Search results for: federal rule of evidence

Authors: Shoaib Rasool

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Migration trends in rural areas of Gujrat are increasing day by day among illiterate people as they consider it as a source of attraction and charm of destination. It affects the life standard both positive and negative way to their families left behind in the context of poverty, socio-economic status and life standards. It also promotes material items and as well as social indicators of living, housing conditions, schooling of their children’s, health seeking behavior and to some extent their family environment. The nature of the present study is to analyze socio-economic conditions regarding life standard of emigrant families left behind in rural areas of Gujrat district, Pakistan. A survey design was used on 150 families selected from rural areas of Gujrat districts through purposive sampling technique. A well-structured questionnaire was administered by the researcher to explore the nature of the study and for further data collection process. The measurement tool was pretested on 20 families to check the workability and reliability before the actual data collection. Statistical tests were applied to draw results and conclusion. The preliminary findings of the study show that emigration has left deep social-economic impacts on life standards of rural families left behind in Gujrat. They improved their life status and living standard through remittances. Emigration is one of the major sources of development of economy of household and it also alleviate poverty at house household level as well as community and country level. The rationale behind migration varies individually and geographically. There are popular considered attractions in Pakistan includes securing high status, improvement in health condition, coping other, getting married then to acquire nationality, using the unfair means, opting educational visas etc. Emigrants are not only sending remittances but also returning with newly acquired skills and valuable knowledge to their country of origin because emigrants learn new methods of living and working. There are also women migrants who experience social downward mobility by engaging in jobs that are beneath their educational qualifications.

Keywords: emigration, life standard, families, left behind, rural area, Gujrat

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Authors: Morteza Rahbar Taramsari, Arya Mahdavi Baramchi, Mercedeh Enshaei, Ghazaleh Keshavarzi Baramchi

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Introduction: Malingering is one of the most challenging issues in the forensic psychology and imposes a heavy financial burden on health care and legal systems. It seems that some mental and personality abnormalities might have a crucial role in developing this condition. Materials and Methods: In this cross-sectional study, we aimed to assess 100 malingering clients of Gilan province general office of forensic medicine, all filled the related questionnaires. The data about some psychometric characteristics were collected through the 71-items version- short form- of Minnesota Multiphasic Personality Inventory (MMPI) questionnaire and the personality traits were assessed by NEO Personality Inventory-Revised (NEO PI-R) - including 240 items- as a reliable and accurate measure of the five domains of personality. Results: The 100 malingering clients (55 males and 45 females) ranged from 23 to 45 (32+/- 5.6) years old. Regarding marital status, 36% were single, 57% were married and 7% were divorced. Almost two-thirds of the participants (64%) were unemployed, 21% were self-employed and the rest of them were employed. The data of MMPI clinical scales revealed that the mean (SD) T score of Hypochondrias (Hs) was 67(9.2), Depression (D) was 87(7.9), Hysteria (Hy) was 74(5.8), Psychopathic Deviate (Pd) was 62(8.5), Masculinity-Feminity (MF) was 76(8.4), Paranoia (Pa) was 62(4.5), Psychasthenia (Pt) was 80(7.9), Schizophrenia (Sc) was 69(6.8), Hypomania (Ma) was 64(5.9)and Social Introversion (Si) was 58(4.3). NEO PI-R test showed five domains of personality. The mean (SD) T score of Neuroticism was 65(9.2), Extraversion was 51(7.9), Openness was 43(5.8), Agreeableness was 35(3.4) and Conscientiousness was 42(4.9). Conclusion: According to MMPI test in our malingering clients, Hypochondriasis (Hs), depression (D), Hysteria (Hy), Muscularity-Feminity (MF), Psychasthenia (Pt) and Schizophrenia (Sc) had high scores (T >= 65) which means pathological range and psychological significance. Based on NEO PI-R test Neuroticism was in high range, on the other hand, Openness, Agreeableness, and Conscientiousness were in low range. Extroversion was in average range. So it seems that malingerers require basic evaluations of different psychological fields. Additional research in this area is needed to provide stronger evidence of the possible positive effects of the mentioned factors on malingering.

Keywords: malingerers, mental profile, MMPI, NEO PI-R, personality profile

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Authors: Panagiota A. Kotsoni, George S. Ypsilandis

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Learning an L2 is a demanding process for all students and in particular for those with learning disabilities (LD) who demonstrate an inability to catch up with their classmates’ progress in a given period of time. This area of study, i.e. examining children with learning disabilities in L2 has not (yet) attracted the growing interest that is registered in L1 and thus remains comparatively neglected. It is this scientific field that this study wishes to contribute to. The longitudinal purpose of this study is to locate effective Supportive Feedback Strategies (SFS) and add to the quality of learning in second language vocabulary in both typically developing (TD) and LD children. Specifically, this study aims at investigating and comparing the performance of TD with LD children on two different types of SFSs related to vocabulary short and long-term retention. In this study two different SFSs have been examined to a total of ten (10) unknown vocabulary items. Both strategies provided morphosyntactic clarifications upon new contextualized vocabulary items. The traditional SFS (direct) provided the information only in one hypertext page with a selection on the relevant item. The experimental SFS (engaging) provided the exact same split information in three successive hypertext pages in the form of a hybrid dialogue asking from the subjects to move on to the next page by selecting the relevant link. It was hypothesized that this way the subjects would engage in their own learning process by actively asking for more information which would further lead to their better retention. The participants were fifty-two (52) foreign language learners (33 TD and 19 LD) aged from 9 to 12, attending an English language school at the level of A1 (CEFR). The design of the study followed a typical pre-post-post test procedure after an hour and after a week. The results indicated statistically significant group differences with TD children performing significantly better than the LD group in both short and long-term memory measurements and in both SFSs. As regards the effectiveness of one SFS over another the initial hypothesis was not supported by the evidence as the traditional SFS was more effective compared to the experimental one in both TD and LD children. This difference proved to be statistically significant only in the long-term memory measurement and only in the TD group. It may be concluded that the human brain seems to adapt to different SFS although it shows a small preference when information is provided in a direct manner.

Keywords: learning disabilities, memory, second/foreign language acquisition, supportive feedback

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Authors: Liaquat Ali, Khurshid Natasha

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Low resource countries are not usually equipped with the organizational tools to implement health care for chronic diseases, and thus, providing effective diabetes care in such countries is a challenging task. Diabetic Association of Bangladesh (BADAS in Bengali acronym) has created a stimulating example to meet this challenge. Starting its journey in 1956 with 39 patients in a small tin shed clinic BADAS, and its affiliated associations now operate 90 hospitals and health centres all over the country. Together, these facilities provide integrated health care to about 1.5 million registered diabetic patients which constitute about 20% of the estimated diabetic population in the country. BADAS has also become a pioneer in health manpower generation in Bangladesh. Along with its affiliates, it now runs 3 Medical Colleges (to generate graduate physicians), 2 Nursing Institutes, and 2 Postgraduate Institutes which conduct 25 postgraduate courses (under the University of Dhaka) in various basic, clinical and public health disciplines. BADAS gives great emphasis on research, which encompasses basic, clinical as well as public health areas. BADAS is an ideal example of public-private partnership in health as most of its infrastructure has been created through government support but it is almost self-reliant in managing its revenue budget which approached approximately 40 million US dollar during 2010. BADAS raises resources by providing high-quality services to the people, both diabetic and non-diabetic. At the same time, BADAS has developed a cross financing model, to support diabetic patients in general and poor diabetic patients (identified through a social welfare network) in particular, through redistribution of the resources. Along with financial sustainability BADAS ensure organizational sustainability through a process of decentralization, community ownership, and democratic management. Presently a large scale pilot project (named as a Health Care Development Project or HCDP) is under implementation under BADAS umbrella with an objective to transform the diabetes care model to a health care model in general. It is expected to create further evidence on providing sustainable (with social safety net) health care delivery for diabetes, and other chronic illnesses as an integral part of general health care delivery in a resource constrained setting.

Keywords: Bangladesh, self sustain, health care, constrain

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Authors: Kate Duggan

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Introduction: Functional Communication Training (FCT) is an approach which aims to reduce behaviours of concern by teaching more effective ways to communicate. It requires identification of the function of the behaviour of concern, through gathering information from key stakeholders and completing observations of the individual’s behaviour including antecedents to, and consequences of the behaviour. Appropriate communicative alternatives are then identified and taught to the individual using systematic instruction techniques. Behaviours of concern demonstrated by individuals with autism spectrum conditions (ASC) frequently have a communication function. When contributing to positive behavior support plans, speech and language therapists and other professionals working with individuals with ASC need to identify alternative communicative behaviours which are equally reinforcing as the existing behaviours of concern. Successful implementation of FCT is dependent on an effective ‘response match’. The new way of communicating must be equally as effective as the behaviour previously used and require the same amount or less effort from the individual. It must also be understood by the communication partners the individual encounters and be appropriate to their communicative contexts. Method: Four case studies within a non-maintained special school environment were described and analysed. A response match framework was used to identify the effectiveness of functional communication training delivered by the student’s speech and language therapist, teacher and learning support assistants. The success of systematic instruction techniques used to develop new communicative behaviours was evaluated using the CODES framework. Findings: Functional communication training can be used as part of a positive behaviour support approach for students within this setting. All case studies reviewed demonstrated ‘response success’, in that the desired response was gained from the new communicative behaviour. Barriers to the successful embedding of new communicative behaviours were encountered. In some instances, the new communicative behaviour could not be consistently understood across all communication partners which reduced ‘response recognisability’. There was also evidence of increased physical or cognitive difficulty in employing the new communicative behaviour which reduced the ‘response effectivity’. Successful use of ‘thinning schedules of reinforcement’, taught students to tolerate a delay to reinforcement once the new communication behaviour was learned.

Keywords: augmentative and alternative communication, autism spectrum conditions, behaviours of concern, functional communication training

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Authors: Rendong Cai, Bei Peng, Yanping Dong

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In risk decision making, individuals are found to be susceptible to 'frames': people tend to be risk averse when the choice is described in terms of potential 'gains' (gain frame), whereas they tend to be risk seeking when the same choice is described in terms of potential 'losses' (loss frame); this effect is termed the framing effect. The framing effect has been well documented and some studies even find a developmental reversal in the framing effect: The more experience an individual has in a certain field, the easier for him to be influenced by the frame relevant to the field, resulting in greater decision inconsistency. Recent studies reported that using a foreign language can reduce the framing effect. However, it is not clear whether foreign language use can overcome the developmental reversal in the framing effect. The present study investigated three potential factors that may influence the developmental reversal in the framing effect: specialized knowledge of the participants, the language in which the problem is presented, and the types of problems. The present study examined the decision making behavior of 188 Chinese-English bilinguals who majored in Finance, with a group of 277 English majors as the control group. They were asked to solve a financial problem (experimental condition) and a life problem (control condition). Each problem was presented in one of the following four versions: native language-gain frame, foreign language-gain frame, native language-loss frame, and foreign language-loss frame. Results revealed that for the life problem, under the native condition, both groups were affected by the frame; but under the foreign condition, this framing effect disappeared for the financial majors. This confirmed that foreign language use modulates framing effects in general decision making, which served as an effective baseline. For the financial problem, under the native condition, only the financial major was observed to be influenced by the frame, which was a developmental reversal; under the foreign condition, however, this framing effect disappeared. The results provide further empirical evidence for the universal of the developmental reversal in risky decision making. More importantly, the results suggest that using a foreign language can overcome such reversal, which has implications for the reduction of decision biases in professionals. The findings also shed new light on the complex interaction between general decision-making and bilingualism.

Keywords: the foreign language effect, developmental reversals, the framing effect, bilingualism

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Authors: Deborah L. Smith

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To review our program and determine the best redesign options, department members gathered feedback and input through focus groups, analysis of data, and a review of the current research to ensure that the changes proposed were not based solely on the state’s new professional standards. In designing course assignments and assessments, we listened to a variety of constituents, including students, other institutions of higher learning, MDE webinars, host teachers, literacy clinic personnel, and other disciplinary experts. As a result, we are designing a program that is more inclusive of a variety of field experiences for growth. We have determined ways to improve our program by connecting academic disciplinary knowledge, educational psychology, and community building both inside and outside the classroom for professional learning communities. The state’s release of new professional standards led my department members to question what is working and what needs improvement in our program. One aspect of our program that continues to be supported by research and data analysis is the function of supervised field experiences with meaningful feedback. We seek to expand in this area. Other data indicate that we have strengths in modeling a variety of approaches such as cooperative learning, discussions, literacy strategies, and workshops. In the new program, field assignments will be connected to multiple courses, and efforts to scaffold student learning to guide them toward best evidence-based practices will be continuous. Despite running a program that meets multiple sets of standards, there are areas of need that we directly address in our redesign proposal. Technology is ever-changing, so it’s inevitable that improving digital skills is a focus. In addition, scaffolding procedures for English Language Learners (ELL) or other students who struggle is imperative. Diversity, equity, and inclusion (DEI) has been an integral part of our curriculum, but the research indicates that more self-reflection and a deeper understanding of culturally relevant practices would help the program improve. Connections with professional learning communities will be expanded, as will leadership components, so that teacher candidates understand their role in changing the face of education. A pilot program will run in academic year 22/23, and additional data will be collected each semester through evaluations and continued program review.

Keywords: DEI, field experiences, program redesign, teacher preparation

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Authors: Atiwat Khatpibunchai, Taweesak Kritjaroen

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A social enterprise is the innovative hybrid organizations where its ultimate goal is to generate revenue and use it as a fund to solve the social and environmental problem. Although the evidence shows the clear value of economic, social and environmental aspects, the limitations of most of the social enterprises are the expanding impact of social and environmental aspects through the normal market mechanism. This is because the major sources of revenues of social enterprises derive from the business advocates who merely wish to support society and environment by using products and services of social enterprises rather than expect the satisfaction and the distinctive advantage of products and services. Thus, social enterprises cannot reach the achievement as other businesses do. The relevant concepts from the literature review revealed that dynamic capability is the ability to sense, integrate and reconfigure internal resources and utilize external resources to adapt to changing environments, create innovation and achieve competitive advantage. The objective of this research is to study the influence of dynamic capability that affects competitive advantage and sustainable performance, as well as to determine important elements of dynamic capability. The researchers developed a conceptual model from the related concepts and theories of dynamic capability. A conceptual model will support and show the influence of dynamic capability on competitive advantage and sustainable performance of social enterprises. The 230 organizations in South-East Asia served as participants in this study. The results of the study were analyzed by the structural equation model (SEM) and it was indicated that research model is consistent with empirical research. The results also demonstrated that dynamic capability has a direct and indirect influence on competitive advantage and sustainable performance. Moreover, it can be summarized that dynamic capability consists of the five elements: 1) the ability to sense an opportunity; 2) the ability to seize an opportunity; 3) the ability to integrate resources; 4) the ability to absorb resources; 5) the ability to create innovation. The study recommends that related sectors can use this study as a guideline to support and promote social enterprises. The focus should be pointed to the important elements of dynamic capability that are the development of the ability to transform existing resources in the organization and the ability to seize opportunity from changing market.

Keywords: dynamic capability, social enterprise, sustainable competitive advantage, sustainable performance

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Authors: Godfrey Nsereko, Daniel Kadobera, Denis Okethwangu, Joyce Nguna, Alex Riolexus Ario

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Background: Malaria is a leading cause of morbidity and mortality in Uganda. In April 2018, malaria cases surged in Nwoya District, northern Uganda, exceeding the action thresholds. We investigated to assess the outbreak’s magnitude, identify transmission risk factors, and recommend evidence-based control measures. Methods: We defined a malaria case as onset of fever in a resident of Nwoya District with a positive Rapid Diagnostic Test or microscopy for malaria P. falciparum from 1 February to 22 May 2018. We reviewed medical records in all health facilities of affected sub-counties to find cases. In a case-control study, we compared exposure risk factors between 107 case-persons and 107 asymptomatic controls matched by age and village. We conducted entomological assessment on vector-density and behavior. Results: We identified 3,879 case-persons (attack rate [AR]=6.5%) and 2 deaths (case-fatality rate=5.2/10,000). Females (AR=8.1%) were more affected than males (AR=4.7%). Of all age groups, the 5-18 year age group (AR=8.4%) was most affected. Heavy rain started on 4 March; a propagated outbreak began during the week of 2 April. In the case-control study, 55% (59/107) of case-patients and 18% (19/107) of controls had stagnant water around households for several days following rainfall (ORM-H=5.6, 95%CI=3.0-11); 25% (27/107) of case-patients and 51% (55/107) of controls wore long-sleeve cloths during evening hours (ORM-H=0.30, 95%CI=0.20-0.60); 29% (31/107) of case-patients and 15% (16/107) of controls did not sleep under a long-lasting insecticide-treated net (LLIN) (ORM-H=2.3, 95%CI=1.1-4.9); 37% (40/107) of case-patients and 52% (56/107) of controls had ≥1 LLIN per 2 household members (ORM-H=0.54, 95%CI=0.30-0.97). Entomological assessment indicated active breeding sites; Anopheles gambiae sensu lato species were the predominant vector. Conclusion: Increased vector breeding sites after heavy rainfall, together with inadequate malaria preventive measures caused this outbreak. We recommended increasing coverage for LLINs and larviciding breeding sites.

Keywords: malaria outbreak, Plasmodium falciparum, global health security, Uganda

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Authors: Raphael Udeh, Luis García De Guadiana Romualdo, Xenia Dolje-Gore

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Background: Quite disturbing is the huge public health impact of COVID-19: As at today [25th March 2021, the COVID-19 global burden shows over 123 million cases and over 2.7 million deaths worldwide. Rationale: Recent evidence shows calprotectin’s potential as a therapeutic target, stating that tasquinimod, from the Quinoline-3-Carboxamide family is capable of blocking the interaction between calprotectin and TLR4. Hence preventing the cytokine release syndrome, that heralds the functional exhaustion in COVID-19. Early preclinical studies showed that tasquinimod inhibit tumor growth and prevent angiogenesis/cytokine storm. Phase I – III clinical studies in prostate cancer showed it has a good safety profile with good radiologic progression free survival but no effect on overall survival. Rationale/hypothesis: Strategic endeavors have been amplified globally to assess new therapeutic interventions for COVID-19 management – thus the clinical and antiviral efficacy of tasquinimod in COVID-19 remains to be explored. Hence the primary objective of this trial will be to evaluate the efficacy of tasquinimod in the treatment of adult patients with severe COVID-19 infections. Therefore, I hypothesise that among adults with COVID19 infection, tasquinimod will reduce the severe respiratory distress associated with COVID-19 compared to placebo, over a 28-day study period. Method: The setting is in Europe. Design – a randomized, placebo-controlled, phase II double-blinded trial. Trial lasts for 28 days from randomization, Tasquinimod capsule given as 0.5mg daily 1st fortnight, then 1mg daily 2nd fortnight. I0 outcome - assessed using six-point ordinal scale alongside eight 20 outcomes. 125 participants to be enrolled, data collection at baseline and subsequent data points, and safety reporting monitored via serological profile. Significance: This work could potentially establish tasquinimod as an effective and safe therapeutic agent for COVID-19 by reducing the severe respiratory distress, related time to recovery, time on oxygen/admission. It will also drive future research – as in larger multi-centre RCT.

Keywords: Calprotectin, COVID-19, Phase II Trial, Tasquinimod

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Authors: Claudia Carbajal, Jija Dutt, Smriti Pahwa, Sumukhi Vaid, Karishma Vats

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ASER Centre, the research and assessment arm of Pratham Education Foundation sees measurement as the first stage of action. ASER uses primary research to push and give empirical foundations to policy discussions at a multitude of levels. At a household level, common citizens use a simple assessment (a floor-level test) to measure learning across rural India. This paper presents the evidence on the applicability of an ASER approach to the health sector. A citizen-led assessment was designed and executed that collected information from young mothers with children up to a year of age. The pilot assessments were rolled-out in two different models: Paid surveyors and student volunteers. The survey covered three geographic areas: 1,239 children in the Jaipur District of Rajasthan, 2,086 in the Rae Bareli District of Uttar Pradesh, and 593 children in the Bhuj Block in Gujarat. The survey tool was designed to study knowledge of health-related issues, daily practices followed by young mothers and access to relevant services and programs. It provides insights on behaviors related to infant and young child feeding practices, child and maternal nutrition and supplementation, water and sanitation, and health services. Moreover, the survey studies the reasons behind behaviors giving policy-makers actionable pathways to improve implementation of social sector programs. Although data on health outcomes are available, this approach could provide a rapid annual assessment of health issues with indicators that are easy to understand and act upon so that measurements do not become an exclusive domain of experts. The results give many insights into early childhood health behaviors and challenges. Around 98% of children are breastfed, and approximately half are not exclusively breastfed (for the first 6 months). Government established diet diversity guidelines are met for less than 1 out of 10 children. Although most households are satisfied with the quality of drinking water, most tested households had contaminated water.

Keywords: citizen-led assessment, rapid health assessment, Infant and Young Children Feeding, water and sanitation, maternal nutrition, supplementation

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Authors: Bharti Jain, Rajeev Jain, Abuzar Kabir, Torki Zughaibi, Shweta Sharma

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Drug-facilitated crimes (DFCs) entail the use of a single drug or a mixture of drugs to render a victim unable. Traditionally, biological samples have been gathered from victims and conducted analysis to establish evidence of drug administration. Nevertheless, the rapid metabolism of various drugs and delays in analysis can impede the identification of such substances. For this, the present article describes a rapid, sustainable, highly efficient and miniaturized protocol for the identification and quantification of three sedative-hypnotic drugs, namely diazepam, chlordiazepoxide and ketamine in alcoholic beverages and complex food samples (cream of biscuit, flavored milk, juice, cake, tea, sweets and chocolate). The methodology involves utilizing fabric phase sorptive extraction (FPSE) to extract diazepam (DZ), chlordiazepoxide (CDP), and ketamine (KET). Subsequently, the extracted samples are subjected to analysis using gas chromatography-mass spectrometry (GC-MS). Several parameters, including the type of membrane, pH, agitation time and speed, ionic strength, sample volume, elution volume and time, and type of elution solvent, were screened and thoroughly optimized. Sol-gel Carbowax 20M (CW-20M) has demonstrated the most effective extraction efficiency for the target analytes among all evaluated membranes. Under optimal conditions, the method displayed linearity within the range of 0.3–10 µg mL–¹ (or µg g–¹), exhibiting a coefficient of determination (R2) ranging from 0.996–0.999. The limits of detection (LODs) and limits of quantification (LOQs) for liquid samples range between 0.020-0.069 µg mL-¹ and 0.066-0.22 µg mL-¹, respectively. Correspondingly, the LODs for solid samples ranged from 0.056-0.090 µg g-¹, while the LOQs ranged from 0.18-0.29 µg g-¹. Notably, the method showcased better precision, with repeatability and reproducibility both below 5% and 10%, respectively. Furthermore, the FPSE-GC-MS method proved effective in determining diazepam (DZ) in forensic food samples connected to drug-facilitated crimes (DFCs). Additionally, the proposed method underwent evaluation for its whiteness using the RGB12 algorithm.

Keywords: drug facilitated crime, fabric phase sorptive extraction, food forensics, white analytical chemistry

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Authors: Baluku Nathan

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Infection prevention and control (IPC) is a practical, evidence-based approach that prevents patients and emergency health workers from being harmed by avoidable infections as a result of antimicrobial resistance; all hospital infection control programs put together various practices which, when used appropriately, restrict the spread of infection. A breach in these control practices facilitates the transmission of infections from patients to health workers, other patients and attendants. It is, therefore, important for all EMTs and patients to adhere to them strictly. It is also imperative for administrators to ensure the implementation of the infection control program for their facilities. Purpose: The purpose of this study was to investigate the influencing factors of prevention practices against Infection exposure among emergency medical technicians (EMTs) in the emergency department at Mbarara hospital. Methodology: This was a descriptive cross-sectional study that employed a self-reported questionnaire that was filled out by 32 EMTs in the emergency department from 12th February to 3rd march 2022. The questionnaire consisted of items concerning the defensive environment and other Factors influencing Infection prevention and control practices in the accident and emergency department of Mbarara hospital. Results: From the findings, majority16(50%) always used protective gear when doing clinical work,14 (43.8%) didn’t use protective gear, citing they were only assisting those performing resuscitations, gumboots were the least used protective gear with only3(9.4%) usage. Regarding disposal techniques of specific products like blood and sharps, results showed 10 (31.3%) said blood is disposed of in red buckets, 5(15.6%) in yellow buckets and only5(15.6%) in black buckets and 12(37.5%) didn’t respond. However, 28(87.5%) said sharps were disposed of in a sharps container. The majority, 17(53.1%), were not aware of the infection control guidelines even though they were pinned on walls of the emergency rooms,15(46.9%) said they had never had quality assurance monitoring events,14(43.8%) said monitoring was continuous while15(46.9 %) said it was discrete. Conclusions: The infection control practices at the emergency department were inadequate in view of less than 100% of the EMTs observing the five principles of infection prevention, such as the use of personal protective equipment and proper waste disposal in appropriate color-coded bins. Dysfunctional infection prevention and control committees accompanied by inadequate supervision to ensure infection control remained a big challenge.

Keywords: infection prevention, influencing factors, emergency medical technician (EMT), emergency unit

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Authors: Baluku Nathan

Abstract:

Infection prevention and control (IPC) is a practical, evidence-based approach that prevents patients and emergency health workers from being harmed by avoidable infections as a result of antimicrobial resistance; all hospital infection control programs put together various practices which, when used appropriately, restrict the spread of infection. A breach in these control practices facilitates the transmission of infections from patients to health workers, other patients, and attendants. It is, therefore important for all emergency medical technicians (EMTs) and patients to strictly adhere to them. It is also imperative for administrators to ensure the implementation of the infection control programme for their facilities. Purpose: The purpose of this study was to investigate the influencing factors of prevention practices against infection exposure among emergency medical technicians (EMTs) in the emergency department at Mbarara hospital. Methodology: This was a descriptive cross-sectional study that employed a self-reported questionnaire that was filled out by 32 EMTs in the emergency department from 12th February to 3rd march 2022. The questionnaire consisted of items concerning the defensive environment and other factors influencing infection prevention and control practices in the accident and emergency department of Mbarara hospital. Results: From the findings, the majority 16 (50%) always used protective gear when doing clinical work, 14 (43.8%) didn’t use protective gear, citing they were only assisting those performing resuscitations, gumboots were the least used protective gear with only3(9.4%) usage. About disposal techniques of specific products like blood and sharps, results showed 10 (31.3%) said blood is disposed of in red buckets, 5 (15.6%) in yellow buckets, and only 5(15.6%) in black buckets, and 12(37.5%) didn’t respond, however, 28(87.5%) said sharps were disposed of in a sharps container. The majority, 17 (53.1%), were not aware of the infection control guidelines even though they were pinned on walls of the emergency rooms, 15(46.9%) said they have never had quality assurance monitoring events, 14(43.8%) said monitoring was continuous while 15(46.9 %) said it was discrete. Conclusions: The infection control practices at the emergency department were inadequate in view of less than 100% of the EMTs observing the five principles of infection prevention, such as the use of personal protective equipment and proper waste disposal in appropriate color-coded bins. Dysfunctional infection prevention and control committees accompanied by inadequate supervision to ensure infection control remained a big challenge.

Keywords: emergency medical technician, infection prevention, influencing factors, infection control

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Authors: Aleksandra Tomic

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According to reliable sources, 4% of all websites is devoted to pornographic material, yet these estimates are often reported to be much higher. The largest internet pornography streaming website reports 21.2 billion visits in 2015 only. Considering the ubiquity of online pornography and the frequency of use, it is necessary to examine its potential influence on the construal of the sexual act and the roles of participants. Apart from the verbal and physical interactions in the pornographic movies themselves, the language in the titles of movies has the power to frame the sexual intercourse. In this study, Critical Discourse Analysis and corpus linguistics approaches will be used to examine the way the sexual intercourse and the roles of the participants are ideologically construed and perpetuated in the Internet pornography discourse. To this end, the study will explore the association between the specific morphosyntactic aspects of the references to performers of both genders, the person and the thematic role, and the gender of referred performer in the corpus of online pornographic movie titles. Distinctive collexeme analysis will be conducted to uncover possible associations between for gender of the performer denoted by the linguistic expression, and the person and thematic role assigned to it in the titles of online pornography movies. Initial results of the chi-square procedure performed on a sample of 295 online pornography movie titles on the largest pornography streaming website ‘Pornhub’ yielded significant results. The use of the three person categories was not equally distributed between genders, X2 (2, N = 106) = 32.52, p < 0.001, with female performers being referred to in the third person in 71.7% of the instances, and speaking in the first person 20.8% of the time, whereas male performers spoke in the first person 68% of the time, and were referred to in the third person in 17% of the instances. Moreover, there was a gender disparity in the assignment of thematic roles, with linguistic expressions for women being assigned the Patient role and men the Agent role in 58.8% of the cases, whereas the roles were reversed in 41.2% of the instances, X2 (1, N = 262) = 8.07633, p < 0.005. The results are discussed in terms of the ideologies surrounding female and male sexuality in the pornography discourse. Potential patterns of power imbalance, objectification, and discrimination are highlighted. Finally, the evidence from psycholinguistic studies on the influence of the language structure on event construal is related to the results of the study.

Keywords: corpus linguistics, gender studies, pornography, thematic roles

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Authors: S. Maleczek, K. Drabczyk, L. Bogdan, A. Iwan

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It is known that for industrial applications using solar panel constructed from silicon solar cells require high-efficiency performance. One of the main problems in solar panels is different mechanical and structural defects, causing the decrease of generated power. To analyse defects in solar cells, various techniques are used. However, the thermal imaging is fast and simple method for locating defects. The main goal of this work was to analyze defects in constructed flexible silicon photovoltaic modules via thermal imaging and electroluminescence method. This work is realized for the GEKON project (No. GEKON2/O4/268473/23/2016) sponsored by The National Centre for Research and Development and The National Fund for Environmental Protection and Water Management. Thermal behavior was observed using thermographic camera (VIGOcam v50, VIGO System S.A, Poland) using a DC conventional source. Electroluminescence was observed by Steinbeis Center Photovoltaics (Stuttgart, Germany) equipped with a camera, in which there is a Si-CCD, 16 Mpix detector Kodak KAF-16803type. The camera has a typical spectral response in the range 350 - 1100 nm with a maximum QE of 60 % at 550 nm. In our work commercial silicon solar cells with the size 156 × 156 mm were cut for nine parts (called single solar cells) and used to create photovoltaic modules with the size of 160 × 70 cm (containing about 80 single solar cells). Flexible silicon photovoltaic modules on polyamides or polyester fabric were constructed and investigated taking into consideration anomalies on the surface of modules. Thermal imaging provided evidence of visible voltage-activated conduction. In electro-luminescence images, two regions are noticeable: darker, where solar cell is inactive and brighter corresponding with correctly working photovoltaic cells. The electroluminescence method is non-destructive and gives greater resolution of images thereby allowing a more precise evaluation of microcracks of solar cell after lamination process. Our study showed good correlations between defects observed by thermal imaging and electroluminescence. Finally, we can conclude that the thermographic examination of large scale photovoltaic modules allows us the fast, simple and inexpensive localization of defects at the single solar cells and modules. Moreover, thermographic camera was also useful to detection electrical interconnection between single solar cells.

Keywords: electro-luminescence, flexible devices, silicon solar cells, thermal imaging

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Authors: M. Bassas, J. Grané-Morcillo, J. Segura, J.M. Soldevila

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Mental health prevention is key in a society where, according to the World Health Organization, the fourth leading cause of death worldwide is suicide. Compassion is closely linked to personal growth. It shows once again that therapies based on prevention remain an urgent and social need. In this sense, a growing body of research demonstrates how cultivating a compassionate mind can help alleviate and prevent a variety of psychological problems. In the early 21st century, there has been a boom in third-generation compassion-based therapies, although there is a lack of empirical evidence of their efficacy. This study proposes a psychotherapy method (‘Being Method’), whose central axis revolves around emotional management through the cultivation of compassion. Therefore, the objective of this research was to analyze the effectiveness of this method with regard to the emotional changes experienced when we focus on what we are concerned about through the filter of compassion. The Being Method was born from the influence of Buddhist philosophy and contemporary psychology based mainly on Western rationalist currents. A quantitative cross-sectional study has been carried out in a sample of women between 18 and 53 years old (n=47; Mage=36.02; SDage= 11.86) interested in personal growth in which the following 6 measuring instruments were administered: Peace of mind Scale (PoM), Rosenberg Self-Esteem Scale (RSES), Subjective Happiness Scale (SHS), 2 Sacles of the Compassionate Action and Engagement Scales (CAES), Coping Response Inventory for Adults (CRI-A) and Cognitive-Behavioral Strategies Evaluation Scale (MOLDES). Following an experimental method approach, participants were divided into an experimental and control group. Longitudinal analysis was also carried out through a pre-post program comparison. Pre-post comparison outcomes indicated significant differences (p<.05) between before and after the therapy in the variables Peace of Mind, Self-esteem, Happiness, Self-compassion (A-B), Compassion (A-B), in several mental molds, as well as in several coping strategies. Also, between-groups tests proved significantly higher means obtained in the experimental group. Thus, these outcomes highlighted the effectiveness of the therapy, improving all the analyzed dimensions. The social, clinical and research implications are discussed.

Keywords: being method, compassion, effectiveness, emotional management, intervention program, personal growth therapy

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Authors: Seba Mohanty, Jitendra Mahakud

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Capital ratio is one of the major indicators of the stability of the commercial banks. Pertinent to its pervasive importance, over the years the regulators, policy makers focus on the maintenance of the particular level of capital ratio to minimize the solvency and liquidation risk. In this context, it is very much important to identify the relationship between capital and risk and find out the factors which determine the capital ratios of commercial banks. The study examines the relationship between capital and risk of the commercial banks operating in India. Other bank specific variables like bank size, deposit, profitability, non-performing assets, bank liquidity, net interest margin, loan loss reserves, deposits variability and regulatory pressure are also considered for the analysis. The period of study is 1997-2015 i.e. the period of post liberalization. To identify the impact of financial crisis and implementation of Basel II on capital ratio, we have divided the whole period into two sub-periods i.e. 1997-2008 and 2008-2015. This study considers all the three types of commercial banks, i.e. public sector, the private sector and foreign banks, which have continuous data for the whole period. The main sources of data are Prowess data base maintained by centre for monitoring Indian economy (CMIE) and Reserve Bank of India publications. We use simultaneous equation model and more specifically Two Stage Least Square method to find out the relationship between capital and risk. From the econometric analysis, we find that capital and risk affect each other simultaneously, and this is consistent across the time period and across the type of banks. Moreover, regulation has a positive significant impact on the ratio of capital to risk-weighted assets, but no significant impact on the banks risk taking behaviour. Our empirical findings also suggest that size has a negative impact on capital and risk, indicating that larger banks increase their capital less than the other banks supported by the too-big-to-fail hypothesis. This study contributes to the existing body of literature by predicting a strong relationship between capital and risk in an emerging economy, where banking sector plays a majority role for financial development. Further this study may be considered as a primary study to find out the macro economic factors which affecting risk and capital in India.

Keywords: capital, commercial bank, risk, simultaneous equation model

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Authors: Vladyslav Povoroznyuk, Nataliia Dzerovych, Larysa Martynyuk, Tetiana Kovtun

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Obesity and osteoporosis are the two diseases whose increasing prevalence and high impact on the global morbidity and mortality, during the two recent decades, have gained a status of major health threats worldwide. Obesity purports to affect the bone metabolism through complex mechanisms. Debated data on the connection between the bone mineral density and fracture prevalence in the obese patients are widely presented in literature. There is evidence that the correlation of weight and fracture risk is site-specific. The aim of this study was to evaluate the Bone Mineral Density (BMD) and Trabecular Bone Score (TBS) in the obese Ukrainian women. We examined 1025 40-89-year-old women, divided them into the groups according to their body mass index: Group a included 360 women with obesity whose BMI was ≥30 kg/m2, and Group B – 665 women with no obesity and BMI of < 30 kg/m2. The BMD of total body, lumbar spine at the site L1-L4, femur and forearm were measured by DXA (Prodigy, GEHC Lunar, Madison, WI, USA). The TBS of L1-L4 was assessed by means of TBS iNsight® software installed on our DXA machine (product of Med-Imaps, Pessac, France). In general, obese women had a significantly higher BMD of lumbar spine, femoral neck, proximal femur, total body, and ultradistal forearm (p<0.001) in comparison with women without obesity. The TBS of L1-L4 was significantly lower in obese women compared to non-obese women (p<0.001). The BMD of lumbar spine, femoral neck and total body differed to a significant extent in women of 40-49, 50-59, 60-69, and 70-79 years (p<0.05). At same time, in women aged 80-89 years the BMD of lumbar spine (p=0.09), femoral neck (p=0.22) and total body (p=0.06) barely differed. The BMD of ultradistal forearm was significantly higher in women of all age groups (p<0.05). The TBS of L1-L4 in all the age groups tended to reveal the lower parameters in obese women compared with the non-obese; however, those data were not statistically significant. By contrast, a significant positive correlation was observed between the fat mass and the BMD at different sites. The correlation between the fat mass and TBS of L1-L4 was also significant, although negative. Women with vertebral fractures had a significantly lower body weight, body mass index and total body fat mass in comparison with women without vertebral fractures in their anamnesis. In obese women the frequency of vertebral fractures was 27%, while in women without obesity – 57%.

Keywords: obesity, trabecular bone score, bone mineral density, women

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Authors: S. R. Santhanam

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A gifted child is one who gives evidence of creativity, good memory, rapid learning. In mathematics, a teacher often comes across some gifted children and they exhibit the following characteristics: unusual alertness, enjoying solving problems, getting bored on repetitions, self-taught, going beyond what teacher taught, ask probing questions, connecting unconnected concepts, vivid imagination, readiness for research work, perseverance of a topic. There are two main areas of research carried out on them: 1)identifying gifted children, 2) interacting and channelizing them. A lack of appropriate recognition will lead the gifted child demotivated. One of the main findings is if proper attention and nourishment are not given then it leads a gifted child to become depressed, underachieving, fail to reach their full potential and sometimes develop negative attitude towards school and study. After identifying them, a mathematics teacher has to develop them into a fall fledged achiever. The responsibility of the teacher is enormous. The teacher has to be resourceful and patient. But interacting with them one finds a lot of surprises and awesomeness. The elementary algebraic identities like (a+b)(a-b)=a²-b², expansion of like (a+b)²(a-b)² and others are taught to students, of age group 13-15 in India. An average child will be satisfied with a single proof and immediate application of these identities. But a gifted child expects more from the teacher and at one stage after a little training will surpass the teacher also. In this short paper, the author shares his experience regarding teaching algebraic identities to gifted children. The following problem was given to a set of 10 gifted children of the specified age group: If a natural number ‘n’ to expressed as the sum of the two squares, will 2n also be expressed as the sum of two squares? An investigation has been done on what multiples of n satisfying the criterion. The attempts of the gifted children were consolidated and conclusion was drawn. A second problem was given to them as: can two natural numbers be found such that the difference of their square is 3? After a successful solution, more situations were analysed. As a third question, the finding of the sign of an algebraic expression in three variables was analysed. As an example: if a,b,c are real and unequal what will be sign of a²+4b²+9c²-4ab-12bc-6ca? Apart from an expression as a perfect square what other methods can be employed to prove an algebraic expression as positive negative or non negative has been analysed. Expressions like 4x²+2y²+13y²-2xy-4yz-6zx were given, and the children were asked to find the sign of the expression for all real values of x,y and z. In all investigations, only basic algebraic identities were used. As a next probe, a divisibility problem was initiated. When a,b,c are natural numbers such that a+b+c is at least 6, and if a+b+c is divisible by 6 then will 6 divide a³+b³+c³. The gifted children solved it in two different ways.

Keywords: algebraic identities, gifted children, Indian scenario, research

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Authors: Vince Scolaro, Lakshman Prasad, Ted Polley, Sanjivan Deshpande

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The LH Ford Bridge, built in the 1960s, comprises 28 spans, is 800m long and crosses the Macquarie River at Dubbo, NSW. The main bridge spans comprise three spans with a 63m center span (25m drop-in section) supported by halving joints from the main cantilevers and back spans of 28m. The main bridge spans were built using complex construction staging (the first of this type in NSW). They comprise twin precast boxes, in-situ reinforced concrete infills, and cantilevered outriggers stressed both longitudinally and transversely. Since construction, this bridge has undergone significantly increased design vehicle loads and showed signs of excessive shrinkage and creep leading to significant sagging of the centre span with evidence of previous failure and remediation of the halving joints. A comprehensive load rating assessment was undertaken taking account of the original complex construction staging. Deficiencies identified included inadequate capacity of the halving joints, failure of the bearings at the halving joints, inadequate shear capacity of the girder webs and inadequate girder flexural capacity to carry B-Double design vehicles. A unique strengthening system comprising two new piers (under each of the halving joints), new bearings and installation of external prestressing to the soffit of both drop-in-span and back spans was adopted. A portion of the dead load had to be transferred from the superstructure to the new piers via innovative soft/stiff bearing combinations to reduce new locked-in stresses resulting from the new pier supports. Significant temporary works comprised a precast concrete shell beam forming the pile cap/pier structure, addition of a temporary suspended scaffold (without overstressing the existing superstructure) and the installation of jacking stays for new bearing top and bottom plates. This paper presents how this existing historic and socially important bridge was strengthened and updated to increase its design life without the need for replacement.

Keywords: strengthening, creep, construction, box girder

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Authors: Roberto Coppo, Francesca Orso, Daniela Dettori, Elena Quaglino, Lei Nie, Mehran M. Sadeghi, Daniela Taverna

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Malignant melanoma is currently the fifth most common cancer in the white population and it is fatal in its metastatic stage. Several research studies in recent years have provided evidence that cancer initiation and progression are driven by genetic alterations of the tumor and paracrine interactions between tumor and microenvironment. Scattered data show that the Endothelial and Smooth muscle cell-Derived Neuropilin-like molecule (ESDN) controls cell proliferation and movement of stroma and tumor cells. To investigate the role of ESDN in the tumor microenvironment during melanoma progression, murine melanoma cells (B16 or B16-F10) were injected in ESDN knockout mice in order to evaluate how the absence of ESDN in stromal cells could influence melanoma progression. While no effect was found on primary tumor growth, increased cell extravasation and lung metastasis formation was observed in ESDN knockout mice compared to wild type controls. In order to understand how cancer cells cross the endothelial barrier during metastatic dissemination in an ESDN-null microenvironment, structure, and permeability of lung blood vessels were analyzed. Interestingly, ESDN knockout mice showed structurally altered and more permeable vessels compared to wild type animals. Since cell surface molecules mediate the process of tumor cell extravasation, the expression of a panel of extravasation-related ligands and receptors was analyzed. Importantly, modulations of N-cadherin, E-selectin, ICAM-1 and VAP-1 were observed in ESDN knockout endothelial cells, suggesting the presence of a favorable tumor microenvironment which facilitates melanoma cell extravasation and metastasis formation in the absence of ESDN. Furthermore, a potential contribution of immune cells in tumor dissemination was investigated. An increased recruitment of macrophages in the lungs of ESDN knockout mice carrying subcutaneous B16-F10 tumors was found. In conclusion, our data suggest a functional role of ESDN in the tumor microenvironment during melanoma progression and the identification of the mechanisms that regulate tumor cell extravasation could lead to the development of new therapies to reduce metastasis formation.

Keywords: melanoma, tumor microenvironment, extravasation, cell surface molecules

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Authors: Vedanki Khandenwal, Pawan Srivastava, Kartick Tarafder, Subhasis Ghosh

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We present here the experimental realization of controlled doping of graphene monolayers through charge transfer by trapping selected organic molecules between the graphene layer and underlying substrates. This charge transfer between graphene and trapped molecule leads to controlled n-type or p-type doping in monolayer graphene (MLG), depending on whether the trapped molecule acts as an electron donor or an electron acceptor. Doping controllability has been validated by a shift in corresponding Raman peak positions and a shift in Dirac points. In the transfer characteristics of field effect transistors, a significant shift of Dirac point towards positive or negative gate voltage region provides the signature of p-type or n-type doping of graphene, respectively, as a result of the charge transfer between graphene and the organic molecules trapped within it. In order to facilitate the charge transfer interaction, it is crucial for the trapped molecules to be situated in close proximity to the graphene surface, as demonstrated by findings in Raman and infrared spectroscopies. However, the mechanism responsible for this charge transfer interaction has remained unclear at the microscopic level. Generally, it is accepted that the dipole moment of adsorbed molecules plays a crucial role in determining the charge-transfer interaction between molecules and graphene. However, our findings clearly illustrate that the doping effect primarily depends on the reactivity of the constituent atoms in the adsorbed molecules rather than just their dipole moment. This has been illustrated by trapping various molecules at the graphene−substrate interface. Dopant molecules such as acetone (containing highly reactive oxygen atoms) promote adsorption across the entire graphene surface. In contrast, molecules with less reactive atoms, such as acetonitrile, tend to adsorb at the edges due to the presence of reactive dangling bonds. In the case of low-dipole moment molecules like toluene, there is a lack of substantial adsorption anywhere on the graphene surface. Observation of (i) the emergence of the Raman D peak exclusively at the edges for trapped molecules without reactive atoms and throughout the entire basal plane for those with reactive atoms, and (ii) variations in the density of attached molecules (with and without reactive atoms) to graphene with their respective dipole moments provides compelling evidence to support our claim. Additionally, these observations were supported by first principle density functional calculations.

Keywords: graphene, doping, charge transfer, liquid phase exfoliation

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Authors: Libing Zhu, Waichung Chen, Kwaicing Lo, Lei Li

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Background: Tian Jiu Therapy (a medicinal vesiculation therapy according to traditional Chinese medicine theory) in San Fu Days (the three hottest days in a year is calculated by the Chinese ancient calendar) is widely used by patients with chronic asthma in China although from modern medicine perspective there is insufficient evidence of its effectiveness and safety issues. We investigated the efficacy and safety of Tian Jiu Therapy compared with placebo in patients with chronic asthma. Methods: Patients with chronic asthma were randomly assigned to Tian Jiu treatment group (n=165), placebo control group (n=158). Registered Chinese Medicine practitioners, in Orthopedics-Traumatology, Acupuncture, and Tui-na Clinical Centre for Teaching and Research, School of Chinese Medicine, The University of Hong Kong, administered Tian Jiu Therapy and placebo treatment in 3 times over 2 months. Patients completed questionnaires and lung function test before treatment and after treatment, 3, 6, 9, and 11 months, respectively. The primary outcome was the no of asthma-related sub-healthy symptoms and the percentage of patients with twenty-three symptoms. Results: 451 patients were recruited totally, 111 patients refused or did not participate according the appointment time and 17 did not meet the inclusion criteria. Consequently, 323 of eligible patients were enrolled. There was nothing difference between Tian Jiu Therapy group and placebo control group at the end of all treatments neither primary nor secondary outcomes. While Tian Jiu Therapy as compared with placebo significantly reduced the percentage of participants who are susceptible waken up by asthma symptoms from 27% to 14% at 2nd follow-up (P < 0.05). Similarly, Tian Jiu Therapy significantly reduced the proportion of participants who had the symptom of running nose and sneezing before onset from 18% to 8% at 2nd follow-up (P < 0.05). Additionally, Tian Jiu Therapy significantly reduced the level of asthma, the proportion of participants who don’t need to processed during asthma attack increased from 6% to 15% at 1st follow-up and 0% to 7% at 3rd follow-up (P < 0.05). Improvements also occurred with Tian Jiu Therapy group, it reduced the proportion of participants who were spontaneously sweating at 3rd follow up and diarrhea after intake of oily food at 4th follow-up (P < 0.05). Conclusion: When added to a regimen of foundational therapy for chronic asthma participants, Tian Jiu Therapy further reduced the need for medications to control asthma, improved the quality of participants’ life, and significantly reduced the level of asthma. What is more, this benefit seems to have an accumulative effect over time was in accordance with the TCM theory of 'winter disease is being cured in summer'.

Keywords: asthma, Tian Jiu Therapy, San Fu Days, triaditional Chinese medicine, clinical trial

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Authors: Rabah Iratni, Husain El Hasasna, Khawlah Athamneh, Halima Al Sameri, Nehla Benhalilou, Asma Al Rashedi

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Background: Cancer therapies have witnessed great advances in the recent past, however, cancer continues to be a leading cause of death, with colorectal cancer being the fourth cause of cancer-related deaths. Colorectal cancer affects both sexes equally with poor survival rate once it metastasizes. Phytochemicals, which are plant derived compounds, have been on a steady rise as anti-cancer drugs due to the accumulation of evidences that support their potential. Here, we investigated the anticancer effect of Rhus coriaria on colon cancer cells. Material and Method: Human colon cancer HT-29 cell line was used. Protein expression and protein phosphorylation were examined using Western blotting. Transcription activity was measure using Quantitative RT-PCR. Human tumoral clonogenic assay was used to assess cell survival. Senescence was assessed by the senescence-associated beta-galactosidase assay. Results: Rhus coriaria extract (RCE) was found to significantly inhibit the viability and colony growth of human HT-29 colon cancer cells. RCE induced senescence and cell cycle arrest at G1 phase. These changes were concomitant with upregulation of p21, p16, downregulation of cyclin D1, p27, c-myc and expression of Senescence-associated-β-Galactosidase activity. Moreover, RCE induced non-canonical beclin-1independent autophagy and subsequent apoptotic cell death through activation of activation caspase 8 and caspase 7. The blocking of autophagy by 3-methyladenine (3-MA) or chloroquine (CQ) reduced RCE-induced cell death. Further, RCE induced DNA damage, reduced mutant p53 protein level and downregulated phospho-AKT and phospho-mTOR, events that preceded autophagy. Mechanistically, we found that RCE inhibited the AKT and mTOR pathway, a regulator of autophagy, by promoting the proteasome-dependent degradation of both AKT and mTOR proteins. Conclusion: Our findings provide strong evidence that Rhus coriaria possesses strong anti-colon cancer activity through induction of senescence and autophagic cell death, making it a promising alternative or adjunct therapeutic candidate against colon cancer.

Keywords: autophagy, proteasome degradation, senescence, mTOR, apoptosis, Beclin-1

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Authors: Bartłomiej K. Sołtysik, Agnieszka Guligowska, Łukasz Kroc, Małgorzata Pigłowska, Elizavetta Fife, Tomasz Kostka

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Introduction: Functional capacity is one of the basic determinants of health in older age. Functional capacity may be influenced by multiple disorders, including cardiovascular and metabolic diseases. Nevertheless, there is relatively little evidence regarding the association of functional status and cardiometabolic risk factors. Aim: The aim of this research is to check possible association between functional capacity and cardiovascular risk factor in a group of younger seniors. Materials and Methods: The study group consisted of 300 participants aged 60-65 years (50% were women). Total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), glucose, uric acid, body mass index (BMI), waist-to-height ratio (WHtR) and blood pressure were measured. Smoking status and physical activity level (by Seven Day Physical Activity Recall Questionnaire ) were analysed. Functional status was assessed with the Timed Up and Go (TUG) Test. The data were compared according to gender, and then separately for both sexes regarding prolonged TUG score (>7 s). The limit of significance was set at p≤0.05 for all analyses. Results: Women presented with higher serum lipids and longer TUG. Men had higher blood pressure, glucose, uric acid, the prevalence of hypertension and history of heart infarct. In women group, those with prolonged TUG displayed significantly higher obesity rate (BMI, WHTR), uric acid, hypertension and ischemic heart disease (IHD), but lower physical activity level, TC or LDL-C. Men with prolonged TUG were heavier smokers, had higher TG, lower HDL and presented with higher prevalence of diabetes and IHD. Discussion: This study shows association between functional status and risk profile of cardiometabolic disorders. In women, the relationship of lower functional status to cardiometabolic diseases may be mediated by overweight/obesity. In men, locomotor problems may be related to smoking. Higher education level may be considered as a protective factor regardless of gender.

Keywords: cardiovascular risk factors, functional capacity, TUG test, seniors

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Authors: W. L. Tsang, H. Y. Li, S. L. Wong, T. Y. Kwok, S. C. Yuen, S. S. Kwok, P. S. Ko, S. Y. Lau

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Introduction: Palliative care is no doubt necessary in surgery. When one looks at studies of what patients with life-threatening illness want and compares to what they experience in surgical units, the gap is huge. Surgical nurses, being patient advocates, should engage with patients and families sooner rather than later in their illness trajectories to consider how to manage the illness, not just their capacity to survive. Objective: This clinical practice guide aims to fill the service gap of palliative care in surgery by producing a quality-driven, evidence-based yet straightforward clinical practice guide based on a focus strategy. Methodology: In line with Guide to Good Nursing Practice: End-of-Life Care recommended by Nursing Council of Hong Kong and the strategic goal of improving quality of palliative care proposed in HA Strategic Plan 2017-2022, multiple phases of work were undertaken from July 2015 to December 2017. A pragmatic clinical practice guide for surgical patients facing life-threatening conditions was developed based on assessments on knowledge of and attitudes towards end-of-life care of surgical nurses. Key domains, including preparation for bereavement, nursing care for imminently dying patients and at the dying scene were crystallized according to the results of the assessments and the palliative care checklist formulated by UCH Palliative Care Team. After a year of rollout, its content was refined through analyses of implementation in routine practice and consensus opinions from frontline nurses. Results and Outcomes: This clinical practice guide inspires surgical nurses with the art of care to provide for patients’ comfort, function, and longevity. It provides practical directions and assists nurses to master the skills on advance care planning and learn how to be clear with patients, families and themselves about the realities of the disease pictures. Through the implementation, patients and families are included in the decision process, and their wishes are honored. The delivery of explicit and high-quality palliative care maintains good nurse-to-patient relations and enhances satisfaction of hospital care of patients and families. Conclusion: Surgical nursing has always been up to the unique challenges of the era. This clinical practice guide has become an island of credibility for our nurses as they traverse the often stormy waters of life-limiting illness.

Keywords: palliative care delivery, palliative care in surgery, hospice care, end-of-life care

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Authors: Wing Chi Wong

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Globally, studying parents caring for children with attention deficit/ hyperactivity disorder (ADHD) is valuable in order to design measures in supporting those parents by health care providers and government. Such parents in Hong Kong seem to encounter detrimental stress and enormous difficulties which are exacerbated by the traditional Chinese culture, exclusion from social members and fiercely competitive educational system. However, seldom studies scrutinize this issue in Hong Kong. This article aims to review the literature regarding parents caring offsprings with ADHD in Hong Kong. Criteria were set for searching among published studies listed in various databases, including MEDLINE, CINCAHL, PsycINFO, ProQuest, Embase, Cochrane Library and Springer Link. Articles with words 'Attention Deficit Hyperactivity Disorder', 'parenting', 'parent', 'family', 'father', 'mother', 'care' in titles and abstracts were identified. Articles with all types of research designs and methods, regardless in English or Chinese, were included. They were limited to years between January 2008 and September 2018. Four relevant studies have resulted. Of them, two were exploratory studies, one was a qualitative study, and one was a survey. Samples were recruited from child psychiatric clinic, Child and Adolescent Mental Health Unit, or multiple family group therapy centres. Authors proclaimed that quality of life of those parents was usually low; particularly mothers perceived a higher stress than fathers; parenting barriers existed; conflicts were commonly raised in parent-child relationship resulting in probable maltreatment to children. Previous studies generally suggested the potential negative outcomes of parents caring children with ADHD. The types and effectiveness of interventions to those parents on relieving their tortures under Hong Kong context had not been explored and systematically evaluated. The scanty studies and existing understanding could not give a promising conclusion pertaining to the appropriate family intervention to parents living with children with ADHD. A stringent research design is necessary to establish evidence on the effectiveness of interventions for those families.

Keywords: attention deficit/ hyperactivity disorder, Hong Kong, parents, interventions

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Authors: Deirdre Mc Grath, Joanne Reid

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Background: Ovarian cancer is the leading cause of mortality among gynaecologic cancers in developed countries and the seventh most common cancer worldwide, with nearly 240,000 women diagnosed each year. Although it is recognized engaging in exercise results in positive health care outcomes, women with ovarian cancer are reluctant to participate. No evidence currently exists focusing on how to successfully implement an exercise intervention program for patients with ovarian cancer, using a realist approach. There is a requirement for the implementation of exercise programmes within the oncology health care setting as engagement in such interventions has positive health care outcomes for women with ovarian cancer both during and following treatment. Aim: To co-design the implementation of an exercise intervention for women following treatment for ovarian cancer. Methods: This study is a realist evaluation using quantitative and qualitative methods of data collection and analysis. Realist evaluation is well-established within the health and social care setting and has, in relation to this study, enabled a flexible approach to investigate how to optimise implementation of an exercise intervention for this patient population. This single centre study incorporates three stages in order to identify the underlying contexts and mechanisms which lead to the successful implementation of an exercise intervention for women who have had treatment for ovarian cancer. Stage 1 - A realist literature review. Stage 2 -Co-design of the implementation of an exercise intervention with women following treatment for ovarian cancer, their carer’s, and health care professionals. Stage 3 –Implementation of an exercise intervention with women following treatment for ovarian cancer. Evaluation of the implementation of the intervention from the perspectives of the women who participated in the intervention, their informal carers, and health care professionals. The underlying programme theory initially conceptualised before and during the realist review was developed further during the co-design stage. The evolving programme theory in relation to how to successfully implement an exercise for these women is currently been refined and tested during the final stage of this realist evaluation which is the implementation and evaluation stage. Results: This realist evaluation highlights key issues in relation to the implementation of an exercise intervention within this patient population. The underlying contexts and mechanisms which influence recruitment, adherence, and retention rates of participants are identified. Conclusions: This study will inform future research on the implementation of exercise interventions for this patient population. It is anticipated that this intervention will be implemented into practice as part of standard care for this group of patients.

Keywords: exercise, ovarian cancer, co-design, implementation

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Authors: Bheki R. Mngomezulu

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The present paper cogently and systematically traces the history of Umkhonto Wesizwe (MK) and identifies its important role in shaping South Africa’s post-apartheid foreign policy and international relations under black leadership. It provides the political and historical contexts within which we can interpret and better understand South Africa’s controversial ‘Quiet Diplomacy’ approach to Zimbabwe’s endemic political and economic crises, which have dragged for too long. On 16 December 1961, the African National Congress (ANC) officially launched the MK as its military wing. The main aim was to train liberation fighters outside South Africa who would return into the country to topple the apartheid regime. Subsequently, the ANC established links with various countries across Africa and the globe in order to solicit arms, financial resources and military training for its recruits into the MK. Drawing from archival research and empirical data obtained through oral interviews that were conducted with some of the former MK cadres, this paper demonstrates how the ANC forged relations with a number of countries that were like-minded in order to ensure that its dream of removing the apartheid government became a reality. The findings reveal that South Africa’s foreign policy posture and international relations after the demise of apartheid in 1994 built on these relations. As such, even former and current socialist countries that were frowned upon by the Western world became post-apartheid South Africa’s international partners. These include countries such as Cuba and China, among others. Even countries that were not recognized by the Western world as independent states received good reception in post-apartheid South Africa’s foreign policy agenda. One of these countries is Palestine. Within Africa, countries with questionable human rights records such as Nigeria and Zimbabwe were accommodated in South Africa’s foreign policy agenda after 1994. Drawing from this history, the paper concludes that it would be difficult to fully understand and appreciate South Africa’s foreign policy direction and international relations after 1994 without bringing the history and the politics of the MK into the equation. Therefore, the paper proposes that the utilitarian role of history should never be undermined in the analysis of a country’s foreign policy direction and international relations. Umkhonto Wesizwe and South Africa are used as examples to demonstrate how such a link could be drawn through archival and empirical evidence.

Keywords: African National Congress, apartheid, foreign policy, international relations

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