Search results for: long term care facility

Authors: Ktiri Fouad

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Objectives: The present study examined how the polyvalent nursing students of the Higher Institute of Nursing Professions and Health Techniques (ISPITS-Rabat-Morocco) conceived the term "feeling stressed.” We checked whether they were referring to a specific type of sensation (emotional, mental, physical) or both or all of them when they said they were stressed at the time they felt it. Materials and methods: A quantitative cross-sectional study was conducted among students of the three years of polyvalent nursing courses. Using a 7-Likert scale, the students were asked to assess their states of stress and the emotional, mental and physical sensations they were experiencing before and after carrying out a mental arithmetic task. An ordinal logistic regression method was used to investigate the association between the states of stress and the 3 types of sensations. Results: 222 polyvalent nursing students out of 307 were included in the experience. Their increased perceived states of stress after carrying out the mental task were found to be significantly associated with emotional distress and mental fatigue and not with physical tiredness. The mental sensation (mental fatigue) was found to have more effects in predicting the likelihood of feeling stressed. In addition, the lower the intensity of emotional or mental sensation, the more likely the students were to experience stress, given that one of both sensations is held constant, whatever the intensity of the physical sensation. We conclude that the polyvalent nursing students refer to mental fatigue and emotional distress and not to physical tiredness when they say they felt stressed, the mental fatigue having more effects. The implications of the study are discussed.

Keywords: feeling stressed”, emotional sensation, mental sensation, physical sensation

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Authors: Vistorina Amputu, Katja Tielboerger, Nichola Knox

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Primary productivity in dry savannahs is constraint by moisture availability and under increasing anthropogenic pressure. Thus, considering climate change and the unprecedented pace and scale of rangeland deterioration, methods for assessing the status of such rangelands should be easy to apply, yield reliable and repeatable results that can be applied over large spatial scales. Global and local scale monitoring of rangelands through satellite data and labor-intensive field measurements respectively, are limited in accurately assessing the spatiotemporal heterogeneity of vegetation dynamics to provide crucial information that detects degradation in its early stages. Fortunately, newly emerging techniques such as unmanned aerial vehicles (UAVs), associated miniaturized sensors and improving digital photogrammetric software provide an opportunity to transcend these limitations. Yet, they have not been extensively calibrated in natural systems to encompass their complexities if they are to be integrated for long-term monitoring. Limited research using drone technology has been conducted in arid savannas, for example to assess the health status of this dynamic two-layer vegetation ecosystem. In our study, we fill this gap by testing the relationship between UAV-estimated cover of rangeland functional attributes and field data collected in discrete sample plots in a Namibian dryland savannah along a degradation gradient. The first results are based on a supervised classification performed on the ultra-high resolution multispectral imagery to distinguish between rangeland functional attributes (bare, non-woody, and woody), with a relatively good match to the field observations. Integrating UAV-based observations to improve rangeland monitoring could greatly assist in climate-adapted rangeland management.

Keywords: arid savannah, degradation gradient, field observations, narrow-band sensor, supervised classification

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Authors: Reihane Mehrparvar

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Human age could exceed further by altering gene expression through food intaking, although as a consequence of recent century eating patterns, human life-span getting shorter by emerging irregulating in autophagy mechanism, insulin, leptin, gut microbiota which are important etiological factors of type-2 diabetes, obesity, infertility, cancer, metabolic and autoimmune diseases. However, restricted calorie intake and vigorous exercise might be beneficial for losing weight and metabolic regulation in a short period but could not be implementable in the long term as a way of life. Therefore, the lack of a dietary program that is compatible with the genes of the body is essential. Sweet and high-glycemic-index (HGI) foods were associated with type-2 diabetes and cancer morbidity. The neuropsychological perspective characterizes the inclination of sweet and HGI-food consumption as addictive behavior; hence this process engages preference of gut microbiota, neural node, and dopaminergic functions. Moreover, meal composition is not the only factor that affects body hemostasis. In this narrative review, it is believed to attempt to investigate how the body responded to different food intakes and represent an accurate model based on current evidence. Eating frequently and ingesting unassimilable protein and carbohydrates may not be compatible with human genes and could cause impairments in the self-renovation mechanism. This trajectory indicates our body is more adapted to starvation and eating animal meat and marrow. Here has been recommended a model that takes into account three important factors: frequent eating, meal composition, and circadian rhythm, which may offer a promising intervention for obesity, inflammation, cardiovascular, autoimmune disorder, type-2 diabetes, insulin resistance, infertility, and cancer through intensifying autophagy-mechanism and eliminate medical costs.

Keywords: metabolic disease, anti-aging, type-2 diabetes, autophagy

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Authors: Abdulkadir Magaji

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This study analyzes and compares the actual measured and simulated performance of a 3.2 kwP grid-connected photovoltaic system. The system is located at the Outdoor Facility of Government Day secondary School Katsina State, which lies approximately between coordinate of 12°15′N 7°30′E. The system consists of 14 Mono crystalline silicon modules connected in two strings of 7 series-connected modules, each facing north at a fixed tilt of 340. The data presented in this study were measured in the year 2015, where the system supplied a total of 4628 kWh to the local electric utility grid. The performance of the system was simulated using PVsyst software using measured and Meteonorm derived climate data sets (solar radiation, ambient temperature and wind speed). The comparison between measured and simulated energy yield are discussed. Although, both simulation results were similar, better comparison between measured and predicted monthly energy yield is observed with simulation performed using measured weather data at the site. The measured performance ratio in the present study shows 58.4% is higher than those reported elsewhere as compared in the study.

Keywords: performance, evaluation, grid connection, photovoltaic system

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Authors: Jorge Luis Morales Romero, Enrique Murillo Othón

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Business to business (B2B) relationships generally go beyond a purely profit-based result, with firms seeking to maintain a relationship for many years because a breakup or getting a new supplier can be very costly. Therefore, identifying the factors which determine a successful relationship in the long term is of great interest to companies. That is why their reputation and the brand image that customers have of them are among the main factors that can achieve a successful relationship; Because of the positive effect which is driven by the client’s loyalty. Additionally, the perception that a customer may have about a brand is different when it is related to goods or to services. Thereby, they create in their minds their own brand image of it based on the past experiences they have had; Thus, a positive relationship is established between goods-related brand image, service-related brand image, and customer loyalty. The present investigation examines the boundary conditions of said relationship by testing the moderating effects of trust, commitment, and relationship value in a B2B environment. All the variables were tested independently as moderators for service-related brand image/loyalty and for goods-related brand image/loyalty, as they are assumed to be separate variables. Survey data was collected through interviews with customers that have both a product-buying relationship and a service relationship with a global B2B brand of healthcare equipment operating in the Mexican healthcare market. Interviewed respondents were either the user or the purchasing manager and/or the responsible for the equipment maintenance for the customer organization. Hence, they were appropriate informants regarding the B2B relationship with this healthcare brand. The moderation models were estimated using the PROCESS macro for the Statistical Package for the Social Sciences Software (SPSS). Results show statistical evidence that both Relationship Value and Trust are significant moderators for the service-related brand image/loyalty relation but not significant for the goods-related brand/loyalty relation. On the other hand, Commitment results in a significant moderator for the goods-related brand/loyalty relation but is not significant for the service-related brand image/loyalty relation.

Keywords: commitment, trust, relationship value, loyalty, B2B, moderator

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Authors: Wilfred Elliam

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Background: Pain is a prevalent and debilitating symptom among breast cancer patients, impacting their quality of life and overall well-being. The experience of pain in this population is multifaceted, influenced by a combination of disease-related factors, treatment side effects, and individual characteristics. Despite advancements in cancer treatment and pain management, many breast cancer patients continue to suffer from chronic pain, which can persist long after the completion of treatment. Understanding the progression of pain in breast cancer patients over time and identifying its correlates is crucial for effective pain management and supportive care strategies. The purpose of this research is to understand the patterns and progression of pain experienced by breast cancer survivors over time. Methods: Data were collected from breast cancer patients at Hartford Hospital at four time points: baseline, 3, 6 and 12 weeks. Key variables measured include pain, body mass index (BMI), fatigue, musculoskeletal pain, sleep disturbance, and demographic variables (age, employment status, cancer stage, and ethnicity). Binomial generalized linear mixed models were used to examine changes in pain and symptoms over time. Results: A total of 100 breast cancer patients aged  18 years old were included in the analysis. We found that the effect of time on pain (p = 0.024), musculoskeletal pain (p= <0.001), fatigue (p= <0.001), and sleep disturbance (p-value = 0.013) were statistically significant with pain progression in breast cancer patients. Patients using aromatase inhibitors have worse fatigue (<0.05) and musculoskeletal pain (<0.001) compared to patients with Tamoxifen. Patients who are obese (<0.001) and overweight (<0.001) are more likely to report pain compared to patients with normal weight. Conclusion: This study revealed the complex interplay between various factors such as time, pain, sleep disturbance in breast cancer patient. Specifically, pain, musculoskeletal pain, sleep disturbance, fatigue exhibited significant changes across the measured time points, indicating a dynamic pain progression in these patients. The findings provide a foundation for future research and targeted interventions aimed at improving pain in breast cancer patient outcomes.

Keywords: breast cancer, chronic pain, pain management, quality of life

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Authors: Benga Ebouele, Thomas Tengen

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Due to long lead time, work in process (WIP) inventory can manifest within the supply chain of most manufacturing system. It implies that there are lesser finished good on hand and more in the process because the work remains in the factory too long and cannot be sold to either customers The supply chain of most manufacturing system is then considered as inefficient as it take so much time to produce the finished good. Time consumed in each operation of the supply chain has an associated energy costs. Such phenomena can be harmful for a hybrid inventory system because a lot of space to store these semi-finished goods may be needed and one is not sure about the final energy cost of producing, holding and delivering the good to customers. The principle that reduces waste of energy within the supply chain of most manufacturing firms should therefore be available to all inventory managers in pursuit of profitability. Decision making by inventory managers in this condition is a modeling process, whereby a dynamical approach is used to depict, examine, specify and even operationalize the relationship between energy consumption and hybrid inventory level. The relationship between energy consumption and inventory level is established, which indicates a poor level of control and hence a potential for energy savings.

Keywords: dynamic modelling, energy used, hybrid inventory, supply chain

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Authors: Kristina Karapetyan, Flora Tkhruni, Tsovinar Balabekyan, Arevik Israyelyan, Tatyana Khachatryan

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The ability of the lactic acid bacteria (LAB) to prevent and cure a variety of diseases, their protective role against infections and colonization of pathogenic microorganisms in the digestive tract, has lead to the coining of the term probiotics or pro-life. LAB inhibiting the growth of pathogenic and food spoilage microorganisms, maintaining the nutritive quality and improving the shelf life of foods. They have also been used as flavor and texture producers. Enterococcus strains have been used for treatment of diseases such as diarrhea or antibiotic associated diarrhea, inflammatory pathologies that affect colon such as irritable bowel syndrome, or immune regulation, diarrhea caused by antibiotic treatments. The obtaining and investigation of biological properties of proteinoceous antibiotics, on the basis of probiotic LAB shown, that bacteriocins, metabiotics, and peptides of LAB represent bactericides have a broad range of activity and are excellent candidates for development of new prophylactic and therapeutic substances to complement or replace conventional antibiotics. The genotyping by 16S rRNA sequencing for LAB were used. Cell free culture broth (CFC) broth was purified by the Gel filtration method on the Sephadex Superfine G 25 resin. Antimicrobial activity was determined by spot-on-lawn method and expressed in arbitrary units (AU/ml). The diversity of multidrug-resistance (MDR) of pathogenic strains to antibiotics, most widely used for treatment of human diseases in the Republics of Armenia and Nagorno Karabakh were examined. It was shown, that difference of resistance of pathogens to antibiotics depends on their isolation sources. The influences of partially purified antimicrobial preparations (AMP), obtained from the different strains of Enterococcus genus on the growth of MDR pathogenic bacteria were investigated. It was shown, that bacteriocin containing partially purified preparations, obtained from different strains of Enterococcus faecium and durans species, possess bactericidal or bacteriostatic activity against antibiotic resistant intestinal, spoilage and food-borne pathogens such as Listeria monocytogenes, Staphylococcus aureus, E. coli, and Salmonella. Endemic strains of LAB, isolated from Matsoni made from donkey, buffalo and goat milk, shown broad spectrum of activity against food spoiling microorganisms, moulds and fungi, such as Salmonella sp., Esherichia coli, Aspergillus and Penicillium species. Highest activity against MDR pathogens shown bacteria, isolated from goat milk products. High stability of the investigated strains of the genus Enerococcus, isolated from samples of matsun from different regions of Nagorno-Karabakh (NKR) to the antibiotics was shown. The obtained data show high stability of the investigated different strains of the genus Enerococcus. The high genetic diversity in Enterococcus group suggests adaptations for specific mutations in different environments. Thus, endemic strains of LAB are able to produce bacteriocins with high and different inhibitory activity against broad spectrum of microorganisms isolated from different sources and belong to different taxonomic group. Prospect of the use of certain antimicrobial preparations against pathogenic strains is obvious. These AMP can be applied for long term use against different etiology antibiotic resistant pathogens for prevention or treatment of infectional diseases as an alternative to antibiotics.

Keywords: antimicrobial biopreparation, endemic lactic acid bacteria, intra-species diversity, multidrug resistance of pathogens

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Authors: Oluwafemi Samuel Oyamakin

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The forest in Nigeria is currently estimated to extend to around 9.6 million hectares, but used to expand over central and southern Nigeria decades ago. The forest estate is shrinking due to long-term human exploitation for agricultural development, fuel wood demand, uncontrolled forest harvesting and urbanization, amongst other factors, compounded by population growth in rural areas. Nigeria has lost more than 50% of its forest cover since 1990 and currently less than 10% of the country is forested. The current deforestation rate is estimated at 3.7%, which is one of the highest in the world. Reducing Emissions from Deforestation and forest Degradation plus conservation, sustainable management of forests and enhancement of forest carbon stocks constituted what is referred to as REDD+. This study evaluated some of the existing way of computing carbon stocks using eight indigenous tree species like Mansonia, Shorea, Bombax, Terminalia superba, Khaya grandifolia, Khaya senegalenses, Pines and Gmelina arborea. While these components are the essential elements of REDD+ programme, they can be brought under a broader framework of systems analysis designed to arrive at optimal solutions for future predictions through statistical distribution pattern of carbon sequestrated by various species of tree. Available data on height and diameter of trees in Ibadan were studied and their respective potentials of carbon sequestration level were assessed and subjected to tests so as to determine the best statistical distribution that would describe the carbon sequestration pattern of trees. The result of this study suggests a reasonable statistical distribution for carbons sequestered in simulation studies and hence, allow planners and government in determining resources forecast for sustainable development especially where experiments with real-life systems are infeasible. Sustainable management of forest can then be achieved by projecting future condition of forests under different management regimes thereby supporting conservation and REDD+ programmes in Nigeria.

Keywords: REDD+, carbon, climate change, height and diameter

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Authors: Beatrice Adeoye

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Background: One of the health challenges developing countries face is air pollution from indoor and outdoor activities. Smoke as a result of cooking, burning wastes and power generators litter the air space on a continual basis due to poverty and governance challenges. The short and long term implications of these actions are enormous and studies have attributed smoke as one of the leading preventable risk factors contributing to global burden of respiratory infections. Design/Methods: The issue at hand therefore includes an exploration of the existing policy frameworks regarding smoke, adherence to international conventions and practices, and more importantly the activities of the government in addressing these issues. Aside this, an understanding of the implications of smoke on peoples’ health and well-being also become crucial. Consequently, this article seeks to interrogate the effect of smoke on the health and well-being of Nigerians and the activities of the policy makers in addressing these challenges. Results (Main Argument): This study reviewed both primary and secondary data on poverty, smoke emission and attendant health risks coupled with existing policies on smoke and air pollution in the country. For instance, over 69% of Nigerians are poor, ranking third in the world; 2.9 billion people live in homes using wood, coal or dung as their primary cooking fuel; equally, 50.6% of Nigerians has no access to regular electricity supply. Further, sustainable policy regarding smoke emission is lacking in the country. This work further submitted that continued low standard of living as a result of governance challenges coupled with a lack of sustainable policy have aggravated the health risks related to smoke in the country. Conclusions: The implication on the health of the children, mothers and vulnerable groups for the future of the country is enormous and may continue if not addressed. Urgent attention therefore needs to be focused on this area considering what this portends for the nation now and in the future.

Keywords: air pollution, indoor, outdoor, respiratory infections

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Authors: K. Sushma Varma, Rajesh Singh

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Non-engineered landfills cause serious environmental damage due to toxic emissions and mobilization of persistent pollutants, organic and inorganic contaminants, as well as soluble metal ions. The available treatment technologies for landfill leachate and solid waste are not effective from an economic, environmental, and social standpoint. The present study assesses the potential of the bioelectrochemical system (BES) integrated with sulfate-reducing bacteria (SRB) in the sustainable treatment and decontamination of landfill wastes. For this purpose, solid waste and landfill leachate collected from different landfill sites were evaluated for long-term treatment using the integrated SRB-BES anaerobic designed bioreactors after pre-treatment. Based on periodic gas composition analysis, physicochemical characterization of the leachate and solid waste, and metal concentration determination, the present system demonstrated significant improvement in volumetric hydrogen production by suppressing methanogenesis. High reduction percentages of Be, Cr, Pb, Cd, Sb, Ni, Cr, COD, and sTOC removal were observed. This mineralization can be attributed to the synergistic effect of ammonia-assisted pre-treatment complexation and microbial sulphide formation. Despite being amended with 0.1N ammonia, the treated leachate level of NO³⁻ was found to be reduced along with SO₄²⁻. This integrated SRB-BES system can be recommended as an eco-friendly solution for landfill reclamation. The BES-treated solid waste was evidently more stabilized, as shown by a five-fold increase in surface area, and potentially useful for leachate immobilization and bio-fortification of agricultural fields. The vector arrangement and magnitude showed similar treatment with differences in magnitudes for both leachate and solid waste. These findings support the efficacy of SRB-BES in the treatment of landfill leachate and solid waste sustainably, inching a step closer to our sustainable development goals. It utilizes low-cost treatment, and anaerobic SRB adapted to landfill sites. This technology may prove to be a sustainable treatment strategy upon scaling up as its outcomes are two-pronged: landfill waste treatment and energy recovery.

Keywords: bio-electrochemical system, leachate /solid waste treatment, landfill leachate, sulfate-reducing bacteria

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Authors: Abhishek N. Srivastava, Rahul Singh, Sumedha Chakma

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The rapid urbanization in the developing countries is generating an enormous amount of waste leading to the creation of unregulated landfill sites at various places at its disposal. The liquid waste, known as leachate, produced from these landfills sites is severely affecting the surrounding water quality. The water quality in the proximity areas of the landfill is found affected by various physico-chemical parameters of leachate such as pH, alkalinity, total hardness, conductivity, chloride, total dissolved solids (TDS), total suspended solids (TSS), sulphate, nitrate, phosphate, fluoride, sodium and potassium, biological parameters such as biochemical oxygen demand (BOD), chemical oxygen demand (COD), Faecal coliform, and heavy metals such as cadmium (Cd), lead (Pb), iron (Fe), mercury (Hg), arsenic (As), cobalt (Co), manganese (Mn), zinc (Zn), copper (Cu), chromium (Cr), nickel (Ni). However, all these parameters are distributive in leachate that produced according to the nature of waste being dumped at various landfill sites, therefore, it becomes very difficult to predict the main responsible parameter of leachate for water quality contamination. The present study is endeavour the comparative analysis of the physical, chemical and biological parameters of various landfills in India viz. Okhla landfill, Ghazipur landfill, Bhalswa ladfill in NCR Delhi, Deonar landfill in Mumbai, Dhapa landfill in Kolkata and Kodungayaiyur landfill, Perungudi landfill in Chennai. The statistical analysis of the parameters was carried out using the Statistical Packages for the Social Sciences (SPSS) and LandSim 2.5 model to simulate the long term effect of various parameters on different time scale. Further, the uncertainties characterization of various input parameters has also been analysed using fuzzy alpha cut (FAC) technique to check the sensitivity of various water quality parameters at the proximity of numerous landfill sites. Finally, the study would help to suggest the best method for the prevention of pollution migration from the landfill sites on priority basis.

Keywords: landfill leachate, water quality, LandSim, fuzzy alpha cut

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Authors: Mohammed Bakhit Kashoob, Mohammed Salim Al-Maashani, Ahmed Abdullah Al-Marhoon

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Fatalities of Road Traffic Crashes (RTCs) on rural roads are usually higher than that on urban roads. The likelihood of traffic accidents may increase with the presence of factors that are associated with the rural type of community such as long-distance, road type, road geometry (e.g., curves and steepens), poor lighting, terrain, obstacles (e.g., animals crossing, boulders or tree branches), heavy truck traffic, weather conditions, and road flaws. Most of these factors are present on the rural roads of Oman. As many cities in Oman are surrounded by mountains and connected by rural roads, this is of great concern. In this paper, the causes of traffic crashes on rural roads in Oman are analyzed. The fatality rate of traffic deaths on rural roads is compared with the fatality rate on urban roads for different regions in Oman. Statistical data and police reports show that the leading cause of RTCs and deaths on rural roads is vehicle speeding, especially on long-distance roads. It is shown that crashes on rural roads result in higher fatalities than crashes on urban roads. In comparison to speed, the numbers of RTCs and deaths that resulted from other causes are small.

Keywords: causes of traffic crashes, road safety, road traffic crash, rural roads

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Authors: Ruzanna Muradyan

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Medical data mining is a crucial field in contemporary healthcare that offers cutting-edge tactics with enormous potential to transform patient care. This abstract examines how sophisticated data mining techniques could transform the healthcare industry, with a special focus on how they might improve patient outcomes. Healthcare data repositories have dynamically evolved, producing a rich tapestry of different, multi-dimensional information that includes genetic profiles, lifestyle markers, electronic health records, and more. By utilizing data mining techniques inside this vast library, a variety of prospects for precision medicine, predictive analytics, and insight production become visible. Predictive modeling for illness prediction, risk stratification, and therapy efficacy evaluations are important points of focus. Healthcare providers may use this abundance of data to tailor treatment plans, identify high-risk patient populations, and forecast disease trajectories by applying machine learning algorithms and predictive analytics. Better patient outcomes, more efficient use of resources, and early treatments are made possible by this proactive strategy. Furthermore, data mining techniques act as catalysts to reveal complex relationships between apparently unrelated data pieces, providing enhanced insights into the cause of disease, genetic susceptibilities, and environmental factors. Healthcare practitioners can get practical insights that guide disease prevention, customized patient counseling, and focused therapies by analyzing these associations. The abstract explores the problems and ethical issues that come with using data mining techniques in the healthcare industry. In order to properly use these approaches, it is essential to find a balance between data privacy, security issues, and the interpretability of complex models. Finally, this abstract demonstrates the revolutionary power of modern data mining methodologies in transforming the healthcare sector. Healthcare practitioners and researchers can uncover unique insights, enhance clinical decision-making, and ultimately elevate patient care to unprecedented levels of precision and efficacy by employing cutting-edge methodologies.

Keywords: data mining, healthcare, patient care, predictive analytics, precision medicine, electronic health records, machine learning, predictive modeling, disease prognosis, risk stratification, treatment efficacy, genetic profiles, precision health

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Authors: Marko Spasojevic, Ying Hei Chui, Yuxiang Chen

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Increasing the level of exterior insulation in residential buildings is a popular way for improving the thermal characteristic of building enclosure and reducing heat loss. However, the layout and properties of materials composing the wall have a great effect on moisture accumulation within the wall cavity, long-term durability of a wall as well as the structural performance. A one-dimensional hygrothermal modeling has been performed to investigate moisture condensation risks and the drying capacity of standard 2×4 and 2×6 light wood-frame wall assemblies including exterior low-permeance extruded polystyrene (XPS) insulation. The analysis considered two different wall configurations whereby the rigid insulation board was placed either between Oriented Strand Board (OSB) sheathing and the stud or outboard to the structural sheathing. The thickness of the insulation varied between 0 mm and 50 mm and the analysis has been conducted for eight different locations in Canada, covering climate zone 4 through zone 8. Results show that the wall configuration with low-permeance insulation inserted between the stud and OSB sheathing accumulates more moisture within the stud cavity, compared to the assembly with the same insulation placed exterior to the sheathing. On the other hand, OSB moisture contents of the latter configuration were markedly higher. Consequently, the analysis of hygrothermal performance investigated and compared moisture accumulation in both the OSB and stud cavity. To investigate the structural performance of the wall and the effect of soft insulation layer inserted between the sheathing and framing, forty nail connection specimens were tested. Results have shown that both the connection strength and stiffness experience a significant reduction as the insulation thickness increases. These results will be compared with results from a full-scale shear wall tests in order to investigate if the capacity of shear walls with insulated sheathing would experience a similar reduction in structural capacities.

Keywords: hygrothermal analysis, insulated sheathing, moisture performance, nail joints, wood shear wall

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Authors: Lilia Edit Aparicio Pico, Paulo Cesar Coronado Sánchez, Roberto Ferro Escobar

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This paper presents the implementation of telemedicine services for physiotherapy, occupational therapy, and speech therapy rehabilitation, utilizing telebroadcasting of audiovisual content to enhance comprehensive patient recovery in rural areas of San Vicente del Caguán municipality, characterized by high levels of social conflict in Colombia. The region faces challenges such as dysfunctional problems, physical rehabilitation needs, and a high prevalence of hearing diseases, leading to neglect and substandard health services. Limited access to healthcare due to communication barriers and transportation difficulties exacerbates these issues. To address these challenges, a research initiative was undertaken to leverage information and communication technologies (ICTs) to improve healthcare quality and accessibility for this vulnerable population. The primary objective was to develop a tele-rehabilitation system to provide asynchronous online therapies and teleconsultation services for patient follow-up during the recovery process. The project comprises two components: Communication systems and human development. A technological component involving the establishment of a wireless network connecting rural centers and the development of a mobile application for video-based therapy delivery. Communications systems will be provided by a radio link that utilizes internet provided by the Colombian government, located in the municipality of San Vicente del Caguán to connect two rural centers (Pozos and Tres Esquinas) and a mobile application for managing videos for asynchronous broadcasting in sidewalks and patients' homes. This component constitutes an operational model integrating information and telecommunications technologies. The second component involves pedagogical and human development. The primary focus is on the patient, where performance indicators and the efficiency of therapy support were evaluated for the assessment and monitoring of telerehabilitation results in physical, occupational, and speech therapy. They wanted to implement a wireless network to ensure audiovisual content transmission for tele-rehabilitation, design audiovisual content for tele-rehabilitation based on services provided by the ESE Hospital San Rafael in physiotherapy, occupational therapy, and speech therapy, develop a software application for fixed and mobile devices enabling access to tele-rehabilitation audiovisual content for healthcare personnel and patients and finally to evaluate the technological solution's contribution to the ESE Hospital San Rafael community. The research comprised four phases: wireless network implementation, audiovisual content design, software application development, and evaluation of the technological solution's impact. Key findings include the successful implementation of virtual teletherapy, both synchronously and asynchronously, and the assessment of technological performance indicators, patient evolution, timeliness, acceptance, and service quality of tele-rehabilitation therapies. The study demonstrated improved service coverage, increased care supply, enhanced access to timely therapies for patients, and positive acceptance of teletherapy modalities. Additionally, the project generated new knowledge for potential replication in other regions and proposed strategies for short- and medium-term improvement of service quality and care indicators

Keywords: e-health, medical informatics, telemedicine, telerehabilitation, virtual therapy

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Authors: Umedov Mekhroz, Griaznova Svetlana

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In connection with the growth of oncological diseases, the design of centers for diagnostics and the production of radiopharmaceuticals is the most relevant area of healthcare facilities. The design of new nuclear medicine centers should be carried out from the standpoint of solving the following tasks: the availability of medical care, functionality, environmental friendliness, sustainable development, improving the safety of drugs, the use of which requires special care, reducing the rate of environmental pollution, ensuring comfortable conditions for the internal microclimate, adaptability. The purpose of this article is to substantiate architectural and planning solutions, formulate recommendations and principles for the design of nuclear medicine centers and determine the connections between the production and medical functions of a building. The advantages of combining the production of radiopharmaceuticals and the department of medical care: less radiation activity is accumulated, the cost of the final product is lower, and there is no need to hire a transport company with a special license for transportation. A medical imaging department is a structural unit of a medical institution in which diagnostic procedures are carried out in order to gain an idea of the internal structure of various organs of the body for clinical analysis. Depending on the needs of a particular institution, the department may include various rooms that provide medical imaging using radiography, ultrasound diagnostics, and the phenomenon of nuclear magnetic resonance. The production of radiopharmaceuticals is an object intended for the production of a pharmaceutical substance containing a radionuclide and intended for introduction into the human body or laboratory animal for the purpose of diagnosis, evaluation of the effectiveness of treatment, or for biomedical research. The research methodology includes the following subjects: study and generalization of international experience in scientific research, literature, standards, teaching aids, and design materials on the topic of research; An integrated approach to the study of existing international experience of PET / CT scan centers and the production of radiopharmaceuticals; Elaboration of graphical analysis and diagrams based on the system analysis of the processed information; Identification of methods and principles of functional zoning of nuclear medicine centers. The result of the research is the identification of the design principles of nuclear medicine centers with the functions of the production of radiopharmaceuticals and the department of medical imaging. This research will be applied to the design and construction of healthcare facilities in the field of nuclear medicine.

Keywords: architectural planning solutions, functional zoning, nuclear medicine, PET/CT scan, production of radiopharmaceuticals, radiotherapy

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Authors: Kebron Abich Asnake

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The outbreak of COVID-19 has had far-reaching socio-economic consequences globally, and Ethiopia is no exception. This abstract provides a summary of a research study on the socio-economic impact of COVID-19 in Ethiopia. The study analyzes the health impact, economic repercussions, social consequences, government response measures, and opportunities for post-crisis recovery. In terms of health impact, the research explores the spread and transmission of the virus, the capacity and response of the healthcare system, and the mortality rate, with a focus on vulnerable populations. The economic impact analysis entails investigating the contraction of the GDP, employment and income loss, disruption in key sectors such as agriculture, tourism, and manufacturing, and the specific implications for small and medium-sized enterprises (SMEs), foreign direct investment, and remittances. The social impact section looks at the disruptions in education and the digital divide, food security and nutrition challenges, increased poverty and inequality, gender-based violence, and mental health issues. The research also examines the measures taken by the Ethiopian government, including health and safety regulations, economic stimulus packages, social protection programs, and support for vulnerable populations. Furthermore, the study outlines long-term recovery prospects, social cohesion, and community resilience challenges. It highlights the need to strengthen the healthcare system and finds a balance between health and economic priorities. The research concludes by presenting recommendations for policy-makers and stakeholders, emphasizing opportunities for post-crisis recovery such as diversification of the economy, enhanced healthcare infrastructure, investment in digital infrastructure and technology, and support for domestic tourism and local industries. This research provides valuable insights into the socio-economic impact of COVID-19 in Ethiopia, offering a comprehensive analysis of the challenges faced and potential pathways towards recovery.

Keywords: impact, covid, ethiopia, health

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Authors: Rahil Sahragard, Mahmoud Hatami, Rostam Bahadori Khalili

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Diabetes is one of the most important health problems in the world and a chronic disease requiring continuous care and therefore, it is necessary for patients to undergo self-care and nutrition education. This study was conducted to evaluate the effect of nutrition education on the metabolic control of diabetic patients in Tehran in 2015. An experimental study was conducted on 100 patients who had previously been approved by a specialist physician for diabetes and at least one year after their onset. At first, patients without any knowledge of the educational program were selected as sample and from them a checklist containing demographic and specific information about diabetes was filled and were taken three fasting blood glucose and three times fasting blood glucose (5 p.m.) Then, the patients received face-to-face training in the same conditions for 2 weeks in a Mehregan hospital of Tehran, and received 3 months of training, while they were fully monitored and during this time, samples that had a cold or blood pressure-related disease or were admitted to the hospital were excluded from the study. After the end of the study, the checklist was filled again and 3 fasting blood glucose and 3 fasting blood glucose samples were taken, the results were statistically analyzed by MC Nemar's statistical test. The research findings were performed on 100 patients 41.7% male and 58.3% women, the range of age was between 22 and 60 years old, with a duration of diabetes ranging from 1 to 15 years. Abnormal fasting blood glucose from 95% to 48.3% (P <0.0001) and non-fasting blood glucose decreased from 91.6% to 71.2% (P <0.001). Research has shown that training on blood glucose control has been successful, therefore, it is recommended that more research is done in the field of education to help patients with diabetes more comfortable.

Keywords: nutrition education, diabetes, function, insulin, chronic, metabolic control

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Authors: Dong Tang, Yongli Zhao

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The study of the microstructure of asphalt is of great importance for the analysis of its macroscopic properties. However, the peculiarities of the chemical composition of the asphalt itself and the limitations of existing direct imaging techniques have caused researchers to face many obstacles in studying the microstructure of asphalt. The advantage of small-angle X-ray scattering (SAXS) is that it allows quantitative determination of the internal structure of opaque materials and is suitable for analyzing the microstructure of materials. Therefore, the SAXS technique was used to study the evolution of microstructures on the nanoscale during asphalt aging. And the reasons for the change in scattering contrast during asphalt aging were also explained with the help of Fourier transform infrared spectroscopy (FTIR). SAXS experimental results show that the SAXS curves of asphalt are similar to the scattering curves of scattering objects with two-level structures. The Porod curve for asphalt shows that there is no obvious interface between the micelles and the surrounding mediums, and there is only a fluctuation of the hot electron density between the two. The Beaucage model fit SAXS patterns shows that the scattering coefficient P of the asphaltene clusters as well as the size of the micelles, gradually increase with the aging of the asphalt. Furthermore, aggregation exists between the micelles of asphalt and becomes more pronounced with increasing aging. During asphalt aging, the electron density difference between the micelles and the surrounding mediums gradually increases, leading to an increase in the scattering contrast of the asphalt. Under long-term aging conditions due to the gradual transition from maltenes to asphaltenes, the electron density difference between the micelles and the surrounding mediums decreases, resulting in a decrease in the scattering contrast of asphalt SAXS. Finally, this paper correlates the macroscopic properties of asphalt with microstructural parameters, and the results show that the high-temperature rutting resistance of asphalt is enhanced and the low-temperature cracking resistance decreases due to the aggregation of micelles and the generation of new micelles. These results are useful for understanding the relationship between changes in microstructure and changes in properties during asphalt aging and provide theoretical guidance for the regeneration of aged asphalt.

Keywords: asphalt, Beaucage model, microstructure, SAXS

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Authors: Meena Kumari, Ajitha Sharma, Mohan Babu Amberkar, Hasitha Manohar, Joseph Thomas, K. L. Bairy

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Aim: To evaluate the pattern of occurrence of adverse drug reactions (ADRs) with platinum compounds in cancer chemotherapy at a tertiary care hospital. Methods: It was a retrospective, descriptive case record study done on patients admitted to the medical oncology ward of Kasturba Hospital, Manipal from July to November 2012. Inclusion criteria comprised of patients of both sexes and all ages diagnosed with cancer and were on platinum compounds, who developed at least one adverse drug reaction during or after the treatment period. CDSCO proforma was used for reporting ADRs. Causality was assessed using Naranjo Algorithm. Results: A total of 65 patients was included in the study. Females comprised of 67.69% and rest males. Around 49.23% of the ADRs were seen in the age group of 41-60 years, followed by 20 % in 21-40 years, 18.46% in patients over 60 years and 12.31% in 1-20 years age group. The anticancer agents which caused adverse drug reactions in our study were carboplatin (41.54%), cisplatin (36.92%) and oxaliplatin (21.54%). Most common adverse drug reactions observed were oral candidiasis (21.53%), vomiting (16.92%), anaemia (12.3%), diarrhoea (12.3%) and febrile neutropenia (0.08%). The results of the causality assessment of most of the cases were probable. Conclusion: The adverse effect of chemotherapeutic agents is a matter of concern in the pharmacological management of cancer as it affects the quality of life of patients. This information would be useful in identifying and minimizing preventable adverse drug reactions while generally enhancing the knowledge of the prescribers to deal with these adverse drug reactions more efficiently.

Keywords: adverse drug reactions, platinum compounds, cancer, chemotherapy

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Authors: Amir M. Shikhli, Refaat H. Abdel-Razek, Salaheddine Bendak

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Innovation is considered to be one of the key factors that influence long-term success of any company. The problem of many organizations in developing countries is trying to implement innovation without a strong basis within the organizational culture to support it. The objective of this study is to assess the effects of organizational culture on innovation in one of the biggest information technology organizations in UAE, Injazat Data System. First, an Organizational Culture Assessment Instrument (OCAI) was used as a survey and Competing Value Framework as a model to analyze the existing culture within the organization and determine its characteristics. Following that, a modified version of the Community Innovation Survey (CIS) was used to determine innovation types introduced by the organization. Then multiple linear regression analysis was used to find out the effects of existing organizational culture on innovation. Results show that existing organizational culture is composed of a combination of Hierarchy (29.4%), Clan (25.8%), Market (24.9%) and Adhocracy (19.9%). Results of the second survey show that the organization focuses on organizational innovation (26.8%) followed by market and product innovations (25.6%) and finally process innovation (22.0%). Regression analysis results reveal that for each innovation type there is a recommended combination of the four culture types. For product innovation, the combination is 47.4% Clan, 17.9% Adhocracy, 1.0% Market and 33.3% Hierarchy; for process innovation it is 19.7% Clan, 45.2% Adhocracy, 32.0% Market and 3.1% Hierarchy; for organizational innovation the combination is 5.4% Clan, 32.7% Adhocracy, 6.0% Market and 55.9% Hierarchy; and for market innovation it is 25.5% Clan, 42.6% Adhocracy, 32.6% Market and 8.4% Hierarchy. Based on these recommended combinations, this study suggests two ways to enhance the innovation culture in the organization. First, if the management decides on the innovation type to be enhanced, a comparison between the existing culture and the recommended combination of selected innovation types will lead to difference in percentages of each culture type. Then further analysis should show how to modify the existing culture to match the recommended combination. Second, if the innovation type is not selected, but the management wants to enhance innovation culture in the organization, the difference in percentages of each culture type will lead to finding out the recommended combination of culture types that gives the narrowest gap between existing culture and recommended combination.

Keywords: developing countries, organizational culture, innovation types, product innovation, process innovation, organizational innovation, marketing innovation

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Authors: Nadine Ponnusamy

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Reducing risks to food security resulting from climate change is recognized as one of the major challenges of the 21st century. The risks to food security have intensified, primarily due to globalization, a growing population, rapid urbanization, and the constantly evolving urban environment. One of the key challenges facing cities is the need to supply sufficient food to households amid increasing demand, which necessitates a continuous effort to enhance food production. Given the severity of climate change, it is imperative to adopt solutions to address food insecurity. Communities and individuals must explore sustainable livelihood options that do not harm the environment. Urban agriculture represents one of the many strategies that can be employed to improve household food security. The objective of this research is to establish the extent to which community gardens can enhance urban food security, focusing on the Thulubukele Community Farm in Newlands West, Durban. The researcher utilized a qualitative case study approach to gain insight into urban agriculture and food security within this context, while also examining the long-term impacts on food security and community development. The sampling method utilized for selecting participants and gathering information included purposive sampling. Since the study centers on urban agriculture, key stakeholders were specifically targeted. Participants were selected for interviews based on their involvement in the food garden. In-depth interviews were conducted to collect and analyze data. Secondary data from the literature facilitated a comparative analysis of similar case studies through precedent studies. This study demonstrates that growing food not only improves the nutritional value of the produce but also enhances household food security, enables individuals to generate disposable income, and facilitates significant contributions to the local community and other organizations in need.

Keywords: community gardens, food security, South Africa, urban agriculture

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Authors: Ching-Ling Lin, Li-Chi Huang, Yao-Tsung Chang, Ruey-Yu Chen, Shwu-Huey Yang

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Introduction & Purpose: Diabetes and its related complications always been a major part of medical cost in Taiwan. To patient with diabetes, self-management blood sugar, improving a healthy lifestyle are the most important thing to avoid getting worse. The aim of this study was to explore the trend of the changing in blood glucose within intervention and followed-up periods of patients who participated in the health coaching program between 2017 and 2020. Design & Methods: The data was combined from two diabetes health coaching program. The intervention group had health coaching and usual care for 6 months, whereas the control had usual care only. The main outcome variables were HbA1c level at baseline, 3, 6, 9, and 12 months. Results: In total, the data were available for 99 patients in the coaching intervention group and for 88 patients in the control group, the dropout rate during the follow-up period is about 18%. Of 187 participants, 54% were female, mean age was 61.5 years (SD=10.19), only 32.1% had a bachelor’s degree or higher, and the mean duration of diabetes treatment at Cathay General Hospital was 9.9 years. Within 12 months, the intervention group had a significant decrease of 0.65% (SD=1.05) in HbA1c level, and a non-significant decrease of 0.13%(SD=0.96) was observed in the control group. The figure showed the effect was the most significant in the first three months of the intervention and can be maintained for up to six months after the intervention was over. The HbA1c values of the two groups at each follow-up point are significantly different. In addition, there were non-significant correlation between HbA1c and gender, age, and educational level. Conclusion: Health coaching might be an effective way to enhance self-management for patients with diabetes and improving their blood sugar control in Taiwan.

Keywords: diabetes, health coaching, HbA1c, self-management

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Authors: Moiseenko F. V., Volkov N. M., Zhabina A. S., Stepanova E. O., Kirillov A. V., Myslik A. V., Artemieva E. V., Agranov I. R., Oganesyan A. P., Egorenkov V. V., Abduloeva N. H., Aleksakhina S. Yu., Ivantsov A. O., Kuligina E. S., Imyanitov E. N., Moiseyenko V. M.

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Analysis of ctDNA in patients with NSCLC is an emerging biomarker. Multiple research efforts of quantitative or at least qualitative analysis before and during the first periods of treatment with TKI showed the prognostic value of ctDNA clearance. Still, these important results are not incorporated in clinical standards. We evaluated the role of ctDNA in EGFR-mutated NSCLC receiving first-line TKI. Firstly, we analyzed sequential plasma samples from 30 patients that were collected before intake of the first tablet (at baseline) and at 6, 12, 24, 36, and 48 hours after the “starting point.” EGFR-M+ allele was measured by ddPCR. Afterward, we included sequential qualitative analysis of ctDNA with cobas® EGFR Mutation Test v2 from 99 NSCLC patients before the first dose, after 2 and 4 months of treatment, and on progression. Early response analysis showed the decline of EGFR-M+ level in plasma within the first 48 hours of treatment in 11 subjects. All these patients showed objective tumor response. 10 patients showed either elevation of EGFR-M+ plasma concentration (n = 5) or stable content of circulating EGFR-M+ after the start of the therapy (n = 5); only 3 of these patients achieved an objective response (p = 0.026) when compared to the former group). The rapid decline of plasma EGFR-M+ DNA concentration also predicted for longer PFS (13.7 vs. 11.4 months, p = 0.030). Long-term ctDNA monitoring showed clinically significant heterogeneity of EGFR-mutated NSCLC treated with 1st line TKIs in terms of progression-free and overall survival. Patients without detectable ctDNA at baseline (N = 32) possess the best prognosis on the duration of treatment (PFS: 24.07 [16.8-31.3] and OS: 56.2 [21.8-90.7] months). Those who achieve clearance after two months of TKI (N = 42) have indistinguishably good PFS (19.0 [13.7 – 24.2]). Individuals who retain ctDNA after 2 months (N = 25) have the worst prognosis (PFS: 10.3 [7.0 – 13.5], p = 0.000). 9/25 patients did not develop ctDNA clearance at 4 months with no statistical difference in PFS from those without clearance at 2 months. Prognostic heterogeneity of EGFR-mutated NSCLC should be taken into consideration in planning further clinical trials and optimizing the outcomes of patients.

Keywords: NSCLC, EGFR, targeted therapy, ctDNA, prognosis

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Authors: Imran Dayan, Ashiqul Khan

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Internal corporate fraud, which is fraud carried out by internal stakeholders of a company, affects the well-being of the organisation just like its external counterpart. Even if such an act is carried out for the short-term benefit of a corporation, the act is ultimately harmful to the entity in the long run. Internal fraud is often carried out by relying upon aberrations from usual business processes. Business processes are the lifeblood of a company in modern managerial context. Such processes are developed and fine-tuned over time as a corporation grows through its life stages. Modern corporations have embraced technological innovations into their business processes, and Enterprise Resource Planning (ERP) systems being at the heart of such business processes is a testimony to that. Since ERP systems record a huge amount of data in their event logs, the logs are a treasure trove for anyone trying to detect any sort of fraudulent activities hidden within the day-to-day business operations and processes. This research utilises the ERP systems in place within corporations to assess the likelihood of prospective internal fraud through developing a framework for measuring the risks of fraud through Process Mining techniques and hence finds risky designs and loose ends within these business processes. This framework helps not only in identifying existing cases of fraud in the records of the event log, but also signals the overall riskiness of certain business processes, and hence draws attention for carrying out a redesign of such processes to reduce the chance of future internal fraud while improving internal control within the organisation. The research adds value by applying the concepts of Process Mining into the analysis of data from modern day applications of business process records, which is the ERP event logs, and develops a framework that should be useful to internal stakeholders for strengthening internal control as well as provide external auditors with a tool of use in case of suspicion. The research proves its usefulness through a few case studies conducted with respect to big corporations with complex business processes and an ERP in place.

Keywords: enterprise resource planning, fraud risk framework, internal corporate fraud, process mining

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Authors: Victor N. Anisimov, Igor E. Serov, Ksenia M. Kolkova, Natalia V. Galkina

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The problem of memorability of the advertising content is closely connected with the key issues of neuromarketing. The memorability of the advertising content contributes to the marketing effectiveness of the promoted product. Significant directions of studying the phenomenon of memorability are the memorability of the brand (detected through the memorability of the logo) and the memorability of the product offer (detected through the memorization of dynamic audiovisual advertising content - commercial). The aim of this work is to reveal the predictors of memorization of static and dynamic audiovisual stimuli (logos and commercials). An important direction of the research was revealing differences in psychophysiological correlates of memorability between static and dynamic audiovisual stimuli. We assumed that static and dynamic images are perceived in different ways and may have a difference in the memorization process. Objective methods of recording psychophysiological parameters while watching static and dynamic audiovisual materials are well suited to achieve the aim. The electroencephalography (EEG) method was performed with the aim of identifying correlates of the memorability of various stimuli in the electrical activity of the cerebral cortex. All stimuli (in the groups of statics and dynamics separately) were divided into 2 groups – remembered and not remembered based on the results of the questioning method. The questionnaires were filled out by survey participants after viewing the stimuli not immediately, but after a time interval (for detecting stimuli recorded through long-term memorization). Using statistical method, we developed the classifier (statistical model) that predicts which group (remembered or not remembered) stimuli gets, based on psychophysiological perception. The result of the statistical model was compared with the results of the questionnaire. Conclusions: Predictors of the memorability of static and dynamic stimuli have been identified, which allows prediction of which stimuli will have a higher probability of remembering. Further developments of this study will be the creation of stimulus memory model with the possibility of recognizing the stimulus as previously seen or new. Thus, in the process of remembering the stimulus, it is planned to take into account the stimulus recognition factor, which is one of the most important tasks for neuromarketing.

Keywords: memory, commercials, neuromarketing, EEG, branding

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Authors: Marica Pidor-Quingco, Francis Cabatingan

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Background: One of the essential roles of a physician is to assess a patient’s worth and support them in making decisions regarding their future preferences when it comes to medical care. Advance Directives is a patient-centered approach which is liked to a better-quality treatment at the end of life. General Objective: To assess and describe the knowledge, attitudes and practices of resident physicians regarding advance directive among the resident physicians in Vicente Sotto Memorial Medical Study. Methods: An analytical cross-sectional study was conducted at Vicente Sotto Memorial Medical Center. There was a total of 129 respondents who gave their consent and was given survey questionnaire containing the demographic profile, knowledge, attitude and practices. Categorical variables were presented as frequency and percentage. Chi Square Test was used to determine the association of demographic profile with knowledge and attitude. Man-Whitney U test was utilized for the association of age with knowledge and attitude. Results: Out of 129 respondents, 36.59% were in favor towards self-determination and autonomy. Majority of the revealed an adequate knowledge and positive attitude regarding advance directives. Based on the results, there were no significant correlations between sociodemographic of the residents towards to knowledge and attitude. Over 66.7% of the respondents had used Advance Directives to their patients but 25% were not comfortable about it. Though most of the respondents was able to discuss AD with their patients, 7.0% of them are not willing to open the topic to the family. Conclusion: VSMMC is a tertiary hospital which also caters Hospice, Palliative and Supportive care to the patients. One of the services offered is initiating Advance Directives which may be a factor for a positive knowledge, attitude and practices towards this topic.

Keywords: advance directives, philippines, physicians, palliative

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Authors: Fariha Salman, Helmet Steinberg, Hiba Al-Zubeidi

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OBJECTIVE: Polycystic ovary syndrome (PCOS) is the most common cause of infertility, with a prevalence of 5-10 % in women of reproductive age. There is evidence for differences between adult and pediatric endocrinologists and other specialists in their approach to the diagnosis and management of PCOS. METHODS: A survey consisting of 37 questions was distributed among adult and pediatric endocrinologists, aiming to understand the current practice for the diagnosis and management of PCOS. A total of 100 responses were available for final analysis; 36 % from adult endocrinologists (AE) and 64 % from pediatric endocrinologists(PE). RESULTS: The majority (64%) of respondents to the survey were endocrinologists from a multispecialty group. For both adults and adolescents with PCOS, the most commonly reported presenting symptoms were menstrual irregularities, obesity and hirsutism. The most common features used for diagnostic criteria were clinical or biochemical hyperandrogenism and ovulatory dysfunction. Most AE and PE screened for PCOS with total testosterone (83%) and free Testosterone (71%), screening for prolactin excess in 70 % and congenital adrenal hyperplasia (83 %), 66 % of AE will obtain pelvic US for evaluation vs 45 % of PE. Only 20 % of all respondents will obtain a midluteal progesterone for documentation of anovulation. In terms of treatment of hyperandrogenism and menstrual irregularities in adolescents, the most common form used is oral contraceptive pills, followed by metformin, then spironolactone. A similar approach was used in adults however the use of spironolactone was higher, 53 % vs 21 % in adolescents. The most common modality used for infertility was lifestyle interventions followed by metformin and clomiphene citrate. Screening of OSA and depression was not done by most of the endocrinologists (never + sometimes), 72 % and 76 %, respectively. Though screening for diabetes/metabolic syndrome and insulin resistance was done by most of the endocrinologists (always+often), 95 and 68 %, respectively. DISCUSSION: There are multiple diagnostic criteria used for PCOS diagnosis, however, given the wide variation in presentation and approach to diagnosis in adults and adolescents, there has not been a consensus on which is the gold standard criteria. CONCLUSION: Our survey showed the most common trends in diagnosing and treating PCOS among adult and pediatric endocrinologists. Further studies and trials need to be conducted to compare different treatment modalities used for hyperandrogenism, menstrual irregularities and infertility, as PCOS, if not treated earlier, can lead to long-term complications.

Keywords: PCOS, adolescents, diagnosis, treatment

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Authors: Ugoh Kelechi Melford, Anene O.

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Introduction: Evidence has shown that there are increasing rates of new HIV and other STI infections occurring among Men who have Sex with Men (MSM) in Nigeria, with the prevalence 3 times higher than the general population as reported by the 2011 National Integrated Bio Behavioral Surveillance Survey. The poor state of health care and support services hinders our effort to control the high rates of these new infections among MSM. Methods: The Initiative for Improved Male Health (IMH-Initiative) works to provide a safe space for young MSM living with HIV to access comprehensive palliative care and support, as well as referrals for other services through drama and dance competitions. An STI assessment was conducted in IMH-Initiative’s Community Center in Calabar, for gay men and other MSM. An STI history was conducted for all clients who visited the community clinic specifically for HCT and STI counseling and referrals within a 5 month period, and their data were collated. Results: 61 MSM were diagnosed, and reported the following in the last 6 months. 49 where living with HIV. 46 had previous histories of untreated anal warts. 20 had previous histories of treated Gonorrhea by self-medication and herbs. 21 had untreated boils and rashes around the genitals. 10 clients where living with HIV, and reported untreated penile and rectal gonorrhea. All clients indicated that there were not comfortable discussing STI infections with staff of public hospitals. Conclusion: It is evident that a reasonable number of STI infections among MSM are not completely treated or ignored. This thereby increases the individual’s risk of HIV infection, and cripples HIV prevention programming in Nigeria. HIV programs targeting MSM must incorporate STI syndromic management, so as to increase access to non-stigmatized diagnosis and treatment of STIs. Also, access to STI drugs for clients cannot be overemphasized.

Keywords: MSM, IBBSS, STI, IMH

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