Search results for: multivariate%20control%20chart

Authors: Md. Rezaul Karim, Andreas Thiel

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Bangladesh is known as one of the most climate vulnerable countries in the world. Innovative technologies are always the key responses to the management of climate impacts. The objectives of this study are to determine the farmer’s perception of climate variability, to compare farmers’ perceptions with metrological data, and to explore the determinants that affect the likelihood of adoption of the selected Climate Smart Agricultural (CSA) technologies. Data regarding climate change perception, determinants and adoption were collected based on the household survey from stratified and randomly selected 365 farmers of the Biral sub-district under Dinajpur district in drought-prone northern Bangladesh. The likelihood of adoption of CSA technologies was analyzed following a multivariate probit model. The findings show that about 82.5% of the farmers perceived increasing temperature, and 75.1 % of farmers perceived decreasing dry season rainfall over the years, which is similarly relevant to metrological data. About 76.4.7% and 80.85% of farmers were aware of the drought tolerance crops and vermicompost, respectively; more than half of the farmers adopted these practices. Around 70.7% of farmers were aware of perching for insect control, but 46.3% of farmers adopted this practice. Although two-thirds of farmers were aware of crop diversification and pheromone trap, adoption was lower compared to the other three CSAs. Results also indicate that the likelihood of adoption of the selected CSAs is significantly influenced by different factors such as socio-economic characteristics, institutional factors and perceived technological or innovation attributes. The likelihood of adopting drought tolerance crops is affected by 11, while crop diversification and perching method by 7, pheromone trap by 9 and vermicompost by 8 determining factors. Lack of information and unavailability of input appear to be major obstacles to the non-adoption of CSA technologies. This study suggests that policy implications are necessary to promote extension services and overcome the obstacles to the non-adoption of individual CSA technologies. It further recommends that the research study should be conducted in a diverse context, nationally or globally.

Keywords: determinants, adoption, climate smart agriculture, northern Bangladesh

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Authors: Wudneh Asegedech Ayele

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Background: Dietary diversity is strongly related with non-communicable disease (NCDs). Diet plays a key role as a risk factor for hypertension. Diets rich in fruits, vegetables, and low-fat dairy products that include whole grains, poultry, fish, and nuts, that contain only small amounts of red meat, sweets, and sugar-containing beverages, and that contain decreased amounts of total and saturated fat and cholesterol have been found to have a protective effect against hypertension. Methods: hospital based Cross-sectional study design was employed from June 1-June 25, 2021. Sampling technique was Systematic random sampling and data were collected using an interview method. Data were entered into Epi Data version 3.1 and exported to SPSS version 25 for processed and analysis respectively. Descriptive statistics were used to summarize data. Bivariate and multivariate logistic regression will employed to determine dietary diversity among hypertension patients. Results: Adequate dietary diversity score were 96 (24.68%). Most of them cereal, white roots and tubers, dark green leafy vegetables, Vitamin A rich fruits ,meat, egg and coffee or tea more intakes. Hypertensive patients who didn’t consume cereals four times less likely adequate dietary diversity than who consumed cereals [AOR= 4.083, 95%: CI (2.096 -7.352)]. Hypertensive patients who didn’t consume white roots and tubers 14 times less likely adequate dietary diversity than who consumed white roots and tubers [AOR= 13.733, 95% CI: (5.388-34.946)]. Conclusion and recommendation the study showed one of fourth part reported adequate dietary diversity score. Cereals, fruits, vegetables and milk and milk products were statistically associated with dietary diversity practice. Health education about dietary modifications and behavioral change to dietary diversity

Keywords: dietary diversity practice and associated facrors among hypertension patients at tirunesh beijing hospital, hypertension, dietary, diversity and tirunesh beijing hospital, associated facrors among hypertension patient, at tirunesh beijing hospita

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Authors: Melba Sheila D'Souza, Anandhi Amirtharaj, Shreedevi Balachandran

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Background: Type 2 diabetes has a significant impact on individuals’ health and well-being. Glycemic control may influence self-efficacy and self-care behaviors, and reduce the risk of complications among adults with type 2 diabetes. Type 2 diabetes has substantial morbidity and mortality and 60% of adults’ poor self-care. Glycemic control is associated with reported self-efficacy and self-care behavior. Adults with type 2 diabetes with less information were less likely to take diabetes self-care. Aim: To examine the relationship between glycemic control, demographic factors, clinical factors on self-efficacy, self-care behaviors among Omani adults with type 2 diabetes. Methods: A correlational, descriptive study was used. Omani adults with type 2 diabetes (n=140) were recruited from a public hospital in Oman. The data were collected during January-March 2015. Ethical approval was given by the college research and ethics committee, College of Nursing, and the Hospital, Sultan Qaboos University Data was collected on self-efficacy, self-care behaviors and glycemic control. The study was approved by the Institution Ethics and Research Committee. Bivariate and multivariate analyses were conducted. Results: Most adults had a fasting blood glucose >7.2mmol/L (90.7%), with the majority demonstrating ‘uncontrolled or poor HbA1c of > 8%’ (65%). Variance of self-care behavior (20.6%) and 31.3% of the variance of the self-efficacy was explained by the age, duration of diabetes, medication, HbA1c and prevention of activities of living. Adults with type 2 diabetes with poor glycemic control were more likely to have poor self-efficacy and poor self-care behaviors. Conclusion: This study confirms that self-efficacy model on outcome predicts self-efficacy and self-care behavior. Higher understanding of diabetes, prevention of normal daily activities, higher ability to fit diabetes life in a positive manner and high patient-physician communication were significant with self-efficacy and self-care behaviors. Hence, glycemic control has a high effect on improving self-care behaviors like diet, exercise, medication, foot care and self-efficacy among type 2 diabetes. Implications: Using these findings to improve self-efficacy, individualized self-care management is recommended for better self-efficacy and self-care behaviors among adults with type 2 diabetes.

Keywords: self-efficacy, self-care behaviors, self-care management, glycemic control, type 2 diabetes, nurse

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Authors: Dragan Zivotic, Mirjana Ilic, Aleksandra Perovic, Predrag Gavrilovic

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As with the provision of other services, the service quality perception is one of the key factors that the modern manager must pay attention to. Countries in which the state regulation is in transition also have specific features in providing fitness services. Identification of the dimensions in which the most significant different service quality perception between different types of fitness centers, enables managers to profile the offer according to the wishes and expectations of users. The aim of the paper was the comparison of the quality of services perception in the field of fitness in Serbia between three categories of fitness centers: the privately owned centers, the publicly owned centers, and the Public-private partnership centers. For this research 350 respondents of both genders (174 men and 176 women) were interviewed, aged between 18 and 68 years, being beneficiaries of fitness services for at least 1 year. Administered questionnaire with 100 items provided information about the 15 basic areas in which they expressed the service quality perception in the gym. The core sample was composed of 212 service users in private fitness centers, 69 service users in public fitness centers and 69 service users in the public-private partnership. Sub-samples were equal in representation of women and men, as well as by age and length of use of fitness services. The obtained results were subject of univariate analysis with the Kruskal-Wallis non-parametric analysis of variance. Significant differences between the analyzed sub-samples were not found solely in the areas of rapid response and quality outcomes. In the multivariate model, the results were processed by backward stepwise discriminant analysis that extracted 3 areas that maximize the differences between sub-samples: material and technical basis, secondary facilities and coaches. By applying the classification function 93.87% of private centers services users, 62.32% of public centers services users and 85.51% of the public-private partnership centers users of services were correctly classified (total 86.00%). These results allow optimizing the allocation of the necessary resources in profiling offers of a fitness center in order to optimally adjust it to the user’s needs and expectations.

Keywords: fitness, quality perception, management, public ownership, private ownership, public-private partnership, discriminative analysis

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Authors: Hanan Khojah, RuAngelie Edrada-Ebel

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Neurodegenerative disease including Alzheimer’s disease is a major cause of long-term disability. Oxidative stress is frequently implicated as one of the key contributing factors to neurodegenerative diseases. Protection against neuronal damage remains a great challenge for researchers. Ficus carica (commonly known as fig) is a species of great antioxidant nutritional value comprising a protective mechanism against innumerable health disorders related to oxidative stress as well as Alzheimer’s disease. The purpose of this work was to characterize the non-polar active metabolites in Ficus carica endocarp, mesocarp, and exocarp. Crude extracts were prepared using several extraction solvents, which included 1:1 water: ethylacetate, acetone and methanol. The dried extracts were then solvent partitioned between equivalent amounts of water and ethylacetate. Purification and fractionation were accomplished by high-throughput chromatography. The isolated metabolites were tested on their effect on human neuroblastoma cell line by cell viability test and cell cytotoxicity assay with acrolein. Molecular weights of the active metabolites were determined via LC–HRESIMS and GC-EIMS. Metabolomic profiling was performed to identify the active metabolites by using differential expression analysis software (Mzmine) and SIMCA for multivariate analysis. Structural elucidation and identification of the interested active metabolites were studied by 1-D and 2-D NMR. Significant differences in bioactivity against a concentration-dependent assay on acrolein radicals were observed between the three fruit parts. However, metabolites obtained from mesocarp and the endocarp demonstrated bioactivity to scavenge ROS radical. NMR profiling demonstrated that aliphatic compounds such as γ-sitosterol tend to induce neuronal bioactivity and exhibited bioactivity on the cell viability assay. γ-Sitosterol was found in higher concentrations in the mesocarp and was considered as one of the major phytosterol in Ficus carica.

Keywords: alzheimer, Ficus carica, γ-Sitosterol, metabolomics

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Authors: An-Yi Wang, Wei-Fong Kao, Shin-Han Tsai

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Introduction: Information as patient characteristics, resuscitation scene, resuscitation provider perspectives and families wish affects on resuscitation decision-making for out-of-hospital cardiac arrest (OHCA). There is no consistency consensus on how families and emergency physicians approach this decision. The main purpose of our study is to evaluate the characteristics of withholding resuscitation efforts arrival at the hospital. Methods: We retrospectively analyzed patients with OHCA without pre-hospital return-of-spontaneous circulation (ROSC) who was sent to our emergency department (ED) between January 2014 and December 2015. Baseline characteristics, pre-hospital course, and causes of the cardiopulmonary arrest among patients were compared. Results: In 2 years, total 155 arrest patients without pre-hospital ROSC was included. 33(21.3%) patients withhold the resuscitation efforts in ED with mean resuscitation duration 4.45 ± 7.04 minutes after ED arrival. In withholding group, the initial rhythm of arrests was all non-shockable. 9 of them received endotracheal intubation before decision-making. None of the patients in withhold resuscitation group survived to discharge. There was no significant difference among gender, underlying cardiovascular disease, malignancy, chronic renal disease, nor witness collapse between withhold and continue resuscitation groups. Univariate analysis showed there was lower percentage of bystander resuscitation (32.3% vs. 50.4%, p=0.071), and the lower percentage of transport via emergency medical service (EMS) (78.8% vs. 91.8%, p=0.054) in withholding group. Multivariate analysis showed old age (adjusted odds ratio=1.06, 95% C.I.=[1.02-1.11], p<0.05), with underlying respiratory insufficiency (adjusted odds ratio=12.16, 95% C.I.=[3.34-44.29], p<0.05), living at home compared with nursing home (adjusted odds ratio=37.75, 95% C.I.=[1.09-1110.70], p<0.05) were more likely to withhold resuscitation. Transport via EMS was more likely to continue resuscitation (adjusted odds ratio=0.11, 95% C.I.=[0.02-0.71], p<0.05). Conclusion: The decision-making for families and emergency physicians to withhold or continue resuscitation for out-of-hospital cardiac arrest is complex and multi-factorial. Continue resuscitation efforts in nursing home residents is high, and further study among this population is warranted.

Keywords: cardiopulmonary resuscitation, out-of-hospital cardiac arrest, termination resuscitation, withhold resuscitation

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Authors: Visa I. Tyakaray, M. Abdulaziz, O. Badmus, N. Karaye, M. Dalhat, A. Shehu, I. Bello, T. Hussaini, S. Akar, G. Effah, P. Nguku

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Introduction: Nigeria has recorded outbreaks of meningitis in the past, being in the meningitis belt. A multi-state outbreak of Cerebrospinal Meningitis (CSM) from Neisseria meningitides occurred in 2017 involving 24 states, and Kano State reported its first two confirmed CSM cases on 22nd March, 2017. We conducted the outbreak investigation to characterize the outbreak, determine its associated risk factors and institute appropriate control measures. Method: We conducted an unmatched Case-control study with ratio 1:2. A case was defined as any person with sudden onset of fever (>38.5˚C rectal or 38.0˚C axillary) and one of the following: neck stiffness, altered consciousness or bulging fontanelle in toddlers while a control was defined as any person who resides around the case such as family members, caregivers, neighbors, and healthcare personnel. We reviewed and validated line list and conducted active case search in health facilities and neighboring communities. Descriptive, bivariate, stratified and multivariate analysis were performed. Laboratory confirmation was by Latex agglutination and/or Culture. Results: We recruited 48 cases with median age of 11 years (1 month – 65 years), attack rate was 2.4/100,000 population with case fatality rate of 8%; 34 of 44 local government areas were affected.On stratification, age was found to be a confounder. Independent factors associated with the outbreak were age (Adjusted Odds Ratio, AOR =6.58; 95% Confidence Interval (CI) =2.85-15.180, history of Vaccination (AOR=0.37; 95% CI=0.13-0.99) and history of travel (AOR=10.16; (1.99-51.85). Laboratory results showed 22 positive cases for Neisseria meningitides types C and A/Y. Conclusion: Major risk factors associated with this outbreak were age (>14years), not being vaccinated and history of travel. We sensitized communities and strengthened case management. We recommended immediate reactive vaccination and enhanced surveillance in bordering communities.

Keywords: cerebrospinal, factors, Kano-Nigeria, meningitis, risk

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Authors: Nicholas Bayfield, Liam Bibo, Charley Budgeon, Robert Larbalestier, Tom Briffa

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Introduction: Stress hyperglycaemia is common following cardiac surgery. Its optimal management is uncertain and may differ by diabetic status. This study assesses the in-hospital glycaemic management of cardiac surgery patients and associated postoperative outcomes. Methods: A retrospective cohort analysis of all patients undergoing cardiac surgery at Fiona Stanley Hospital from February 2015 to May 2019 was undertaken. Management and outcomes of hyperglycaemia following cardiac surgery were assessed. Follow-up was assessed to 1 year postoperatively. Multivariate regression modelling was utilised. Results: 1050 non-diabetic patients and 689 diabetic patients were included. In the non-diabetic cohort, patients with mild (peak blood sugar level [BSL] < 14.3), transient stress hyperglycaemia managed without insulin were not at an increased risk of wound-related morbidity (P=0.899) or mortality at 1 year (P=0.483). Insulin management was associated with wound-related readmission to hospital (P=0.004) and superficial sternal wound infection (P=0.047). Prolonged or severe stress hyperglycaemia was predictive of hospital re-admission (P=0.050) but not morbidity or mortality (P=0.546). Diabetes mellitus was an independent risk factor 1-year mortality (OR; 1.972 [1.041–3.736], P=0.037), graft harvest site wound infection (OR; 1.810 [1.134–2.889], P=0.013) and wound-related readmission (OR; 1.866 [1.076–3.236], P=0.026). In diabetics, postoperative peak BSL > 13.9mmol/L was predictive of graft harvest site infections (OR; 3.528 [1.724-7.217], P=0.001) and wound-related readmission OR; 3.462 [1.540-7.783], P=0.003) regardless of modality of management. A peak BSL of 10.0-13.9 did not increase the risk of morbidity/mortality compared to a peak BSL of < 10.0 (P=0.557). Diabetics with a peak BSL of 13.9 or less did not have significantly increased morbidity/mortality outcomes compared to non-diabetics (P=0.418). Conclusion: In non-diabetic patients, transient mild stress hyperglycaemia following cardiac surgery does not uniformly require treatment. In diabetic patients, postoperative hyperglycaemia with peak BSL exceeding 13.9mmol/L was associated with wound-related morbidity and hospital readmission following cardiac surgery.

Keywords: cardiac surgery, pulmonary embolism, pulmonary embolectomy, cardiopulmonary bypass

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Authors: Roengchai Tansuchat, Woraphon Yamaka, Paravee Maneejuk

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From the past recent, the global financial crisis, economic instability, and large fluctuation in agricultural commodity price have led to increased concerns about the volatility transmission among them. The problem is further exacerbated by commodities volatility caused by other commodity price fluctuations, hence the decision on hedging strategy has become both costly and useless. Thus, this paper is conducted to analysis the volatility spillover effect among major agriculture including corn, soybeans, wheat and rice, to help the commodity suppliers hedge their portfolios, and manage the risk and co-volatility of them. We provide a switching regime approach to analyzing the issue of volatility spillovers in different economic conditions, namely upturn and downturn economic. In particular, we investigate relationships and volatility transmissions between these commodities in different economic conditions. We purposed a Copula-based multivariate Markov Switching GARCH model with two regimes that depend on an economic conditions and perform simulation study to check the accuracy of our proposed model. In this study, the correlation term in the cross-hedge ratio is obtained from six copula families – two elliptical copulas (Gaussian and Student-t) and four Archimedean copulas (Clayton, Gumbel, Frank, and Joe). We use one-step maximum likelihood estimation techniques to estimate our models and compare the performance of these copula using Akaike information criterion (AIC) and Bayesian information criteria (BIC). In the application study of agriculture commodities, the weekly data used are conducted from 4 January 2005 to 1 September 2016, covering 612 observations. The empirical results indicate that the volatility spillover effects among cereal futures are different, as response of different economic condition. In addition, the results of hedge effectiveness will also suggest the optimal cross hedge strategies in different economic condition especially upturn and downturn economic.

Keywords: agricultural commodity futures, cereal, cross-hedge, spillover effect, switching regime approach

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Authors: Melissa Hachem, Maxime Loizeau, Nadine Saleh, Isabelle Momas, Lynda Bensefa-Colas

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Professional drivers are exposed inside their vehicles to high levels of air pollutants due to the considerable time they spend close to motor vehicle emissions. Little is known about ultrafine particles (UFP) or black carbon (BC) adverse respiratory health effects compared to the regulated pollutants. We aimed to study the short-term associations between UFP and BC concentrations inside vehicles and (1) the onset of mucosal irritation and (2) the acute changes in lung function of Parisian taxi drivers during a working day. An epidemiological study was carried out on 50 taxi drivers in Paris. UFP and BC were measured inside their vehicles with DiSCmini® and microAeth®, respectively. On the same day, the frequency and the severity of nose, eye, and throat irritations were self-reported by each participant and a spirometry test was performed before and after the work shift. Multivariate analysis was used to evaluate the associations between in-taxis UFP and BC concentrations and mucosal irritation and lung function, after adjustment for potential confounders. In-taxis UFP concentrations ranged from 17.9 to 37.9 × 103 particles/cm³ and BC concentrations from 2.2 to 3.9 μg/m³, during a mean of 9 ± 2 working hours. Significant dose-response relationships were observed between in-taxis UFP concentrations and both nasal irritation and lung function. The increase of in-taxis UFP (for an interquartile range of 20 × 103 particles/cm3) was associated to an increase in nasal irritation (adjusted OR = 6.27 [95% CI: 1.02 to 38.62]) and to a reduction in forced expiratory flow at 25–75% by −7.44% [95% CI: −12.63 to −2.24], forced expiratory volume in one second by −4.46% [95% CI: −6.99 to −1.93] and forced vital capacity by −3.31% [95% CI: −5.82 to −0.80]. Such associations were not found with BC. Incident throat and eye irritations were not related to in-vehicle particles exposure; however, they were associated with outdoor air quality (estimated by the Atmo index) and in-vehicle humidity, respectively. This study is the first to show a significant association, within a short-period of time, between in-vehicle UFP exposure and acute respiratory effects in professional drivers.

Keywords: black carbon, lung function, mucosal irritation, taxi drivers, ultrafine particles

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Authors: Naiara de Almeida Rios

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The environmental education, from Tbilisi, is signaled as an important instrument for conservation and environmental management. However, the social, economic, political and environmental aspects of each place require an environmental management that corresponds to the reality to which they are inserted, as well as environmental education practices. The city of Belém, the capital of the State of Pará, is one of the most important cities in the Amazon Region, and its vast water dimension requires that its watersheds take a careful look at their socio-environmental management. The Estrada Nova Hydrographic Basin is considered as one of the most critical river basins in the city due to flooding, lack of basic sanitation and degradation of water bodies. In this context, environmental education is understood as one of the necessary conditions to reduce environmental degradation. Environmental education presents itself as an instrument of social transformation and conservation of natural resources (especially water resources), where thinking about the sustainability of natural resources is moving towards dialogue on the importance of building an environmental awareness. The commitment that environmental education proposes covers all spheres of society, since the main objective of the same is the transformation of thought and attitudes from the understanding of reality. Therefore, to analyze how the government is managing the basin, as well as the environmental education practices developed in it, is fundamental, so that government can be charged with improvements for the population and for the natural environment. Therefore, the objective of this study is to analyze the influence of environmental education actions developed by local public authorities in the management of the Estrada Nova Hydrographic Basin, Belém/PA. For the accomplishment of this study, some methodological procedures will be used, like documentary analysis, bibliographical survey and fieldwork. If the multivariate statistical method is used to analyze the results obtained in the field. Unfortunately, public policies in the area of ​environmental education in Belém are still moving in short steps, since government interests have had very little dialogue with the socio-environmental problems that affect the Estrada Nova Hydrographic Basin. Both formal and informal environmental education has been poorly developed, hampering the continuous process proposed by water resources management.

Keywords: environmental education, environmental management, hydrographic basin, water resources

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Authors: Kafeero Frank

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This study aimed at developing a frame work for open source software adoption in an institution of higher learning in Uganda, with the case of KIU as a study area. There were mainly four research questions based on; individual staff interaction with open source software forum, perceived FOSS characteristics, organizational characteristics and external characteristics as factors that affect open source software adoption. The researcher used causal-correlation research design to study effects of these variables on open source software adoption. A quantitative approach was used in this study with self-administered questionnaire on a purposively and randomly sampled sample of university ICT staff. Resultant data was analyzed using means, correlation coefficients and multivariate multiple regression analysis as statistical tools. The study reveals that individual staff interaction with open source software forum and perceived FOSS characteristics were the primary factors that significantly affect FOSS adoption while organizational and external factors were secondary with no significant effect but significant correlation to open source software adoption. It was concluded that for effective open source software adoption to occur there must be more effort on primary factors with subsequent reinforcement of secondary factors to fulfill the primary factors and adoption of open source software. Lastly recommendations were made in line with conclusions for coming up with Kyambogo University frame work for open source software adoption in institutions of higher learning. Areas of further research recommended include; Stakeholders’ analysis of open source software adoption in Uganda; Challenges and way forward. Evaluation of Kyambogo University frame work for open source software adoption in institutions of higher learning. Framework development for cloud computing adoption in Ugandan universities. Framework for FOSS development in Uganda IT industry

Keywords: open source software., organisational characteristics, external characteristics, cloud computing adoption

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Authors: Einat Peles, Anat Sason, Ariel Claman, Gabriel Barkay, Miriam Adelson

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Individuals with opioid addiction are characterized as suffering from stress responses disturbance, including the hypothalamic-pituitary-adrenal (HPA) axis, and autonomic nervous system function. HPA axis is known to be stabilized during methadone maintenance treatment (MMT). Mindfulness (present-oriented, nonjudgmental awareness of cognitions, emotions, perceptions, and habitual behavioral reactions in daily life) counteracts stress. To our knowledge, the relation between perceived stress and mindfulness trait among MMT patients has never been studied. To measure indices of mindfulness and their relation to perceived stress among MMT patients, a cross-sectional random sample of current MMT patients was performed using questionnaires for perceived stress (PSS) and mindfulness trait (FFMQ- yields a total score and individual scores for five internally consistent mindfulness factors: Observing, Describing, Acting with awareness and consciousness, Non-judging the inner experience, Non-reactivity to the inner experience). Two additional groups were studied to serve as reference groups; Medical students that are known to suffer from stress, and Axis II psychiatric diagnosis patients that are known to characterized with poor mindfulness trait. Results: Groups included 41 MMT patients, 27 Axis II patients and 36 medical students. High perceived stressed (PSS≥18) defined among 61% of the MMT patients and 50% of the medical students. Highest mindfulness score observed among non-stressed MMT patients (153.5±17.2) followed by the groups of stressed MMT and non-stressed student (128.9±17.0 and 130.5±13.3 respectively), with the lowest score among stressed students (116.3±17.9) (multivariate analyses, corrected model p (F=14.3) < 0.0005, p (group) < 0.0005, p (stress) < 0.0005, p (interaction) =0.2). Linear inverse correlations were found between perceived stress score and mindfulness score among MMT patients (R=-0.65, p < 0.0005) and students (R=-0.51, p=0.002). Axis II patients had the lowest mindfulness score (103.4±25.3). Conclusion: High prevalence of high perceived stressed which characterized with poor mindfulness trait observed in both MMT patients and medical students, two different population groups. The effectiveness of mindfulness treatment in reducing stress and improve mindfulness trait should be evaluated to improve rehabilitation of MMT patients, and students success.

Keywords: mindfulness, stress, methadone maintenance treatment, medical students

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Authors: Gudakesh Yadav

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Utter Pradesh, which is one of the largest states of India with unequal distribution of resources and different socioeconomic and cultural characteristics, level of different new born health care indicators varies a lot from one district to another district. State shared more than 21 percent of total live births of India; whereas, it accounts for 28 percent of total infant deaths of the country, with the 53 per thousand infant mortality rate. The present paper attempts to examine tempo-spatial changes in new born care practices during NFHS-1 to NFHS-3 and DLHS-2 to DLHS-3 in Uttar Pradesh and different regions. Descriptive statistics, rate-ratios, concentration index, multivariate and decomposition analysis has been used for the study. Findings of the study reveal that new born care practices have improved over the time in the state and across all the regions because of giving more emphasis on venerable groups like poor, rural, less educated mothers and scheduled caste & tribes but still it did not achieve the desired successes. Regional analysis of third rounds of DLHS shows that, coverage of intuitional delivery was the lowest in the central region. Performance of the southern region was the lowest in terms of initiation of breastfeeding, keeping baby warm and dry after the birth. The study calls for proper follow up of new born children to accelerate new born and child health care service and prioritises increasing antenatal check-ups and institutional delivery, which helps to improve level of other new born care services. At the policy level there is need to reach venerable groups like scheduled caste and tribes, poor and uneducated, and new mother especially in rural areas. High focused district should be allocated for better implementation of new born care promotion programme in low performing districts. Partnership with the private sector health professional is necessary to reach the every part of population.

Keywords: decomposition, inequality, initiation of breastfeeding, institutional delivery

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Authors: Alessandro Suardi, Rodolfo Picchio, Domenico Coaloa, Maria Bonaventura Forleo, Nadia Palmieri, Luigi Pari

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The reconversion process of the Italian sugar supply chain to bio-energy supply chains, as a result of the 2006 Sugar CMO reform, have involved research to define the best logistics, the most adapted energy crops for the Italian territory and their sustainability. Rapeseed (Brassica napus L.), Giant reed (Arundo donax L.) and Poplar (Poplar ssp.) are energy crops considered strategic for the development of Italian energy supply-chains. This study analyzed the environmental and the economic impacts on the farm level of these three energy crops. The environmental assessment included six farming units, two per crop, which were extracted from a sample of 251 rapeseed farm units (2751 ha), 7 giant reed farm units (7.8 ha), and 91 poplar farm units (440 ha) using a statistical multivariate analysis. Life Cycle Assessment (LCA) research method has been used to evaluate and compare the sustainability of the agricultural phases of the crops studied. The impact analyses have been performed at mid-point and end-point levels. The results of the analysis shown that the fertilization, is the major source of environmental impact of the agricultural phase due to the production of the fertilizers and the soil emissions of GHG following the treatment. The perennial energy crops studied (Arundo donax L., Poplar ssp.) were environmentally more sustainable if compared with the annual crop (Brassica napus L.) for all the impact categories at mid-point and end-point levels analyzed. The most relevant impact category influenced by the agricultural process result the fossil depletion, mainly due to the fossil fuels consumed during the mineral fertilizers production (urea). Human health was the most affected damage category at the end point level. Poplar result the energy crop with the best environmental performance for the Italian territory, in the distribution areas most suitable for its cultivation.

Keywords: LCA, energy crops, rapeseed, giant reed, poplar

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Authors: Maria de Nazaré Moraes Soares, Silvia Maria Dias Pedro Rebouças, José Carlos Lázaro

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The Solidarity Economy (SE) acts in the re-articulation of the economic field to the other spheres of social action. The significant participation of women in SE resulted in the formation of a national network of self-managed enterprises in Brazil: The Solidarity and Feminist Economy Network (SFEN). The objective of the research is to identify factors of gender justice and feminist self-management practices that adhere to the reality of women in SE enterprises. The conceptual apparatus related to feminist studies in this research covers Nancy Fraser approaches on gender justice, and Patricia Yancey Martin approaches on feminist management practices, and authors of postcolonial feminism such as Mohanty and Maria Lugones, who lead the discussion to peripheral contexts, a necessary perspective when observing the women’s movement in SE. The research has a quantitative nature in the phases of data collection and analysis. The data collection was performed through two data sources: the database mapped in Brazil in 2010-2013 by the National Information System in Solidary Economy and 150 questionnaires with women from 16 enterprises in SFEN, in a state of Brazilian northeast. The data were analyzed using the multivariate statistical technique of Factor Analysis. The results show that the factors that define gender justice and feminist self-management practices in SE are interrelated in several levels, proving statistically the intersectional condition of the issue of women. The evidence from the quantitative analysis allowed us to understand the dimensions of gender justice and feminist management practices intersectionality; in this sense, the non-distribution of domestic work interferes in non-representation of women in public spaces, especially in peripheral contexts. The study contributes with important reflections to the studies of this area and can be complemented in the future with a qualitative research that approaches the perspective of women in the context of the SE self-management paradigm.

Keywords: feminist management practices, gender justice, self-management, solidarity economy

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Authors: Fawad Ali

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Toxic heavy metal contamination has a negative impact on soil quality which ultimately pollutes the agriculture system. In the current work, we analyzed uptake of various heavy metals by dietary vegetables grown in wastewater irrigated areas of Swabi city. The samples of soil and vegetables were analyzed for heavy metals viz Cd, Cr, Mn, Fe, Ni, Cu, Zn and Pb using Atomic Absorption Spectrophotometer. High levels of metals were found in wastewater irrigated soil and vegetables in the study area. Especially the concentrations of Pb and Cd in the dietary vegetable crossed the permissible level of World Health Organization. Substantial positive correlation was found among the soil and vegetable contamination. Transfer factor for some metals including Cr, Zn, Mn, Ni, Cd and Cu was greater than 0.5 which shows enhanced accumulation of these metals due to contamination by domestic discharges and industrial effluents. Linear regression analysis indicated significant correlation of heavy metals viz Pb, Cr, Cd, Ni, Zn, Cu, Fe and Mn in vegetables with concentration in soil of 0.964 at P≤0.001. Abelmoschus esculentus indicated Health Risk Index (HRI) of Pb >1 in adults and children. The source identification analysis carried out by Principal Component Analysis (PCA) and Cluster Analysis (CA) showed that ground water and soil were being polluted by the trace metals coming out from industries and domestic wastes. Hierarchical cluster analysis (HCA) divided metals into two clusters for wastewater and soil but into five clusters for soil of control area. PCA extracted two factors for wastewater, each contributing 61.086 % and 16.229 % of the total 77.315 % variance. PCA extracted two factors, for soil samples, having total variance of 79.912 % factor 1 and factor 2 contributed 63.889 % and 16.023 % of the total variance. PCA for sub soil extracted two factors with a total variance of 76.136 % factor 1 being 61.768 % and factor 2 being 14.368 %of the total variance. High pollution load index for vegetables in the study area due to metal polluted soil has opened a study area for proper legislation to protect further contamination of vegetables. This work would further reveal serious health risks to human population of the study area.

Keywords: health risk, vegetables, wastewater, atomic absorption sepctrophotometer

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Authors: Eleni C. Mazarakioti, Anastasios Zotos, Anna-Akrivi Thomatou, Efthimios Kokkotos, Achilleas Kontogeorgos, Athanasios Ladavos, Angelos Patakas

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“Gigantes Elefantes” is a particularly dynamic crop of giant beans cultivated in western Macedonia (Greece). This variety of large beans growing in this area and specifically in the regions of Prespes and Kastoria is a protected designation of origin (PDO) species with high nutritional quality. Mislabeling of geographical origin and blending with unidentified samples are common fraudulent practices in Greek food market with financial and possible health consequences. In the last decades, multi-elemental composition analysis has been used in identifying the geographical origin of foods and agricultural products. In an attempt to discriminate the authenticity of Greek beans, multi-elemental analysis (Ag, Al, As, B, Ba, Be, Ca, Cd, Co, Cr, Cs, Cu, Fe, Ga, Ge, K, Li, Mg, Mn, Mo, Na, Nb, Ni, P, Pb, Rb, Re, Se, Sr, Ta, Ti, Tl, U, V, W, Zn, Zr) was performed by inductively coupled plasma mass spectrometry (ICP-MS) on 320 samples of beans, originated from Greece (Prespes and Kastoria), China and Poland. All samples were collected during the autumn of 2021. The obtained data were analysed by principal component analysis (PCA), an unsupervised statistical method, which allows for to reduce of the dimensionality of the enormous datasets. Statistical analysis revealed a clear separation of beans that had been cultivated in Greece compared with those from China and Poland. An adequate discrimination of geographical origin between bean samples originating from the two Greece regions, Prespes and Kastoria, was also evident. Our results suggest that multi-elemental analysis combined with the appropriate multivariate statistical method could be a useful tool for bean’s geographical authentication. Acknowledgment: This research has been financed by the Public Investment Programme/General Secretariat for Research and Innovation, under the call “YPOERGO 3, code 2018SE01300000: project title: ‘Elaboration and implementation of methodology for authenticity and geographical origin assessment of agricultural products.

Keywords: geographical origin, authenticity, multi-elemental analysis, beans, ICP-MS, PCA

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Authors: Yan Zhang, Felix Kin Peng Hui, Colin Duffield, Caroline X. Gao

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In post-pandemic Australia, it is unclear how building occupant have changed their behaviour in their interaction with buildings and other occupants. This research provides information on occupant behaviour change compared to before the pandemic and examines the predictors for those behaviour changes. This paper analyses survey responses from 2298 building occupants in Melbourne to investigate occupant behaviour change and determinants for those changes one year after the pandemic in Australia. The behaviour changes were grouped into three categories based on respiratory infection routes: (1) fomite: hand-shaking and hand hygiene behaviours; (2) airborne: individual interventions to indoor air quality such as face masking, window openings for occupants working in naturally ventilated space; (3) droplets: social distancing, reducing working hours in the workplace. The survey shows that the pandemic has significantly changed occupants' behaviour in all three categories compared to before the pandemic. The changes are significantly associated with occupants' perceived indoor air quality, indoor environmental cleanliness, and occupant density, demonstrating their growing awareness of respiratory infection risk that influences their health behaviours. The two most significant factors identified from multivariate regressions to drive the behaviour change include occupant risk perception of respiratory infections at the workplace and their observed co-worker's behaviour change. Based on the survey results, the paper provides adjusted estimates for related occupant behaviour parameters. The study also discusses alternatives for managing window operations in naturally ventilated buildings to improve occupant satisfaction. This paper could help Building Managers, and Building Designers understand occupant behaviour change to improve building operations and new building design to enhance occupant experience. Also, building energy modellers and risk assessors may use the findings to adjust occupant behaviour-related parameters to improve the models. The findings contribute to the knowledge of Human-Building Interaction.

Keywords: human-building interaction, risk perception, occupant behaviour, IAQ, COVID-19

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Authors: Tchapo Tchaga Sophia, Cai Chun

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This study measures the efficiency level of corporate governance to improve the quality level of value relevance in the resolution of market value efficiency increase issues, transparency problems, risk frauds, agency problems, investors' confidence, and decision-making issues using IFRS and Corporate Governance Acts (CGA). The final sample of this study contains 3660 firms from ten countries' stock markets from 2010 to 2020. Based on the efficiency market theory and the positive accounting theory, this paper uses multiple econometrical methods (DID method, multivariate and univariate regression methods) and models (Ohlson model and compliance index model) regression to see the incidence results of corporate governance mechanisms on the value relevance level under the influence of IFRS and corporate governance regulations act framework in Africa's stock exchanges for non-financial firms. The results on value relevance show that the corporate governance system, strengthened by the adoption of IFRS and enforcement of new corporate governance regulations, produces better financial statement information when its compliance level is high. And that is both value-relevant and comparable to results in more developed markets. Similar positive and significant results were obtained when predicting future book value per share and earnings per share through the determination of stock price and stock return. The findings of this study have important implications for regulators, academics, investors, and other users regarding the effects of IFRS and the Corporate Governance Act (CGA) on the relationship between corporate governance and accounting information relevance in the African stock market. The contributions of this paper are also based on the uniqueness of the data used in this study. The unique data is from Africa, and not all existing findings provide evidence for Africa and of the DID method used to examine the relationship between corporate governance and value relevance on African stock exchanges.

Keywords: corporate governance value, market efficiency value, value relevance, African stock market, stock return-stock price

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Authors: Csaba Kalman

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In spite of the existence of numerous second language (L2) motivation theories, the teacher’s role in motivating learners has remained an under-researched niche to this day. If we narrow down our focus on the teacher’s role on motivating adult learners of English in an English as a Foreign Language (EFL) context in corporate environments, empirical research is practically non-existent. This study fills the above research niche by exploring the most motivating aspects of the teacher’s personality, behaviour, and teaching practices that affect adult learners’ L2 motivation in corporate contexts in Hungary. The study was conducted in a wide range of industries in 18 organisations that employ over 250 people in Hungary. In order to triangulate the research, 21 human resources managers, 18 language teachers, and 466 adult learners of English were involved in the investigation by participating in interview studies, and quantitative questionnaire studies that measured ten scales related to the teacher’s role, as well as two criterion measure scales of intrinsic and extrinsic motivation. The qualitative data were analysed using a template organising style, while descriptive, inferential statistics, as well as multivariate statistical techniques, such as correlation and regression analyses, were used for analysing the quantitative data. The results showed that certain aspects of the teacher’s personality (thoroughness, enthusiasm, credibility, and flexibility), as well as preparedness, incorporating English for Specific Purposes (ESP) in the syllabus, and focusing on the present, proved to be the most salient aspects of the teacher’s motivating influence. The regression analyses conducted with the criterion measure scales revealed that 22% of the variance in learners’ intrinsic motivation could be explained by the teacher’s preparedness and appearance, and 23% of the variance in learners’ extrinsic motivation could be attributed to the teacher’s personal branding and incorporating ESP in the syllabus. The findings confirm the pivotal role teachers play in motivating L2 learners independent of the context they teach in; and, at the same time, call for further research so that we can better conceptualise the motivating influence of L2 teachers.

Keywords: adult learners, corporate contexts, motivation, teacher’s role

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Authors: Helena Bolini, Erick Esmerino, Adriano Cruz, Juliana Paixao

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The currently concern for health has increased demand for low-calorie ingredients and functional foods as probiotics. Understand the reasons that infer on food choice, besides a challenging task, it is important step for development and/or reformulation of existing food products. The use of appropriate multivariate statistical techniques, such as External Preference Map (PrefMap), associated with regression by Partial Least Squares (PLS) can help in determining those factors. Thus, this study aimed to determine, through PLS regression analysis, the sensory attributes considered drivers of liking in probiotic petit suisse cheeses, strawberry flavor, sweetened with different sweeteners. Five samples in same equivalent sweetness: PROB1 (Sucralose 0.0243%), PROB2 (Stevia 0.1520%), PROB3 (Aspartame 0.0877%), PROB4 (Neotame 0.0025%) and PROB5 (Sucrose 15.2%) determined by just-about-right and magnitude estimation methods, and three commercial samples COM1, COM2 and COM3, were studied. Analysis was done over data coming from QDA, performed by 12 expert (highly trained assessors) on 20 descriptor terms, correlated with data from assessment of overall liking in acceptance test, carried out by 125 consumers, on all samples. Sequentially, results were submitted to PLS regression using XLSTAT software from Byossistemes. As shown in results, it was possible determine, that three sensory descriptor terms might be considered drivers of liking of probiotic petit suisse cheese samples added with sweeteners (p<0.05). The milk flavor was noticed as a sensory characteristic with positive impact on acceptance, while descriptors bitter taste and sweet aftertaste were perceived as descriptor terms with negative impact on acceptance of petit suisse probiotic cheeses. It was possible conclude that PLS regression analysis is a practical and useful tool in determining drivers of liking of probiotic petit suisse cheeses sweetened with artificial and natural sweeteners, allowing food industry to understand and improve their formulations maximizing the acceptability of their products.

Keywords: acceptance, consumer, quantitative descriptive analysis, sweetener

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Authors: Lohendy Munoz-Vargas, Stephen O. Opiyo, Rose Digianantonio, Michele L. Williams, Asela Wijeratne, Gregory Habing

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Non-typhoidal Salmonella enterica is a zoonotic pathogen with critical importance in animal and public health. The persistence of Salmonella on farms affects animal productivity and health, and represents a risk for food safety. The intestinal microbiota plays a fundamental role in the colonization and invasion of this ubiquitous microorganism. To overcome the colonization resistance imparted by the gut microbiome, Salmonella uses invasion strategies and the host inflammatory response to survive, proliferate, and establish infections with diverse clinical manifestations. Cattle serve as reservoirs of Salmonella, and periparturient cows have high prevalence of Salmonella shedding; however, to author`s best knowledge, little is known about the association between the gut microbiome and the onset of Salmonella shedding during the periparturient period. Thus, the objective of this study was to assess the association between changes in bacterial communities and the onset of Salmonella shedding in cattle approaching parturition. In a prospective cohort study, fecal samples from 98 dairy cows originating from four different farms were collected at four time points relative to calving (-3 wks, -1 wk, +1 wk, +3 wks). All 392 samples were cultured for Salmonella. Sequencing of the V4 region of the 16S rRNA gene using the Illumina platform was completed to evaluate the fecal microbiome in a selected sample subset. Analyses of microbial composition, diversity, and structure were performed according to time points, farm, and Salmonella onset status. Individual cow fecal microbiomes, predominated by Bacteroidetes, Firmicutes, Spirochaetes, and Proteobacteria phyla, significantly changed before and after parturition. Microbial communities from different farms were distinguishable based on multivariate analysis. Although there were significant differences in some bacterial taxa between Salmonella positive and negative samples, our results did not identify differences in the fecal microbial diversity or structure for cows with and without the onset of Salmonella shedding. These data suggest that determinants other than the significant changes in the fecal microbiome influence the periparturient onset of Salmonella shedding in dairy cattle.

Keywords: dairy cattle, microbiome, periparturient, Salmonella

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Authors: Salwa S. Dawaki, Init Ithoi, Sa’adatu I. Yelwa

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Introduction: Parasitic infections are major public health problems worldwide, particularly in developing countries. Two third of the world population is infected while about 3 billion are at risk of parasitic infections. It is demonstrated that most parasitic infections occur as multiple infections especially among poor and rural communities of most countries in the tropical regions. Parasitic infections are endemic in Nigeria, yet multiple infections are rarely reported. The study aimed to estimate the prevalence and identify factors associating with multiple parasitic infections among rural population in Kano State Nigeria. Methodology: A cross-sectional survey was conducted from June to August 2013 in rural Kano State, Nigeria. Three samples stool, urine, and blood were collected from each of the 551 volunteers aged between one and ninety years old recruited for the survey. A pre-tested questionnaire was used to obtain epidemiological data. Data were analysed using appropriate descriptive, univariate and multivariate logistic regression methods. Major findings: The participants were 61.7% male, 38.3% female, and 69.0% were adults of 15 years and above. Overall, 463 (84%) were infected with parasitic infections among which 60.9% had multiple infections. A total of 15 parasitic species were recovered, and up to 8 different parasitic species were found concurrently in a single host. Plasmodium was the most common parasite followed by Blastocystis, Entamoeba species, and hookworms. It was found that presence of an infected family member (P = 0.017; OR = 1.52; 95% CI = 1.08, 2.13) and not wearing shoes outside home (P = 0.043; OR = 1.50; 95% CI = 1.01, 2.18) significantly associated with higher risk of having multiple parasitic infections among the studied population. Conclusion: Parasitic infections pose a public health challenge in the rural community of Kano. Multiple parasitic infections are highly prevalent and presence of an infected family member as well as not wearing proper foot wear outside home increases the risk of infection. Poor hygiene, unfavourable socioeconomic conditions, and culture promote survival and transmission of parasites. There is a need for implementation of integrated approach aimed at controlling or eliminating the infections with emphasis on public awareness.

Keywords: multiple infections, parasitic infections, poor hygiene, risk of infection

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Authors: Tian Yi Du, Guan Rong Fan, Dong Dong Zou, Di Xue

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Background: The patient satisfaction survey is becoming of increasing importance for hospitals or other providers to get more reimbursement and/or more governmental subsidies. However, when the results of patient satisfaction survey are compared among medical institutions, there are some concerns. The primary objectives of this study were to evaluate patient satisfaction in tertiary hospitals of Shanghai and to compare the satisfaction rating on physician services between patients and observers. Methods: Two hundred outpatients were randomly selected for patient satisfaction survey in each of 28 public tertiary hospitals of Shanghai. Four or five volunteers were selected to observe 5 physicians’ practice in each of above hospitals and rated observed physicians’ practice. The outpatients that the volunteers observed their physician practice also filled in the satisfaction questionnaires. The rating scale for outpatient survey and volunteers’ observation was: 1 (very dissatisfied) to 6 (very satisfied). If the rating was equal to or greater than 5, we considered the outpatients and volunteers were satisfied with the services. The validity and reliability of the measure were assessed. Multivariate regressions for each of the 4 dimensions and overall of patient satisfaction were used in analyses. Paired t tests were applied to analyze the rating agreement on physician services between outpatients and volunteers. Results: Overall, 90% of surveyed outpatients were satisfied with outpatient care in the tertiary public hospitals of Shanghai. The lowest three satisfaction rates were seen in the items of ‘Restrooms were sanitary and not crowded’ (81%), ‘It was convenient for the patient to pay medical bills’ (82%), and ‘Medical cost in the hospital was reasonable’ (84%). After adjusting the characteristics of patients, the patient satisfaction in general hospitals was higher than that in specialty hospitals. In addition, after controlling the patient characteristics and number of hospital visits, the hospitals with higher outpatient cost per visit had lower patient satisfaction. Paired t tests showed that the rating on 6 items in the dimension of physician services (total 14 items) was significantly different between outpatients and observers, in which 5 were rated lower by the observers than by the outpatients. Conclusions: The hospital managers and physicians should use patient satisfaction and observers’ evaluation to detect the room for improvement in areas such as social skills cost control, and medical ethics.

Keywords: patient satisfaction, observation, quality, hospital

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Authors: Iris W. A. Boot, Anke Wesselius, Maurice P. Zeegers

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Diet may play an essential role in the aetiology of bladder cancer (BC). Vitamin D is involved in various biological functions which have the potential to prevent BC development. Besides, vitamin D also influences the uptake of calcium and phosphorus , thereby possibly indirectly influencing the risk of BC. The aim of the present study was to investigate the relation between vitamin D intake and BC risk. Individual dietary data were pooled from three cohort studies. Food item intake was converted to daily intakes of vitamin D, calcium and phosphorus. Pooled multivariate hazard ratios (HRs), with corresponding 95% confidence intervals (CIs) were obtained using Cox-regression models. Analyses were adjusted for gender, age and smoking status (Model 1), and additionally for the food groups fruit, vegetables and meat (Model 2). Dose–response relationships (Model 1) were examined using a nonparametric test for trend. In total, 2,871 cases and 522,364 non-cases were included in the analyses. The present study showed an overall increased BC risk for high dietary vitamin D intake (HR: 1.14, 95% CI: 1.03-1.26). A similar increase BC risk with high vitamin D intake was observed among women and for the non-muscle invasive BC subtype, (HR: 1.41, 95% CI: 1.15-1.72, HR: 1.13, 95% CI: 1.01-1.27, respectively). High calcium intake decreased the BC risk among women (HR: 0.81, 95% CI: 0.67-0.97). A combined inverse effect on BC risk was observed for low vitamin D intake and high calcium intake (HR: 0.67, 95% CI: 0.48-0.93), while a positive effect was observed for high vitamin D intake in combination with low, moderate and high phosphorus (HR: 1.31, 95% CI: 1.09-1.59, HR: 1.17, 95% CI: 1.01-1.36, HR: 1.16, 95% CI: 1.03-1.31, respectively). Combining all nutrients showed a decreased BC risk for low vitamin D intake, high calcium and moderate phosphor intake (HR: 0.37, 95% CI: 0.18-0.75), and an increased BC risk for moderate intake of all the nutrients (HR: 1.18, 95% CI: 1.02-1.38), for high vitamin D and low calcium and phosphor intake (HR: 1.28, 95% CI: 1.01-1.62), and for moderate vitamin D and calcium and high phosphorus intake (HR: 1.27, 95% CI: 1.01-1.59). No significant dose-response analyses were observed. The findings of this study show an increased BC risk for high dietary vitamin D intake and a decreased risk for high calcium intake. Besides, the study highlights the importance of examining the effect of a nutrient in combination with complementary nutrients for risk assessment. Future research should focus on nutrients in a wider context and in nutritional patterns.

Keywords: bladder cancer, nutritional oncology, pooled cohort analysis, vitamin D

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Authors: Nadia Naseem, Farwa Batool, Nasir Mehmood, AbdulHannan Nagi

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Background: The incidence and mortality of breast cancer vary significantly in geographically distinct populations. In Pakistan, breast cancer has shown an increase in incidence in young females and is characterized by more aggressive behavior. The tumor suppressor TP53 gene is a crucial genetic factor that plays a significant role in breast carcinogenesis. This study investigated the TP53 mutations in molecular subtypes of both nodes negative and positive breast cancer in young Pakistani patients. Material and Methods: p53, Estrogen Receptor (ER), Progesterone Receptor (PR), Her-2 neu and Ki 67 expressions were analyzed immunohistochemically in a series of 75 node negative (A) and 75 node positive (B) young (aged: 19-40 years) breast cancer patients diagnosed between 2014 to 2017 at two leading hospitals of Punjab, Pakistan. Tumor tissue specimens and peripheral blood samples were examined for TP53 mutations by direct sequencing of the gene (exons 4-9). The relation of TP53 mutations to these markers and clinicopathological data was investigated. Results: Mean age of the patients was 32.4 + 9.1 SD. Invasive breast carcinoma was the most frequent histological variant (A=92%, B=94.6%). Grade 3 carcinoma was the commonest grade (A=72%, B=81.3%). Triple negative cases (ER-, PR-, Her-2) formed most of the molecular subtypes (A=44%, B=50.6%). A total of 17.2% (A: 6.6%, B: 10.6%) patients showed TP53 mutations. Mutations were significantly more frequent in triple negative cases (A: 74.8%, B: 62.2%) compared to HER2-positive patients (P < 0.0001). In the multivariate analysis of the whole patient group, the independent prognosticator were triple negative cases (P=0.021), TP53 overexpression by IHC (P=0.001) and advanced-stage disease (P=0.007). No statistically significant correlation between TP53 mutations and clinicopathological parameters was found (P < 0.05). Conclusions: It is concluded that TP53 mutations are infrequently present in breast carcinoma of young Pakistani population and there was no significant correlation between p53 mutation and early onset disease. Immunohistochemically detected TP53 expression in our resource-constrained to set up can be beneficial in predicting mutations at the younger age in our population.

Keywords: immunohistochemistry (IHC), invasive breast carcinoma (IBC), Pakistan, TP53

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Authors: Sopit Tubtimhin, Chaliya Wamaloon, Anchalee Supattagorn

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Background and Significance: Breast cancer is the most frequently diagnosed and leading cause of cancer death among women. This study aims to determine factors potentially predicting recurrence and long-term survival after the first recurrence in surgically treated patients between postmenopausal and younger women. Methods and Analysis: A retrospective cohort study was performed on 498 Thai women with invasive breast cancer, who had undergone mastectomy and been followed-up at Ubon Ratchathani Cancer Hospital, Thailand. We collected based on a systematic chart audit from medical records and pathology reports between January 1, 2002, and December 31, 2011. The last follow-up time point for surviving patients was December 31, 2016. A Cox regression model was used to calculate hazard ratios of recurrence and death. Findings: The median age was 49 (SD ± 9.66) at the time of diagnosis, 47% was post-menopausal women ( ≥ 51years and not experienced any menstrual flow for a minimum of 12 months), and 53 % was younger women ( ˂ 51 years and have menstrual period). Median time from the diagnosis to the last follow-up or death was 10.81 [95% CI = 9.53-12.07] years in younger cases and 8.20 [95% CI = 6.57-9.82] years in postmenopausal cases. The recurrence-free survival (RFS) for younger estimates at 1, 5 and 10 years of 95.0 %, 64.0% and 58.93% respectively, appeared slightly better than the 92.7%, 58.1% and 53.1% for postmenopausal women [HRadj = 1.25, 95% CI = 0.95-1.64]. Regarding overall survival (OS) for younger at 1, 5 and 10 years were 97.7%, 72.7 % and 52.7% respectively, for postmenopausal patients, OS at 1, 5 and 10 years were 95.7%, 70.0% and 44.5 respectively, there were no significant differences in survival [HRadj = 1.23, 95% CI = 0.94 -1.64]. Multivariate analysis identified five risk factors for negatively impacting on survival were triple negative [HR= 2.76, 95% CI = 1.47-5.19], Her2-enriched [HR = 2.59, 95% CI = 1.37-4.91], luminal B [HR = 2.29, 95 % CI=1.35-3.89], not free margin [HR = 1.98, 95%CI=1.00-3.96] and patients who received only adjuvant chemotherapy [HR= 3.75, 95% CI = 2.00-7.04]. Statistically significant risks of overall cancer recurrence were Her2-enriched [HR = 5.20, 95% CI = 2.75-9.80], triple negative [HR = 3.87, 95% CI = 1.98-7.59], luminal B [HR= 2.59, 95% CI = 1.48-4.54,] and patients who received only adjuvant chemotherapy [HR= 2.59, 95% CI = 1.48-5.66]. Discussion and Implications: Outcomes from this studies have shown that postmenopausal women have been associated with increased risk of recurrence and mortality. As the results, it provides useful information for planning the screening and treatment of early-stage breast cancer in the future.

Keywords: breast cancer, menopause status, recurrence-free survival, overall survival

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Authors: Mehravar Javid, Sadrieh Khajavi Mazanderani, Kelly Gleischman, Zoe Andris

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The present study was conducted with the aim of investigating the effectiveness of transactional analysis group training on self-knowledge and Its dimensions (self, child, and adult) in counselors working in public and private high schools in Tehran. Counseling has become an important job for society, and there is a need for consultants in organizations. Providing better and more efficient counseling is one of the goals of the education system. The personal characteristics of counselors are important for the success of the therapy. In TA, humans have three ego states, which are named parent, adult, and child, and the main concept in the transactional analysis is self-state, which means a stable feeling and pattern of thinking related to behavioral patterns. Self-knowledge, considered a prerequisite to effective communication, fosters psychological growth, and recognizing it, is pivotal for emotional development, leading to profound insights. The research sample included 30 working counselors (22 women and 8 men) in the academic year 2019-2020 who achieved the lowest scores on the self-knowledge questionnaire. The research method was quasi-experimental with a control group (15 people in the experimental group and 15 people in the control group). The research tool was a self-awareness questionnaire with 29 questions and three subscales (child, parent, and adult Ego state). The experimental group was exposed to transactional analysis training for 10 once-weekly 2-hour sessions; the questionnaire was implemented in both groups (post-test). Multivariate covariance analysis was used to analyze the data. The data showed that the level of self-awareness of counselors who received transactional analysis training is higher than that of counselors who did not receive any training (p<0.01). The result obtained from this analysis shows that transactional analysis training is an effective therapy for enhancing self-knowledge and its subscales (Adult ego state, Parent ego state, and Child ego state). Teaching transactional analysis increases self-knowledge, and self-realization and helps people to achieve independence and remove irresponsibility to improve intra-personal and interpersonal relationships.

Keywords: ego state, group, transactional analysis, self-knowledge

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Authors: Ammar Asma, Bouafia Nabiha, Ghammam Rim, Ezzi Olfa, Ben Cheikh Asma, Mahjoub Mohamed, Helali Radhia, Sma Nesrine, Chouchène Imed, Boussarsar Hamadi, Njah Mansour

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Background: Central venous catheter associated infections (CVC-AI) are among the serious hospital-acquired infections. The aims of this study are to determine the incidence of CVC-AI, and their risk factors among patients followed in a Tunisian medical intensive care unit (ICU). Materials / Methods: A prospective cohort study conducted between September 15th, 2015 and November 15th, 2016 in an 8-bed medical ICU including all patients admitted for more than 48h. CVC-AI were defined according to CDC of ATLANTA criteria. The enrollment was based on clinical and laboratory diagnosis of CVC-AI. For all subjects, age, sex, underlying diseases, SAPS II score, ICU length of stay, exposure to CVC (number of CVC placed, site of insertion and duration catheterization) were recorded. Risk factors were analyzed by conditional stepwise logistic regression. The p-value of < 0.05 was considered significant. Results: Among 192 eligible patients, 144 patients (75%) had a central venous catheter. Twenty-eight patients (19.4%) had developed CVC-AI with density rate incidence 20.02/1000 CVC-days. Among these infections, 60.7% (n=17) were systemic CVC-AI (with negative blood culture), and 35.7% (n=10) were bloodstream CVC-AI. The mean SAPS II of patients with CVC-AI was 32.76 14.48; their mean Charlson index was 1.77 1.55, their mean duration of catheterization was 15.46 10.81 days and the mean duration of one central line was 5.8+/-3.72 days. Gram-negative bacteria was determined in 53.5 % of CVC-AI (n= 15) dominated by multi-drug resistant Acinetobacter baumani (n=7). Staphylococci were isolated in 3 CVC-AI. Fourteen (50%) patients with CVC-AI died. Univariate analysis identified men (p=0.034), the referral from another hospital department (p=0.03), tobacco (p=0.006), duration of sedation (p=0.003) and the duration of catheterization (p=0), as possible risk factors of CVC-AI. Multivariate analysis showed that independent factors of CVC-AI were, male sex; OR= 5.73, IC 95% [2; 16.46], p=0.001, Ramsay score; OR= 1.57, IC 95% [1.036; 2.38], p=0.033, and duration of catheterization; OR=1.093, IC 95% [1.035; 1.15], p=0.001. Conclusion: In a monocenter cohort, CVC-AI had a high density and is associated with poor outcome. Identifying the risk factors is necessary to find solutions for this major health problem.

Keywords: central venous catheter associated infection, intensive care unit, prospective cohort studies, risk factors

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