Search results for: Peter James C. Icalia

Authors: Kathryn L. Duncan, Charles A. Kuntz, James O. Simcock

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A surgical approach to the cranium for treatment of frontal lobe and olfactory bulb neoplasia in dogs is described in this report, which provided excellent access for visualisation and removal of gross neoplastic tissue. An 8-year-old spayed female Shih Tzu crossbreed dog (dog 1) and a 13-year-old neutered male Miniature Fox Terrier (dog 2) were evaluated for removal of neoplasms involving both the frontal lobe and olfactory bulb. Both dogs presented with abnormal neurological clinical signs, decreased menace responses, and behavioural changes. Additionally, dog 2 presented with compulsive circling and generalized tonic-clonic seizure activity. Computed tomography was performed in both dogs, and MRI was also performed in dog 1. Imaging was consistent with frontal lobe and olfactory bulb neoplasia. A transorbital frontal bone craniectomy, with orbital ligament desmotomy and ventrolateral retraction of the globe, was performed in both cases without complication. Dog 1 had a focal area of lysis in the frontal bone adjacent to the neoplasm in the frontal lobe. The presence of the bone defect provided part of the impetus for this approach, as it would permit resection of the lytic bone. In addition, the neoplasms would be surgically accessible without encountering interposed brain parenchyma, reducing the risk of iatrogenic injury. Both dogs were discharged from the hospital within 72 hours post-operatively, both with normal mentation. Case 1 had a histopathologic diagnosis of malignant anaplastic neoplasm. The tumour recurred 101d postoperatively, and the patient was euthanized. Case 2 was diagnosed with a meningioma and was neurologically normal at 294d postoperatively. This transorbital surgical approach allowed successful removal of the intracranial frontal lobe and olfactory bulb neoplasms in 2 dogs. This approach should be considered for dogs with lateralized frontal lobe and olfactory bulb neoplasms that are closely associated with the suborbital region of the frontal bone.

Keywords: neurosurgery, small animal surgery, surgical oncology, veterinary neurology

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Authors: Andras Dezső, Peter Baumli, George Kaptay

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The phosphorous is the important components in the steels, because it makes the changing of the mechanical properties and possibly modifying the structure. The phosphorous can be create the Fe3P compounds, what is segregated in the ferrite grain boundary in the intervals of the nano-, or microscale. This intermetallic compound is decreasing the mechanical properties, for example it makes the blue brittleness which means that the brittle created by the segregated particles at 200 ... 300°C. This work describes the phosphide solubility by the other components effect. We make calculations for the Ni, Mo, Cu, S, V, C, Si, Mn, and the Cr elements by the Thermo-Calc software. We predict the effects by approximate functions. The binary Fe-P system has a solubility line, which has a determinating equation. The result is below: lnwo = -3,439 – 1.903/T where the w0 means the weight percent of the maximum soluted concentration of the phosphorous, and the T is the temperature in Kelvin. The equation show that the P more soluble element when the temperature increasing. The nickel, molybdenum, vanadium, silicon, manganese, and the chromium make dependence to the maximum soluted concentration. These functions are more dependent by the elements concentration, which are lower when we put these elements in our steels. The copper, sulphur and carbon do not make effect to the phosphorous solubility. We predict that all of cases the maximum solubility concentration increases when the temperature more and more high. Between 473K and 673 K, in the phase diagram, these systems contain mostly two or three phase eutectoid, and the singe phase, ferritic intervals. In the eutectoid areas the ferrite, the iron-phosphide, and the metal (III)-phospide are in the equilibrium. In these modelling we predicted that which elements are good for avoid the phosphide segregation or not. These datas are important when we make or choose the steels, where the phosphide segregation stopping our possibilities.

Keywords: phosphorous, steel, segregation, thermo-calc software

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Authors: Anita K. Kovacs, Peter Hegyes, Zsolt Bozso, Gabor Toth

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Fluorination has been used extensively by the pharmaceutical industry as a strategy to improve the pharmacokinetics of drugs due to its effectiveness in increasing the potency of antimicrobial peptides (AMPs). Multiple-fluorinated indole-ring-containing tryptophan derivatives have the potential of having better antimicrobial activity than the widely used mono-fluorinated indole-ring containing tryptophan derivatives, but they are not available commercially. Therefore, our goal is to synthesize multiple-fluorinated indole-ring containing tryptophan derivatives to incorporate them into AMPs to enhance their antimicrobial activity. During our work, we are trying several methods (classical organic synthesis, enzymic synthesis, and solid phase peptide synthesis) for the synthesis of the said compounds, with mixed results. With classical organic synthesis (four different routes), we did not get the desired results. The reaction of serin with substituted indole in the presence of acetic anhydride led to racemic tryptophane; with the reaction of protected serin with indole in the presence of nickel complex was unsuccessful; the reaction of serin containing protected dipeptide with disuccinimidyl carbonate we achieved a tryptophane containing dipeptide, its chiral purity is being examined; the reaction of alcohol with substituted indole in the presence of copper complex was successful, but it was only a test reaction, we could not reproduce the same result with serine. The undergoing tryptophan-synthase method has shown some potential, but our work has not been finished yet. The successful synthesis of the desired multiple-fluorinated indole-ring-containing tryptophan will be followed by solid phase peptide synthesis in order to incorporate it into AMPs to enhance their antimicrobial activity. The successful completion of these phases will mean the possibility of manufacturing new, effective AMPs.

Keywords: halogenation, fluorination, tryptophan, enhancement of antimicrobial activity

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Authors: Aniekan James Akpan, Inemesit Akpan Umoren, Uduak Iwok

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From prehistoric and primitive cultures, education was seen as a process of culture transmission by way of guiding children into becoming good members of their local communities. Even in modern cultures, education is seen as a systematic discipline aimed at cultivating genuine values to improve oneself and society. Without education, the chances of realizing the desired vision are marred as it is believed that nations that invest much in education are able to reap the desired benefits technologically, economically, socially, politically, and otherwise. In this sense, the moulding of character is considered the primary purpose of education, and until the audience of mass media through its various vehicles is seen as tools for improving the overall development of society. It is believed that a media-friendly person is likely to perform better than someone who is less friendly. This work, therefore, examines the role media play in educational development. As highlighted by the study, a summary of the functions of media shows that they widen horizon by acting as a liberating force, breaking distance, bonds, and transforming a traditional society into a modern one. With the use of technological development theory, agenda-setting theory as well as uses and gratification theory and multiple intelligence theory, the work identifies different ways in which mass media help in educational development and draws attention to the audience’s perception of media functions in terms of educational development. With a survey method and a population of 6,903,321 people, the work sampled 220 respondents using purposive technique drawn from rural communities in the South-South region of Nigeria. The work concludes that mass media are potent vehicles for teaching and learning and therefore recommends that government should provide basic infrastructures to the rural communities to aid full utilization of media potentials in educational development and equally urge media owners and practitioners to as a matter of urgency increase coverage time on issues bordering on education as it is done for political and other issues.

Keywords: educational, development, media usage, perception

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Authors: Si Jack Chong, Chew Theng Yap, Wan Loong James Mok

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Introduction: Regional burn centres face the spectra of introduced multi-drug resistant organisms (MDRO) from transfer patients resident in MDRO endemic countries. MDRO can cause severe nosocomial infection, which in massive burn patients, will lead to greater morbidity and mortality and strain the institution financially. We aim to highlight 4 key measures that have effectively prevented transmission of imported MDRO. Methods: A case of Candida auris (C. auris) from a massive burn patient transferred from an MDRO endemic country is used to illustrate the measures. C. auris is a globally emerging multi-drug resistant fungal pathogen causing nosocomial transmission. Results: Infection control measures used to mitigate the risk of outbreak from transfer cases are: (1) Multidisciplinary team approach involving Infection Control and Infectious Disease specialists early to ensure appropriate antibiotics use and implementation of barrier measures, (2) aseptic procedures for dressing change with strict isolation and donning of personal protective equipment in the ward, (3) early screening of massive burn patient from MDRO endemic region, (4) hydrogen peroxide vaporization terminal cleaning for operating theatres and rooms. Conclusion: The prevalence of air travel and international transfer to regional burn centres will need effective infection control measures to reduce the risk of transmission from imported massive burn patients. In our centre, we have effectively implemented 4 measures which have reduced the risks of local contamination. We share a recent case report to illustrate successful management of a potential MDRO outbreak resulting from transfer of massive burn patient resident in an MDRO endemic area.

Keywords: burns, burn unit, cross infection, infection control

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Authors: Eman Merza, Stephen Pearson, Glen Lichtwark, Peter Malliaras

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The Achilles tendon (AT) exhibits volume changes related to fluid flow under acute load which may be linked to changes in stiffness. Fluid flow provides a mechanical signal for cellular activity and may be one mechanism that facilitates tendon adaptation. This study aimed to investigate whether isometric intervention involving a high level of load duration and intensity could maximize the immediate reduction in AT volume and stiffness compared to interventions involving a lower level of load duration and intensity. Sixteen healthy participants (12 males, 4 females; age= 24.4 ± 9.4 years; body mass= 70.9 ± 16.1 kg; height= 1.7 ± 0.1 m) performed three isometric interventions of varying levels of load duration (2 s and 8 s) and intensity (35% and 75% maximal voluntary isometric contraction) over a 3 week period. Freehand 3D ultrasound was used to measure free AT volume (at rest) and length (at 35%, 55%, and 75% of maximum plantarflexion force) pre- and post-interventions. The slope of the force-elongation curve over these force levels represented individual stiffness (N/mm). Large reductions in free AT volume and stiffness resulted in response to long-duration high-intensity loading whilst less reduction was produced with a lower load intensity. In contrast, no change in free AT volume and a small increase in AT stiffness occurred with lower load duration. These findings suggest that the applied load on the AT must be heavy and sustained for a long duration to maximize immediate volume reduction, which might be an acute response that enables optimal long-term tendon adaptation via mechanotransduction pathways.

Keywords: Achilles tendon, volume, stiffness, free tendon, 3d ultrasound

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Authors: Kathryn L. Duncan, Charles A. Kuntz, Alessandra C. Santamaria, James O. Simcock

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Access to megavoltage radiation therapy for small animals is limited in many locations around the world. This can preclude the use of palliative radiation therapy for the treatment of appendicular osteosarcoma in dogs. The objective of this study was to retrospectively assess the adverse effects and survival times of dogs with appendicular osteosarcoma that were treated with hypofractionated orthovoltage radiation therapy and adjunctive carboplatin chemotherapy administered via a single subcutaneous infusion. Medical records were reviewed retrospectively to identify client-owned dogs with spontaneously occurring appendicular osteosarcoma that was treated with palliative orthovoltage radiation therapy and a single subcutaneous infusion of carboplatin. Data recorded included signalment, tumour location, results of diagnostic imaging, haematologic and serum biochemical analyses, adverse effects of radiation therapy and chemotherapy, and survival times. Kaplan-Meier survival analysis was performed, and log-rank analysis was used to determine the impact of specific patient variables on survival time. Twenty-three dogs were identified that met the inclusion criteria. Median survival time for dogs was 182 days. Eleven dogs had adverse haematologic effects, 3 had adverse gastrointestinal effects, 6 had adverse effects at the radiation site and 7 developed infections at the carboplatin infusion site. No statistically significant differences were identified in survival times based on sex, tumour location, development of infection, or pretreatment serum alkaline phosphatase. Median survival time and incidence of adverse effects were comparable to those previously reported in dogs undergoing palliative radiation therapy with megavoltage or cobalt radiation sources and conventional intravenous carboplatin chemotherapy. The use of orthovoltage palliative radiation therapy may be a reasonable alternative to megavoltage radiation in locations where access is limited.

Keywords: radiotherapy, veterinary oncology, chemotherapy, osteosarcoma

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Authors: John Scanlon, Antony Raymond, Randeep Aujla, Peter D’Alessandro, Satyen Gohil

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Background: The incidence of significant acute chondral injuries with patella dislocation is around 10-15%. It is accepted that chondral procedures should only be performed in the presence of joint stability Methods:Patients were identified from surgeon/hospital logs. Patient demographics, lesion size and location, surgical procedure, patient reported outcome measures, post-operative MR imaging, and complications were recorded. PROMs and patient satisfaction was obtained. Results:20 knees (18 patients) were included. Mean age was 18.6 years (range; 11-39), and the mean follow-up was 16.6 months (range; 2-70). The defect locations were the lateral femoral condyle (9/20; 45%), patella (9/20; 45%), medial femoral condyle (1/20; 5%) and the trochlea (1/20; 5%). The mean defect size was 2.6cm2. Twelve knees were treated with cartilage fixation, 5 with microfracture, and 3 with OATS. At follow up, the overall mean Lysholm score was 77.4 (± 17.1), with no chondral regenerative procedure being statistically superior. There was no difference in Lysholm scores between those patients having acute medial patellofemoral ligament reconstruction versus medial soft tissue plication (p=0.59). Five (25%) knees required re-operation (one arthroscopic arthrolysis; one patella chondroplasty; two removal of loose bodies; one implant adjustment). Overall, 90% responded as being satisfied with surgery. Conclusion: Our aggressive pathway to identify and treat acute cartilage defects with early operative intervention and patella stabilisation has shown high rates of satisfaction and Lysholm scores. The full range of chondral restoration options should be considered by surgeons managing these patients.

Keywords: patella dislocation, chondral restoration, knee, patella stabilisation

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Authors: Patricia Mikchaela D. L. Feliciano, Ciela Kadeshka A. Fuentes, Bea Trixia B. Gales, Ethel Princess A. Gepulango, Martin R. Hernandez, Elina Andrea S. Lantion, Jhoe Cynder P. Legaspi, Peter F. Quilala, Gina C. Castro

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Propolis is a resin-like material used by bees to fill large gap holes in the beehive. It has been found to possess anti-inflammatory property, which stimulates hair growth in rats by inducing hair keratinocytes proliferation, causing water retention and preventing damage caused by heat, ultraviolet rays, and other microorganisms without abnormalities in hair follicles. The present study aimed to formulate 10% and 30% Propolis Hair Cream for use in enhancing hair properties. Raw propolis sample was tested for heavy metals using Atomic Absorption Spectroscopy; zinc and chromium were found to be present. Likewise, propolis was extracted in a percolator using 70% ethanol and concentrated under vacuum using a rotary evaporator. The propolis extract was analyzed for total flavonoid content. Compatibility of the propolis extract with excipients was evaluated using Differential Scanning Calorimetry (DSC). No significant changes in organoleptic properties, pH and viscosity of the formulated creams were noted after four weeks of storage at 2-8°C, 30°C, and 40°C. The formulated creams were found to be non-irritating based on the Modified Draize Rabbit Test. In vivo efficacy was evaluated based on thickness and tensile strength of hair grown on previously shaved rat skin. Results show that the formulated 30% propolis-based cream had greater hair enhancing properties than the 10% propolis cream, which had a comparable effect with minoxidil.

Keywords: atomic absorption spectroscopy, differential scanning calorimetry (DSC), modified draize rabbit test, propolis

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Authors: Peter Iyobosa Asemota

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This study on solid waste management practices addressed aspects of environmental and health impacts resulting from poor management of solid waste. The study was occasioned by the observed rate and volume of illegal and indiscriminate dumping of solid waste materials especially in informal settlements. The main focus of this study was to establish the impact of waste management practices on human health and the environment. The study, therefore, presents a critical analysis of the state of solid waste management in the study area and the implications for human health and the environment. The study was carried out in Kayamandi informal settlement within Stellenbosch municipality. The sustainable management of solid waste is very important in order to minimize the environmental and public health risks associated with improper solid waste management. There is no denying the fact that the problems of waste management will become critical as time goes on because of improper and inefficient waste management practices. Towns and cities exhibit the burdens of waste management which is a characteristics feature of most African cities. The study critically assess the implementation of waste management practices by the residents of the informal settlement; identify the factors affecting management issues in the operation of solid waste management system by the municipality; identify factors militating against the implementation of waste management policies and legislation. Furthermore, a waste assessment study was carried out to assess the generation; composition of the waste stream and also determine the attitudes and behavior of the residents with regard to waste management practices. Findings from the study revealed that Kayamandi is not different from other informal settlements with regards to waste management. People are of the opinion that solid waste management is the sole responsibility of municipal authorities and as such, the government should be responsible for bearing the cost of solid waste management.

Keywords: environment, waste, waste composition, waste stream, policy, waste categories, sanitary landfill, waste collection, integrated solid waste management

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Authors: James Barmby

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Canada’s westernmost provinces of British Columbia and Alberta are similar in many respects as they are both reliant on volatile natural resources for major portions of their economies. The two provinces have banded together to develop mutually beneficial trade, investment and labour market mobility rules, but in terms of developing systems of higher education, the two provinces are attempting to align higher education programs to economic development objectives by means that are quite different. In British Columbia, the recently announced initiative, B.C’s Skills for Jobs Blueprint will “make sure education and training programs are aligned with the demands of the labor market.” Meanwhile in Alberta, the province’s institutions of higher education are enjoying the tenth year of their membership in the Campus Alberta Quality Council, which makes recommendations to government on issues related to post-secondary education, including the approval of new programs. In B.C., public institutions of higher education are encouraged to comply with government objectives, and are rewarded with targeted funds for their efforts. In Alberta, the institutions as a system tell the government what programs they want to offer and government can agree or not agree to fund these programs through a ministerial approval process. In comparing the two higher education systems, the question emerges as to which one is more beneficial to the province: the one where change is directed primarily by financial incentives to achieve economic objectives or the one that makes recommendations to the government for changes in programs to achieve institutional objectives? How is institutional autonomy affected in each strategy? Does institutional autonomy matter anymore? In recent years, much has been written in regard to academic freedom, but less about institutional autonomy, which is seen by many as essential to protecting academic freedom. However, while institutional autonomy means freedom from government control, it does not necessarily mean self-government. In this study, a comparison of the two higher education systems is made using recent government policy initiatives in both provinces, and responses to those actions by the higher education institutions. The findings indicate that the economic needs in both provinces take precedence over issues of institutional autonomy.

Keywords: alberta, British Columbia, institutional autonomy, funding

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Authors: Annet Namusoke, Annet Namayanja, Peter Wasswa, Shakirah Nampijja

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Common bean cultivar G2333 which offers broad resistance for anthracnose has been widely used as a source of resistance in breeding for anthracnose resistance. The cultivar is pyramided with three genes namely CO-4, CO-5 and CO-7 and of these three genes, the CO-4 gene has been found to offer the broadest resistance. The main aim of this work was to identify and validate easily assayable PCR based co-dominant molecular markers for selection of the CO-4 gene in segregating populations derived from crosses of G2333 with RWR 1946 and RWR 2075, two commercial Andean cultivars highly susceptible to anthracnose. Marker sequences for the study were obtained by blasting the sequence of the COK-4 gene in the Phaseolus gene database. Primer sequence pairs that were not provided from the Phaseolus gene database were designed by the use of Primer3 software. PCR conditions were optimized and the PCR products were run on 6% HPAGE gel. Results of the polymorphism test indicated that out of 18 identified markers, only two markers namely BM588 and BM211 behaved co-dominantly. Phenotypic evaluation for reaction to anthracnose disease was done by inoculating 21days old seedlings of three parents, F1 and F2 populations with race 7 of Colletotrichum lindemuthianum in the humid chamber. DNA testing of the BM588 marker onto the F2 segregating population of the crosses RWR 1946 x G 2333 and RWR 2075 x G2333 further revealed that the marker BM588 co-segregated with disease resistance with co-dominance of two alleles of 200bp and 400bp, fitting the expected segregation ratio of 1:2:1. The BM588 marker was significantly associated with disease resistance and gave promising results for marker assisted selection of the CO-4 gene in the breeding lines. Activities to validate the BM211 marker are also underway.

Keywords: codominant, Colletotrichum lindemuthianum, MAS, Phaseolus vulgaris

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Authors: James Kinyua Gitonga, Toshio Fujimi

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Vulnerability assessment and analysis is essential to solving the degree of damage and loss as a result of natural disasters. Urban flooding causes a major economic loss and casualties, at Mathare residential area in Nairobi, Kenya. High population caused by rural-urban migration, Unemployment, and unplanned urban development are among factors that increase flood vulnerability in Mathare area. This study aims to analyse flood risk physical vulnerabilities in Mathare based on scientific data, research data that includes the Rainfall data, River Mathare discharge rate data, Water runoff data, field survey data and questionnaire survey through sampling of the study area have been used to develop the risk curves. Three structural types of building were identified in the study area, vulnerability and risk curves were made for these three structural types by plotting the relationship between flood depth and damage for each structural type. The results indicate that the structural type with mud wall and mud floor is the most vulnerable building to flooding while the structural type with stone walls and concrete floor is least vulnerable. The vulnerability of building contents is mainly determined by the number of floors, where households with two floors are least vulnerable, and households with a one floor are most vulnerable. Therefore more than 80% of the residential buildings including the property in the building are highly vulnerable to floods consequently exposed to high risk. When estimating the potential casualties/injuries we discovered that the structural types of houses were major determinants where the mud/adobe structural type had casualties of 83.7% while the Masonry structural type had casualties of 10.71% of the people living in these houses. This research concludes that flood awareness, warnings and observing the building codes will enable reduce damage to the structural types of building, deaths and reduce damage to the building contents.

Keywords: flood loss, Mathare Nairobi, risk curve analysis, vulnerability

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Authors: Thomas F. Ducey, Kristin M. Trippe, James A. Ippolito, Jeffrey M. Novak, Mark G. Johnson, Gilbert C. Sigua

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The Oronogo-Duenweg mining belt –approximately 20 square miles around the Joplin, Missouri area– is a designated United States Environmental Protection Agency Superfund site due to lead-contaminated soil and groundwater by former mining and smelting operations. Over almost a century of mining (from 1848 to the late 1960’s), an estimated ten million tons of cadmium, lead, and zinc containing material have been deposited on approximately 9,000 acres. Sites that have undergone remediation, in which the O, A, and B horizons have been removed along with the lead contamination, the exposed C horizon remains incalcitrant to revegetation efforts. These sites also suffer from poor soil microbial activity, as measured by soil extracellular enzymatic assays, though 16S ribosomal ribonucleic acid (rRNA) indicates that microbial diversity is equal to sites that have avoided mine-related contamination. Soil analysis reveals low soil organic carbon, along with high levels of bio-available zinc, that reflect the poor soil fertility conditions and low microbial activity. Our study looked at the use of several materials to restore and remediate these sites, with the goal of improving soil health. The following materials, and their purposes for incorporation into the study, were as follows: manure-based biochar for the binding of zinc and other heavy metals responsible for phytotoxicity, locally sourced biosolids and compost to incorporate organic carbon into the depleted soils, effective microorganisms harvested from nearby pristine sites to provide a stable community for nutrient cycling in the newly composited 'soil material'. Our results indicate that all four materials used in conjunction result in the greatest benefit to these mine-impacted soils, based on above ground biomass, microbial biomass, and soil enzymatic activities.

Keywords: locally effective microorganisms, biochar, remediation, reclamation

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Authors: James Patrick A. Diaz, Raul E. Ramboyong

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Background: Hypertensive response during maximal exercise test provides important information on the level of blood pressure control and evaluation of treatment. Method: A single center retrospective descriptive study was conducted among 117 young (aged 20 to 40) and middle age (aged 40 to 65) hypertensive patients, who underwent treadmill stress test. Currently on maintenance frontline medication either monotherapy (Angiotensin-converting enzyme inhibitor/Angiotensin receptor blocker [ACEi/ARB], Calcium channel blocker [CCB], Diuretic - Hydrochlorthiazide [HCTZ]) or combination therapy (ARB+CCB, ARB+HCTZ), who attained a maximal exercise on treadmill stress test (TMST) with hypertensive response (systolic blood pressure: male >210 mm Hg, female >190 mm Hg, diastolic blood pressure >100 mmHg, or increase of >10 mm Hg at any time during the test), on Bruce and Modified Bruce protocol. Exaggerated blood pressure response during exercise (systolic [SBP] and diastolic [DBP]), peak exercise blood pressure (SBP and DBP), recovery period (SBP and DBP) and test for ischemia and their antihypertensive medication/s were investigated. Analysis of variance and chi-square test were used for statistical analysis. Results: Hypertensive responses on maximal exercise test were seen mostly among female population (P < 0.000) and middle age (P < 0.000) patients. Exaggerated diastolic blood pressure responses were significantly lower in patients who were taking CCB (P < 0.004). A longer recovery period that showed a delayed decline in SBP was observed in patients taking ARB+HCTZ (P < 0.036). There were no significant differences in the level of exaggerated systolic blood pressure response and during peak exercise (both systolic and diastolic) in patients using either monotherapy or combination antihypertensives. Conclusion: Calcium channel blockers provided lower exaggerated diastolic BP response during maximal exercise test in hypertensive middle age patients. Patients on combination therapy using ARB+HCTZ exhibited a longer recovery period of systolic blood pressure.

Keywords: antihypertensive, exercise test, hypertension, hyperytensive response

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Authors: James Beringer

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Switzerland’s ability to forge a strong national identity across linguistic barriers has long been of interest to nationalism scholars. This begs the question of how this has been achieved, given that traditional explanations of luck or exceptionalism appear highly reductionist. This paper evaluates the theory that successful Swiss management of linguistic diversity stems from the strong integration of multilingualism into Swiss national identity. Using archival analysis of Swiss government records, historical accounts of prominent Swiss citizens, as well as secondary literature concerning the fundamental aspects of Swiss national identity, this paper charts the historical evolution of Swiss national identity. It explains how multilingualism was deliberately and successfully integrated into Swiss national identity as a response to political fragmentation along linguistic lines during the First World War. Its primary conclusions are the following. Firstly, the earliest foundations of Swiss national identity were purposefully removed from any association with a single national language. This produced symbols, myths, and values -such as a strong commitment to communalism, the imagery of the Swiss natural landscape, and the use of Latin expressions, which can be adopted across Swiss linguistic groups. Secondly, the First World War triggered a turning point in the evolution of Swiss national identity. The fundamental building blocks proved insufficient in preventing political fractures amongst linguistic lines, as each Swiss linguistic group gravitated towards its linguistic neighbours within Europe. To avoid a repeat of such fragmentation, a deliberate effort was made to fully integrate multilingualism as a fundamental aspect of Swiss national identity. Existing natural symbols, such as the St Gotthard Mountains, were recontextualized in order to become associated with multilingualism. The education system was similarly reformed to reflect the unique multilingual nature of the Swiss nation. The successful result of this process can be readily observed in polls and surveys, with large segments of the Swiss population highlighting multilingualism as a uniquely Swiss characteristic, indicating the symbiotic connection between multilingualism and the Swiss nation.

Keywords: language's role in identity formation, multilingualism in nationalism, national identity formation, Swiss national identity history

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Authors: Vanja Vejzagic, Jackie Brander Brown, Peter Schmidt

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Purpose: For some time now, the global hotel industry trends are strongly oriented towards sustainable development and environmental management accounting (EMA) should have the supporting role for hotel’s corporate social responsibility (CSR) management. The aim of this paper is thus to analyse and present data on the key steps leading toward the effective incorporation of EMA within hotel performance information systems. Design/Methodology/Approach: The research study is a continuation of the process carried out on the sample of 20 eco-hotels in the UK, a year ago. Research evidence was obtained via in-depth case studies on sample of 180 hotels (4 and 5 stars hotels) located in Croatia. Research was conducted through interviews with key personnel and an online survey which specifically focused on 10 business areas considered vital for successful EMA integration. Findings: The research results indicate a pattern by which hotels can determine the existing level of their sustainable (environmental) business. Furthermore, the management understanding of the sustainability concept was still proven to lead to a relatively subjective appreciation and presentation of sustainable hotel operations and their performance. It was determined that majority of analysed hotel organisations reflect typical short-term, financially oriented performance information systems. Steps for EMA introduction have been offered. Research Limitations/Implications: CSR is still a broad-set concept. Exploring the effects of EMA on such-like a defined management system may be subject to considerable influence of the respondent’s subjective perception of the concept. Originality/Value: This article should be of interest to higher education academics and careers staff who have an interest in CSR introduction and the ways of implementing its informational support for performance measurement.

Keywords: environmental management accounting, EMA, corporate social responsibility, CSR, sustainability, hotel

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Authors: Aniekan Peter, ECS Naidu, Edidiong Akang, U. Offor, R. Kalhapure, A. A. Chuturgoon, T. Govender, O. O. Azu

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Introduction: Nano-drugs are novel innovations in the management of human immunodeficiency virus (HIV) pandemic, especially resistant strains of the virus in their sanctuary sites: testis and the brain. There are safety concerns to be addressed to achieve the full potential of this new drug delivery system. Aim of study: Our study was designed to investigate toxicity profile of Tenofovir Nanoparticle (TDF-N) synthesized by University of Kwazulu-Natal (UKZN) Nano-team for prevention and treatment of HIV infection. Methodology: Ten adult male Sprague-Dawley rats maintained at the Animal House of the Biomedical Resources Unit UKZN were used for the study. The animals were weighed and divided into two groups of 5 animal each. Control animals (A) were administered with normal saline. Therapeutic dose (4.3 mg/kg) of TDF-N was administered to group B. At the end of four weeks, animals were weighed and sacrificed. Liver and kidney were removed fixed in formal saline, processed and stained using H/E, PAS and MT stains for light microscopy. Serum was obtained for renal function test (RFT), liver function test (LFT) and full blood count (FBC) using appropriate analysers. Cellular measurements were done using ImageJ and Leica software 2.0. Data were analysed using graph pad 6, values < 0.05 were significant. Results: We reported no histological alterations in the liver, kidney, FBC, LFT and RFT between the TDF-N animals and saline control. There were no significant differences in weight, organo-somatic index and histological measurements in the treatment group when compared with saline control. Conclusion/recommendations: TDF-N is not toxic to the liver, kidney and blood cells in our study. More studies using human subjects is recommended.

Keywords: tenofovir nanoparticles, liver, kidney, blood cells

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Authors: Vladimir Littva, Peter Kutis

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Based on common practice, we know that an empathic approach to a patient is one of the characteristics of a physiotherapist. Although empathy is regarded as an essential condition of the psychotherapeutic relationship, it has taken quite a while for attention to be paid to it in clinical practice. Patients who are experiencing a sense of understanding from health care providers are more willing to cooperate, and treatment within the optimistic attunes a more comfortable framework of care. Age, experience, family, education and the working environment may have an impact on the degree of empathy for paramedics. Within the KEGA project no. 003KU-4-2021, we decided to investigate the level of empathy in the work of physiotherapists in Slovakia. Research sample and Methods: The sample comprised 194 respondents – physiotherapists working on the territory of Slovakia. 112 were men and 82 women. The age of respondents was between 21 and 64 years of age. 133 were married, 51 were single and ten were divorced. 98 were living in the countryside and 96 in towns. Twenty-two grew up without siblings, 95 with one sibling and 77 with two and more siblings. In the survey, we used the Empathy Assessment Questionnaire (EAQ) with 18 questions with four possible answers: strongly disagree, disagree, agree; and strongly agree, which we validated linguistically and psychometrically. All data were statistically processed by SPSS 25. Results: We evaluated the intrinsic reliability of the questionnaire EAQ using Cronbach's Alpha and the coefficient is 0.756 in the whole set. This means that the questionnaire is a quite strong and reliable measurement tool. The mean for individual questions ranged from 2.39 to 3.74 (maximum was 4). In Pearson's correlations, we confirmed the significant differences between the groups regarding sex in 8 questions out of 18, regarding age in 5 questions, regarding family status in 4 questions and regarding siblings in 4 questions out of 18 at the level 5% (p <0.05). Conclusion: The results obtained during the research show the importance of adequate communication with the patient due to his health and well-being. Empathy in the physiotherapists’ profession is very important. It would be worthwhile if the students of physiotherapy would receive a course during their study that would deal exclusively with empathy, empathic approach, burnout, or psycho-emotional hygiene.

Keywords: empathy, approach, clinical practice, physiotherapists

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Authors: Dirson Santos De Campos, Deller James Ferreira, Anderson Cavalcante Gonçalves, Uyara Ferreira Silva

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Rubrics to learning research provide many evaluation criteria and expected performance standards linked to defined student activity for learning and pedagogical objectives. Despite the rubric being used in education at all levels, academic literature on rubrics as a tool to support research in SQL Education is quite rare. There is a large class of SQL queries is syntactically correct, but certainly, not all are semantically correct. Detecting and correcting errors is a recurring problem in SQL education. In this paper, we usthe Rubric Abstract Framework (RAF), which consists of steps, that allows us to map the information to measure student performance guided by didactic objectives defined by the teacher as long as it is contextualized domain modeling by rubric. An empirical study was done that demonstrates how rubrics can mitigate student difficulties in finding logical errors and easing teacher workload in SQL education. Detecting and correcting logical errors is an important skill for students. Researchers have proposed several ways to improve SQL education because understanding this paradigm skills are crucial in software engineering and computer science. The RAF instantiation was using in an empirical study developed during the COVID-19 pandemic in database course. The pandemic transformed face-to-face and remote education, without presential classes. The lab activities were conducted remotely, which hinders the teaching-learning process, in particular for this research, in verifying the evidence or statements of knowledge, skills, and abilities (KSAs) of students. Various research in academia and industry involved databases. The innovation proposed in this paper is the approach used where the results obtained when using rubrics to map logical errors in query formulation have been analyzed with gains obtained by students empirically verified. The research approach can be used in the post-pandemic period in both classroom and distance learning.

Keywords: rubric, logical error, structured query language (SQL), empirical study, SQL education

Procedia PDF Downloads 179

Authors: Adrian Lo

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Since the beginning of modern architecture, ideas of free plan and transparency have proliferated well into current trends of building design, from houses to highrise office buildings. The movement’s notion of a spatially homogeneous, open, and limitless ‘free plan’ stands opposite to the spatially heterogeneous ‘separation of rooms’ defined by load-bearing walls, which in turn triggered new notions of transparency achieved by vast expanses of glazed walls. Similarly, transparency was also dichotomized as something that was physical or optical, as well as something conceptual, akin to spatial organization. As opposed to merely accepting the duality and possible incompatibility of these dichotomies, this paper seeks to ask how can space be both literally and phenomenally transparent, as well as display both homogeneous and heterogeneous qualities? This paper explores this potential destabilization or blurring of spatial phenomena by dissecting the transparent layers and volumes of a series of selected case studies to investigate how different architects have devised strategies of spatial ambivalence, ambiguity, and interpenetration. Projects by Peter Eisenman, Sou Fujimoto, and SANAA will be discussed and analyzed to show how the superimposition of geometries and spaces achieve different conditions of layering, transparency, and interstitiality. Their particular buildings will be explored to reveal various innovative kinds of spatial interpenetration produced through the articulate relations of the elements of architecture, which challenge conventional perceptions of interior and exterior whereby visual homogeneity blurs with spatial heterogeneity. The results show how spatial conceptions such as interpenetration and transparency have the ability to subvert not only inside-outside dialectics but could also produce multiple degrees of interiority within complex and indeterminate spatial dimensions in constant flux as well as present alternative forms of social interaction.

Keywords: interpenetration, literal and phenomenal transparency, spatial heterogeneity, visual homogeneity

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Authors: James Britton, Vijaya Krishna, Manus Biggs, Abhay Pandit

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Regeneration of the spinal cord after injury remains a great challenge due to the complexity of this organ. Inflammation and gliosis at the injury site hinder the outgrowth of axons and hence prevent synaptic reconnection and reinnervation. Hyaluronic acid (HA) is the main component of the spinal cord extracellular matrix and plays a vital role in cell proliferation and axonal guidance. In this study, we have synthesized and characterized a photo-cross-linkable HA-tyramine (tyr) hydrogel from a chemical, mechanical, electrical, biological and structural perspective. From our experimentation, we have found that HA-tyr can be synthesized with controllable degrees of tyramine substitution using click chemistry. The complex modulus (G*) of HA-tyr can be tuned to mimic the mechanical properties of the native spinal cord via optimization of the photo-initiator concentration and UV exposure. We have examined the degree of tyramine-tyramine covalent bonding (polymerization) as a function of UV exposure and photo-initiator use via Photo and Nuclear magnetic resonance spectroscopy. Both swelling and enzymatic degradation assays were conducted to examine the resilience of our 3D printed hydrogel constructs in-vitro. Using a femtosecond 780nm laser, the two-photon polymerization of HA-tyr hydrogel in the presence of riboflavin photoinitiator was optimized. A laser power of 50mW and scan speed of 30,000 μm/s produced high-resolution spatial patterning within the hydrogel with sustained mechanical integrity. Using dorsal root ganglion explants, the cytocompatibility of photo-crosslinked HA-tyr was assessed. Using potentiometry, the electrical conductivity of photo-crosslinked HA-tyr was assessed and compared to that of native spinal cord tissue as a function of frequency. In conclusion, we have developed a biocompatible hydrogel that can be used for photolithographic 3D printing to fabricate tissue engineered constructs for neural tissue regeneration applications.

Keywords: 3D printing, hyaluronic acid, photolithography, spinal cord injury

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Authors: Ayedun Hassan, Ayadi Odunayo Peter

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The ancient city of Abeokuta has been supplied with pipe borne water since 1911, yet, a continuous increase in population and unplanned city expansion makes water a very precious and scarce commodity. The government reserved areas (GRA’s) are well planned, and public water supply is available; however, the sub-urban areas consist of scattered structures with individuals trying to source water by digging wells and boreholes. The geology of the city consists of basement rock which makes digging wells and boreholes very difficult. The present study was conducted to assess the risk arising from the consumption of toxic elements in the groundwater of Abeokuta, Ogun State, Nigeria. Forty-five groundwater samples were collected from nine different areas of Abeokuta and analyzed for physicochemical parameters and toxic elements. The physicochemical parameters were determined using standard methods, while the toxic elements were determined using Inductively Coupled Plasma-Mass Spectrometer (ICP/MS). Ninety-six percent (96%) of the water sample has pH < 6.5, and 11% has conductivity > 250 µSCm⁻¹ limits in drinking water as recommended by WHO. Seven percent (7%) of the samples have Pb concentration >10 µgL⁻¹ while 75% have Al concentration >200 µgL⁻¹ recommended by WHO. The order for risk of cancer from different area of Abeokuta are Cd²⁺ > As³⁺ > Pb²⁺ > Cr⁶⁺ for Funaab, Camp and Obantoko; As³⁺ > Cd²⁺ > Pb²⁺ > Cr⁶⁺ for Ita Osin, Isale Igbein, Ake and Itoku; Cd²⁺ >As > Cr⁶⁺ > Pb²⁺ for Totoro; Pb²⁺ > Cd²⁺ > As³⁺ > Cr⁶⁺ for Idiaba. The order of non-cancer hazard index (HI) calculated for groundwater of Abeokuta City are Cd²⁺ > As³⁺ > Mn²⁺ > Pb²⁺ > Ni²⁺ and were all greater than one, which implies susceptibility to other illnesses. The sources of these elements are the rock and inappropriate waste disposal method, which leached the elements into the groundwater. A combination of sources from food will accumulate these elements in the human body system. Treatment to remove Al and Pb is necessary, while the method of water distribution should be reviewed to ensure access to potable water by the residents.

Keywords: Abeokuta, groundwater, Nigeria, risk

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Authors: Shahin A. Abdel-Naby, James P. Colgan, Michael S. Pindzola

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A time-dependent close-coupling method is developed to calculate a total, double and triple autoionization rates for hollow atomic ions of four-electron systems. This work was motivated by recent observations of the four-electron Auger process in near K-edge photoionization of C+ ions. The time-dependent close-coupled equations are solved using lattice techniques to obtain a discrete representation of radial wave functions and all operators on a four-dimensional grid with uniform spacing. Initial excited states are obtained by relaxation of the Schrodinger equation in imaginary time using a Schmidt orthogonalization method involving interior subshells. The radial wave function grids are partitioned over the cores on a massively parallel computer, which is essential due to the large memory requirements needed to store the coupled-wave functions and the long run times needed to reach the convergence of the ionization process. Total, double, and triple autoionization rates are obtained by the propagation of the time-dependent close-coupled equations in real-time using integration over bound and continuum single-particle states. These states are generated by matrix diagonalization of one-electron Hamiltonians. The total autoionization rates for each L excited state is found to be slightly above the single autoionization rate for the excited configuration using configuration-average distorted-wave theory. As expected, we find the double and triple autoionization rates to be much smaller than the total autoionization rates. Future work can be extended to study electron-impact triple ionization of atoms or ions. The work was supported in part by grants from the American University of Sharjah and the US Department of Energy. Computational work was carried out at the National Energy Research Scientific Computing Center (NERSC) in Berkeley, California, USA.

Keywords: hollow atoms, autoionization, auger rates, time-dependent close-coupling method

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Authors: Ian Campbell, Gillian Mitchell, Paul James, Na Li, Ella Thompson

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The genetic cause of the majority of multiple-case breast cancer families remains unresolved. Next generation sequencing has emerged as an efficient strategy for identifying predisposing mutations in individuals with inherited cancer. We are conducting whole exome sequence analysis of germ line DNA from multiple affected relatives from breast cancer families, with the aim of identifying rare protein truncating and non-synonymous variants that are likely to include novel cancer predisposing mutations. Data from more than 200 exomes show that on average each individual carries 30-50 protein truncating mutations and 300-400 rare non-synonymous variants. Heterogeneity among our exome data strongly suggest that numerous moderate penetrance genes remain to be discovered, with each gene individually accounting for only a small fraction of families (~0.5%). This scenario marks validation of candidate breast cancer predisposing genes in large case-control studies as the rate-limiting step in resolving the missing heritability of breast cancer. The aim of this study is to screen genes that are recurrently mutated among our exome data in a larger cohort of cases and controls to assess the prevalence of inactivating mutations that may be associated with breast cancer risk. We are using the Agilent HaloPlex Target Enrichment System to screen the coding regions of 168 genes in 1,000 BRCA1/2 mutation-negative familial breast cancer cases and 1,000 cancer-naive controls. To date, our interim analysis has identified 21 genes which carry an excess of truncating mutations in multiple breast cancer families versus controls. Established breast cancer susceptibility gene PALB2 is the most frequently mutated gene (13/998 cases versus 0/1009 controls), but other interesting candidates include NPSR1, GSN, POLD2, and TOX3. These and other genes are being validated in a second cohort of 1,000 cases and controls. Our experience demonstrates that beyond PALB2, the prevalence of mutations in the remaining breast cancer predisposition genes is likely to be very low making definitive validation exceptionally challenging.

Keywords: predisposition, familial, exome sequencing, breast cancer

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Authors: Yuchen LI, Martyn Kurr, Peter Golyshin

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Biological invasion is a global problem. Invasive species can threaten local ecosystems by competing for resources, consuming local species, and reproducing faster than natives. Sargassum muticum is an invasive algae in the UK. It negatively impacts local algae through overshading and can cause reductions in local biodiversity. One possibility for its success is herbivore release. According to the Enemy Release Hypothesis, invasives are less impacted by local herbivores than natives. In many species, gastrointestinal (GI) tract microbes have been found as a key factor in food preference and similar mechanisms may exist in the relationship between local consumers and S. muticum. Some populations of native Littorina snails accept S. muticum as a food source, while others avoid it. This project aims to establish the relationship between GI tract microbes and the feeding preferences of L. littorea, when offered both native algae and S. muticum. Individuals of L. littorea from a site invaded by S. muticum around 18 years ago were compared to those from an un-invaded site nearby. Sargassum-experienced snails are more likely to consume it than those naïve, and pronounced differences were found in the GI-tract microbial communities through 16S (prokaryote) and 18S (eukaryote) sequencing. Sargassum-naïve snails were then exposed to a faecal pellets from experienced snails to ‘inoculate’ them with microbes from the exposed snails. Preliminary results suggest these faecal-pellet-exposed but otherwise Sargassum-naïve snails subsequently begun consuming S. muticum. It is unclear if these results are due to genuine changes in GI-tract microbes or through some other mechanism, such as behavioural responses to chemical cues in the faecal pellets, but these results are nevertheless of significance for invasive ecology, suggesting that foraging preferences for an invasive prey type are malleable and possibly programmable in laboratory settings.

Keywords: invasive algae, sea snails, gut microbiome, biocontrol

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Authors: Shaun G. Abbott, Rebecca C. Reynolds, James B. Etter, John B. F. de Wit

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The benefits of physical activity (PA) on health are well documented. Low socioeconomic status (SES) is associated with poor health, with PA a suggested mediator. Pedometers and accelerometers offer an effective behavior change tool to increase PA levels. While the role of pedometer and accelerometer use in increasing PA is recognized in many populations, little is known in low-SES groups. We are aiming to assess the effectiveness of pedometer- and accelerometer-based interventions for increasing PA step count and improving subsequent health outcomes among low-SES groups of high-income countries. Medline, Embase, PsycINFO, CENTRAL and SportDiscus databases were searched to identify articles published before 10th July, 2015; using search terms developed from previous systematic reviews. Inclusion criteria are: low-SES participants classified by income, geography, education, occupation or ethnicity; study duration minimum 4 weeks; an intervention and control group; wearing of an unsealed pedometer or accelerometer to objectively measure PA as step counts per day for the duration of the study. We retrieved 2,142 articles from our database searches, after removal of duplicates. Two investigators independently reviewed titles and abstracts of these articles (50% each) and a combined 20% sample were reviewed to account for inter-assessor variation. We are currently verifying the full texts of 430 articles. Included studies will be critically appraised for risk of bias using guidelines suggested by the Cochrane Public Health Group. Two investigators will extract data concerning the intervention; study design; comparators; steps per day; participants; context and presence or absence of obesity and/or chronic disease. Heterogeneity amongst studies is anticipated, thus a narrative synthesis of data will be conducted with the simplification of selected results into percentage increases from baseline to allow for between-study comparison. Results will be presented at the conference in December if selected.

Keywords: accelerometer, pedometer, physical activity, socioeconomic, step count

Procedia PDF Downloads 324

Authors: Masita Mokeira, Kimani Rita, Obonyo Brian, Kwenda Kennedy, Mugambi Purity, Kirui Joan, Chomba Eric, Orwa Daniel, Waiganjo Peter

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Rugby is a highly intense and physical game requiring speed and strength. The need for physical fitness therefore cannot be over-emphasized. Sports are no longer about lifting weights so as to build muscle. Most professional teams are investing much more in the sport in terms of time, equipment and other resources. To play competitively, Kenyan players may therefore need to complement their ‘home-grown’ and sometimes ad-hoc training and nutrition regimes with carefully measured strength and conditioning, diet, nutrition, and supplementation. Nokia Research Center and University of Nairobi conducted an exploratory study on needs and behaviours surrounding sports in Africa. Rugby being one sport that is gaining ground in Kenya was selected as the main focus. The end goal of the research was to identify areas where mobile technology could be used to address gaps, challenges and/or unmet needs. Themes such as information gap, social culture, growth, and development, revenue flow, and technology adoption among others emerged about the sport. From the growth and development theme, it was clear that as rugby continues to grow in the country, teams, coaches, and players are employing interesting techniques both in training and playing. Though some of these techniques are indeed scientific, those employing them are sometimes not fully aware of their scientific basis. A further case study on sports science in rugby in Kenya focusing on physical fitness and nutrition revealed interesting findings. This paper discusses findings on emerging adoption of techniques in managing physiological and nutritional needs of rugby players across different levels of rugby in Kenya namely high school, club and national levels.

Keywords: rugby, nutrition, physiological needs, sports science

Procedia PDF Downloads 375

Authors: Qin Ou, Yanghui Xu, Xintu Wang, Kim Maren Lompe, Gang Liu, Jan Peter Van Der Hoek

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Microplastics (MPs) can undergo the photooxidation process under ultraviolet (UV) exposure, which determines their transformation and fate in environments. The presence of dissolved organic matter (DOM) can interact with MPs and take participate in the photo-degradation of MPs. As an important DOM component, dissolved black carbon (DBC), widely distributed in aquatic environments, can accelerate or inhibit the sunlight-driven photo-transformation of environmental pollutants. However, the role and underlying mechanism of DBC in the photooxidation of MPs are not clear. Herein, the DBC (< 0.45 µm) was extracted from wood biochar and fractionated by molecular weight (i.e., <3 KDa, 3 KDa−30 KDa, 30 KDa−0.45 µm). The effects of DBC chemical composition (i.e., molecular weight and chemical structure) in DBC-mediated photo-transformation of polystyrene (PS) MPs were investigated. The results showed that DBC initially inhibited the photo-degradation of MPs due to light shielding. Under UV exposure for 6−24 h, the presence of 5 mg/L DBC decreased the carbonyl index of MPs compared to the control. This inhibitory effect of DBC was found to decrease with increasing irradiation time. Notably, DBC initially decreased but then increased the hydroxyl index with aging time, suggesting that the role of DBC may shift from inhibition to acceleration. In terms of the different DBC fractions, the results showed that the smallest fraction of DBC (<3 KDa) significantly accelerated the photooxidation of PS MPs since it acted as reactive oxygen species (ROS) generators, especially in promoting the production of ¹O₂ and ³DBC* and •OH. With the increase in molecular weight, the acceleration effect of DBC on the degradation of MPs was decreased due to the increase of light shielding and possible decrease of photosensitization ability. This study thoroughly investigated the critical role of DBC chemical composition in the photooxidation process, which helps to assess the duration of aging and transformation of MPs during long-term weathering in natural waters.

Keywords: microplastics, photo-degradation, dissolved black carbon, molecular weight, photosensitization

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Authors: James Boag

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The needs of people with a diagnosis of dementia and their carers and families are physical, psychosocial, and psychological and begin at the time of diagnosis. There is frequently a lack of emotional support and counselling. Care- giving support is required from the presentation of the first symptoms of dementia until death. Alzheimer's disease begins decades before the clinical symptoms begin to appear, and in many cases, it remains undiagnosed, or diagnosed too late for any possible interventions to have any effect. However, if an incorrect diagnosis is given, it may result in a person being treated, without effect, for a type of dementia they do not have and delaying the interventions they should have received. Being diagnosed with dementia can cause emotional distress to the person, and physical and emotional support is needed, which will become more important as the disease progresses. The severity of the patient's dementia and their symptoms has a bearing of the impact on the carer and the support needed. A lack of insight and /or a denial of the diagnosis, grief, reacting to anticipated future losses, and coping methods to maximise the disease outcome, are things that should be addressed. Because of the stigma, it is important for carers not to lose contact with family and others because social isolation leads to depression and burnout. The impact on a carer's well- being and quality of life can be influenced by the severity of the illness, its type of dementia, its symptoms, healthcare support, financial and social status, career, age, health, residential setting, and relationship to the patient. Carer burnout due to lack of support leads to people diagnosed with dementia being put into residential care prematurely. Often dementia is not recognised as a terminal illness, limiting the ability of the person diagnosed with dementia and their carers to work on advance care planning and getting access to palliative and other support. Many carers have been satisfied with the physical support they were given in their everyday life, however, it was agreed that there was an immense unmet need for psychosocial support, especially after diagnosis and approaching end of life. Providing continuity and coordination of care is important. Training is necessary for providers to understand that every case is different, and they should understand the complexities. Grief, the emotional response to loss, is suffered during the progression of the disease and long afterwards, and carers should continue to be supported after the death of the person they were caring for.

Keywords: dementia, caring, challenges, needs

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