Search results for: general hospital

Authors: Herlin Vallejo, Jhon Osorio

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Quality is a concept that has gained importance in different scenarios over time, especially in the area of health. The nursing staff is one of the actors that contributes most to the care process and the satisfaction of the users in the evaluation of quality. However, until now, there are few tools to measure the quality of care in specialized performance scenarios. Patients receiving ambulatory cancer treatments can face various problems, which can increase their level of distress, so improving the quality of outpatient care for cancer patients should be a priority for oncology nursing. The experience of the patient in relation to the care in these services has been little investigated. The purpose of this study was to understand the perception that patients have about quality care in outpatient chemotherapy services. A qualitative, exploratory, descriptive study was carried out in 9 patients older than 18 years, diagnosed with cancer, who were treated at the Institute of Cancerology, in outpatient chemotherapy rooms, with a minimum of three months of treatment with curative intention and which had given your informed consent. The total of participants was determined by the theoretical saturation, and the selection of these was for convenience. Unstructured interviews were conducted, recorded and transcribed. The analysis of the information was done under the technique of content analysis. Three categories emerged that reflect the perception that patients have regarding quality care: patient-centered care, care with love and effects of care. Patients highlighted situations that show that care is centered on them, incorporating elements of patient-centered care from the institutional, infrastructure, qualities of care and what for them, in contrast, means inappropriate care. Care with love as a perception of quality care means for patients that the nursing staff must have certain qualities, perceive caring with love as a family affair, limits on care with love and the nurse-patient relationship. Quality care has effects on both the patient and the nursing staff. One of the most relevant effects was the confidence that the patient develops towards the nurse, besides to transform the unreal images about cancer treatment with chemotherapy. On the other hand, care with quality generates a commitment to self-care and is a facilitator in the transit of oncological disease and chemotherapeutic treatment, but from the perception of a healing transit. It is concluded that care with quality from the perception of patients, is a construction that goes beyond the structural issues and is related to an institutional culture of quality that is reflected in the attitude of the nursing staff and in the acts of Care that have positive effects on the experience of chemotherapy and disease. With the results, it contributes to better understand how quality care is built from the perception of patients and to open a range of possibilities for the future development of an individualized instrument that allows evaluating the quality of care from the perception of patients with cancer.

Keywords: nursing care, oncology service hospital, quality management, qualitative studies

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Authors: Essam Mansour

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The key purpose of this study is to show information-seeking behaviour of Kuwaiti Judges (KJs). Being one of the few studies about the information needs and information-seeking behaviour conducted in Arab and developing countries, this study is a pioneer one among many studies conducted in information seeking, especially with this significant group of information users. The authors tried to investigate this seeking behavior in terms of KJs' thoughts, perceptions, motivations, techniques, preferences, tools and barriers met when seeking information. The authors employed a questionnaire, with a response rate 77.2 percent. This study showed that most of KJs were likely to be older, educated and with a work experience ranged from new to old experience. There is a statistically reliable significant difference between KJs' demographic characteristics and some sources of information, such as books, encyclopedias, references and mass media. KJs were using information moderately to make a decision, to be in line with current events, to collect statistics and to make a specific/general research. The office and home were the most frequent location KJs were accessing information from. KJs' efficiency level of the English language is described to be moderately good, and a little number of them confirmed that their efficiency level of French was not bad. The assistance provided by colleagues, followed by consultants, translators, sectaries and librarians were found to be most strong types of assistance needed when seeking information. Mobile apps, followed by PCs, information networks (the Internet) and information databases were the highest technology tool used by KJs. Printed materials, followed by non-printed and audiovisual materials were the most preferred information formats KJs use. The use of languages, the recency of information and the place of information, the deficit role of the library to deliver information were at least significant barriers to KJs when seeking information.

Keywords: information users, information-seeking behaviour, information needs, judges, Kuwait

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Authors: G. Salavwa, P. Erhijakpor Jr., H. Ukwu

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This study will explore child labour issues in Nigeria because it is capable of affecting the physical and general well-being of children who perform hazardous work. This feat will be achieved through qualitative research methodology. Data collection shall be elicited by oral interviews and documental content analysis to delve on the application of the Convention on the Rights of the Child (CRC), International Labour Organization ILO and Geneva Convention relating to child labour practices in Nigeria. This will include the relevance of present domestic laws relating to child labour as implemented in Nigeria, together with factors that contribute to the practice of child labour in the country. The oral interview data analysis will be performed by breaking the interview data into significant statements and themes. This shall be done by comparing and determining the commonalities that are prevalent in the participants’ views regarding child labour menace in Nigeria. Presumably, findings from this study shall unveil that a poor educational policy, a widespread poverty level which is mostly prevalent amongst families in the rural areas of the country, a lack of employment for adults, have led to the ineffectiveness of the local child labour laws in Nigeria. These has in turn culminated into a somewhat non-implementation of the international laws of the CRC, ILO and Geneva Declaration on child labour to which the Nigerian government is a signatory. Based on the finding, this study will calls on the government of Nigeria to extend its free educational policy from the elementary, secondary to tertiary educations. The government also has to ensure that offenders of children’s rights should face a severe punishment.

Keywords: commonalities, tertiary, constitution, qualitative

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Authors: Daniela Salih Khidir, Mohamed G. Al Kuwari, Mercia V. Walt, Izzeldin J. Ibrahim

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Background: University-based physical activity interventions aim to establish durable social patterns during the transition to adulthood. This study is a comprehensive evaluation of a 3-year intervention-based program to increase the culture of physical activity (PA) routine in Qatar campuses community, using a holistic approach. Methodology: General assessment methods: formative evaluation-SIH Campuses logic model design, stakeholders’ identification; process evaluation-members’ step counts analyze and qualitative Appreciative Inquiry session (4-D model); daily steps categorized as: ≤5,000, inactive; 5,000-7,499 low active; ≥7,500, physically active; outcome evaluation - records 3 years interventions. Holistic PA interventions methods: walking interventions - pedometers distributions and walking competitions for students and staff; educational interventions - in campuses implementation of bilingual educational materials, lectures, video related to PA in prevention of non-communicable diseases (NCD); articles published online; monthly emails and sms notifications for pedometer use; mass media campaign - radio advertising, yearly pre/post press releases; community stakeholders interventions-biyearly planning/reporting/achievements rewarding/ qualitative meetings; continuous follow-up communication, biweekly steps reports. Findings: Results formative evaluation - SIH in Campuses logic model identified the need of PA awareness and education within universities, resources, activities, health benefits, program continuity. Results process evaluation: walking interventions: Phase 1: 5 universities recruited, 2352 members, 3 months competition; Phase 2: 6 new universities recruited, 1328 members in addition, 4 months competition; Phase 3: 4 new universities recruited in addition, 1210 members, 6 months competition. Results phase 1 and 2: 1,299 members eligible for analyzes: 800 females (62%), 499 males (38%); 86% non-Qataris, 14% Qatari nationals, daily step count 5,681 steps, age groups 18–24 (n=841; 68%) students, 25–64; (n=458; 35.3%) staff; 38% - low active, 37% physically active and 25% inactive. The AI main themes engaging stakeholders: awareness/education - 5 points (100%); competition, multi levels of involvement in SIH, community-based program/motivation - 4 points each (80%). The AI points represent themes’ repetition within stakeholders’ discussions. Results education interventions: 2 videos implementation, 35 000 educational materials, 3 online articles, 11 walking benefits lectures, 40 emails and sms notifications. Results community stakeholders’ interventions: 6 stakeholders meetings, 3 rewarding gatherings, 1 focus meeting, 40 individual reports, 18 overall reports. Results mass media campaign: 1 radio campaign, 7 press releases, 52 campuses newsletters. Results outcome evaluation: overall 2013-2016, the study used: 1 logic model, 3 PA holistic interventions, partnerships 15 universities, registered 4890 students and staff (aged 18-64 years), engaged 30 campuses stakeholders and 14 internal stakeholders; Total registered population: 61.5% female (2999), 38.5% male (1891), 20.2% (988) Qatari nationals, 79.8% (3902) non-Qataris, 55.5% (2710) students aged 18 – 25 years, 44.5% (2180) staff aged 26 - 64 years. Overall campaign 1,558 members eligible for analyzes: daily step count 7,923; 37% - low active, 43% physically active and 20% inactive. Conclusion: The study outcomes confirm program effectiveness and engagement of young campuses community, specifically female, in PA. The authors recommend implementations of 'holistic PA intervention program approach in Qatar' aiming to impact the community at national level for PA guidelines achievement in support of NCD prevention.

Keywords: campuses, evaluation, Qatar, step-count

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Authors: Forrest Kaatz, Adhemar Bultheel

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We use an informational statistical mechanics approach to study the catalytic thermodynamics of platinum and palladium cuboctahedral nanoclusters. Nanoclusters and their adatoms are viewed as chemical graphs with a nearest neighbor adjacency matrix. We use the Morse potential to determine bond energies between cluster atoms in a coordination type calculation. We use adsorbate energies calculated from density functional theory (DFT) to study the adatom effects on the thermodynamic quantities, which are derived from a Hamiltonian. Oxygen radical and molecular adsorbates are studied on platinum clusters and hydrogen on palladium clusters. We calculate the entropy, free energy, and total energy as the coverage of adsorbates increases from bridge and hollow sites on the surface. Thermodynamic behavior versus adatom coverage is related to the structural distribution of adatoms on the nanocluster surfaces. The thermodynamic functions are characterized using a simple adsorption model, with linear trends as the coverage of adatoms increases. The data exhibits size effects for the measured thermodynamic properties with cluster diameters between 2 and 5 nm. Entropy and enthalpy calculations of Pt-O2 compare well with previous theoretical data for Pt(111)-O2, and our Pd-H results show similar trends as experimental measurements for Pd-H2 nanoclusters. Our methods are general and may be applied to wide variety of nanocluster adsorbate systems.

Keywords: catalytic thermodynamics, palladium nanocluster absorbates, platinum nanocluster absorbates, statistical mechanics

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Authors: Adesoji Tunbosun Jaiyeola, Josiah Adeyemo

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Sediment yield can be considered to be the total sediment load that leaves a drainage basin. The knowledge of the quantity of sediments present in a river at a particular time can lead to better flood capacity in reservoirs and consequently help to control over-bane flooding. Furthermore, as sediment accumulates in the reservoir, it gradually loses its ability to store water for the purposes for which it was built. The development of hydrological models to forecast the quantity of sediment present in a reservoir helps planners and managers of water resources systems, to understand the system better in terms of its problems and alternative ways to address them. The application of artificial intelligence models and technique to such real-life situations have proven to be an effective approach of solving complex problems. This paper makes an extensive review of literature relevant to the theories and applications of evolutionary algorithms, and most especially genetic programming. The successful applications of genetic programming as a soft computing technique were reviewed in sediment modelling and other branches of knowledge. Some fundamental issues such as benchmark, generalization ability, bloat and over-fitting and other open issues relating to the working principles of GP, which needs to be addressed by the GP community were also highlighted. This review aim to give GP theoreticians, researchers and the general community of GP enough research direction, valuable guide and also keep all stakeholders abreast of the issues which need attention during the next decade for the advancement of GP.

Keywords: benchmark, bloat, generalization, genetic programming, over-fitting, sediment yield

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Authors: Janis E. Campbell

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Most of what is known about complementary, alternative or traditional medicine (CATM) in the United States today is known from either the National Health Interview Survey a cross-sectional survey with a few questions or from small cross-sectional or cohort studies with specific populations. The broad geographical distribution in CATM use or providers is not known. For this project, we used geospatial cluster analysis to determine if there were clusters of CATM provider by county in the US. In this analysis, we used the National Provider Index to determine the geographic distribution of providers in the US. Of the 215,769 CAMT providers 211,603 resided in the contiguous US: Acupuncturist (26,563); Art, Poetry, Music and Dance Therapist (2,752); Chiropractor (89,514); Doula/Midwife (3,535); Exercise (507); Homeopath (380); Massage Therapist (36,540); Mechanotherapist (1,888); Naprapath (146); Naturopath (4,782); Nutrition (42,036); Reflexologist (522); Religious (2,438). ESRI® spatial autocorrelation was used to determine if the geographic location of CATM providers were random or clustered. For global analysis, we used Getis-Ord General G and for Local Indicators of Spatial Associations with an Optimized Hot Spot Analysis using an alpha of 0.05. Overall, CATM providers were clustered with both low and high. With Chiropractors, focusing in the Midwest, religious providers having very small clusters in the central US, and other types of CAMT focused in the northwest and west coast, Colorado and New Mexico, the great lakes areas and Florida. We will discuss some of the implications of this study, including associations with health, economic, social, and political systems.

Keywords: complementary medicine, alternative medicine, geospatial, United States

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Authors: Xue Wang, Li-Wei Fan

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The technology innovation has become the driving force of social and economic development and transformation. The guidance and support of public policies is an important condition to promote the realization of technology innovation goals. Policy effectiveness evaluation is instructive in policy learning and adjustment. This paper reviews existing studies and systematically evaluates the effectiveness of policy-driven technological innovation. We used 167 articles from WOS and CNKI databases as samples to clarify the measurement of technological innovation indicators and analyze the classification and application of policy evaluation methods. In general, technology innovation input and technological output are the two main aspects of technological innovation index design, among which technological patents are the focus of research, the number of patents reflects the scale of technological innovation, and the quality of patents reflects the value of innovation from multiple aspects. As for policy evaluation methods, statistical analysis methods are applied to the formulation, selection and evaluation of the after-effect of policies to analyze the effect of policy implementation qualitatively and quantitatively. The bibliometric methods are mainly based on the public policy texts, discriminating the inter-government relationship and the multi-dimensional value of the policy. Decision analysis focuses on the establishment and measurement of the comprehensive evaluation index system of public policy. The economic analysis methods focus on the performance and output of technological innovation to test the policy effect. Finally, this paper puts forward the prospect of the future research direction.

Keywords: technology innovation, index, policy effectiveness, evaluation of policy, bibliometric analysis

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Authors: Sajed Yaghoubnezhad, Sedygheh Rezai

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Background and Aim: Since currently in Iran, students with learning disabilities are identified after entering school, and with the approach to the gap between IQ and academic achievement, the purpose of this study is to design and calculate the content validity of the pre-school screening checklist (5-7) exposed to learning difficulties. Methods: This research is a fundamental study, and in terms of data collection method, it is quantitative research with a descriptive approach. In order to design this checklist, after reviewing the research background and theoretical foundations, cognitive abilities (visual processing, auditory processing, phonological awareness, executive functions, spatial visual working memory and fine motor skills) are considered the basic variables of school learning. The basic items and worksheets of the screening checklist of pre-school students 5 to 7 years old with learning difficulties were compiled based on the mentioned abilities and were provided to the specialists in order to calculate the content validity ratio index. Results: Based on the results of the table, the validity of the CVR index of the background information checklist is equal to 0.9, and the CVR index of the performance checklist of preschool children (5 to7 years) is equal to 0.78. In general, the CVR index of this checklist is reported to be 0.84. The results of this study provide good evidence for the validity of the pre-school sieve screening checklist (5-7) exposed to learning difficulties.

Keywords: checklist, screening, preschoolers, learning difficulties

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Authors: Akbarov Elbek Elmurodovich

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Introduction: We are analyzing the topic of hemolytic anemia observed in patients after COVID-19 infection. The purpose of this research is to investigate the development of hemolytic anemia, identify its causes, and study treatment methods. Objective and Task: The goal of our research is to analyze the changes in blood occurring after COVID-19 infection and study the development of hemolytic anemia. Our main task is to analyze the results and assess subsequent changes in patients. Materials and Methods: The study was conducted among patients treated with a diagnosis of COVID-19 in the Department of Infectious Diseases at the TTA 1-Multiprofile Clinic from March to August 2023. Out of the 32 patients included, 16 were female, and 16 were male. Monitoring Blood Coagulation in Patients: The hemoglobin level of patients upon admission was initially measured using the URITEST-150 analyzer. The average for women was 110 g/l, and for men was 120 g/l. Over the course of 3 months, a decrease was observed: an average of 72 g/l in women (a decrease of up to 35%) and 84 g/l in men (a decrease of up to 30%). In the next 2 months, the positive dynamics of hemoglobin levels were observed, with an average increase to 93 g/l in women (>28%) and 112 g/l in men (>25%). Research Results: Hemolytic anemia developed in men within 5 months, reaching up to 112 g/l. In women, this process required a longer period, with the last month of observation (6 months) showing that women reached levels of up to 112 g/l, similar to men. Conclusion: Hemolytic anemia observed in patients after COVID-19 infection was monitored for 6 months (5 months in men, 6 months in women), reaching up to 112 g/l. The first 3 months after contracting COVID showed the period of development of anemia, and the subsequent 3 months indicated a stabilization period in patients.

Keywords: COVID, anemia, hemoglobin, tma, virus, viral infrection

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Authors: Tirthankar Chakraborty, Indranil Mukherjee

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The environmental aspect had a major effect on industrial decisions after the deteriorating condition of our surroundings dsince the industrial activities became apparent. Green buildings have been seen as a possible solution to reduce the carbon emissions from construction projects and the housing industry in general. Though this has been established in several areas, with many commercial buildings being designed green, the scope for expansion is still significant and further information on the importance and advantages of green buildings is necessary. Several commercial green building projects have come up and the green buildings are mainly implemented in the residential sector when the residential projects are constructed to furnish amenities to a large population. But, residential buildings, even those of medium sizes, can be designed to incorporate elements of sustainable design. In this context, this paper attempts to give a theoretical appraisal of the use of renewable energy systems in residential buildings of different sizes considering the weather conditions (solar insolation and wind speed) of the metropolis, Kolkata, India. Three cases are taken; one with solar power, one with wind power and one with a combination of the two. All the cases are considered in conjunction with conventional energy, and the efficiency of each in fulfilling the total energy demand is verified. The optimum combination for reducing the carbon footprint of the residential building is thus established. In addition, an assessment of the amount of money saved due to green buildings in metered water supply and price of coal is also mentioned.

Keywords: renewable energy, green buildings, solar power, wind power, energy hybridization, residential sector

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Authors: Howard Prosser

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This paper examines how critical thinking is framed, especially for primary-school students, in the recently established Australian Curriculum: History. Critical thinking is one of the curriculum’s 'general capabilities.' History provides numerous opportunities for critical thinking’s application in everyday life. The so-called 'history wars' that took place just prior to the curriculum’s introduction in 2014 sought to bring to light the limits of a singular historical narrative and reveal that which had been repressed. Consequently, the Australian history curriculum reflects this shifting mindset. Teachers are presented with opportunities to treat history in the classroom as a repository of social possibility, especially related to democratic potential, beyond hackneyed and jingoistic tales of Australian nationhood. Yet such opportunities are not explicit within the document and are up against pre-existing pedagogic practices. Drawing on political thinker Cornelius Castoriadis’s rendering of the 'social-historical' and 'paidea,' as well as his mobilisation of psychoanalysis, the study outlines how the curriculum’s critical-thinking component opens up possibilities for students and teachers to revise assumptions about how history is understood. This ontological shift is ultimately creative: the teachers’ imaginations connect the students’ imaginations, and vice versa, to the analysis that is at the heart of historical thinking. The implications of this social imagination add to the current discussions about historical consciousness among scholars like Peter Seixas. But, importantly, it has practical application in the primary-school classroom where history becomes creative acts, like play, that is indeterminate and social rather than fixed and individual.

Keywords: Australia, Castoriadis, critical thinking, history, imagination

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Authors: Tabitha Mberi, Tirus Wanyoike, Joseph Sevilla

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The use of Information and Communication Technology (ICT) in Government is gradually becoming a major requirement to transform delivery of services to its stakeholders by improving quality of service and efficiency. In Kenya, the devolvement of government from local authorities to county governments has resulted in many counties adopting online revenue collection systems which can be easily accessed by its stakeholders. Strathmore Research and Consortium Centre (SRCC) implemented a revenue collection system in Taita Taveta, a County in coastal Kenya. It consisted of two systems that are integrated; an online system dubbed “CountyPro” for processing county services such as Business Permit applications, General Billing, Property Rates Payments and any other revenue streams from the county. The second part was a Point of Sale(PoS) system used by the county revenue collectors to charge for market fees and vehicle parking fees. This study assesses the success and challenges in adoption of the integrated system. Qualitative and quantitative data collection methods were used to collect data on the adoption of the system with the researcher using focus groups, interviews, and questionnaires to collect data from various users of the system An analysis was carried out and revealed that 87% of the county revenue officers who are situated in county offices describe the system as efficient and has made their work easier in terms of processing of transactions for customers.

Keywords: e-government, counties, information technology, online system, point of sale

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Authors: Wided Khiari, Adel Karaa

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This study aims to establish a typology of Tunisian listed firms according to their corporate governance characteristics and disclosure quality. The paper uses disclosed scores to examine corporate governance practices of Tunisian listed firms. A content analysis of 46 Tunisian listed firms from 2001 to 2010 has been carried out and a disclosure index developed to determine the level of disclosure of the companies. The disclosure quality is appreciated through the quantity and also through the nature (type) of information disclosed. Applying the decision tree method, the obtained tree diagrams provide ways to know the characteristics of a particular firm regardless of its level of disclosure. Obtained results show that the characteristics of corporate governance to achieve good quality of disclosure are not unique for all firms. These structures are not necessarily all of the recommendations of best practices, but converge towards the best combination. Indeed, in practice, there are companies which have a good quality of disclosure, but are not well-governed. However, we hope that by improving their governance system their level of disclosure may be better. These findings show, in a general way, a convergence towards the standards of corporate governance with a few exceptions related to the specificity of Tunisian listed firms and show the need for the adoption of a code for each context. These findings shed the light on corporate governance features that enhance incentives for good disclosure. It allows identifying, for each firm and in any date, corporate governance determinants of disclosure quality. More specifically, and all being equal, obtained tree makes a rule of decision for the company to know the level of disclosure based on certain characteristics of the governance strategy adopted by the latter.

Keywords: corporate governance, disclosure, decision tree, economics

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Authors: Khairul Bariah Sulaiman, Tajul Aris Yang

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Malaysian dried cocoa beans have been reported to have low quality flavour and are often sold at discounted prices. Various efforts have been made to improve the Malaysian beans quality. Among these efforts is introduction of the shallow box fermentation technique and pulp preconditioned through pods storage. However, after nearly four decades of the effort was done, Malaysian cocoa farmers still received lower prices for their beans. So, this study was carried out in order to assess the flavour quality of dried cocoa beans produced by shallow box fermentation techniques, combination of shallow box fermentation with pods storage and compared to dried cocoa beans obtained from Ghana. A total of eight samples of dried cocoa was used in this study, which one of the samples was Ghanaian beans (coded with no.8), while the rest were Malaysian cocoa beans with different post-harvest processing (coded with no. 1, 2, 3, 4, 5, 6 and 7). Cocoa liquor was prepared from all samples in the prescribed techniques and sensory evaluation was carried out using Quantitative Descriptive Analysis (QDA) Method with 0-10 scale by Malaysian Cocoa Board trained panelist. Sensory evaluation showed that cocoa attributes for all cocoa liquors ranging from 3.5 to 5.3, whereas bitterness was ranging from 3.4 to 4.6 and astringent attribute ranging from 3.9 to 5.5, respectively. Meanwhile, all cocoa liquors were having acid or sourness attribute ranging from 1.6 to 3.6, respectively. In general cocoa liquor prepared from sample coded no 4 has almost similar flavour profile and no significantly different at p < 0.05 with Ghana, in term of most flavour attributes as compared to the other six samples.

Keywords: cocoa beans, flavour, fermentation, shallow box, pods storage

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Authors: Kasbparast Mehdi, Hassani Zainab

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Aim: The purpose of this research was to investigate the effectiveness of therapeutical sensorimotor exercise. The statistical population of women who were diagnosed with patellofemoral pain syndrome by a doctor and were between the ages of 35 and 45 and registered for the first time in a sports club in the 4th district of Tehran, 30 people by random sampling and according to The include and exclude criteria were selected and divided into 2 equal control and experimental and homogeneous groups (in terms of height, weight and BMI).In both control and experimental groups, the pain was measured using a Visual Analog Scale(VAS) functionality was measured using the step-down test and quality of life was measured using a World Health Organization Quality of Life Scale (WHOQOL-BREF) (pre-test). Then, only the experimental group performed sensorimotor exercises for 12 weeks and 3 sessions each week, a total of 24 sessions and each session for 1 hour, and during this period, the control group only continued their daily activities. After the end of the training period, the desired factors were evaluated again (post-test) in the same way as the pre-test was done for them (experimental group and control group), with the same quality. Findings: The statistical results showed that in the experimental group, the amount of pain, function and quality of life had a statistical improvement (P≤0.05). Conclusion: In general conclusion, it can be stated that using sensorimotor exercises not only improved functionality and quality of life but also reduced the amount of pain in people with patellofemoral pain syndrome.

Keywords: pain, PFPS, sensori motor training, functionality

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Authors: Zaw Z Aung

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Background: High-risk groups for hepatitis B infection (HBV) are people who injected drugs (PWID), men who have sex with men (MSM), people living with HIV (PLHIV) and persons with hepatitis C (HCV), etc. HBV/HCV coinfected patients are at increased risk of cirrhosis, hepatic decompensation and hepatocellular carcinoma. To the best of author’s knowledge, there is currently no data for hepatitis B vaccine utilization in HCV positive patients and their antibody response. Methodology: From February 2018 to May 2018, consented participants at or above 18 years who came to the clinic in Mandalay were tested with the anti-HCV rapid test. Those who tested HCV positive (n=168) were further tested with hepatitis B profile and asked about their previous hepatitis B vaccination history and risk factors. Results: Out of 168 HCV positive participants, three were excluded for active HBV infections. The remaining 165 were categorized into previously vaccinated 64% (n=106) and unvaccinated 36% (n=59) There were three characteristics groups- PWID monoinfected (n=77), General Population (GP) monoinfected (n=22) and HIV/HCV coinfected participants (n=66). Unvaccinated participants were highest in HIV/HCV, with 68%(n=45) followed by GP (23%, n=5) and PWID (12%, n=9). Among previously vaccinated participants, the highest percentage was PWID (88%, n=68), the second highest was GP (77%, n=17) and lowest in HIV/HCV patients (32%, n=21). 63 participants completed third doses of vaccination (PWID=36, GP=13, HIV/HCV=14). 53% of participants who completed 3 dose of hepatitis B were non-responders (n=34): HIV/HCV (86%, n=12), PWID (44%, n=16), and GP (46%, n=6) Conclusion: Even in the presence of effective and safe hepatitis B vaccine, uptake is low among high risk groups especially PLHIV that needs to be improved. Integration or collaboration of hepatitis B vaccination program, HIV/AIDS and hepatitis C treatment centers is desirable. About half of vaccinated participants were non-responders so that optimal doses, schedule and follow-up testing need to be addressed carefully for those groups.

Keywords: Hepatitis B vaccine, Hepatitis C, HIV, Myanmar

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Authors: Shilpa Avarebeel

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Background: India is one of the seven identified countries in South-East Asia region, regularly reporting dengue infection and may soon transform into a major niche for dengue epidemics. Objective: To study the clinical profile of dengue in our setting with special reference to respiratory complication. Study design: Descriptive and exploratory study, for one year in 2014. All patients confirmed as dengue infection were followed and their clinical profile, along with outcome was determined. Study proforma was designed based on the objective of the study and it was pretested and used after modification. Data was analyzed using statistical software SPSS-Version 16. Data were expressed as mean ±S .D for parametric variables and actual frequencies or percentage for non-parametric data. Comparison between groups was done using students’ t-test for independent groups, Chie square test, one-way ANOVA test, Karl Pearson’s correlation test. Statistical significance is taken at P < 0.05. Results: Study included 134 dengue positive cases. 81% had dengue fever, 18% had dengue hemorrhagic fever, and one had dengue shock syndrome. Most of the cases reported were during the month of June. Maximum number of cases was in the age group of 26-35 years. Average duration of hospital stay was less than seven days. Fever and myalgia was present in all the 134 patients, 16 had bleeding manifestation. 38 had respiratory symptoms, 24 had breathlessness, and 14 had breathlessness and dry cough. On clinical examination of patients with respiratory symptoms, all twenty-eight had hypoxia features, twenty-four had signs of pleural effusion, and four had ARDS features. Chest x-ray confirmed the same. Among the patients with respiratory symptoms, the mean platelet count was 26,537 c/cmm. There was no statistical significant difference in the platelet count in those with ARDS and other dengue complications. Average four units of platelets were transfused to all those who had ARDS in view of bleeding tendency. Mechanical ventilator support was provided for ARDS patients. Those with pleural effusion and pulmonary oedema were given NIV (non-invasive ventilation) support along with supportive care. However, steroids were given to patients with ARDS and 10 patients with signs of respiratory distress. 100%. Mortality was seen in patients with ARDS. Conclusion: Dengue has to be checked for those presenting with fever and breathlessness. Supportive treatments remain the cornerstone of treatment. Platelet transfusion has to be given only by clinical judgment. Steroids have no role except in early ARDS, which is controversial. Early NIV support helps in speedy recovery of dengue patients with respiratory distress.

Keywords: adult respiratory distress syndrome, dengue fever, non-invasive ventilation, pulmonary complication

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Authors: Christina Knorr

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Analysis of the evacuation of occupants of a building plays a significant role in Fire Safety Engineering. One of the tools used for the analysis is the concept of the Required Safe Egress Time (RSET). It is generally accepted that RSET is measured from the time the fire ignites until the time that all occupants have evacuated to a safe location. Instructions on how RSET is determined can be found in both the International Fire Engineering Guidelines and, more recently, in the Australian Fire Engineering Guidelines. The guidelines also specify measures that could be applied to reduce the RSET and hence improve the performance of fire-safety measures of a building. Further, it is suggested that the delay period can be reduced through “training programs.” This study examined the overall level of fire-safety awareness among occupants of residential apartment buildings in Australia and investigated the possible effects of fire-safety training on the delay period and, hence, the RSET. A questionnaire, interviews, and an experiment were conducted to collect data about people’s fire-safety knowledge, people’s behaviour and nature, and the duration of activities people are likely to undertake in the event of a fire. The study led to an investigation into the delay and response time approximations and the development of a new equation to incorporate the impact of training into the RSET calculations for the general use of the fire engineering community. Regardless of the RSET, it can be concluded that fire-safety education and training for residents of apartment buildings have a direct impact on improving their behaviour and firefighting equipment usage in a fire incident.

Keywords: fire safety engineering, fire safety training, occupant evacuation behaviour, required safe egress time

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Authors: Adekunle Saheed Ajisebiyawo

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This paper examines the influence of identity politics on the development of electoral democracy in Nigeria. The paper was anchored on a theory of African democracy adopted the qualitative methodology and deployed data from secondary sources to evaluate the 2023 presidential election, and found that ethnicity, religion, and regional sentiments played a major role in the election. The practical implications of this paper are that while Nigeria’s democracy is tending towards consolidation, if the unexpected does not happen, e.g., military takeover, religious and ethnic identities can mar the country’s development as competent candidates that have good policies will be voted out based on religious and ethnic sentiments. Thus, there is a need to de-emphasize religion and ethnicity in the Nigerian polity. Candidates and parties that campaign based on racial or religious narratives should be barred from contesting elective positions. The paper concluded that identity politics is inimical to Nigeria’s democratization process as well as efforts aimed at uniting and integrating the country; it, therefore, recommended that to establish a sound electoral democracy and a strong united country, the menace of ethnic, religious, and regional cleavages should be addressed. To achieve this, efforts should be intensified towards providing a set of principles for nation-building which should be included in the constitution. In addition, the paper urges the media to support the formation of an inclusive government, cutting across tribes and religions in the country to reduce the negative impact of ethnicity and religion in the country.

Keywords: cleavages, democracy, ethnicity, election, identity politics, religion

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Authors: Ghazal Zahed, Leila Tabatabaee, Amirhossein Hosseini, Somaye Fatahi

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Functional retentive overflow incontinence (Retentive FI) is the most common cause of fecal soiling in children. Affected patients may have more problems with their parents and peer group, self-esteem issues, and more psychiatric comorbidities than the general population. Therapeutic interventions for Retentive FI and related problems and comorbid conditions are needed at the same time. Based on the clinical experiences, patients with retentive FI and comorbid psychiatric disorders, were accelerated in their treatment of fecal incontinence when they were being treated with Risperidone for their psychiatric comorbidities, therefore this study was conducted to evaluate the effect of Risperidone in the treatment of Retentive FI in children and adolescents. In this double-blind randomized clinical trial, 136 patients aged 4-18 years eligible for the study were randomly divided into two groups receiving Risperidone and placebo. About half of these patients had newly diagnosed psychiatric disorders and were drug naïve, this was considered in their division. In addition to polyethylene glycol, all the participants received family counseling and education for withholding behaviors and related behavioral interventions, and nonpharmacological interventions for psychiatric comorbidities. A significant correlation was observed between the duration of treatment with risperidone and the presence of psychiatric comorbidities (P <0.001) for diurnal fecal incontinence. Based on our findings in this study, Risperidone, used commonly for psychiatric disorders in children and adolescents, may be useful in the treatment of retentive fecal incontinence in the presence of psychiatric comorbidities, and along with other interventions.

Keywords: Retentive Fecal Incontinence, Risperidone, Treatment, Pediatric, Encopresis, Atypical Antipsychotics, Fecal Soiling

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Authors: Goran Sporiš, Dinko Vuleta, Stefan Lovro

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The purpose of the present study was to determine the associations between health-related quality of life (HRQOL) and physical activity (PA) in different domains. In this cross-sectional study, participants were 169 Croatian police officers (mean age 35.14±8.95 yrs, mean height 180.93±7.53 cm, mean weight 88.39±14.05 kg, mean body-mass index 26.90±3.39 kg/m2). The dependent variables were two general domains extracted from the HRQOL questionnaire: (1) physical component scale (PCS) and (2) mental component scale (MCS). The independent variables were job-related, transport, domestic and leisure-time PA, along with other factors: age, body-mass index, smoking status, psychological distress, socioeconomic status and time spent in sedentary behaviour. The associations between dependent and independent variables were analyzed by using multiple regression analysis. Significance was set up at p < 0.05. PCS was positively associated with leisure-time PA (β 0.28, p < 0.001) and socioeconomic status (SES) (β 0.16, p=0.005), but inversely associated with job-related PA (β -0.15, p=0.012), domestic-time PA (β -0.14, p=0.014), age (β -0.12, p=0.050), psychological distress (β -0.43, p<0.001) and sedentary behaviour (β -0.15, p=0.009). MCS was positively associated with leisure-time PA (β 0.19, p=0.013) and SES (β 0.20, p=0.002), while inversely associated with age (β -0.23, p=0.001), psychological distress (β -0.27, p<0.001) and sedentary behaviour (β -0.22, p=0.001). Our results added new information about the associations between domain-specific PA and both physical and mental component scale in police officers. Future studies should deal with the same associations in other stressful occupations.

Keywords: health, fitness, police force, relations

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Authors: Yu-Ching Lin, Meei-Ling Gau, Ghi-Hwei Kao, Hung-Chang Lee

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Objective: To compare the pushing experiences and birth outcomes of three different pushing positions during the second stage of labor. The three positions were: semi-recumbent, squatting, and squatting with the aid of ergonomically designed ankle supports. Methods: A randomized controlled trial was conducted at a regional teaching hospital in northern Taiwan. Data were collected from 168 primiparous women in their 38th to 42nd gestational week. None of the participants received epidural analgesia during labor and all were free of pregnancy and labor-related complications. Intervention: During labor, after full cervical dilation and when the fetal head had descended to at least the +1 station and had turned to the occiput anterior position, the experimental group was asked to push in the squatting position while wearing the ergonomically designed ankle supports; comparison group A was asked to push in the squatting position without the use of these supports; and comparison group B was asked to push in a standard semi-recumbent position. Measures: The participants completed a demographic and obstetrics datasheet, the Short Form McGill Pain Questionnaire (MPQ-SF), and the Labor Pushing Experience scale within 4-hours postpartum. Conclusion: In terms of delivery time, the duration between the start of pushing to crowning for the experimental group (squatting with ankle supports) averaged 25.52 minutes less (F =6.02, p< .05) than the time for comparison group B (semi-recumbent). Furthermore, the duration between the start of pushing to infant birth averaged 25.21 minutes less for the experimental group than for comparison group B (F =6.14, p< .05). Moreover, the experimental group had a lower average VAS pain score (5.05±3.22) than comparison group B and the average McGill pain score for the experimental group was lower than both comparison groups (F=18.12, p< .001). In summary, the participants in the group that delivered from a squatting position with ankle supports had better labor pushing experiences than their peers in the comparison groups. Results: In comparison to both unsupported squatting and semi-recumbent pushing, squatting with the aid of ergonomically designed ankle supports reduced pushing times, ameliorated labor pain, and improved the pushing experience. Clinical application and suggestion: The squatting with ankle-support intervention introduced in the present study may significantly reduce tiredness and difficulties in maintaining balance as well as increase pushing efficiency. Thus, this intervention may reduce the caring needs of women during the second stage of labor. This intervention may be introduced in midwifery education programs and in clinical practice as a method to improve the care of women during the second stage of labor.

Keywords: second stage of labor, pushing, squatting with ankle supports, squatting

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Authors: Maryam Sadeghi

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Civilization and industrialization are two important factors that make people believe they are just depriving of savagery and brutality. But practical studies show exactly something different. How groups of people behave, when they are put in extreme situations is the very unpleasant truth about the human being in general. Both novels deal with the fragility of human society, no matter the people who are playing a role are children or grown-ups, who by definition should know better. Both novels have got beautiful plots in which no one enforces rules and laws on the characters, so they begin to show their true nature. The present study is undertaken to investigate the process of a journey from lack of humanity to a sort of self-consciousness which happens at the end of both Blindness by Saramago and Lord of the Flies by Golding. In order to get the best result the two novels have been studied precisely and lots of different articles and critical essays have been analyzed, which shows people drift into cruelty and savagery easily but can also drift out of it. In blindness losing sight, and being apart from society in a deserted tropical island in Lord of the Flies causes limitation. Limitation in any form makes people rebel. Although in the process of both novels, any kind of savagery, brutality, filth, and social collapse can be observable and both writers believe that human being has the potential of being animal images, but they both also want to show that the very nature of human being is divine. Children’s weeping at the end Lord of the Flies and Doctor’s remark at the end of Blindness “I don’t think we did go blind, I think we are blind, blind but seeing, blind people who can see but do not see”, show exactly the matter of insight at the end of the novels. The fact that divinity exists in the very nature of human being is the indubitable aim that makes this research truly valuable.

Keywords: brutality, lack of humanity, savagery, Blindness

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Authors: Claire Baudry, Jessica Pearson, Laura-Emilie Savage, George Tarbulsy

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Over the last fifty years, maternal sensitivity and child development among vulnerable families have been a priority for researchers. For this reason, attachment-based interventions have been implemented and been shown to be effective in enhancing child development. Most of the time, child outcomes are measured shortly after the intervention. Objectives: The goal of the study was to investigate the effects of an attachment-based intervention on child development shortly after the intervention ended and one-year post-intervention. Methods: Over the seventy-two mother-child dyads referred by Child Protective Services in the province of Québec, Canada, forty-two were included in this study: 24 dyads who received 6 to 8 intervention sessions and 18 dyads who did not. Intervention and none intervention dyads were matched for the following variables: duration of child protective services, the reason for involvement with child protection, age, sex, and family status. Internalizing and externalizing behaviors were measured 3 and 12 months after the end of the intervention when the average age of children were respectively 45 and 54 months old. Findings: Independent-sample t-tests were conducted to compare scores between the two groups and the two data collection times. In general, on differences observed between the two groups three months after the intervention ended, just a few of them were still present nine months later. Conclusions: This first set of analyses suggests that the effects of attachment-based intervention observed three months following the intervention are not lasting for most of them. Those results inform us of the importance of considering the possibility to offer more attachment-based intervention sessions for those highly vulnerable families.

Keywords: attachment-based intervention, child behaviors, child protective services, highly vulnerable families

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Authors: Ayman M. Arfaj, Jose Lauro M. Llamas, Saleh Y Qahtani

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Sulfur Loading Operation (SLO) is an operation that poses risk of exposure to toxic gases such as Hydrogen Sulfid and Sulfur Dioxide during molten sulfur loading operation. In this operation molten sulfur is loaded into a truck tanker in a liquid state and the temperature of the tanker must maintain liquid sulfur within a 43-degree range — between 266 degrees and 309 degrees Fahrenheit in order for safe loading and unloading to occur. Accordingly, in this study, the e potential risk of occupational exposure to the airborne toxic gases was assessed at three sulfur loading facilities. The concentrations of toxic airborne substances such as Hydrogen Sulfide (H2S) and Sulfur Dioxide (SO2), were monitored during operations at the different locations within the sulfur loading operation facilities. In addition to extensive real-time monitoring, over one hundred and fifty samples were collected and analysed at internationally accredited laboratories. The concentrations of H2S, and SO2 were all found to be well below their respective occupational exposure limits. Very low levels of H2S account for the odours observed intermittingly during mixing and application operations but do not pose a considerable health risk and hence these levels are considered a nuisance. These results were comparable to those reported internationally. Aside from observing the usual general safe work practices such as wearing safety glasses, there are no specific occupational health related concerns at the examined sulfur loading facilities.

Keywords: exposure assessment, sulfur loading operation, health risk study, molten sulfur, toxic airborne substances, air contaminants monitoring

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Authors: Khaled Saad Eldin Mohamed Ragab

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This paper investigates analytically the torsion behavior of steel fibered high strength self compacting concrete beams reinforced by GFRP bars. Nonlinear finite element analysis on 12­ beams specimens was achieved by using ANSYS software. The nonlinear finite element analysis program ANSYS is utilized owing to its capabilities to predict either the response of reinforced concrete beams in the post elastic range or the ultimate strength of a reinforced concrete beams produced from steel fiber reinforced self compacting concrete (SFRSCC) and reinforced by GFRP bars. A general description of the finite element method, theoretical modeling of concrete and reinforcement are presented. In order to verify the analytical model used in this research using test results of the experimental data, the finite element analysis were performed. Then, a parametric study of the effect ratio of volume fraction of steel fibers in ordinary strength concrete, the effect ratio of volume fraction of steel fibers in high strength concrete, and the type of reinforcement of stirrups were investigated. A comparison between the experimental results and those predicted by the existing models are presented. Results and conclusions thyat may be useful for designers have been raised and represented.

Keywords: nonlinear analysis, torsionally loaded, self compacting concrete, steel fiber reinforced self compacting concrete (SFRSCC), GFRP bars and sheets

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Authors: Alina Rahim, Joanne Moffatt, Jessica Taylor, Joseph Hartland, Tamer Abdelrazik

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Background: In 2011, 15% of maternal deaths in Uganda were due to hypertensive disorders (pre-eclampsia and eclampsia). The majority of these deaths are avoidable with optimum antenatal care. The aim of the study was to evaluate how antenatal monitoring of pre-eclampsia was carried out in a low resource setting and to identify barriers to best practice as recommended by the World Health Organisation (WHO) as part of a 4th year medical student External Student Selected component field trip. Method: Women admitted to hospital with pre-eclampsia in rural Uganda (Villa Maria and Kitovu Hospitals) over a year-long period were identified using the maternity register and antenatal record book. It was not possible to obtain notes for all cases identified on the maternity register. Therefore a total of thirty sets of notes were reviewed. The management was recorded and compared to Ugandan National Guidelines and WHO recommendations. Additional qualitative information on routine practice was established by interviewing staff members from the obstetric and midwifery teams. Results: From the records available, all patients in this sample were managed according to WHO recommendations during labour. The rate of Caesarean section as a mode of delivery was noted to be high in this group of patients; 56% at Villa Maria and 46% at Kitovu. Antenatally two WHO recommendations were not routinely met: aspirin prophylaxis and calcium supplementation. This was due to lack of resources, and lack of attendance at antenatal clinic leading to poor detection of high-risk patients. Medical management of pre-eclampsia varied between individual patients, overall 93.3% complied with Ugandan national guidelines. Two patients were treated with diuretics, which is against WHO guidance. Discussion: Antenatal monitoring of pre-eclampsia is important in reducing severe morbidity, long-term disability and mortality amongst mothers and their babies 2 . Poor attendance at antenatal clinic is a barrier to healthcare in low-income countries. Increasing awareness of the importance of these visits for women should be encouraged. The majority of cases reviewed in this sample of women were treated according to Ugandan National Guidelines. It is recommended to commence the use of aspirin prophylaxis for women at high-risk of developing pre-eclampsia and the creation of detailed guidelines for Uganda which would allow for standardisation of care county-wide.

Keywords: antenatal monitoring, low resource setting, pre-eclampsia, Uganda

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Authors: P. Booma Devi, Dilip A. Shah

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This paper seeks the potentials of studying aerodynamic characteristics of inward cavities called dimples, as an alternative to the classical vortex generators. Increasing stalling angle is a greater challenge in wing design. But our examination is primarily focused on increasing lift. In this paper, enhancement of lift is mainly done by introduction of dimple or cavity in a wing. In general, aircraft performance can be enhanced by increasing aerodynamic efficiency that is lift to drag ratio of an aircraft wing. Efficiency improvement can be achieved by improving the maximum lift co-efficient or by reducing the drag co-efficient. At the time of landing aircraft, high angle of attack may lead to stalling of aircraft. To avoid this kind of situation, increase in the stalling angle is warranted. Hence, improved stalling characteristic is the best way to ease landing complexity. Computational analysis is done for the wing segment made of NACA 0012. Simulation is carried out for 30 m/s free stream velocity over plain airfoil and different types of cavities. The wing is modeled in CATIA V5R20 and analyses are carried out using ANSYS CFX. Triangle and square shapes are used as cavities for analysis. Simulations revealed that cavity placed on wing segment shows an increase of maximum lift co-efficient when compared to normal wing configuration. Flow separation is delayed at downstream of the wing by the presence of cavities up to a particular angle of attack.

Keywords: lift, drag reduce, square dimple, triangle dimple, enhancement of stall angle

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Authors: Calvin Chiu, Samar Saade Needham

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The factors associated with the development of major depressive disorder (MDD) have been an ongoing area of concern within the field of psychopathology. Among parents, the rise in stress factors for individuals receiving less social support contributes to an increase in MDD cases. Understanding the causal aspects of MDD through the interworking of stress development within social support disparities provides critical insights into preventive measures for depressive symptoms. The present study seeks to assess the impact of social support on stress formation within MDD. Such that single parents lacking social support prompt an increase in stress formation, which proliferates the progression of MDD. Participants in this study were 450 ethnic minority mothers and fathers experiencing health inequities during pregnancy and early childhood. Perceived stress, social support, and depression are assessed by multi-item questionnaires that produce score ranges for general findings. Results indicated that lower social support scores resulted in higher depression scores, and higher perceived stress scores produced higher depression scores. Furthermore, single parents reported higher depression scores. These findings overlap with studies on paternal depression and suggest that MDD is a product of stress accumulation due to declining social support systems. Future studies may specify effective social support systems for decreasing stress accumulation in MDD formation in preventive strategies.

Keywords: major depressive disorder, stress formation, cognitive-behavioral outcomes, deficit-based behaviors

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