Search results for: children care

Authors: Melanie Moen, Christiaan Bezuidenhout

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Cases of parents murdering their offspring are incomprehensible but sadly as old as humanity itself. The act of killing your own child is known as filicide. Revenge filicide is an act where one parent kills their own offspring for retribution for hurting and upsetting the other parent. The true extent of filicide in South Africa is unknown, but in the United States, filicide constitutes more or less 2.5% of all murders. The focus of this contribution is to extend the knowledge of revenge filicide. Data was collected through court documents and newspaper articles. Newspapers that cover murder cases are between 75% to 100% accurate compared to official sources. Often family-related murders are violent in nature, and for this reason, these crimes receive extensive media coverage. The cases of twenty revenge filicide murderers (14 male and 6 female) were qualitatively analyzed to determine the motivations and offense characteristics of revenge filicide offenders. Findings related to a loss of social identity due to rejection; extreme rage-type anger; external locus of control; sadism; a desire to cause pain, and a need to inflict harm. The initial emotional response may escalate from mild anger to a level of narcissistic rage which eventually culminates in the murdering of the child to punish and hurt the other parent and to restore control. To our knowledge, our study is the first to systematically examine the motivations related to revenge filicides from a South African perspective. Filicide is a complex phenomenon with diverse possibilities and reasons why it occurs. However, it was apparent in this study that the motivations for revenge filicides were often linked to complex personal and interpersonal relationship problems. Further research within this field is imperative.

Keywords: revenge filicide, child murder, rage, anger, narcissistic rage, parent kills child

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Authors: Haruna Maama

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Environmental, social and governance (ESG) reporting is gaining considerable attention despite being voluntary. Meanwhile, it consumes resources to provide ESG reporting, raising a question of its value relevance. The study examined the impact of ESG reporting on the market value of listed firms in SSA. The annual and integrated reports of 276 listed sub-Sahara Africa (SSA) firms. The integrated reporting scores of the firm were analysed using a content analysis method. A multiple regression estimation technique using a GMM approach was employed for the analysis. The results revealed that ESG has a positive relationship with firms’ market value, suggesting that investors are interested in the ESG information disclosure of firms in SSA. This suggests that extensive ESG disclosures are attempts by firms to obtain the approval of powerful social, political and environmental stakeholders, especially institutional investors. Furthermore, the market value analysis evidence is consistent with signalling theory, which postulates that firms provide integrated reports as a signal to influence the behaviour of stakeholders. This finding reflects the value placed on investors' social, environmental and governance disclosures, which affirms the views that conventional investors would care about the social, environmental and governance issues of their potential or existing investee firms. Overall, the evidence is consistent with the prediction of signalling theory. In the context of this theory, integrated reporting is seen as part of firms' overall competitive strategy to influence investors' behaviour. The findings of this study make unique contributions to knowledge and practice in corporate reporting.

Keywords: environmental accounting, ESG accounting, signalling theory, sustainability reporting, sub-saharan Africa

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Authors: Mir Mohammad Reza Hosseini

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In new years immune checkpoint inhibitors have gathered care as being one of the greatest talented kinds of immunotherapy on the prospect. There has been a specific emphasis on the immune checkpoint molecules, cytotoxic T-lymphocyte antigen-4 (CTLA-4) and programmed cell death protein 1 (PD-1). In 2011, ipilimumab, the primary antibody obstructive an immune checkpoint (CTLA4) was authorized. It is now documented that recognized tumors have many devices of overpowering the antitumor immune response, counting manufacture of repressive cytokines, staffing of immunosuppressive immune cells, and upregulation of coinhibitory receptors recognized as immune checkpoints. This was fast followed by the growth of monoclonal antibodies directing PD1 (pembrolizumab and nivolumab) and PDL1 (atezolizumab and durvalumab). Anti-PD1/PDL1 antibodies have developed some of the greatest extensively set anticancer therapies. We also compare and difference their present place in cancer therapy and designs of immune-related toxicities and deliberate the role of dual immune checkpoint inhibition and plans for the organization of immune-related opposing proceedings. In this review, the employed code and present growth of numerous immune checkpoint inhibitors are abridged, while the communicating device and new development of Immune checkpoint inhibitors in cancer therapy-based synergistic therapies with additional immunotherapy, chemotherapy, phototherapy, and radiotherapy in important and clinical educations in the historical 5 years are portrayed and tinted. Lastly, we disapprovingly measure these methods and effort to find their fortes and faintness based on pre-clinical and clinical information.

Keywords: checkpoint, cancer therapy, PD-1, PDL-1, CTLA4, immunosuppressive

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Authors: Nur Atiqah Adam, Mor Jack Ng, Bernard Chern, Kok Hian Tan

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Introduction: Gestational diabetes (GDM) is a common pregnancy complication with short and long-term health consequences for both mother and fetus. Factors such as family history of diabetes mellitus, maternal obesity, maternal age, ethnicity and parity have been reported to influence the risk of GDM. In a multi-racial country like Singapore, it is worthwhile to study the GDM prevalences of different ethnicities. We aim to investigate the influence of ethnicity on the racial prevalences of GDM in Singapore. This is important as it may help us to improve guidelines on GDM healthcare services according to significant risk factors unique to Singapore. Materials and Methods: Obstetric cohort data of 926 singleton deliveries in KK Women’s and Children’s Hospital (KKH) from 2011 to 2013 was obtained. Only patients aged 18 and above and without complicated pregnancies or chronic illnesses were targeted. Factors such as ethnicity, maternal age, parity and maternal body mass index (BMI) at booking visit were studied. A multivariable logistic regression model, adjusted for confounders, was used to determine which of these factors are significantly associated with an increased risk of GDM. Results: The overall GDM prevalence rate based on WHO 1999 criteria & at risk screening (race alone not a risk factor) was 8.86%. GDM rates were higher among women above 35 years old (15.96%), obese (15.15%) and multiparous women (10.12%). Indians had a higher GDM rate (13.0 %) compared to the Chinese (9.57%) and Malays (5.20%). However, using multiple logistic regression model, variables that are significantly related to GDM rates were maternal age (p < 0.001) and maternal BMI at booking visit (p = 0.006). Conclusion: Maternal age (p < 0.001) and maternal booking BMI (p = 0.006) are the strongest risk factors for GDM. Ethnicity per se does not seem to have a significant influence on the prevalence of GDM in Singapore (p = 0.064). Hence we should tailor guidelines on GDM healthcare services according to maternal age and booking BMI rather than ethnicity.

Keywords: ethnicity, gestational diabetes, healthcare, pregnancy

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Authors: Asma Ammar, Nabiha Bouafia , Asma BenCheikh, Mohamed Mahjoub, Olfa Ezzi, Wadiaa Bannour, Radhia Helali, Mansour Njah

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Background: The objective of the present study was to identify factors associated with vaccination against Hepatitis B virus (HBV) among healthcare workers (HWs) in the University Hospital Center (UHC) Farhat Hached Sousse, Tunisia. Methods: We conducted a descriptive cross-sectional study all licensed physicians (n= 206) and a representative sample of paramedical staff (n= 372) exercising at UHC Hached Sousse (Tunisia) during two months (January and February 2014). Data were collected using a self-administered and pre-tested questionnaire, which composed by 21 questions. In order to determinate factors associated with vaccination against hepatitis B among HWs, this questionnaire was based on the Health Belief Model, one of the most classical behavior theories. Logistic regression with the stepwise method of Hosmer and Lemeshow was used to identify the determinants of the use of vaccination against HBV. Results: The response rates were 79.8%. Fifty two percent believe that HBV is frequent in our healthcare units and 60.6% consider it a severe infection. The prevalence of HWs vaccination was 39%, 95% CI [34.49%; 43.5%]. In multivariate analysis, determinants of the use of vaccination against HBV among HWs were young age (p=10-4), male gender (p = 0. 006), high or very high importance accorded to health (p = 0.035), perception membership in a risk group for HBV infection (p = 0.038) and very favorable or favorable opinion about vaccination against HVB (p=10-4). Conclusion: The results of our study should be considered in any strategy for preventing VHB infection in HWs. In the mean time, coverage with standard vaccines should be improved also by supplying complete information on the risks of VHB infection and on the safety and efficacy of vaccination.

Keywords: Hepatitis B virus, healthcare workers, prevalence, vaccination

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Authors: Mukhtar Sarkin-Kebbi

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Insurgency, religious extremism and other related religious crises become hydra-headed in Nigeria, which caused destruction of human lives and properties worth of billions naira. As result, millions people were displaced and million children were out of school most of whom from Muslims community. The wrong teaching and misinterpretation of Islam by some Muslim community fuel the spread of extremist ideology hatred among Muslim sects, non-Muslims and emergency of extremist groups, like Boko Haram. A multi-religious country like Nigeria to realise its development in all human aspects, there must be unity and religious tolerance. Many agreed that changing the ideologies of insurgents and religious extremism will require intellectual role with vigorous campaign. Muslim scholars can play a vital role in promoting social reform and peaceful coexistence. This paper discusses the importance of unity among Muslim community and religious tolerance in light of the Qur’an and the Hadith. The paper also reviews the relationship between Muslims and non Muslims during the life time the Prophet (S.A.W.) in order to serve as exemplary model. Contemporary issues such as religious extremism, sectarians, intolerance and their consequences were examined. To minify religious intolerance and extremism,the paper identifies the roles to be played by Muslim scholars with references from Qur’an and Sunnah. The paper concludes that to realise overall human development and eternal salvation, Muslim should shun away from any religious crises and embrace unity and religious tolerance. Finally the paper recommends among others that only pious and learned scholars should be allowed to preach in any religious gathering, Muslim should exercise patience, tolerance in dealing with Muslims and non Muslims. Muslims should leave by example from the teaching of Qur’an and Sunnah of the Prophet (S.A.W.).

Keywords: Muslim scholars, peace building, religious extremism, religious tolerance

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Authors: Getachew Adugna

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Background: Chronic energy malnutrition and human immune deficiency virus among pregnant women are highly prevalent in Sub-Saharan Africa, and they are interrelated in a vicious cycle. However, the prevalence of chronic energy malnutrition and its determinant factors among human immune deficiency virus-positive pregnant women is not well studied in Ethiopia and Addis Ababa in particular. Objective: To determine the prevalence & associated factors of chronic energy malnutrition among human immune deficiency virus-positive pregnant women in health centres of Addis Ababa Ethiopia. Methods: An institution-based cross-sectional study was conducted and a systematic random sampling technique was used to select study subjects. A total of 253 study subjects were enrolled in the study—a structured and pre-tested questionnaire collected sociodemographic, maternal health-related, and nutritional-related variables. MUAC measurements were taken and medical charts were reviewed. Bi-variable and multi-variable logistic regression analyses were used to assess the effect of different factors on chronic energy malnutrition. Result: The overall prevalence of chronic energy malnutrition was 32.0%. It was significantly associated with dietary counselling (AOR: 0.062; 95%CI: 0.007, 0.549), CD4 level (AOR: 0.219; 95%CI: 0.025, 1.908), and clinical stage (AOR: 0.127; 95%CI: 0.053, 0.305). Conclusions: The prevalence of chronic energy malnutrition among Human Immune deficiency virus-infected pregnant women in Addis Ababa was high and Nutritional Intervention should be an integral part of the HIV care program.

Keywords: chronic energy malnutrition, HIV, MUAC, Addis Ababa

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Authors: Stjepka Popović, Lucija Vejmelka

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Background: Cyberbullying has become a prevalent issue worldwide, including in Croatia. However, a comprehensive understanding of the extent and nature of cyberbullying in the Croatian context is lacking. Objective: The objective of this systematic review is to evaluate the quality of current research conducted in Croatia on the subject of cyberbullying, identify any gaps in the research, and provide suggestions for future investigations. It examines the prevalence gender and age differences of cyberbullying in Croatia. Participants and Setting: Research is done on secondary data resources (published studies) of cyberbullying in Croatia. The participants in these studies that were included in systematic review are children and youth of all ages residing in Croatia who have been involved in cyberbullying incidents. The setting includes various environments where cyberbullying may occur, such as social media platforms and educational institutions. Methods: To identify pertinent studies on cyberbullying in Croatia, a comprehensive exploration of both international and domestic electronic databases was systematically undertaken. Relevant studies were chosen according to predefined criteria that determined inclusion and exclusion. Key findings from the selected studies were extracted and synthesized, enabling the identification of patterns in the data. Results: A total of 43 studies that fulfilled the inclusion criteria were identified in the review. The prevalence of cyberbullying victimization in Croatia ranged from 7% - 55.3%, with adolescents being the most affected group. The prevalence of cyberbullying perpetration was ranging from 3.2% - 30.3%. The most prevalent form of cyberbullying included gossiping and mocking others. Gender and age differences are highlighted. Conclusions: The outcomes of this systematic review highlight the pressing need for targeted interventions and preventative measures to address cyberbullying in Croatia. Additionally, it is crucial to conduct further research to investigate the long-term impacts and potential factors that can help mitigate cyberbullying in the context of Croatia.

Keywords: cyberbullying, online risky behavior, Croatia, systematic review

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Authors: G. R. Constantine, M.C.K. Thilakasiri, V.S. Mohottala, T.V. Soundaram, D.S. Rathnayake, E.G.H.E. De Silva, A.L.S. Mohamed, V.R. Weerasekara

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Orthostatic hypotension is prevalent in the elderly population, and it is an important risk factor contributing to falls in the elderly. This study aims to evaluate the prevalence of orthostatic hypotension in hospitalized elderly patients, changes in blood pressure during the hospital stay, morbidities associated with it and its association with falls in the elderly. A cross-sectional descriptive study was conducted in the National Hospital of Sri Lanka (NHSL) in a sample of 120 patients of age 65 years or above who were admitted to the medical wards. The demographic, clinical data was obtained by an interviewer-administered questionnaire. Two validated questionnaires were used to assess symptoms and effects of orthostatic hypotension and risk factors associated with falls. Orthostatic hypotension on admission and after 3 days of hospital stay was measured by bed-side mercury sphygmomanometer. Prevalence of orthostatic hypotension among the study population was 63.3%(76 patients). But no significant change in the orthostatic hypotension noted after 3 days of hospital admission (SND 0.61, SE= 5.59, p=0.27). There was no significant association found between orthostatic hypotension and its symptoms (dizziness and vertigo, vision problems, malaise, fatigue, poor concentration, neck stiffness), impact on standing or walking and non-communicable diseases. Falls were experienced by 27.5 % (33 patients) of the study population and prevalence of patients with orthostatic hypotension who had experienced falls was 25.9% (28 patients). In conclusions, orthostatic hypotension is more prevalent among elderly patients, but It wasn’t associated with symptoms, and non-communicable diseases, or as a risk factor for falls in elderly.

Keywords: orthostatic hypotension, elderly falls, emergency geriatric, Sri Lanka

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Authors: Sinead Impey, Damon Berry, Selma Furtado, Miriam Galvin, Loretto Grogan, Orla Hardiman, Lucy Hederman, Mark Heverin, Vincent Wade, Linda Douris, Declan O'Sullivan, Gaye Stephens

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Healthcare is a knowledge-rich environment. This knowledge, while valuable, is not always accessible outside the borders of individual clinics. This research aims to address part of this problem (at a study site) by constructing a maximal data set (knowledge artefact) for motor neurone disease (MND). This data set is proposed as an initial knowledge base for a concurrent project to develop an MND patient data platform. It represents the domain knowledge at the study site for the duration of the research (12 months). A knowledge elicitation method was also developed from the lessons learned during this process - the WICKED method. WICKED is an anagram of the words: eliciting and confirming data, information, knowledge, wisdom. But it is also a reference to the concept of wicked problems, which are complex and challenging, as is eliciting expert knowledge. The method was evaluated at a second site, and benefits and limitations were noted. Benefits include that the method provided a systematic way to manage data, information, knowledge and wisdom (DIKW) from various sources, including healthcare specialists and existing data sets. Limitations surrounded the time required and how the data set produced only represents DIKW known during the research period. Future work is underway to address these limitations.

Keywords: healthcare, knowledge acquisition, maximal data sets, action design science

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Authors: N. Haj Salem, M. Belhadj, S. Ben Jomâa, S. Saadi, R. Dhouieb, A. Chadly

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Introduction: Sudden death in young is seen as a dramatic phenomenon requiring knowledge of its impact and determining their causes. Aim: We aim to study the epidemiological characteristics of sudden death in young, and to discuss the mechanism and the importance of autopsy in these situations. Material and methods: We performed a retrospective cohort study using autopsy data from the department of forensic medicine at the University Hospital of Fattouma Bourguiba, Monastir-Tunisia. A review of all autopsies performed during 23 years was done. In each case, clinical information and circumstances of death were obtained. We have included all sudden death in persons aged between 1 year and 35 years for the male and from one year to 45 years for female. We collected 312 cases of sudden death during the studied period. The collected data were processed using SPSS 20. The significance level was set at 0.05. Results: Thirty-two cases of cardiac ischemic sudden death have been collected. Myocardial infarction was the second cause of sudden death in young patients. There was a male predominance. The most affected subjects were aged between 25-45 years. The death occurred more frequently at rest. Coronary artery disease has been discovered in twenty-four cases (75%). A severe coronary artery disease was observed in two children with medical history of familial hypercholesterolemia. The myocardial infarction occurred in healthy coronary arteries in eight cases. An anomalous course of coronary arteries, in particular, myocardial bridging, was found in eight cases (25%). Toxicological screening was negative in all cases. Second cause of death was hypertrophic cardiomyopathy. Neurological and respiratory causes of death were implicated respectively in 10% and 15%. Conclusion: Identifying epidemiological characteristics of sudden death in this population is important for guiding approaches to prevention that must be based on dietary hygienic measures and the control of cardiovascular risk factors.

Keywords: autopsy, cardiac death, sudden death, young

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Authors: Maria Margoudi, Zacharoula Smyraniou

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The current paper presents the results of a conducted case study, which was part of the author’s master thesis. During the past few years the number of children diagnosed with Learning Difficulties has drastically augmented and especially the cases of ADHD (Attention Deficit Hyperactivity Disorder). One of the core characteristics of ADHD is a deficit in working memory functions. The review of the literature indicates a plethora of educational software that aim at training and enhancing the working memory. Nevertheless, in the current paper, the possibility of using for the same purpose free, online games will be explored. Another issue of interest is the potential effect of the working memory training to the core symptoms of ADHD. In order to explore the abovementioned research questions, three digital tests are employed, all of which are developed on the E-slate platform by the author, in order to check the level of ADHD’s symptoms and to be used as diagnostic tools, both in the beginning and in the end of the case study. The tools used during the main intervention of the research are free online games for the training of working memory. The research and the data analysis focus on the following axes: a) the presence and the possible change in two of the core symptoms of ADHD, attention and impulsivity and b) a possible change in the general cognitive abilities of the individual. The case study was conducted with the participation of a thirteen year-old, female student, diagnosed with ADHD, during after-school hours. The results of the study indicate positive changes both in the levels of attention and impulsivity. Therefore we conclude that the training of working memory through the use of free, online games has a positive impact on the characteristics of ADHD. Finally, concerning the second research question, the change in general cognitive abilities, no significant changes were noted.

Keywords: ADHD, attention, impulsivity, online games

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Authors: Abeer Ahmed Abdelhamed

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Introduction: Postoperative pulmonary complications (PPCs) are the most common complications observed and managed after abdominal or cardiothoracic surgery. Hypoxemia, atelectasis, pleural effusion, or diaphragmatic dysfunction, are often a source of morbidity in cardiac surgery patients, and are more common in patients receiving unilateral or bilateral internal mammary artery (IMT) grafts than patients receiving saphenous vein (SV) grafts alone. Purpose: The aim of this work was to investigate the effect of Threshold load inspiratory muscle training on pulmonary gas exchange and maximum inspiratory pressure (MIP) in patient undergoing coronary revascularization. Subject: Thirty three male patients eligible for coronary revascularization were selected to participate in the study. Method: They were divided into two groups(17 patients in the intervention group and 16 patients in the control group), the interventional group received inspiratory muscle training at 30% of their maximum inspiratory pressure throughout the hospitalization period in addition to routine post operative care. Result: The results of this study showed a significant improvement on maximum inspiratory pressure(MIP), Arterial-alveolar pressure gradient (A-a gradient) and oxygen saturation in the intervention group. Conclusion: Inspiratory muscle training using threshold mode significantly improves maximum inspiratory pressure, pulmonary gas exchange tested by alveolar-arterial gradient and oxygen saturation in Patients undergoing coronary revascularization.

Keywords: coronary revascularization, inspiratory muscle training, maximum inspiratory pressure, pulmonary gas exchange

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Authors: C. F. Jones Couto

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The implementation of quality Physical Education (PE) inspires and instils lasting healthy behavioural patterns, hence have the potential as an educational tool to teach values in today’s society. The goal of PE should be to contribute to the acceptance of the infinite qualities of South Africa’s (RSA) diversity and to claim RSA’s diversity as a source of strength that forms a universal bond of a common set of values. There is a global change in the interaction of children with their environment; their lives are shaped by forces that do not necessarily assist them in learning and applying values. In most countries today, the responsibility for developing values is assigned to schools in formal teaching settings. Values-based education offers an investment in individual and societal improvement through attendance to a values framework. The aim of this qualitative research is to develop a PE programme aligned with the current South African curriculum, enriched with values of Olympism and Ubuntuism, and to present PE teacher training workshops (TTW). Participatory action research will be used as the basis of how data will be collected, analysed, and presented on an ongoing, cyclical basis. PE teachers from different schools in the Tshwane District of RSA will participate as they can best inform the research questions and enhance the understanding of the phenomenon under study. The outcomes of using PE as a tool to teach values can propose recommendations to the Department of Basic Education of RSA to improve and implement a quality PE curriculum that is applicable to practice and that will optimize the chances of meeting the South African National Curriculum Statement standards. A PE programme with the aim of holistic development, based on the values of Olympism and Ubuntuism, can strive to ensure that the values set out in RSA’s constitution are part of PE organization, planning, and teaching at each South African school.

Keywords: olympism, physical education, teacher training, ubuntuism, values-based education

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Authors: Jamie R. Chua, Christina Irene D. Mejia, Regina P. Berba

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Disseminated tuberculosis is an infectious disease caused by Mycobacterium tuberculosis involving two or more non-contiguous sites identified through bacteriologic confirmation or clinical diagnosis. Over the five year period included in the study, the UP-PGH TB DOTS clinic had total of 3,967 referrals, and the prevalence of disseminated tuberculosis is 1% (68/3967). The mean age was 33.9 years (range 19-64 years) with a male: female ratio of 1:1. 67% (52 patients) had no predisposing comorbid illness or immune disorder. The most common presenting symptoms were abdominal pain (19%), back pain (13%), abdominal enlargement (11%) and mass (10.2%). Anemia, leukocytosis, hypoalbuminemia, and high-normal serum calcium were common biochemical and hematologic findings. Around 36% (25) of patients were diagnosed clinically with disseminated tuberculosis despite lacking bacteriologic evidence of multi-organ involvement. The lungs (86%) is still the most commonly involved site, followed by intestinal (22%), vertebral/Pott’s (27%), and pelvic/genital (19%). The mean time from presentation to initiation of therapy was 22 days (SD 32.7). Only 18 patients (29.3%) were properly recorded to have been referred to local TB DOTs facilities. Of the 68 patients, only 16% (11 patients) continued follow-up at PGH, and all had documented treatment completion. Treatment outcomes of the remaining were unknown. Due to the variety of involved sites, a high index of suspicion is required. Knowledge on clinical features, common radiographic findings, and histopathologic characteristics of disseminated TB is important as bacteriologic evidence of infection is not always apparent.

Keywords: disseminated tuberculosis, Mycobacterium tuberculosis, miliary tuberculosis, tuberculosis

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Authors: Joseph Mary Ssembatya, Blessing Michael Taremwa

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Background: Multiple schwannomas are typically associated with neurofibromatosis type 1 (NF1), but rare cases occur independently of neurofibromatosis. Schwannomas are benign, slow-growing tumors, primarily affecting the cervical and lumbar spine. When large, they may extend over multiple vertebral levels, posing surgical challenges. Case Presentation: A 13-year-old Ugandan Munyankore female patient, presented with a 6-year history of progressive quadriparesis, particularly in the lower limbs. Clinical examination showed hypertonia and hyperreflexia, with no indicators of neurofibromatosis or prior trauma. MRI revealed two “kissing” schwannomas extending from C2 to T2 in the cervical spine. Decompressive surgery was performed through laminoplasty and partial lesion resection, and histology confirmed schwannoma. Two weeks postoperatively, the patient experienced cerebrospinal fluid (CSF) leakage, neck pain, and headache, which required re-operation and duraplasty. Following these interventions, the patient’s neurological status stabilized, with noted improvement in lower limb strength. Discussion: “Kissing” schwannomas are most frequently documented in the cerebellopontine angle, rarely in the spine, and even more rarely in children. While multiple schwannomas are often associated with NF2, this case had no family history or clinical signs of the disorder. Giant invasive spinal schwannomas (GISS) that span multiple vertebrae demand intricate surgical approaches due to their proximity to neurovascular structures. Conclusion: This is the first reported case of kissing cervical schwannomas in a young patient from a low- to middle-income country. Surgical decompression, though challenging, is critical for neurological recovery in such advanced cases.

Keywords: kissing schwannoma, cervical spine, low resource, young, uganda

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Authors: Chassel T. Paras, Tryxzy Q. Dela Cruz, Ma. Carmela Lousie V. Goingco, Pauline L. Tolentino, Carmela S. Dizon

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In implementing inclusive education, parental involvement is measured to be an irreplaceable contributing factor. Parental involvement is described as an indispensable aspect of the teaching-learning process and has a remarkable effect on the student's academic performance. However, there are still differences in the viewpoints, expectations, and needs of both parents and teachers that are not yet fully conveyed in their relationship; hence, the perceptions of SNED teachers are essential in their collaboration with parents. This qualitative study explored how SNED teachers perceive the roles of parental involvement in the teaching-learning process of students with special needs. To answer this question, one-on-one face-to-face semi-structured interviews with three SNED teachers in a selected public school in Angeles City, Philippines, that offer special needs education services were conducted. The gathered data are then analyzed using Interpretative Phenomenological Analysis (IPA). The results revealed four superordinate themes, which include: (1) roles of parental involvement, (2) parental involvement opportunities, (3) barriers to parental involvement, and (4) parent-teacher collaboration practices. These results indicate that SNED teachers are aware of the roles and importance of parental involvement; however, despite parent-teacher collaboration, there are still barriers that impede parental involvement. Also, SNED teachers acknowledge the big roles of parents as they serve as main figures in the teaching-learning process of their children with special needs. Lastly, these results can be used as input in developing a school-facilitated parenting involvement framework that encompasses the contribution of SNED teachers in planning, developing, and evaluating parental involvement programs, which future researchers can also use in their studies

Keywords: parental involvement, special needs education, teaching-learning process, teachers’ perceptions, special needs education teachers, interpretative phenomenological analysis

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Authors: Souhir Chelly, Asma Ben Cheikh, Hela Ghali, Salwa Khefacha, Lamine Dhidah, Mohamed Ben Rejeb, Houyem Said Latiri

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The hospital risk management department is firstly involved in the methodological analysis of grade zero sterilization incidents. The system is based on a subsequent analysis process in compliance with the ongoing requirements of the Haute Autorité de santé (HAS) for a reactive approach to risk, allowing to identify failures and start the appropriate preventive and corrective measures. The use of the association of litigation and risk management (ALARM) method makes easier the grade zero analysis and brings to light the team or institutional, organizational, temporal, individual factors representative of undesirable effects. Two main factors come out again from this analysis, pre-disinfection step of the emergency block unsupervised instrumentalist intern was poorly done since she did not remove the battery from micro air motor. At the sterilization unit, the worker who was not supervised by the nurse did the conditioning of the motor without having checked it if it still contained the battery. The main cause is that the management of human resources was inadequate at both levels, the instrumental trainee in the block who was not supervised by his supervisor and the worker of the sterilization unit who was not supervised by the responsible nurse. There is a lack of research help, advice, and collaboration. The difficulties encountered during this type of analysis are multiple. The first is based on its necessary acceptance by the various actors of care involved, which should not perceive it as a tool leading to individual punishment, but rather as a means to improve their practices.

Keywords: ALARM (Association of Litigation and Risk Management Method), incident, risk management, sterilization

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Authors: Zhang Jun Xiong

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Objective: To explore the effect of physical exercise and outdoor lighting on the improvement of pupils' eyesight. Methods: A total of 208 first grade students in a primary school in Chengdu were enrolled in the study, 104 of whom were nearsighted and 104 had normal vision. They were randomly divided into indoor exercise group, outdoor exercise group, indoor control group and outdoor control group. Indoor and outdoor exercise groups performed moderate and high-intensity aerobic exercise three times a week, 60 minutes each time; The indoor and outdoor control groups had normal study and life during the experiment, without exercise intervention. The experiment lasted for one academic year, and the visual indicators of the subjects were tested before and after the experiment. Results: After the experiment, the visual fatigue index of the subjects with normal vision in the outdoor exercise group, indoor exercise group and outdoor control group decreased by 1.5 ± 2.89, 1.4 ± 3.05, 2.12 ± 2.66 respectively, and the diopter index decreased by 0.30D ± 0.09, 0.41D ± 0.16, 0.40D ± 0.19 respectively, while the visual fatigue score of the subjects with normal vision in the indoor control group increased by 2.3 ± 2.15, and the diopter decreased by 0.53D ± 0.22, There were significant differences in visual fatigue and diopter among the subjects with normal vision in each group (P<0.001). After the experiment, the visual fatigue index of the myopic subjects in the outdoor exercise group, indoor exercise group and outdoor control group decreased by 1.8 ± 1.95, 0.8 ± 1.81, 1.1 ± 1.85 respectively, and the diopter index decreased by 0.35D ± 0.21, 0.52D ± 0.24, 0.52D ± 0.15 respectively, while the visual fatigue score of the myopic subjects in the indoor control group increased by 1.3 ± 2.66, and the diopter decreased by 0.62D ± 0.29. There were significant differences between groups in visual fatigue and diopter (P<0.001). Conclusion: Both physical exercise and outdoor lighting can have a beneficial effect on children's vision, and the superposition effect of the two is better. It is suggested that outdoor physical exercise should be carried out more in primary school.

Keywords: physical exercise, outdoor lighting, pupil, vision, myopia

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Authors: Karim Hajjar, Luis Lillo, Diego Martinez, Manuel Hermosilla, Nicholas Risko

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Objectives: This study examines the relationship between universal health coverage (UCH) and the burden of emergency diseases at a global level. Methods: Data on Disability-Adjusted Life Years (DALYs) from emergency conditions were extracted from the Institute for Health Metrics and Evaluation (IHME) database for the years 2015 and 2019. Data on UHC, measured using two variables, 1) coverage of essential health services and 2) proportion of population spending more than 10% of household income on out-of-pocket health care expenditure, was extracted from the World Bank Database for years preceding our outcome of interest. Linear regression was performed, analyzing the effect of the UHC variables on the DALYs of emergency diseases, controlling for other variables. Results: A total of 133 countries were included. 44.4% of the analyzed countries had coverage of essential health services index of at least 70/100, and 35.3% had at least 10% of their population spend greater than 10% of their household income on healthcare. For every point increase in the coverage of essential health services index, there was a 13-point reduction in DALYs of emergency medical diseases (95% CI -16, -11). Conversely, for every percent decrease in the population with large household expenditure on healthcare, there was a 0.48 increase in DALYs of emergency medical diseases (95% CI -5.6, 4.7). Conclusions: After adjusting for multiple variables, an increase in coverage of essential health services was significantly associated with improvement in DALYs for emergency conditions. There was, however, no association between catastrophic health expenditure and DALYs.

Keywords: emergency medicine, universal healthcare, global health, health economics

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Authors: Seon Yeong Byeon, Hwa Sung Shin

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Nanofibrous sheets are of interest in the beauty industries due to the properties of moisturizing, adhesion to skin and delivery of nutrient materials. The benefit and function of the cosmetic products should not be considered without safety thus a non-toxic manufacturing process is ideal when fabricating the products. In this study, we have developed cosmetic patches consisting of alginate and Spirulina extract, a marine resource which has antibacterial and antioxidant effects, without addition of harmful cross-linkers. The patches obtained their structural stabilities by layer-upon-layer electrospinning of an alginate layer on a formerly spread polycaprolactone (PCL) layer instead of crosslinking method. The morphological characteristics, release of Spirulina extract, water absorption, skin adhesiveness and cytotoxicity of the double-layered patches were assessed. The image of scanning electron microscopy (SEM) showed that the addition of Spirulina extract has made the fiber diameter of alginate layers thinner. Impregnation of Spirulina extract increased their hydrophilicity, moisture absorption ability and skin adhesive ability. In addition, wetting the pre-dried patches resulted in releasing the Spirulina extract within 30 min. The patches were detected to have no cytotoxicity in the human keratinocyte cell-based MTT assay, but rather showed increased cell viability. All the results indicate the bioactive and hydro-adhesive double-layered patches have an excellent applicability to bioproducts for personal skin care in the trend of ‘A mask pack a day’.

Keywords: alginate, cosmetic patch, electrospun nanofiber, polycaprolactone, Spirulina extract

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Authors: Tanja Salary

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This study uncovers a gap in the research and adds to the body of knowledge regarding medication errors in a juvenile justice facility. The study includes an introduction to data collected about medication errors in a juvenile justice facility and explores contributing factors that relate to those errors. The data represent electronic incident records of the medication errors that were documented from the years 2011 through 2019. In addition, this study reviews both current and historical research of empirical data about patient safety standards and quality care comparing traditional healthcare facilities to juvenile justice residential facilities. The theoretical/conceptual framework for the research study pertains to Bandura and Adams’s (1977) framework of self-efficacy theory of behavioral change and Mark Friedman’s results-based accountability theory (2005). Despite the lack of evidence in previous studies about addressing medication errors in juvenile justice facilities, this presenter will relay information that adds to the body of knowledge to note the importance of how assessing the potential relationship between medication errors. Implications for more research include recommendations for more education and training regarding increased communication among juvenile justice staff, including nurses, who administer medications to juveniles to ensure adherence to patient safety standards. There are several opportunities for future research concerning other characteristics about factors that may affect medication administration errors within the residential juvenile justice facility.

Keywords: juvenile justice, medication errors, psychotropic medications, behavioral health, juveniles, incarcerated youth, recidivism, patient safety

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Authors: Mario Isaza-Ruget, Claudia C. Colmenares-Mejia, Nancy Yomayusa, Camilo A. González, Andres Cely, Jossie Murcia

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Quantification of risks associated with complications development from chronic kidney disease (CKD) through accurate survival models can help with patient management. A retrospective cohort that included patients diagnosed with CKD from a primary care program and followed up between 2013 and 2018 was carried out. Time-dependent and static covariates associated with demographic, clinical, and laboratory factors were included. Deep Learning (DL) survival analyzes were developed for three CKD outcomes: CKD stage progression, >25% decrease in Estimated Glomerular Filtration Rate (eGFR), and Renal Replacement Therapy (RRT). Models were evaluated and compared with Random Survival Forest (RSF) based on concordance index (C-index) metric. 2.143 patients were included. Two models were developed for each outcome, Deep Neural Network (DNN) model reported C-index=0.9867 for CKD stage progression; C-index=0.9905 for reduction in eGFR; C-index=0.9867 for RRT. Regarding the RSF model, C-index=0.6650 was reached for CKD stage progression; decreased eGFR C-index=0.6759; RRT C-index=0.8926. DNN models applied in survival analysis context with considerations of longitudinal covariates at the start of follow-up can predict renal stage progression, a significant decrease in eGFR and RRT. The success of these survival models lies in the appropriate definition of survival times and the analysis of covariates, especially those that vary over time.

Keywords: artificial intelligence, chronic kidney disease, deep neural networks, survival analysis

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Authors: Mohammed-Hareef Asunramu, Sana Hashemi, Raja Ohri, Luc Worthington, Nadia Zaman, Junkai Zhu

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Background: The 2012 Health and Social Care Act committed to a ‘parity of esteem between mental and physical health services. Although this investment, aimed to both increase the quality of services and ensure the retention of mental health staff, questions remained regarding its ability to prevent mental health problems. One possible solution is a focus on the social determinants of health which have been shown to impact mental health. Aim: To examine the relationship between the index of multiple deprivations (IMD) and the prevalence of common mental health disorders (CMD) for CCGs in NHS England between 2019 and 2020. Design and setting: Cross-sectional analysis of 189 CCGs in NHS England. Methods: A multivariate linear regression model was utilized with CMD as outcome variable and IMD, age and ethnicity as explanatory variables. Datasets were obtained from Public Health England and the latest UK Census. Results: CCG IMD was found to have a significantly positive relationship with CMD. For every 1-point increase in IMD, CMD increases by 0.25%. Ethnicity had a significantly positive relationship with CMD. For every 1% increase in the population that identifies as BME, there is a 0.03% increase in CMD. Age had a significantly negative relationship with CMD. For every 1% increase in the population aged 60+, there is a 0.11% decrease in CMD. Conclusion: This study demonstrates that addressing mental health issues may require a multi-pronged approach. Beyond budget increases, it is essential to prioritize health equity, with careful considerations towards ethnic minorities and different age brackets.

Keywords: deprivation, health inequality, mental health, social determinants

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Authors: Ofole Ndidi

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Context: Empirical studies show that through dual primary attachment mothers and fathers contribute to children’s development and behaviours. While the contribution of mothers is well documented in past researches, fathers’ involvement in Nigeria has received much less attention. As such, exploring fathers’ involvement in sexual behaviours will provide insight for policy implementation and programming designed to delay sexual debut among sexually inexperienced young people in Nigeria. Objective of study: This study examined the extent to which father involvement (father’s parenting style, attitude, father-child communication, father’s marital status, and father’s socio-economic status) could predict delay in sexual debut of a representative sample of Nigeria adolescents in lower secondary. Materials and Methods: Multistage sampling technique was adopted to draw a cross section of 1023 adolescents with the age range of 10-23 years and mean years of 12±2.1 who reported sexually inexperience from six geographical zones in Nigeria. Multiple Regressions was used to analyze the data collected with four standardized self-report measures at 0.05 level of significance. Results: Findings of this study revealed that the independent variables (father’s parenting style, paternal attitudes, paternal–child communication, paternal marital status and paternal socio–economic status) contributed significantly to the delay of sexual debut. However, fathers’ attitude made the most potent contribution (β = 0.255, P < 0.05). Conclusions: The outcomes of this study have implications for programs that are designed to reduce high-risk behaviors among adolescents. It concluded that sexuality education and interventions should involve the fathers in a more integrated and collaborative fashion.

Keywords: father, sexual debut, adolescents, Nigeria

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Authors: Huanhuan Qiang, Sijia Jin

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Population aging has become a global trend, and China has entered an aging society, implementing an active aging system focused on home and community-based care. However, most urban communities where elderly people live face issues such as monotonous planning, unappealing landscapes, and inadequate aging infrastructure, which do not meet the requirements for active aging. Intergenerational friendliness and mutual assistance are key components in China's active aging policy framework. Therefore, residential development should prioritize enhancing intergenerational friendliness. Residential and public spaces are central to community life and well-being, offering new and challenging venues to improve relationships among residents of different ages. They are crucial for developing intergenerational communities with diverse generations and non-blood relationships. This paper takes the Maigaoqiao community in Nanjing, China, as a case study, examining intergenerational interactions in public spaces. Based on Maslow's hierarchy of needs and using time geography analysis, it identifies the spatiotemporal behavior characteristics of intergenerational groups in outdoor activities. Then construct an intergenerational-friendly evaluation system and an IPA quadrant model for public spaces in residential areas. Lastly, it explores optimization strategies for public spaces to promote intergenerational friendly interactions, focusing on five aspects: accessibility, safety, functionality, a sense of belonging, and interactivity.

Keywords: intergenerational friendliness, demand theory, spatiotemporal behavior, IPA analysis, existing residential public space

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Authors: Parul Suraia, Harshit Sosan Lakra

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Indigenous communities represent some of the most marginalized populations globally, with India labeled as tribals, experiencing particularly pronounced marginalization and a concerning decline in their numbers. These communities often inhabit geographically challenging regions characterized by low population densities, posing significant challenges to providing essential infrastructure services. Jharkhand, a Schedule 5 state, is infamous for its low-level health status due to disparities in access to health care. The primary objective of this study is to investigate the spatial inequalities in healthcare accessibility among tribal populations within the state and pinpoint critical areas requiring immediate attention. Health indicators were selected based on the tribal perspective and association of Sustainable Goal 3 (Good Health and Wellbeing) with other SDGs. Focused group discussions in which tribal people and tribal experts were done in order to finalize the indicators. Employing Principal Component Analysis, two essential indices were constructed: the Tribal Health Index (THI) and the Tribal Health Intervention Index (THII). Index values were calculated based on the district-wise secondary data for Jharkhand. The bivariate spatial association technique, Moran’s I was used to assess the spatial pattern of the variables to determine if there is any clustering (positive spatial autocorrelation) or dispersion (negative spatial autocorrelation) of values across Jharkhand. The results helped in facilitating targeting policy interventions in deprived areas of Jharkhand.

Keywords: tribal health, health spatial disparities, health status, Jharkhand

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Authors: Donna-Marie Phyllis Lanton

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Sarcopenia is a well-known geriatric syndrome characterized by the progressive and generalized loss of muscle quantity or quality. The incidence of sarcopenia increases with age and is associated with adverse outcomes such as the increased risk of falls, cognitive impairment, loss of independence, diminished quality of life, increased health costs, need for care in a skilled nursing facility, and increased mortality. Physical activity, including resistance training, is the most prevalent recommendation for treating and preventing sarcopenia. Residents (N = 23) of a skilled nursing facility in East Orlando, Florida, participated in a 90-day strength training program designed using the PARIHS framework to improve measures of muscle mass, muscle strength, physical performance, and quality of life. Residents engaged in both resistance and balance exercises for 1 hour two times a week. Baseline data were collected and compared to data at Days 30, 60, and 90. T tests indicated significant gains on all measures from baseline to 90 days: muscle mass increased by 1.2 (t[22] = 2.85, p = .009), grip strength increased by 4.02 (t[22] = 8.15, p < .001), balance increased by 2.13 (t[22] = 18.64, p < .001), gait speed increased by 1.83 (t[22] = 17.84, p < .001), chair speed increased 1.87 (t[22] = 16.36, p < .001), and quality of life score increased by 17.5 (t[22] = 19.26, p < .001). For residents with sarcopenia in skilled nursing facilities, a 90-day strength training program with resistance and balance exercises may provide an option for decreasing the incidence of sarcopenia among that population

Keywords: muscle mass, muscle strength, older adults, PARIHS framework

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Authors: Marco Antonio Lara De la Calleja, María Catalina Ovando Chico, Eduardo Lopez Ruiz

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Community empowerment has been proved to be a key element in the solution of the food security problem. As a result of a conceptual analysis, it was found that agricultural production, economic development and governance, are the traditional basis of food security models. Although the literature points to social inclusion as an important factor for food security, no model has considered it as the basis of it. The aim of this research is to identify different dimensions that make an integral model for food security, with emphasis on community empowerment. A diagnosis was made in the study community (Tatoxcac, Zacapoaxtla, Puebla), to know the aspects that impact the level of food insecurity. With a statistical sample integrated by 200 families, the Latin American and Caribbean Food Security Scale (ELCSA) was applied, finding that: in households composed by adults and children, have moderated food insecurity, (ELCSA scale has three levels, low, moderated and high); that result is produced mainly by the economic income capacity and the diversity of the diet on its food. With that being said, a model was developed to promote food security through five dimensions: 1. Regional context of the community; 2. Structure and system of local food; 3. Health and nutrition; 4. Information and technology access; and 5. Self-awareness and empowerment. The specific actions on each axis of the model, allowed a systemic approach needed to attend food security in the community, through the empowerment of society. It is concluded that the self-awareness of local communities is an area of extreme importance, which must be taken into account for participatory schemes to improve food security. In the long term, the model requires the integrated participation of different actors, such as government, companies and universities, to solve something such vital as food security.

Keywords: community empowerment, food security, model, systemic approach

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Authors: Prachi Chavda

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The world, as of today, is smaller than it was for those who lived few decades ago. Internet, media and telecommunications have impacted the world like never before. Culture is the pillar upon which a society mushrooms. A culture develops with human creativity over the years and also by the exchange and intermixing of ideas and way of life across different civilizations and we can say that one of the influencing medium of exchange and intermixing of these ideas is cinema. Cinema has been the wonderful as well as important medium of communication since it has been emerged. Change is the thumb rule of life and so have been Indian cinema. As society has evolved from time to time so has the stories of Indian Cinema and its characters, hence it directly effects to the Indian culture as cinema has been very strong mediator for information exchange. The paper tries to discuss deeply how Indian cinema (reel life) and Indian culture (real life) has been influencing each other that results into a constant modification in both. Moreover, the research tries to deal with the issue with some examples that as a outcome how movies impact the Indian culture positively and negatively on culture. Therefore, it spreads the wave of change in cultural settings of society. The paper also tries to light the psychology of youth of India. Today, children and youth greatly admire the ostentatious materialistic display of outfits and style of the actors in the movies. Also, the movies bearing romanticism and showcasing disputatious issues like pre-marital sex, live-in relationship, homo-sexuality etc. though without highlighting them extensively have indeed inspired the commoners. Pros and cons always exist. Such revelation of issues certainly give a spark in the minds of those who are in their formative years and the effect of which is seen with the passage of time Thus, we can say that emergence of cinema as a strong tool of social change as well as culture as a triggering factor for transformation in cinema. As, a finding we can say that culture and cinema of India are influencing factors for each other. Cinema and culture are two sides of a coin, where both are responsible for evolution of each other.

Keywords: cinema, culture, influence, transformation

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