Search results for: mega primary school

Authors: V. Argyropoulos, M. Nikolaraizi, K. Tanou

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There is little available information concerning the cognitive and communicative abilities of the people who are deaf-blind. This mainly stems from the general inadequacy of existing assessment instruments employed with deafblind individuals. Although considerable variability exists with regard to cognitive capacities of the deaf-blind, careful examination of the literature reveals that the majority of these persons suffer from significant deficits in cognitive and adaptive functioning. The few reports available primarily are case studies, narrative program descriptions, or position papers by workers in the field. Without the objective verification afforded by controlled research, specialists in psychology, education, and other rehabilitation services must rely on personal speculations or biases to guide their decisions in the planning, implementation, and evaluation of services to deaf-blind children and adults. This paper highlights the framework and discusses the results of an action research network. The aim of this study was twofold: a) to describe and analyse the different ways in which a student with deafblindness approached a number of developmental issues such as novel tasks, exploration and manipulation of objects, reactions to social stimuli, motor coordination, and quality of play and b) to map the appropriate functional approach for the specific student that could be used to develop strategies for classroom participation and socialization. The persons involved in this collaborative action research scheme were general teachers, a school counsellor, academic staff and student teachers. Rating scales and checklists were used to gather information in natural activities and settings, and additional data were also obtained through interviews with the educators of the student. The findings of this case study indicated that there is a great need to focus on the development of effective intervention strategies. The results showed that the identification of positive reinforcers for this population might represent an important and challenging aspect of behaviour programmes. Finally, the findings suggest that additional empirical work is needed to increase attention to methodological and social validity issues.

Keywords: action research, cognitive and communicative abilities, deafblindness, effective strategies

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Authors: Diab Z., Hamad A., Dixit A., Al-Rikabi M., Keshaverzi F.

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Introduction: According to the NICE guidelines, 2020Prasugrel is the recommended first line treatment in adults with acute coronary syndromes (ACS) in patients with ST-segment-elevation myocardial infarction (STEMI), defined as ST elevation or new left bundle branch block on ECG , that cardiologists intend to treat with primary percutaneous coronary intervention (PCI). The current literature suggests that this is largely due to safety and efficacy, and cost effectiveness. We wanted to do an audit to examine the adherence of the MRI hospital with guidelines in using prasugrel as first-line therapy in patients with STEMI and undergoing PPCI. AIM: To examine the adherence of the MRI hospital with guidelines in using prasugrel as first-line therapy in patients with STEMI and undergoing PPCI Methods: We looked at the patients presented to MRI during1^st of January 2022 to 28th February 2022. We included all the people who were above 18 and were brought to the hospital through the PPCI pathway and diagnosed as ACS and underwent PPCI. We excluded Patients who were brought to the hospital through the PPCI pathway and underwent coronary angiography and their diagnosis was found other than STEMI or if the outcome was death before discharge or they were above age >75 (as per guideline increase bleeding risk of prasugrel in a person aged 75 or older). Results: The total number of patients was 100. There were a total of seventy patients who had STEMI and fit the criteria for inclusion. Out of these, only 72.9% (51) were given Prasugrel as a first line. Seventeen (17) 24.3% STEMI patients were candidates for prasugrel as first-line therapy but were instead offered (clopidogrel/ticagrelor). Two 2 (2.9%) STEMI patients were not given prasugrel as first-line therapy because of C/I (CVA) or the use of anticoagulant Nine 9 (9%) of them died before discharge. Eleven 11 (11%) were above the age of 75. Ten 10 (10%) of patients had a diagnosis other than STEMI. Conclusions and recommendations: Our audit has shown the need to increase awareness amongst staff re: the first line use of Prasugrel as per NICE guidelines. We aim to arrange awareness sessions for staff and increase visibility of the guidelines for the staff to encourage them to adhere to the guideline. Further research is needed to find the optimum treatment in patients above 75.

Keywords: pasurgrel, PCI, NICE, STEMI

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Authors: E. Von Cheong, Carol Sinnott, Darren Dahly, Patricia M. Kearney

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Introduction and Aim: Adverse childhood experiences (ACEs) are all too common and have been linked to poorer health and wellbeing across the life course. While the prevention of ACEs is a worthy goal, it is important that we also try to lessen the impact of ACEs for those who do experience them. This study aims to investigate associations between adverse childhood experiences (ACEs) and later-life depressive symptoms; and to explore whether perceived social support (PSS) moderates these. Method: We analysed baseline data from the Mitchelstown (Ireland) 2010-11 cohort involving 2047 men and women aged 50–69 years. Self-reported assessments included ACEs (Centre for Disease Control ACE questionnaire), PSS (Oslo Social Support Scale), and depressive symptoms (CES-D). The primary exposure was self-report of at least one ACE. We also investigated the effects of ACE exposure by the subtypes abuse, neglect, and household dysfunction. Associations between each of these exposures and depressive symptoms were estimated using logistic regression, adjusted for socio-demographic factors that were selected using the Directed Acyclic Graph (DAG) approach. We also tested whether the estimated associations varied across levels of PSS (poor, moderate, and good). Results: 23.7% of participants reported at least one ACE (95% CI: 21.9% to 25.6%). ACE exposures (overall or subtype) were associated with a higher odds of depressive symptoms, but only among individuals with poor PSS. For example, exposure to any ACE (vs. none) was associated with 3 times the odds of depressive symptoms (Adjusted OR 2.97; 95% CI 1.63 to 5.40) among individuals reporting poor PSS, while among those reporting moderate PSS, the adjusted OR was 1.18 (95% CI 0.72 to 1.94). Discussion: ACEs are common among older adults in Ireland and are associated with higher odds of later-life depressive symptoms among those also reporting poor PSS. Interventions that enhance perception of social support following ACE exposure may help reduce the burden of depression in older populations.

Keywords: adverse childhood experiences, depression, later-life, perceived social support

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Authors: Bushra Zafar, Usman Qamar

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Large data sample size and dimensions render the effectiveness of conventional data mining methodologies. A data mining technique are important tools for collection of knowledgeable information from variety of databases and provides supervised learning in the form of classification to design models to describe vital data classes while structure of the classifier is based on class attribute. Classification efficiency and accuracy are often influenced to great extent by noisy and undesirable features in real application data sets. The inherent natures of data set greatly masks its quality analysis and leave us with quite few practical approaches to use. To our knowledge first time, we present a new approach for investigation of structure and quality of datasets by providing a targeted analysis of localization of noisy and irrelevant features of data sets. Machine learning is based primarily on feature selection as pre-processing step which offers us to select few features from number of features as a subset by reducing the space according to certain evaluation criterion. The primary objective of this study is to trim down the scope of the given data sample by searching a small set of important features which may results into good classification performance. For this purpose, a heuristic for wrapper-based feature selection using genetic algorithm and for discriminative feature selection an external classifier are used. Selection of feature based on its number of occurrence in the chosen chromosomes. Sample dataset has been used to demonstrate proposed idea effectively. A proposed method has improved average accuracy of different datasets is about 95%. Experimental results illustrate that proposed algorithm increases the accuracy of prediction of different diseases.

Keywords: data mining, generic algorithm, KNN algorithms, wrapper based feature selection

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Authors: Anthony J. Kondracki, Bonzo I. Reddick, Jennifer L. Barkin

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We sought to examine the association of maternal Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and treponema pallidum (TP) (syphilis) infections with preterm birth (PTB) (<37 weeks gestation), low birth weight (LBW) (<2500 grams) and prenatal care (PNC) attendance. This cross-sectional study was based on data drawn from the 2020 United States National Center for Health Statistics (NCHS) Natality File. We estimated the prevalence of all births, early/late PTBs, moderately/very LBW, and the distribution of sexually transmitted infections (STIs) according to maternal characteristics in the sample. In multivariable logistic regression models, we examined adjusted odds ratios (aORs) and their corresponding 95% confidence intervals (CIs) of PTB and LBW subcategories in the association with maternal/infant characteristics, PNC status, and maternal CT, NG, and TP infections. In separate logistic regression models, we assessed the risk of these newborn outcomes stratified by PNC status. Adjustments were made for race/ethnicity, age, education, marital status, health insurance, liveborn parity, previous preterm birth, gestational hypertension, gestational diabetes, PNC status, smoking, and infant sex. Additionally, in a sensitivity analysis, we assessed the association with early, full, and late term births and the potential impact of unmeasured confounding using the E-value. CT (1.8%) was most prevalent STI in pregnancy, followed by NG (0.3%), and TP (0.1%). Non-Hispanic Black women, 20-24 years old, with a high school education, and on Medicaid had the highest rate of STIs. Around 96.6% of women reported receiving PNC and about 60.0% initiated PNC early in pregnancy. PTB and LBW were strongly associated with NG infection (12.2% and 12.1%, respectively) and late initiation/no PNC (8.5% and 7.6%, respectively), and ≤10 prenatal visits received (13.1% and 10.3%, respectively). The odds of PTB and LBW were 2.5- to 3-foldhigher for each STI among women who received ≤10 prenatal visits than >10 visits. Adequate prenatal care utilization and timely screening and treatment of maternal STIs can substantially reduce the burden of adverse newborn outcomes.

Keywords: low birthweight, prenatal care, preterm birth, sexually transmitted infections

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Authors: Ravid Yinon

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Introduction: Pelvic trauma causes high mortality, particularly among the elderly population. Pelvic injury ranges from low-energy incidents such as falls to high-energy trauma like motor vehicle accidents. The mortality rate among high-energy trauma patients is higher, as can be expected. The elderly population is more vulnerable to pelvic trauma even at low energy mechanisms due to the fragility and diminished physiological reserve of these patients. The aim of this study is to examine whether there is a higher long-term mortality in pelvic injuries in the elderly from the low-energy mechanism than those injured in high energy. Methods: A retrospective cohort study was conducted in a level 1 trauma center with injured patients aged 65 years and over with pelvic trauma. The patients were divided into two groups of low and high-energy mechanisms of injury. Multivariate analysis was conducted to characterize the differences between the groups. Results: There were 585 consecutive injured patients over the age of 65 with a documented pelvic injury who were treated at the primary trauma center between 2008-2020. The injured in the high energy group were younger (mean HE- 75.18, LE-80.73), with fewer comorbidities (mean 0.78 comorbidities at HE and 1.28 at LE), more men (52.6% at HE and 27.4% at LE), were consumed more treatments facilities such as angioembolization, ICU admission, emergency surgeries and blood products transfusion and higher mortality rate at admission (HE- 19/133, 14.28%, LE- 10/452, 2.21%) compared to the low energy group. However, in a long-term follow-up of one year after the injury, mortality in the low-energy group was significantly higher (HE- 14/114, 12.28%, LE- 155/442, 35.06%). Discussion: Although it can be expected that in the mechanism of high energy, the mortality rate in the long term would be higher, it was found that mortality at the low energy patient was higher. Apparently, low-energy pelvic injury in geriatric patients is a measure of frailty in these patients, causes injury to more frail and morbid patients, and is a predictor of mortality in this population in the long term. Conclusion: The long-term follow-up of injured elderly with pelvic trauma should be more intense, and the healthcare provider should put more emphasis on the rehabilitation of these special patient populations in an attempt to prevent long-term mortality.

Keywords: pelvic trauma, elderly trauma, high energy trauma, low energy trauma

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Authors: Ahmed Ismail, Mustafa Baysal

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Although the energy source in the world is mainly based on fossil fuels today, there is a need for alternative energy generation systems, which are more economic and environmentally friendly, due to continuously increasing demand of electric energy and lacking power resources and networks. Distributed Energy Resources (DERs) such as fuel cells, wind and solar power have recently become widespread as alternative generation. In order to solve several problems that might be encountered when integrating DERs to power system, the microgrid concept has been proposed. A microgrid can operate both grid connected and island mode to benefit both utility and customers. For most distributed energy resources (DER) which are connected in parallel in LV-grid like micro-turbines, wind plants, fuel cells and PV cells electrical power is generated as a direct current (DC) and converted to an alternative currents (AC) by inverters. So the inverters are assumed to be primary components in a microgrid. There are many control techniques of parallel inverters to manage active and reactive sharing of the loads. Some of them are based on droop method. In literature, the studies are usually focused on improving the transient performance of inverters. In this study, the performance of two different controllers based on droop control method is compared for the inverters operated in parallel without any communication feedback. For this aim, a microgrid in which inverters are controlled by conventional droop controller and modified droop controller is designed. Modified controller is obtained by adding PID into conventional droop control. Active and reactive power sharing performance, voltage and frequency responses of those control methods are measured in several operational cases. Study cases have been simulated by MATLAB-SIMULINK.

Keywords: active and reactive power sharing, distributed generation, droop control, microgrid

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Authors: Haniyeh Parhizkar

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When Sarris came up with the "auteur theory" in 1962, he emphasized that the utmost premise of auteur theory is the inner meanings and concepts of a film and that a film is purely an art form. Today's mainstream movies are conceptually closer to what the Frankfurt School scholars regarded as "reproduced" and "mass culture" years ago. Hollywood goes on to be a huge movie-making machine that leads the dominant paradigms of films throughout the world and cinema is far from art. Although there are still movies, directors, and audiences who favor art cinema over Hollywood and mainstream movies, it's an almost undeniable fact that, for the most part, people's perception of movies is widely influenced by their American depiction and Hollywood's legacy of mass culture. With the uprising of Hollywood studios as the forerunners of the movie industry and cinema being largely dependent on economics rather than artistic values, this distinctive role of cinema has diminished and is replaced with a global standard. The Blockbuster 2022 film, 'Everything, Everywhere, All at Once' is now the most-awarded movie of all time, winning seven Oscars at the 95th Academy Awards. Despite its main cast being Asian, the movie is produced by American incorporation and is heavily influenced by Hollywood's dominant themes of superheroes, fantasy, action, and adventure. The New Yorker film critic, Richard Brody, called the movie "a pitch for a Marvel" and critiqued the film for being "universalized" and "empty of history and culture". Other critics of Variety pinpointed the movie's similarities to Marvel, particularly in their storylines of multi-universe which manifest traces of American legacy. As argued by these critics, 'Everything, Everywhere, All at Once' might appear as a unique and authentic film at first glance, but it can be argued that it is yet another version of a Marvel movie. While the movie's universal acclaim was regarded as recognition and an acknowledgment of its Asian cast, the issue that arises here is when the Hollywood influences and American themes are so robust in the film, is the movie industry honoring another culture or is it yet another celebration of Hollywood's dominant paradigm. This essay will employ a critical approach to Hollywood's dominance and mass-produced culture, which has deprived authenticity of non-American movies and is constantly reproducing the same formula of success.

Keywords: hollywoodization, universalization, blockbuster, dominant paradigm, marvel, authenticity, diversity

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Authors: Kadry M. Sadek, Tarek K. Abouzed, Mousa A. Ayoub

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The presence of endocrine-disrupting compounds, such as bisphenol A (BPA), in the environment can cause serious health problems. However, there are controversial opinions. This study investigated the reproductive, metabolic, oxidative and immunologic-disrupting effects of bisphenol A in male rabbits. Rabbits were divided into five groups. The first four rabbit groups were administered oral BPA (1, 10, 50, or 100 mg/kg/day) for ten weeks. The fifth group was administered corn oil as the vehicle. BPA significantly decreased serum testosterone, estradiol and the free androgen index (FAI) and significantly increased sex hormone binding globulin (SHBG) compared with the placebo group. The higher doses of BPA showed a significant decrease in follicular stimulating hormone (FSH) and luteinizing hormone (LH). A significant increase in blood glucose levels was identified in the BPA groups. The non-significant difference in insulin levels is a novel finding. The cumulative testicular toxicity of BPA was clearly demonstrated by the dose-dependent decrease in absolute testes weight, primary measures of semen quality and a significant increase in testicular malonaldehyde (MDA). Moreover, BPA significantly decreased total antioxidant capacity (TAC) and significantly increased immunoglobulin G (IgG) at the highest concentration. Our results suggest that BPA, especially at higher doses, is associated with many adverse effects on metabolism, oxidative stress, immunity, sperm quality and markers of androgenic action. These results may reflect the estrogenic effects of BPA, which we hypothesize could be related, in part, to an inhibitory effect on testicular steroidogenesis. The induction of oxidative stress by BPA may play an additional role in testicular toxicity. These results suggest that BPA poses a threat to endocrine and reproductive functions.

Keywords: bisphenol A, oxidative stress, rabbits, semen quality, steroidogenesis

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Authors: Farideh Halakou, Emel Sen, Attila Gursoy, Ozlem Keskin

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Protein–Protein Interactions (PPIs) mediate major biological processes in living cells. The study of PPIs as networks and analyze the network properties contribute to the identification of genes and proteins associated with diseases. In this study, we have created the sub-networks of brain and lung metastasis from primary tumor in breast cancer. To do so, we used seed genes known to cause metastasis, and produced their interactions through a network-topology based prioritization method named GUILDify. In order to have the experimental support for the sub-networks, we further curated them using STRING database. We proceeded by modeling structures for the interactions lacking complex forms in Protein Data Bank (PDB). The functional enrichment analysis shows that KEGG pathways associated with the immune system and infectious diseases, particularly the chemokine signaling pathway, are important for lung metastasis. On the other hand, pathways related to genetic information processing are more involved in brain metastasis. The structural analyses of the sub-networks vividly demonstrated their difference in terms of using specific interfaces in lung and brain metastasis. Furthermore, the topological analysis identified genes such as RPL5, MMP2, CCR5 and DPP4, which are already known to be associated with lung or brain metastasis. Additionally, we found 6 and 9 putative genes that are specific for lung and brain metastasis, respectively. Our analysis suggests that variations in genes and pathways contributing to these different breast metastasis types may arise due to change in tissue microenvironment. To show the benefits of using structural PPI networks instead of traditional node and edge presentation, we inspect two case studies showing the mutual exclusiveness of interactions and effects of mutations on protein conformation which lead to different signaling.

Keywords: breast cancer, metastasis, PPI networks, protein conformational changes

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Authors: Colm Barcoe, Garvan Whelan

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Over the past five years, visitations of American holidaymakers to Ireland have grown exponentially owing to the online strategies of Tourism Ireland, a Destination Marketer (DMO) with a meagre budget which is extended by their understanding of best practices to maximise their monetary allowance. This suggested framework incorporates a range of Key Performance Indicators (KPI’s) such as financial, marketing, and operational that offer a scale of measurement from which the Irish DMO can monitor the success of each promotional campaign when targeting the US and Canada. These are presented not as final solutions but rather as suggestions based on empirical evidence obtained from both primary and secondary sources. This research combines the wisdom extracted through qualitative methodologies with the objective of understanding the processes that drive both emergent and agile strategies. The Study extends the work relative to performance and examines the role of social media in the context of promoting Ireland to North America. There are two main themes that are identified and analysed in this investigation, these are the approach of the DMO when advocating Ireland as a brand and the benefits of digital platforms set against a proposed scale of KPIs, such as destination marketing, brand positioning, and identity development. The key narrative of this analysis is to focus on the power of social media when capitalising upon marketing opportunities, operating on a relatively small budget. This will always be a relevant theme of discussion due to the responsibility of an organisation like Tourism Ireland operating under the restraints imposed by government funding. The overall conclusions of this research may help inform those concerned with the implementing of social media strategies develop clearer models of measurement when promoting a destination to North America. The suggestions of this study will benefit small and medium enterprises particularly.

Keywords: destination marketing, framework, measure, performance

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Authors: Shakhawath Hossain, Tazkia Tahsin

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Introduction/Background: Intellectual disability is a disability characterized by significant limitations both in intellectual functioning and in adaptive behavior, which covers many everyday social and practical skills. Vocational education is a multi-professional approach that is provided to individuals of working age with health-related impairments, limitations, or restrictions with work functioning and whose primary aim is to optimize work participation. Instrumental Activities of Daily Living activities to support daily life within the home and community. Like as community mobility, financial management, meal preparation, and clean-up, shopping. Material and Method: Electronic searches of Medline, PubMed, Google scholar, OT Seeker literature using the key terms of intellectual disability, vocational rehabilitation, instrumental activities of daily living and Occupational Therapy, as well as a thorough manual search for relevant literature. Results: There were 13 articles, all qualitative and quantitative, which are included in this review. All studies were mixed methods in design. To take the Occupational Therapy services, there is a significant improvement in their children's various areas like as sensory issues, cognitive abilities, perceptual skills, visual, motor planning, and group therapy. After taking the vocational and instrumental activities of daily living training children with intellectual disabilities to participate in their daily activities and work as an employee different company or organizations. Conclusion: The persons with intellectual disability are an integral part of our society who deserves social support and opportunities like other human beings. From the result section of the project papers, it is found that the significant benefits of Occupational Therapy services in the aspects of vocational and instrumental activities of daily living.

Keywords: occupational therapy, daily living activities, intellectual disabilities, instrumental ADL

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Authors: Thyagi Ponnamperuma

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Background: Comorbidity between posttraumatic stress disorder (PTSD) and other psychological problems is common. Recent studies focused to investigate the underlying relationship between PTSD and comorbid psychopathologies. Among adolescents, higher rates of emotional and behavioral problems (EBP) have been reported following trauma, often coexisted with PTSD. The current study, thus, examined the relationship of posttraumatic stress symptoms to EBP in adolescents exposed to a variety of traumatic events. Further, the study investigated the relationship of trauma and comorbid PTSS to the self-perceived negative impact of EBP on daily functioning. Methods: Participants were 729 Sri Lankan adolescents (age 12 to 16 years; 54.9% female) living in areas impacted in varying degrees by the 2004 tsunami. In 2008, school-based screening was conducted and completed measures of, trauma exposure, PTSS, EBP, and related functional impairment. Results: Participants reported a high prevalence of trauma exposure (n = 438), including interpersonal violence (n = 155). DSM-IV criteria for full or partial PTSD were met by 23.7% of the trauma-exposed sample. Across all participants, 13.4% and 16.7% displayed clinically relevant levels of EBP and functional impairment, respectively. Among the trauma-exposed, 7% met criteria for both EBP and PTSD. EBP total scores and caseness were significantly higher in trauma-exposed adolescents with PTSD than in either those without PTSD or the non-traumatized control group. In subscale analysis, higher prevalence of serious emotional, conduct, and hyperactivity problems were reported in the PTSD positive group; the PTSD negative group did not differ significantly from the control group on any of the problem scales. In regression analyses, PTSS (β = .28, p < .001) and interpersonal violence (β = .13, p = .033) were significant predictors of EBP, cumulative trauma (β = .11, p = .076) showed no significant effect. Further, PTSS exacerbated the impact of EBP on daily functioning (β = 0.29, p = .023). Conclusion: PTSS were closely linked to EBP in adolescents, even years after the traumatic experience. PTSD and emotional and behavioral problems together pose a heightened risk for impaired daily functioning. Longitudinal studies are needed to clarify the causal pathway.

Keywords: adolescents, comorbidity, emotional and behavioral problems, functional impairment, posttraumatic stress, traumatic events

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Authors: Gülşen Kocaevli

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This paper aims to conduct a comparative analysis on the reflections of cultural elements such as language, festival, and food both in the case of Turkish immigrants in Germany and Mexican immigrants in the United States within a historical perspective. These reflections will be studied first by giving a certain background information on the migratory history of the two nations, Mexican immigration to the US, and Turkish immigration to Germany, respectively. These two cases were picked as the analytical subjects of this paper because both nations first migrated to the related country to constitute a labor force since there was a huge need for that due to several reasons such as the loss of manpower after certain wars or revolutions. At the end of this comparative study, it is speculated to be found that there are certain parallels between these two immigrant societies in the way that they reflect their cultures in the receiving country since both nations have a conventionalist nature which makes them tend more to protect their cultures and pay less effort to integrate into the society in which they are living. Even though this integration might be realized in certain fields like economic status and exogamy, it does not cover all segments nor is there any desire of the receiving government to integrate the immigrants but rather they make policies to assimilate them. This research paper will use a qualitative method which is fundamentally based on the interpretative data drawn from several sociological or ethnographic studies conducted in the related field. The primary and secondary resources of this paper will cover academic books, journal articles, particularly those reporting interviews with the immigrants, and certain governmental documents as well as publicized statistics regarding the subject of analysis. By the use of the aforementioned methodology and resources, the conventionalist nature of the two immigrant nations is aimed to be presented as the unifying factor in the way that Mexicans in the US and Turks in Germany reflect and protect their cultures in the form of language, festivals, and food.

Keywords: assimilation, culture, German-Turks, immigration, Mexican Americans

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Authors: Engy S. El-Kayal, Mohamed M. S. Arafa

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There are various causes of ankle pain including traumatic and non-traumatic causes. Various imaging techniques are available for assessment of AP. MRI is considered to be the imaging modality of choice for ankle joint evaluation with an advantage of its high spatial resolution, multiplanar capability, hence its ability to visualize small complex anatomical structures around the ankle. However, the high costs and the relatively limited availability of MRI systems, as well as the relatively long duration of the examination all are considered disadvantages of MRI examination. Therefore there is a need for a more rapid and less expensive examination modality with good diagnostic accuracy to fulfill this gap. HRU has become increasingly important in the assessment of ankle disorders, with advantages of being fast, reliable, of low cost and readily available. US can visualize detailed anatomical structures and assess tendinous and ligamentous integrity. The aim of this study was to compare the diagnostic accuracy of HRU with MRI in the assessment of patients with AP. We included forty patients complaining of AP. All patients were subjected to real-time HRU and MRI of the affected ankle. Results of both techniques were compared to surgical and arthroscopic findings. All patients were examined according to a defined protocol that includes imaging the tendon tears or tendinitis, muscle tears, masses, or fluid collection, ligament sprain or tears, inflammation or fluid effusion within the joint or bursa, bone and cartilage lesions, erosions and osteophytes. Analysis of the results showed that the mean age of patients was 38 years. The study comprised of 24 women (60%) and 16 men (40%). The accuracy of HRU in detecting causes of AP was 85%, while the accuracy of MRI in the detection of causes of AP was 87.5%. In conclusions: HRU and MRI are two complementary tools of investigation with the former will be used as a primary tool of investigation and the latter will be used to confirm the diagnosis and the extent of the lesion especially when surgical interference is planned.

Keywords: ankle pain (AP), high-resolution ultrasound (HRU), magnetic resonance imaging (MRI) ultrasonography (US)

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Authors: Timothy Scheinert, Eliza Wright

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Background: Link Health is a Boston-based non-profit leveraging in-person and digital platforms to promote health equity. Its primary aim is to financially support low-income individuals through enrollment in federal benefit programs. This study examines the monetary impact of enrollment in several benefit programs. Methodologies: Approximately 17,000 individuals have been screened for eligibility via digital outreach, community events, and in-person clinics. Enrollment and financial distributions are evaluated across programs, including the Affordable Connectivity Program (ACP), Lifeline, LIHEAP, Transitional Aid to Families with Dependent Children (TAFDC), and the Supplemental Nutrition Assistance Program (SNAP). Major Findings: A total of 1,895 individuals have successfully applied, collectively distributing an estimated $1,288,152.00 in aid. The largest contributors to this sum include: ACP: 1,149 enrollments, $413,640 distributed annually. Child Care Financial Assistance (CCFA): 15 enrollments, $240,000 distributed annually. Lifeline: 602 enrollments, $66,822 distributed annually. LIHEAP: 25 enrollments, $48,750 distributed annually. SNAP: 41 enrollments, $123,000 distributed annually. TAFDC: 21 enrollments, $341,760 distributed annually. Conclusions: These results highlight the role of targeted outreach and effective enrollment processes in promoting access to federal benefit programs. High enrollment rates in ACP and Lifeline demonstrate a considerable need for affordable broadband and internet services. Programs like CCFA and TAFDC, despite lower enrollment numbers, provide sizable support per individual. This analysis advocates for continued funding of federal benefit programs. Future efforts can be made to develop screening tools that identify eligibility for multiple programs and reduce the complexity of enrollment.

Keywords: benefits, childcare, connectivity, equity, nutrition

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Authors: Bahar Ayberk

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The study was conducted to determine the relationship between physical fitness and academic performance among university students. A far-famed saying ‘Sound mind in a sound body’ referring to the potential quality of increased physical fitness in the intellectual development of individuals seems to be endorsed. There is a growing body of literature the impact of physical fitness on academic achievement, especially in elementary and middle-school aged children. Even though there are numerous positive effects related to being physically active and physical fitness, their effect on academic achievement is not very much clear for university students. The subjects for this study included 25 students (20 female and 5 male) enrolled in Yeditepe University, Physiotherapy and Rehabilitation Department of Health Science Faculty. All participants filled in a questionnaire about their socio-demographic status, general health status, and physical activity status. Health-related physical fitness testing, included several core components: 1) body composition evaluation (body mass index, waist-to-hip ratio), 2) cardiovascular endurance evaluation (queen’s college step test), 3) muscle strength and endurance evaluation (sit-up test, push-up test), 4) flexibility evaluation (sit and reach test). Academic performance evaluation was based on student’s Cumulative Grade Point Average (CGPA). The prevalence of the subjects participating physical activity was found to be 40% (n = 10). CGPA scores were significantly higher among students having regular physical activity when we compared the students having regular physical activities or not (respectively 2,71 ± 0.46, 3.02 ± 0.28 scores, p = 0.076). The result of the study also revealed that there is positive correlation relationship between sit-up, push up and academic performance points (CGPA) (r = 0.43, p ≤ 0.05 ) and negative correlation relationship between cardiovascular endurance parameter (Queen's College Step Test) and academic performance points (CGPA) (r = -0.47, p ≤ 0.05). In conclusion, the findings confirmed that physical fitness level was generally associated with academic performance in the study group. Cardiovascular endurance and muscle strength and endurance were associated with student’s CGPA, whereas body composition and flexibility were unrelated to CGPA.

Keywords: academic performance, health-related physical fitness, physical activity, physical fitness testing

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Authors: Ashit Syngle, Inderjit Verma, Pawan Krishan

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Therapeutic approaches used previously relied on disease-modifying antirheumatic drugs (DMARDs) that had only partial clinical benefit and were associated with significant toxicity. Spironolactone, an oral aldosterone antagonist, suppresses inflammatory mediators. Clinical efficacy of spironolactone compared with placebo in patients with active psoriatic arthritis despite treatment with prior traditional DMARDs. In the 24-week, placebo-controlled study patients (n=31) were randomized to placebo and spironolactone (2 m/kg/day). Patients on background concurrent DMARDs continued stable doses (methotrexate, leflunomide, and/or sulfasalazine). Primary outcome measures were the assessment of disease activity measures i.e. 28-joint disease activity score (DAS28) and diseases activity in psoriatic arthritis (DAPSA) at week 24. The key secondary endpoint was change from baseline in Health Assessment Questionnaire–Disability Index (HAQ-DI) at week 24. Additional efficacy outcome measures at week 24 included improvements in the markers of inflammation (ESR and CRP) and pro-inflammatory cytokines TNF-α, IL-6 and IL-1. At week 24, spironolactone significantly reduced disease activity measure DAS-28 (p<0.001) and DAPSA (p=0.001) compared with placebo. Significant improvements in key secondary measures HAQ-DI (disability index) were evident with spironolactone (p=0.02) versus placebo. After week 24, there was significant reduction in pro-inflammatory cytokines level TNF-α, IL-6 (p<0.01) as compared with placebo group. However, there was no significant improvement in IL-1 in both treatment and placebo groups. There were minor side effects which did not mandate stopping of spironolactone. No change in any biochemical profile was noted after spironolactone treatment. Spironolactone was effective in the treatment of PsA, improving disease activity, physical function and suppressing the level of pro-inflammatory cytokines. Spironolactone demonstrated an acceptable safety profile and was well tolerated.

Keywords: spironolactone, inflammation, inflammatory cytokine, psoriatic arthritis

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Authors: Chen-Ya Juan

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In recent years, the increasing number of children with special needs has brought a lot of attention by many scholars and experts in education, which enforced the preschool teachers face the harsh challenge in the classroom. To protect the right of equal education for all children, enhance the quality of children learning, and take care of the needs of children with special needs, the special education paraprofessional becomes one of the future employment trends for students of the department of the early childhood care and education. Problem-based learning is a problem-oriented instruction, which is different from traditional instruction. The instructor first designed an ambiguous problem direction, following the basic knowledge of early intervention, students had to find clues to solve the problem defined by themselves. In the class, the total instruction included 20 hours, two hours per week. The primary purpose of this paper is to investigate the relationship of student academic scores, self-awareness, learning motivation, learning attitudes, and early intervention knowledge. A total of 105 college students participated in this study and 97 questionnaires were effective. The effective response rate was 90%. The student participants included 95 females and two males. The average age of the participants was 19 years old. The questionnaires included 125 questions divided into four major dimensions: (1) Self-awareness, (2) learning motivation, (3) learning attitudes, and (4) early intervention knowledge. The results indicated (1) the scores of self-awareness were 58%; the scores of the learning motivations was 64.9%; the scores of the learning attitudes was 55.3%. (2) After the instruction, the early intervention knowledge has been increased to 64.2% from 38.4%. (3) Student’s academic performance has positive relationship with self-awareness (p < 0.05; R = 0.506), learning motivation (p < 0.05; R = 0.487), learning attitudes (p < 0.05; R = 0.527). The results implied that although students had gained early intervention knowledge by using PBL instruction, students had medium scores on self-awareness and learning attitudes, medium high in learning motivations.

Keywords: college students, children with special needs, problem-based learning, learning motivation

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Authors: Marinel Dayawon

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Student participation in classroom activities is vital in the teaching- learning the process as it develops self-confidence, social relationships and good academic performance of students. It is the teacher’s empathetic manner and creativity to create solutions that encourage teamwork and mutual support while dropping the academic competition within the class that hinder every shy student to walk with courage and talk with conviction because they consider their ideas, weak, as compared to the bright students. This study aimed to explore the different design thinking strategies that will change the mindset of shy students in classroom activities, maximizing their participation in all given tasks while sharing their views through ideation and providing them a wider world through compromise agreement within the members of the group, sensitivity to one’s idea, thus, arriving at a collective decision in the development of a prototype that indicates improvement in their classroom involvement. The study used the qualitative type of research. Triangulation is done through participant observation, focus group discussion and interview, documented through photos and videos. The respondents were the second- year Bachelor of Secondary Education students of the Institute of Teacher Education at Isabela State University- Cauayan City Campus. The result of the study revealed that reticent students when involved in game activities through a slap and tap method, writing their clustered ideas, using sticky notes is excited in sharing ideas as it doesn’t use oral communication. It is also observed after three weeks of using the design thinking strategies; shy students volunteer as secretary, rapporteur or group leader in the team- building activities as it represents the ideas of the heterogeneous group, removing the individual identity of the ideas. Superior students learned to listen to the ideas of the reticent students and involved them in the prototyping process of designing a remediation program for high school students showing reticence in the classroom, making their experience as a benchmark. The strategies made a 360- degrees transformation of the shy students, producing their journal log, in their journey to being open. Thus, faculty members are now adopting the design thinking approach.

Keywords: design thinking activities, qualitative, reticent students, Isabela, Philippines

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Authors: S. H. Jang

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Posterior reversible encephalopathy syndrome (PRES) is characterized by acute neurologic symptoms (visual loss, headache, altered mentality and seizures) and by typical imaging findings (bilateral subcortical and cortical edema with predominatly posterior distribution). Nephrotic syndrome is a syndrome comprising signs of proteinuria, hypoalbuminemia, and edema. It is well known that hypertension predispose patient with nephrotic syndrome to PRES. A 45-year old male was referred for suddenly developed vertigo, disequilibrium. He had previous history of nephrotic syndrome. His medical history included diabetes controlled with medication. He was hospitalized because of generalized edema a few days ago. His vital signs were stable. On neurologic examination, his mental state was alert. Horizontal nystagmus to right side on return to primary position was observed. He showed good grade motor weakness and ataxia in right upper and lower limbs without other sensory abnormality. Brain MRI showed increased signal intensity in FLAIR image, decreased signal intensity in T1 image and focal enhanced lesion in T1 contrast image at whole midbrain, pons and cerebellar peduncle symmetrically, which was compatible with vasogenic edema. Laboratory findings showed severe proteinuria and hypoalbuminemia. He was given intravenous dexamethasone and diuretics to reduce vasogenic edema and raise the intra-vascular osmotic pressure. Nystagmus, motor weakness and limb ataxia improved gradually over 2 weeks; He recovered without any neurologic symptom and sign. Follow-up MRI showed decreased vasogenic edema fairly. We report a case of brain stem PRES in normotensive, nephrotic syndrome patient.

Keywords: posterior reversible encephalopathy syndrome, MRI, nephrotic syndrome, vasogenic brain edema

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Authors: Arda Bagus M, Yehezkiel Festian P, Budianto Santoso

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The Tourism Area of Southern Malang is administratively located in the Regency of Malang, East Java Province, Indonesia and geographically is in a position between 112o17' - 112o57' E dan 7o44' - 8o26' S. Southern Malang consists of several sub-districts that directly borders with the Indian Ocean, such as Donomulyo, Bantur, Gedangan, Sumbermanjing, Tirto Yudo, and Ampel Gading. This area has a high geotourism potential because of the existence of geodiversity such as beaches, waterfalls, caves, and karst area. However, to the best of the authors’ knowledge, there is still no systematic data that informs the geotourism potentials to the public. The aim of this research is to complete the lack of data and then arrange it systematically so it can be used for both tourism and research purposes. Research methods such as field observation, literature study, and depth interview to local people have been implemented. Aspects reviewed by visiting the field are accommodation, transportation, and the feasibility of a place to be geotourism object. The primary data was taken in Sumbermanjing, Gedangan, Bantur, and Donomulyo sub-district. A literature study is needed to determine the regional geology of Southern Malang and as a comparison to new data obtained in the field. The results of the literature study show that southern Malang consists of three formations: Wonosari Formation, Mandalaka Formation, and River-swamps Sediment Formation with the age range of Oligocene to Quaternary. Depth interviews have been conducted by involving local people with the aim of knowing cultural-history in the research area. From this research, the geotourism object distribution map has been made. The map also includes Geotrek and basic geological information of each object. The results of this research can support the development of geotourism in Southern Malang.

Keywords: geodiversity, geology, geotourism, geotrek, southern Malang

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Authors: O. O. Oguntoye

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Product consumption constitutes an important consideration for sustainable development. Seeing how product consumption could be highly unsustainable, coupled with how existing policies on corporate responsibility do not particularly address the consumption aspect of product lifecycle, conducting this research became necessary. The research makes an attempt to provide a framework by which to gauge corporate responsibility of product suppliers in terms of their commitment towards the sustainable consumption of their products. Through an exploration of relevant literature, independently established ideas with which to assess a given product supplier were galvanised into a four-criterion framework. The criteria are: (1) Embeddedness of consumption as a factor in corporate sustainability policy, (2) Level of understanding of consumption behaviour, (3) Breadth of behaviour-influencing strategies adopted, and (4) Inclusiveness for all main dimensions of sustainability. This resulting framework was then applied in a case study involving a UK-based furniture supplier where interviews and content analysis of corporate documents were used as the mode for primary data collection. From the case study, it was found that the supplier had performed to different levels across the four themes of the assessment. Two major areas for improvement were however identified – one is for the furniture supplier to focus more proactively on understanding consumption behaviour and, two is for it to widen the scope of its current strategies for enhancing sustainable consumption of supplied furniture. As a generalisation, the framework presented here makes it possible for companies to reflect with a sense of guidance, how they have demonstrated commitment towards sustainable consumption through their values, culture, and operations. It also provides a foundation for developing standardized assessment which the current widely used frameworks such as the GRI, the Global Compact, and others do not cover. While these popularly used frameworks mainly focus on sustainability of companies within the production and supply chain management contexts (i.e. mostly ‘upstream’), the framework here provides an extension by bringing the ‘downstream’ or consumer bit into light.

Keywords: corporate sustainability, design for sustainable consumption, extended producer responsibility, sustainable consumer behaviour

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Authors: Hadjer Sadoune, Liza Lamini, Scherazade Krim, Amel Djouadi, Rachida Rihani

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Deep neural networks are highly regarded for their accuracy in predicting intricate fermentation processes. Their ability to learn from a large amount of datasets through artificial intelligence makes them particularly effective models. The primary obstacle in improving the performance of these models is to carefully choose the suitable hyperparameters, including the neural network architecture (number of hidden layers and hidden units), activation function, optimizer, learning rate, and other relevant factors. This study predicts biogas production from real wastewater treatment plant data using a sophisticated approach: hybrid Bayesian optimization with a tree-structured Parzen estimator (BO-TPE) for an optimised deep neural network (DNN) model. The plant utilizes an Upflow Anaerobic Sludge Blanket (UASB) digester that treats industrial wastewater from soft drinks and breweries. The digester has a working volume of 1574 m3 and a total volume of 1914 m3. Its internal diameter and height were 19 and 7.14 m, respectively. The data preprocessing was conducted with meticulous attention to preserving data quality while avoiding data reduction. Three normalization techniques were applied to the pre-processed data (MinMaxScaler, RobustScaler and StandardScaler) and compared with the Non-Normalized data. The RobustScaler approach has strong predictive ability for estimating the volume of biogas produced. The highest predicted biogas volume was 2236.105 Nm³/d, with coefficient of determination (R2), mean absolute error (MAE), and root mean square error (RMSE) values of 0.712, 164.610, and 223.429, respectively.

Keywords: anaerobic digestion, biogas production, deep neural network, hybrid bo-tpe, hyperparameters tuning

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Authors: Jubril Olatunbosun Akinde

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Unplanned population growth are mostly attributed to a lack of infrastructural facilities and poor economic condition in the rural dwellings and the incidence of rural-urban migration, which has resulted in severe housing deficiency in the urban centre, with a resultant pressure on housing delivery in the cities. Affordable housing does not only encompass environmental factors that make living acceptable and comfortable, which include good access routes, ventilation, sanitation and access to other basic human needs, which include water and safety. The research assessed the housing affordability and safety measures in the varied residential area of lagos by examining the demographic and socioeconomic attributes of residents; examining the existing residential safety measures; by examining the residential quality in terms of safety; the researcher therefore examined if relationship between housing affordability and safety in the varied residential areas. The research adopted the bartlett, kotrlik and higgins (2001) method of t-test to determine the sample size which specifies different populations at different levels of significance (α). The researcher adopted primary data which was sourced from a field survey where the sample population was simply randomly selected to give a member of the population an equal chance of being selected, therefore, the sample size for the field survey was two hundred (200) respondents, and subjected to necessary testing. The research come to conclusion that housing safety and security is the responsibility of every resident, the landlords/landladies possess a better sense of security in their neighbourhood than renters in the community, therefore they need to be aware of their responsibility of ensuring the safety of lives and property.

Keywords: housing, housing affordability, housing security, residential, residential quality

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Authors: Kai Pei Huang, Ting Chung Hung, Li Ching Wu

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Amyloidosis refers to a variety of conditions wherein amyloid proteins are abnormally deposited in organ or tissues and cause harm. Among the several forms of amyloidosis, the principal types of that in inpatient medical services are the AL amyloidosis (primary) and AA amyloidois (secondary). AL Amyloidois is due to deposition of protein derived from overproduction of immunoglobulin light chain in plasma cell myeloma. Furthermore, it is a systemic disorder that can present with a variety of symptoms, including heavy proteinemia and edema, heptosplenomegaly, otherwise unexplained heart failure. We reported a 78-year-old female presenting dysuria, oliguria and leg edema for several months. Laboratory data showed proteinuria (UPCR:1679.8), leukocytosis (WBC:16.2 x 10^3/uL), results of serum urea nitrogen (39mg/dL), creatinine (0.76 mg/dL), IgG (748 mg/dL.), IgA (635 mg/dL), IgM (63 mg/dL), kappa light chain(18.8 mg/dL), lambda light chain (110.0 mg/dL) and kappa/lambda ratio (0.17). Renal biopsy found amyloid fibrils in glomerular mesangial area, and Congo red stain highlights amyloid deposition in glomeruli. Additional lab studies included serum protein electrophoresis, which shows a major monoclonal peak in β region and minor small peak in gamma region, and the immunotyping studies for serum showed two IgA/λ type. We treated sample with beta-mercaptoethanol which reducing the polymerized immunoglobulin to clarify two IgA/λ are secreted from the same plasma cell clone in bone marrow. Later examination confirmed it existed plasma cell infiltration in bone marrow, and the immunohistochemical staining showed monotypic for λ light chain and are positive for IgA. All findings mentioned above reveal it is a case of plasma cell myeloma with λ Light Chain Amyloidosis.

Keywords: amyloidosis, immunoglobulin light chain, plasma cell myeloma, serum protein electrophoresis

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Authors: Rajai Al-Rousan

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The repair and strengthening of concrete structures is a big challenge for the concrete industry for both engineers and contractors. Due to increasing economical constraints, the current trend is to repair/upgrade deteriorated and functionally obsolete structures rather than replacing them with new structures. CFRP has been used previously by air space industries regardless of the high costs. The decrease in the costs of the composite materials, as results of the technology improvement, has made CFRP an alternative to conventional materials for many applications. The primary objective of this research is to investigate the flexural behavior of reinforced concrete (RC) beams externally strengthened with CFRP composites exposed for three years for the following conditions: (a) room temperature, (b) cyclic ponding in 15% salt-water solution, (c) hot-water of 65oC, and (d) rapid freeze/thaw cycles. Results indicated that the after three years of various environmental conditions, the bond strength between the concrete beams and CFRP sheets was not affected. No signs of separation or debonding of CFRP sheets were observed before testing. Also, externally strengthening RC beams with CFRP sheets leads to a substantial increase in the ductility of concrete structures. This is a result of forcing the concrete to undergo inelastic deformation, resulting in compression failure of the structure after yielding of steel reinforcement. In addition, exposure to heat water tank for three years reduces the ultimate load by about 11%. This 11% reduction in the ultimate load equates to about 53%, 46% and 68% loss of the gain of the strength attributed to the CFRP of 2/3 Layer, 1 Layers and 2 Layers CFRP Sheets respectively. This mean that with decreasing of number of layers the environmental exposure had an efficient effect on concrete by protection concrete from environmental effect and adverse effect on the bond performance.

Keywords: flexural, behavior, CFRP, composites, environment, conditions

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Authors: Dafna Knani, Sarit S. Sivan

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Aggrecan, one of the main components of the intervertebral disc (IVD), belongs to the family of proteoglycans (PGs) that are composed of glycosaminoglycan (GAG) chains covalently attached to a core protein. Its primary function is to maintain tissue hydration and hence disc height under the high loads imposed by muscle activity and body weight. Significant PG loss is one of the first indications of disc degeneration. A possible solution to recover disc functions is by injecting a synthetic hydrogel into the joint cavity, hence mimicking the role of PGs. One of the hydrogels proposed is GAG-analogues, based on sulfate-containing polymers, which are responsible for hydration in disc tissue. In the present work, we used molecular dynamics (MD) to study the effect of the hydrogel crosslinking (type and degree) on the swelling behavior of the suggested GAG-analogue biomimetics by calculation of cohesive energy density (CED), solubility parameter, enthalpy of mixing (ΔEmix) and the interactions between the molecules at the pure form and as a mixture with water. The simulation results showed that hydrophobicity plays an important role in the swelling of the hydrogel, as indicated by the linear correlation observed between solubility parameter values of the copolymers and crosslinker weight ratio (w/w); this correlation was found useful in predicting the amount of PEGDA needed for the desirable hydration behavior of (CS)₄-peptide. Enthalpy of mixing calculations showed that all the GAG analogs, (CS)₄ and (CS)₄-peptide are water-soluble; radial distribution function analysis revealed that they form interactions with water molecules, which is important for the hydration process. To conclude, our simulation results, beyond supporting the experimental data, can be used as a useful predictive tool in the future development of biomaterials, such as disc replacement.

Keywords: molecular dynamics, proteoglycans, enthalpy of mixing, swelling

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Authors: Jin Young Kim, Kwon Kyoo Kang

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The SGR1 (STAYGREEN1) protein is a critical regulator of plant leaves in chlorophyll degradation and senescence. The functions and mechanisms of tomato SGR1 action are poorly understood and worthy of further investigation. To investigate the function of the SGR1 gene, we generated a SGR1-knockout (KO) null line via clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9-mediated gene editing and conducted RNA sequencing and gas chromatography tandem mass spectrometry (GC-MS/MS) analysis to identify the differentially expressed genes. The SlSGR1 (Solanum lycopersicum SGR1) knockout null line clearly showed a turbid brown color with significantly higher chlorophyll and carotenoid content compared to wild-type (WT) fruit. Differential gene expression analysis revealed 728 differentially expressed genes (DEGs) between WT and sgr1 #1-6 line, including 263 and 465 downregulated and upregulated genes, respectively, for which fold change was >2, and the adjusted p-value was <0.05. Most of the DEGs were related to photosynthesis and chloroplast function. In addition, the pigment, carotenoid changes in sgr1 #1-6 line was accumulated of key primary metabolites such as sucrose and its derivatives (fructose, galactinol, raffinose), glycolytic intermediates (glucose, G6P, Fru6P) and tricarboxylic acid cycle (TCA) intermediates (malate and fumarate). Taken together, the transcriptome and metabolite profiles of SGR1-KO lines presented here provide evidence for the mechanisms underlying the effects of SGR1 and molecular pathways involved in chlorophyll degradation and carotenoid biosynthesis.

Keywords: tomato, CRISPR/Cas9, null line, RNA-sequencing, metabolite profiling

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Authors: Samuel Pimpong

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In most liberal and constitutional democracies, the media serves as a dominant power in the construction of the fundamental building blocks for the consolidation of democratic governance. However, the extent to which the media can enhance democratic consolidation in a country depends to a large extent on the independence of the media, the robustness of legislative frameworks and the safety of journalists in discharging their duties without fear or favor. This study sought to examine pertinent issues, practices and challenges facing the media in Ghana’s Fourth Republic and attempts to make recommendations regarding the way forward. The work adopted a qualitative study approach. A total of sixteen (16) participants were purposively selected for face-to-face interviews. The study hinges on the democratic participant media theory and the development media theory. Primary data was analyzed via thematic analysis procedure. The study revealed that although Ghana has repealed its criminal libel laws, nonetheless other statutory Acts, such as the Electronic Communications Act 2008 (ACT 775) and the Criminal and other offences Act 1960 (Act 29), among others continue to stifle freedom of expression. On the other hand, press freedom is being abused by the use of fake content publication. Further, the study revealed that the absence of a comprehensive regulatory structure impedes the activities carried out by the media. Consequently, the study recommends a regulatory structure to oversee media activities and content, as the National Media Commission (NMC) lacks the authority to do so. In this direction, the study recommends a limitation on the role of the National Communications Authority (NCA) to administer broadcasting signals and transfer its licensing and sanctioning powers to the NMC in order to create one sole and completely independent media regulatory authority that deals with all media related issues.

Keywords: media, constitutional democracy, democratic consolidation, fourth republic

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