mir-Nasiri, Hudyjaya Siswoyo Jo

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The paper describes conceptual design, control strategies, and partial simulation for a new fully autonomous lower limb wearable exoskeleton system for human motion enhancement that can support its weight and increase strength and endurance. Various problems still remain to be solved where the most important is the creation of a power and cost efficient system that will allow an exoskeleton to operate for extended period without batteries being frequently recharged. The designed exoskeleton is enabling to decouple the weight/mass carrying function of the system from the forward motion function which reduces the power and size of propulsion motors and thus the overall weight, cost of the system. The decoupling takes place by blocking the motion at knee joint by placing passive air cylinder across the joint. The cylinder is actuated when the knee angle has reached the minimum allowed value to bend. The value of the minimum bending angle depends on usual walk style of the subject. The mechanism of the exoskeleton features a seat to rest the subject’s body weight at the moment of blocking the knee joint motion. The mechanical structure of each leg has six degrees of freedom: four at the hip, one at the knee, and one at the ankle. Exoskeleton legs are attached to subject legs by using flexible cuffs. The operation of all actuators depends on the amount of pressure felt by the feet pressure sensors and knee angle sensor. The sensor readings depend on actual posture of the subject and can be classified in three distinct cases: subject stands on one leg, subject stands still on both legs and subject stands on both legs but transit its weight from one leg to other. This exoskeleton is power efficient because electrical motors are smaller in size and did not participate in supporting the weight like in all other existing exoskeleton designs.

Keywords: energy efficient system, exoskeleton, motion enhancement, robotics

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Authors: Yutong Xu, Wanting Zhang, Jia Wang, Zihan Guo, Weiguang Ma

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Background: The resilience education of intern nursing students has significant implications for the development and improvement of the nursing workforce. The clinical internship period is a critical time for enhancing resilience. Aims: To evaluate the resilience level of Chinese nursing interns and identify the factors affecting resilience early in their careers. Methods: The cross-sectional study design was adopted. From March 2022 to May 2023, 512 nursing interns in tertiary care hospitals were surveyed online with the Connor-Davidson Resilience Scale, the Clinical Learning Environment scale for Nurse, and the Career Adapt-Abilities Scale. Structural equation modeling was used to clarify the relationships among these factors. Indirect effects were tested using bootstrapped Confidence Intervals. Results: The nursing interns showed a moderately high level of resilience[M(SD)=70.15(19.90)]. Gender, scholastic attainment, had a scholarship, career adaptability and clinical learning environment were influencing factors of nursing interns’ resilience. Career adaptability and clinical learning environment positively and directly affected their resilience level (β = 0.58, 0.12, respectively, p＜0.01). career adaptability also positively affected career adaptability (β = 0.26, p < 0.01), and played a fully mediating role in the relationship between clinical learning environment and resilience. Conclusion: Career adaptability can enhance the influence of clinical learning environment on resilience. The promotion of career adaptability and the clinical teaching environment should be the potential strategies for nursing interns to improve their resilience, especially for those female nursing interns with low academic performance. Implications for Nursing Educators Nursing educators should pay attention to the cultivation of nursing students' resilience; for example, by helping them integrate to the clinical learning environment and improving their career adaptability. Reporting Method: The STROBE criteria were used to report the results of the observations critically. Patient or Public Contribution No patient or public contribution.

Keywords: resilience, clinical learning environment, career adaptability, nursing interns

Procedia PDF Downloads 89

Authors: Avirup Chowdhury, Angus K. McFadyen, Linsey Batchelor

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Blood cultures (BCs) are an important aspect of management of the septic patient, identifying the underlying pathogen and its antibiotic sensitivities. However, while the current literature outlines indications for initial BCs to be taken, there is little guidance for repeat sampling in the following 5-day period and little information on how antibiotic use can affect the usefulness of this investigation. A retrospective cohort study was conducted using inpatients who had undergone 2 or more BCs within 5 days between April 2016 and April 2017 at a 400-bed hospital in the west of Scotland and received antibiotic therapy between the first and second BCs. The data for BC sampling was collected from the electronic microbiology database, and cross-referenced with data from the hospital electronic prescribing system. Overall, 283 BCs were included in the study, taken from 92 patients (mean 3.08 cultures per patient, range 2-10). All 92 patients had initial BCs, of which 83 were positive (90%). 65 had a further sample within 24 hours of commencement of antibiotics, with 35 positive (54%). 23 had samples within 24-48 hours, with 4 (17%) positive; 12 patients had sampling at 48-72 hours, 12 at 72-96 hours, and 10 at 96-120 hours, with none positive. McNemar’s Exact Test was used to calculate statistical significance for patients who received blood cultures in multiple time blocks (Initial, < 24h, 24-120h, > 120h). For initial vs. < 24h-post BCs (53 patients tested), the proportion of positives fell from 46/53 to 29/53 (one-tailed P=0.002, OR 3.43, 95% CI 1.48-7.96). For initial vs 24-120h (n=42), the proportions were 38/42 and 4/42 respectively (P < 0.001, OR 35.0, 95% CI 4.79-255.48). For initial vs > 120h (n=36), these were 33/36 and 2/36 (P < 0.001,OR ∞). These were also calculated for a positive in initial or < 24h vs. 24-120h (n=42), with proportions of 41/42 and 4/42 (P < 0.001, OR 38.0, 95% CI 5.22-276.78); and for initial or < 24h vs > 120h (n=36), with proportions of 35/36 and 2/36 respectively (P < 0.001, OR ∞). This data appears to show that taking an initial BC followed by a BC within 24 hours of antibiotic commencement would maximise blood culture yield while minimising the risk of false negative results. This could potentially remove the need for as many as 46% of BC samples without adversely affecting patient care. BC yield decreases sharply after 48 hours of antibiotic use, and may not provide any clinically useful information after this time. Further multi-centre studies would validate these findings, and provide a foundation for future health policy generation.

Keywords: antibiotics, blood culture, efficacy, inpatient

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Authors: Benjamin Bonsu Bruce, Marian Dorcas Quain David Appiah-Kubi, Gertrude Osei-Diko, Harrison Kwame Dapaah

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Taro [Colocasia esculenta (L.) Schott] is a major staple food and remains a significant crop to many cultural and agricultural customs worldwide. In Ghana, taro is mostly propagated using vegetative material, which is conserved in field collection and recycled from their farms to establish new fields. However, this practice promotes the accumulation of systemic pathogens. Prior exposure to pests and subsequent expression of disease symptoms can also be a huge constraint to sustainable conservation and utilization of taro genetic resources. In vitro, slow growth is one of the most promising techniques to be utilized for conservation. The objective of this study was to find a medium-term in vitro conservation protocol for local and exotic taro genotypes. The medium-term conservation study was conducted using actively growing shoots obtained from in vitro cultures. Explants were cultured to full strength in complete Murashige and Skoog medium supplemented with Mannitol at different concentrations (0g/l, 20g/l, 25g/l, and 30g/l). Another medium that was tested as an additional treatment is the White’s medium. The highest number of shoots (6.33) and leaves (22.67) occurred on medium containing 20 and 25g/l mannitol in genotype SAO 006 as compared to other genotypes, whereas 30g/l mannitol was the best to restrict growth for the entire 6 months period in terms of shoot height (22.50cm). The study reveals that mannitol supplemented culture media could reduce the growth of Colocasia plantlets, especially in stem height. Culture growth following 6 months of conservation, showed that healthy shoot cultures of Taro were obtained after 6 months of storage in a medium containing 20gl⁻¹ and 25gl⁻¹ mannitol.

Keywords: complete murashige, skoog medium, culture conditions, mannitol, slow growth conservation

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Authors: K. K. Kaidarova, Ye. K. Aibuldinov, Zh. B. Iskakova, G. Zh. Alzhanova, S. Zh. Zayrova

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Currently, the existing road infrastructure of Kazakhstan needs the reconstruction of existing highways and the construction of new roads. The solution to this problem can be achieved by replacing traditional building materials with industrial waste, which in their chemical and mineralogical composition are close to natural raw materials and can partially or completely replace some natural binding materials in road construction. In this regard, the purpose of this study is to develop building materials based on the red sludge of the Pavlodar aluminum plant, blast furnace slag of the Karaganda Metallurgical Plant, lime production waste of the Pavlodar Aluminum Plant as a binder for natural loam. Changes in physical and mechanical properties were studied for uniaxial compression strength, linear expansion coefficient, water resistance, and frost resistance of the samples. Nine mixtures were formed with different percentages of these wastes 1-20:25:4; 2-20:25:6; 3-20:25:8; 4-30:30:4; 5-30:30:6; 6-30:30:8; 7-40:35:4; 8-40:35:6; 9-40:35:8 and the mixture identifier were labeled based on the waste content and composition number. The results of strength measurement during uniaxial compression of the samples showed an almost constant increase in strength and amounted to 0.67–3.56 MPa after three days and 3.33–7.38 MPa after 90 days. This increase in compressive strength is a consequence of the addition of lime and becomes more pronounced over time. The water resistance of the developed materials after 90 days was 7.12 MPa, and the frost resistance for the same period was 7.35 MPa. The maximum values of strength determination were shown by a sample of the composition 9-40:35:8. The study of the mineral composition showed that there was no contamination with heavy metals or dangerous substances. It was determined that road materials made of red sludge, blast furnace slag, lime production waste, and natural loam mixture could be used due to their strength indicators and environmental characteristics.

Keywords: production waste, uniaxial compression, water resistance of materials, frost resistance of samples

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Authors: Ahmed Bux Jamali

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The purpose of this study is to examine and evaluate the overall counterterrorism cooperation during Obama Administration towards Pakistan. It aims and focuses on the performances and measures taken by United States of America during President Obama in office in order to eradicate terrorism from Pakistan. Being a grave national security threat, terrorism played a disastrous role in the domestic peace and stability of both countries. For the sake of curbing this menace in South Asia in general and Pakistan in particular, the role of Obama Administration is viable and results-oriented despite major ups and downs in Pakistan U.S Relations during that period of time. Obama administration formulated policies when he comes to office in 2009 by looking at the already efforts done by Bush Administration to counterterrorism from Pakistan. Obama’s foreign policy was revolving around defense and diplomacy when it comes to dealing with Pakistan. The concept of smart power was indeed a core principle of Obama’s administration to gain the strategic objectives in Pakistan. Obama’s strategies in terms of providing military aid packages and various assistance programs, working on institutional building and strengthening the economy helped Pakistan in strengthening the military capabilities to go for militant operation in the safe havens area in the tribal areas of Pakistan. It further helped building institutional mechanism in the governmental policies to counter terrorism and militancy. The training of combat forces, artillery, and equipment provided by US proved fatal for the militant terrorist organizations seeking hideouts in the tribal areas of Pakistan. Resultantly, many top leaders of al Qaeda and many affiliated militant groups were captured and given to US as well. Despite many ups and downs in the bilateral relations on various domestic and international issues, both countries didn’t compromise the elimination of terrorist phenomena from Pakistan which was indeed a great success of the Obama administration’s counterterrorism and counterinsurgency strategies in the long run.

Keywords: counterterrorism cooperation, national security strategy, Obama administration, Pakistan-US relations

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Authors: Eva Karaskova, Jana Volejnikova, Dusan Holub, Maria Velganova-Veghova, Michaela Spenerova, Dagmar Pospisilova

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Background: Hepcidin is the central regulator of iron metabolism. Its production is mainly affected by an iron deficiency and the presence of inflammatory activity in the body. The aim of this study was to compare serum hepcidin levels in paediatric patients with newly diagnosed inflammatory bowel disease and hepcidin levels during maintenance therapy, correlate changes of serum hepcidin levels with selected markers of iron metabolism and inflammation and type of provided treatment. Methods: Children with newly diagnosed Crohn's disease (CD) and ulcerative colitis (UC) were included in this prospective study. Blood and stool samples were collected before treatment (baseline). Serum hepcidin, hemoglobin levels, platelet counts, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), interleukin-6 (IL 6), ferritin, iron, soluble transferrin receptors, and fecal calprotectin were assessed. The same parameters were measured and compared with the baseline levels in the follow-up period, during maintenance therapy (average of 39 months after diagnosis). Results: Patients with CD (n=30) had higher serum hepcidin levels (expressed as a median and interquartile range) at diagnosis than subjects with UC (n=13). These levels significantly decreased during the follow-up (from 36.5 (11.5-79.6) ng/ml to 2.1 (0.9-6.7) ng/ml). Contrarily, no significant serum hepcidin level changes were observed in UC (from 5.4 (3.4-16.6) ng/ml to 4.8 (0.9-8.1) ng/ml). While in children with CD hepcidin level dynamics correlated with disease activity and inflammatory markers (ESR, CRP), an only correlation with serum iron levels was observed in patients with UC. Conclusion: Children with CD had higher serum hepcidin levels at diagnosis compared to subjects with UC. Decrease of serum hepcidin in the CD group during anti-inflammatory therapy has been observed, whereas low hepcidin levels in children with UC have remained unchanged. Acknowledgment: This study was supported by grant MH CZ–DRO (FNOl, 00098892).

Keywords: children, Crohn's disease, ulcerative colitis, anaemia, hepcidin

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Authors: Mohammad K. Rumjaun, Sana Amjed, Muhammad A. Ghazi, Safa G. Attar, Jason Raw

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Background: National Health Service (NHS) in England is one of the leading healthcare systems in the world and it heavily relies on the recruitment of overseas doctors. 30.7% of the doctors currently serving in NHS are overseas doctors. Most of these doctors do not receive the essential induction required to work in the NHS when they first arrive and therefore, they mostly struggle to work effectively in the first few months of their new jobs as compared to UK graduates. In our hospital, the clinical need for a dedicated induction programme for the International Medical Graduates (IMGs) was identified for their initial settling period and this programme was designed to achieve this. Methods: A questionnaire was designed for the previous 7 IMGs (Group 1) in order to identify the difficulties they faced in their initial phase. Thereafter, an induction programme consisting of presentations explaining the NHS and hospital framework, communication skills practice sessions, the clinical ceiling of care and patient simulation training was implemented for 6 new IMGs (Group 2). Another survey was done and compared with the previous. Results: After this programme, group 2 required only 1 week to understand the complexity of the IT systems as compared 3 weeks in group 1. 83% of group 2 was well-supported for their on-call duties after this programme as compared to 29% and 100% of group 2 was aware of their role in the job after the induction as compared to 0%. Furthermore, group 2 was able to function independently and confidently in their roles after only 1 month as compared to an average of 3 months for group 1. After running the PDSA cycles, our results show clear evidence that this programme has tremendously benefitted the IMGs in settling in the NHS. The IMGs really appreciated this initiative and have given positive feedback. Conclusion: Leaving your home country to begin your career in a different country is not an easy transition and undoubtedly, everyone struggles. It is important to invest in a well-structured induction programme for the IMGs in the initial phase of their jobs as this will improve not only their confidence and efficacy but also patients’ safety.

Keywords: induction programme, international medical graduates, NHS, overseas doctors struggles.

Procedia PDF Downloads 135