Search results for: family physician program

Authors: Areej Alosimi, Heather Wharrad, Katharine Whittingham

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Palliative care is a crucial element in nursing, especially with the steep increase in non-communicable diseases. Providing education in palliative care can help elevate the standards of care and address the growing need for it. However, palliative care has not been introduced into nursing curricula, specifically in Saudi Arabia, evidenced by students' inadequate understanding of the subject. Digital learning has been identified as a persuasive and effective method to improve education. The study aims to assess the feasibility and accessibility of implementing digital learning in palliative care education in Saudi Arabia by investigating the potential of delivering palliative care nurse education via distance learning. The study will utilize a sequential exploratory mixed-method approach. Phase one will entail identifying needs, developing a web-based program in phase two, and intervention implementation with a pre-post-test in phase three. Semi-structured interviews will be conducted to explore participant perceptions and thoughts regarding the intervention. Data collection will incorporate questionnaires and interviews with nursing students. Data analysis will use SPSS to analyze quantitative measurements and NVivo to analyze qualitative aspects. The study aims to provide insights into the feasibility of implementing digital learning in palliative care education. The results will serve as a foundation to investigate the effectiveness of e-learning interventions in palliative care education among nursing students. This study addresses a crucial gap in palliative care education, especially in nursing curricula, and explores the potential of digital learning to improve education. The results have broad implications for nursing education and the growing need for palliative care globally. The study assesses the feasibility and accessibility of implementing digital learning in palliative care education in Saudi Arabia. The research investigates whether palliative care nurse education can be effectively delivered through distance learning to improve students' understanding of the subject. The study's findings will lay the groundwork for a larger investigation on the efficacy of e-learning interventions in improving palliative care education among nursing students. The study can potentially contribute to the overall advancement of nursing education and the growing need for palliative care.

Keywords: undergraduate nursing students, E-Learning, Palliative care education, Knowledge

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Authors: Ewa Kamarad

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Recent problems with adopting the EU Regulation on matrimonial property regimes have clearly proven that Member States are unable to agree on the scope of the Regulation and, therefore, on the definitions of matrimonial property and marriage itself. Taking into account that the Regulation on the law applicable to divorce and legal separation, as well as the Regulation on matrimonial property regimes, were adopted in the framework of enhanced cooperation, it is evident that lack of a unified definition of marriage has very wide-ranging consequences. The main problem with the unified definition of marriage is that the EU is not entitled to adopt measures in the domain of material family law, as this area remains under the exclusive competence of the Member States. Because of that, the legislation on marriage in domestic legal orders of the various Member States is very different. These differences concern not only issues such as form of marriage or capacity to enter into marriage, but also the most basic matter, namely the core of the institution of marriage itself. Within the 28 Member States, we have those that allow both different-sex and same-sex marriages, those that have adopted special, separate institutions for same-sex couples, and those that allow only marriage between a man and a woman (e.g. Hungary, Latvia, Lithuania, Poland, Slovakia). Because of the freedom of movement within the European Union, it seems necessary to somehow recognize the civil effects of a marriage that was concluded in another Member State. The most crucial issue is how far that recognition should go. The thesis presented in the presentation is that, at an absolute minimum, the authorities of all Member States must recognize the civil status of the persons who enter into marriage in another Member State. Lack of such recognition might cause serious problems, both for the spouses and for other individuals. The authorities of some Member States may treat the marriage as if it does not exist because it was concluded under foreign law that defines marriage differently. Because of that, it is possible for the spouse to obtain a certificate of civil status stating that he or she is single and thus eligible to enter into marriage – despite being legally married under the law of another Member State. Such certificate can then be used in another country to serve as a proof of civil status. Eventually the lack of recognition can lead to so-called “international bigamy”. The biggest obstacle to recognition of marriages concluded under the law of another Member State that defines marriage differently is the impossibility of transcription of a foreign civil certificate in the case of such a marriage. That is caused by the rule requiring that a civil certificate issued (or transcribed) under one country's law can contain only records of legal institutions recognized by that country's legal order. The presentation is going to provide possible solutions to this problem.

Keywords: civil status, recognition of marriage, conflict of laws, private international law

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Authors: Daniela E. Marin, Cornelia Braicu, Gina C. Pistol, Roxana Cojocneanu-Petric, Ioana Berindan Neagoe, Mihail A. Gras, Ionelia Taranu

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Aristolochic acid (AA) is a carcinogenic, mutagenic, and nephrotoxic compound commonly found in the Aristolochiaceae family of plants. AA is frequently associated with urothelial carcinoma of the upper urinary tract in human and animals and is considered as being responsible for Balkan Endemic Nephropathy. The pig provides a good animal model because the porcine urological system is very similar to that of humans, both in aspects of physiology and anatomy. MicroRNA (miRNA) are small non-coding RNAs that have an impact on a wide range of biological processes by regulating gene expression at post-transcriptional level. The objective of this study was to analyze the miRNA profiling in the kidneys of AA intoxicated swine. For this purpose, ten TOPIGS-40 crossbred weaned piglets, 4-week-old, male and females with an initial average body weight of 9.83 ± 0.5 kg were studied for 28 days. They were given ad libitum access to water and feed and randomly allotted to one of the following groups: control group (C) or aristolochic acid group (AA). They were fed a maize-soybean-meal-based diet contaminated or not with 0.25mgAA/kg. To profile miRNA in the kidneys of pigs, microarrays and bioinformatics approaches were applied to analyze the miRNA in the kidney of control and AA intoxicated pigs. After normalization, our results have shown that a total of 5 known miRNAs and 4 novel miRNAs had different profiling in the kidney of intoxicated animals versus control ones. Expression of miR-32-5p, miR-497-5p, miR-423-3p, miR-218-5p, miR-128-3p were up-regulated by 0.25mgAA/kg feed, while the expression of miR-9793-5p, miR-9835-3p, miR-9840-3p, miR-4334-5p was down-regulated. The microRNA profiling in kidney of intoxicated animals was associated with modified expression of target genes as: RICTOR, LASP1, SFRP2, DKK2, BMI1, RAF1, IGF1R, MAP2K1, WEE1, HDGF, BCL2, EIF4E etc, involved in cell division cycle, apoptosis, cell differentiation and cell migration, cell signaling, cancer etc. In conclusion, this study provides new data concerning the microRNA profiling in kidney after aristolochic acid intoxications with important implications for human and animal health.

Keywords: aristolochic acid, kidney, microRNA, swine

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Authors: Freddy Munzhelele

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Setting: the empirical research has shown that the life cycle theory has an impact on the firms’ financing decisions, particularly the dividend pay-outs. Accordingly, the life cycle theory posits that as a firm matures, it gets to a level and capacity where it distributes more cash as dividends. On the other hand, the young firms prioritise investment opportunities sets and their financing; thus, they pay little or no dividends. The research on firms’ financing decisions also demonstrated, among others, the adoption of trade-off and pecking order theories on the dynamics of firms capital structure. The trade-off theory talks to firms holding a favourable position regarding debt structures particularly as to the cost and benefits thereof; and pecking order is concerned with firms preferring a hierarchical order as to choosing financing sources. The case of life cycle hypothesis explaining the financial managers’ decisions as regards the firms’ capital structure dynamics appears to be an interesting link, yet this link has been neglected in corporate finance research. If this link is to be explored as an empirical research, the financial decision-making alternatives will be enhanced immensely, since no conclusive evidence has been found yet as to the dynamics of capital structure. Aim: the aim of this study is to examine the impact of life cycle theory on the capital structure dynamics trade-off and pecking order theories of firms listed in retail, industrial and mining sectors of the JSE. These sectors are among the key contributors to the GDP in the South African economy. Design and methodology: following the postpositivist research paradigm, the study is quantitative in nature and utilises secondary data obtainable from the financial statements of sampled firm for the period 2010 – 2022. The firms’ financial statements will be extracted from the IRESS database. Since the data will be in panel form, a combination of the static and dynamic panel data estimators will used to analyse data. The overall data analyses will be done using STATA program. Value add: this study directly investigates the link between the life cycle theory and the dynamics of capital structure decisions, particularly the trade-off and pecking order theories.

Keywords: life cycle theory, trade-off theory, pecking order theory, capital structure, JSE listed firms

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Authors: Yei Mian Adrian Yap

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This study aims to assess the Japanese and Singaporean mainstream teachers’ attitudes and teaching-efficacy towards the inclusion of students with special needs in the regular classrooms by investigating what kind of key variables influence their attitudes and teaching-efficacy. It also further investigates how they strategize to address their challenges to include their students with special needs in their regular classrooms. In order to understand the nature of teachers’ attitudes and teaching-efficacy towards the inclusive education, a mixed-method research methodology was carried out in Japan and Singapore; it involved an explanatory sequential method of employing quantitative research first before qualitative research. In the quantitative research, 189 Japanese and 183 Singaporean teachers were invited to participate in the questionnaires and out of these participants, 38 Japanese and 15 Singaporean teachers shared their views during their semi-structured interviews. Based on the empirical findings, Japanese teachers’ attitudes and teaching-efficacy were more likely to be influenced by their experiences in teaching students with special needs, knowledge about disability legislation, presence of their disabled family members and level of confidence to teach students with special needs. On the other hand, Singaporean teachers’ attitudes and teaching-efficacy were affected by gender, educational level, received trainings in special needs education, knowledge about disability legislation and level of confidence to teach students with special needs. Both country results also demonstrated that there was a positive correlation between their teaching-efficacy and attitude. Narrative findings further expanded the reasons behind these quantitative factors that shaped teachers’ attitudes and teaching-efficacy. Also, it discussed the various problems faced by Japanese and Singaporean teachers and how they identified their coping strategies to circumvent their challenges in including their students with special needs in their regular classrooms. The significance of this research manifests in necessary educational reforms in both countries especially in the context of inclusive education. These findings may not be as definitive as expected but it is believed that it could provide useful information on the current situation about teachers’ concerns towards the inclusive education. In conclusion, this research could potentially make its positive contribution to the body of literature on teachers’ attitudes and teaching-efficacy in the context of Asian developed countries. Further, these findings could posit that regular teachers’ positive attitudes and strong sense of teaching self-efficacy could directly improve the success rate of inclusion of students with special needs in the regular classrooms.

Keywords: attitudes, inclusive education, special education, teaching-efficacy

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Authors: Dhouibi Mohamed, Stirbu Bogdan, Chabotier André, Pirlot Marc

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Effects of erosion and wear on the performance of small caliber guns have been analyzed throughout numerical and experimental studies. Mainly, qualitative observations were performed. Correlations between the volume change of the chamber and the maximum pressure are limited. This paper focuses on the development of a numerical model to predict the maximum pressure evolution when the interior shape of the chamber changes in the different weapon’s life phases. To fulfill this goal, an experimental campaign, followed by a numerical simulation study, is carried out. Two test barrels, « 5.56x45mm NATO » and « 7.62x51mm NATO,» are considered. First, a Coordinate Measuring Machine (CMM) with a contact scanning probe is used to measure the interior profile of the barrels after each 300-shots cycle until their worn out. Simultaneously, the EPVAT (Electronic Pressure Velocity and Action Time) method with a special WEIBEL radar are used to measure: (i) the chamber pressure, (ii) the action time, (iii) and the bullet velocity in each barrel. Second, a numerical simulation study is carried out. Thus, a coupled interior ballistic model is developed using the dynamic finite element program LS-DYNA. In this work, two different models are elaborated: (i) coupled Eularien Lagrangian method using fluid-structure interaction (FSI) techniques and a coupled thermo-mechanical finite element using a lumped parameter model (LPM) as a subroutine. Those numerical models are validated and checked through three experimental results, such as (i) the muzzle velocity, (ii) the chamber pressure, and (iii) the surface morphology of fired projectiles. Results show a good agreement between experiments and numerical simulations. Next, a comparison between the two models is conducted. The projectile motions, the dynamic engraving resistances and the maximum pressures are compared and analyzed. Finally, using this obtained database, a statistical correlation between the muzzle velocity, the maximum pressure and the chamber volume is established.

Keywords: engraving process, finite element analysis, gun barrel erosion, interior ballistics, statistical correlation

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Authors: E. C. Swart, E. Kunneke

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Background: Disparities in food security exist between communities and households across the country, reflecting continuing social and economic inequalities. The purpose of this study was to investigate the presence of food insecurity amongst UWC students. Method: Cross-sectional study recruited 200 students via email and cellphone from an ICS generated list of randomly selected students aged 18-25. Data collection took place during the first two weeks of term 3. Individual appointments were made with consenting participants and conducted in English by trained BSc Dietetics students. Data was analysed using SPSS. The hunger scale used by Stats SA (October 2010) was used. Dietary intake was assessed using a single 24hr recall. Results: Sixty-three percent of the students reported that they do experience some food insecurity whilst 14.5% reported to go hungry due to inadequate access to food. Coping mechanisms during periods of food insecurity include: Asking a friend, neighbour, family member (40%); Borrow (15%); Steal (none); Casual jobs (12%). Anthropometric status of students did not differ statistically significantly by food security status. A statistically significantly greater proportion of Xhosa speaking students reported inadequate money for food. Students residing in residences off campus appear to be least food secure in terms of money available and limiting food intake, whilst those residing at home are less food insecure. Similar proportions of students who receive bursaries or whose parents are paying reported going hungry whilst those who supports themselves never goes hungry. Mean nutrient intake during the previous 24 hours of students who reported inadequate resources to buy food, who eat less due to inadequate resources and who goes hungry only differed statistically significantly for Vitamin B (go hungry) and for fibre (money shortage). In general the nutrient intake is lower for those who reported to eat less and go hungry except for added sugar, vitamin A and folate (go hungry), and energy, fibre, iron, riboflavin and folate (eat less). For students who reported to have inadequate money to buy food, the mean nutrient intake was higher except for calcium and thiamin. The mean body mass index of this group of students was also higher even though the difference was not statistically significant. Conclusion: Hunger is present on campus however a single 24hr recall did not confirm statistically significant lower nutrient intakes for students who reported different levels of food insecurity.

Keywords: anthropometry, dietary intake, nutritional status, students

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Authors: Chloe Richards, Adrian Delgado Ollero, Yan Delaure, Fiona Regan

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Growing concern about the natural environment has accelerated the search for non-toxic, but at the same time, economically reasonable, antifouling materials. Bioinspired surfaces, due to their nano and micro topographical antifouling capabilities, provide a hopeful approach to the design of novel antifouling surfaces. Biological organisms are known to have highly evolved and complex topographies, demonstrating antifouling potential, i.e. shark skin. Previous studies have examined the antifouling ability of topographic patterns, textures and roughness scales found on natural organisms. One of the mechanisms used to explain the adhesion of cells to a substrate is called attachment point theory. Here, the fouling organism experiences increased attachment where there are multiple attachment points and reduced attachment, where the number of attachment points are decreased. In this study, an attempt to characterize the microtopography of the common brill fish, Scophthalmus rhombus, was undertaken. Scophthalmus rhombus is a small flatfish of the family Scophthalmidae, inhabiting regions from Norway to the Mediterranean and the Black Sea. They reside in shallow sandy and muddy coastal areas at depths of around 70 – 80 meters. Six engineered surfaces (inspired by the Brill fish scale) produced by a 2-photon polymerization (2PP) process were evaluated for their potential as an antifouling solution for incorporation onto tidal energy blades. The micro-textures were analyzed for their AF potential under both static and dynamic laboratory conditions using two laboratory grown diatom species, Amphora coffeaeformis and Nitzschia ovalis. The incorporation of a surface topography was observed to cause a disruption in the growth of A. coffeaeformis and N. ovalis cells on the surface in comparison to control surfaces. This work has demonstrated the importance of understanding cell-surface interaction, in particular, topography for the design of novel antifouling technology. The study concluded that biofouling can be controlled by physical modification, and has contributed significant knowledge to the use of a successful novel bioinspired AF technology, based on Brill, for the first time.

Keywords: attachment point theory, biofouling, Scophthalmus rhombus, topography

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Authors: Sukhvinder Kaur, Jayanta Bora, Ashok Agarwal, Sangeeta Kaul

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Background: HIV and STI transmission can be prevented if condoms are used properly, but condom tear may lead to infections even if are used consistently. Studies reveal high rates of condom breakage among Female Sex Workers (FSWs). USAID PHFI-PIPPSE is piloting a prevention model among high risk groups at Thane district of Maharashtra, India by implementing prevention and advocacy efforts for such risk behaviors. The current analysis highlights the correlates of condom breakage among FSWs from Thane. Method: A Behavioral Tracking Survey was conducted in 2014-15 among 503 FSWs through probability-based two stage random sampling from 3,660 FSWs at 100 hotspots, to understand levels of high risk behaviors, awareness and exposure to prevention programs. Bi-variate and multivariate-logistic regression methods used to assess the association of condom breakage while having sex with age, STI occurrence, anal sex with clients and alcohol consumption. Only self-reported STIs (Genital sore/ulcer, yellowish/ greenish discharge from vagina with/without foul smell, lower abdominal pain without diarrhea/dysentery or menses) were considered. Major Findings: Results depicted FSWs who reported condom breakage while having sex with any type of partner (paying clients, non-paying partners and other than main partner husband/boyfriend) had significantly high number of STIs (42.3% vs 16.9 %, P, 0.000) and had started sexual relationship in <16 years of age (31.0% vs 16.4 %, P, 0.000). Multivariate analysis after controlling the age at sex, knowledge about HIV and literacy, highlighted significantly higher odds of condom breakage among FSWs who have reported currently suffering with STI [AOR 2.91, 95% CI 1.75 - 4.83; P, 0.000]; who had anal sex with their paying client [AOR 2.59, 95% CI 1.59 - 4.19; P, 0.000]; and who consumed alcohol in the last 12 months [AOR 1.89, 95% CI 1.01 - 3.53; P, 0.047]. Conclusion: Risky behavior like anal sex with paying clients and impact of alcohol while having sex are main factors for condom breakage among young sex workers; and condom breakage leads to STIs. Hence, program interventions should address measures for prevention of condom breakage for HIV/STI prevention.

Keywords: female sex workers, condom breakage, anal sex, young sex workers

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Authors: Giorgi Katamadze

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Open public service and accountability towards citizens is an important feature of democratic state based on rule of law. Effective use of electronic resources simplifies bureaucratic procedures, makes direct communications, helps exchange information, ensures government’s openness and in general helps develop electronic/digital democracy. Development of electronic democracy should be a strategic dimension of Georgian governance. Formation of electronic democracy, its functional improvement should become an important dimension of the state’s information policy. Electronic democracy is based on electronic governance and implies modern information and communication systems, their adaptation to universal standards. E-democracy needs involvement of governments, voters, political parties and social groups in an electronic form. In the last years the process of interaction between the citizen and the state becomes simpler. This process is achieved by the use of modern technological systems which gives to a citizen a possibility to use different public services online. For example, the website my.gov.ge makes interaction between the citizen, business and the state more simple, comfortable and secure. A higher standard of accountability and interaction is being established. Electronic democracy brings new forms of interactions between the state and the citizen: e-engagement – participation of society in state politics via electronic systems; e-consultation – electronic interaction among public officials, citizens and interested groups; e-controllership – electronic rule and control of public expenses and service. Public transparency is one of the milestones of electronic democracy as well as representative democracy as only on mutual trust and accountability can democracy be established. In Georgia, institutional changes concerning establishment and development of electronic democracy are not enough. Effective planning and implementation of a comprehensive and multi component e-democracy program (central, regional, local levels) requires telecommunication systems, institutional (public service, competencies, logical system) and informational (relevant conditions for public involvement) support. Therefore, a systematic project of formation of electronic governance should be developed which will include central, regional, municipal levels and certain aspects of development of instrumental basis for electronic governance.

Keywords: e-democracy, e-governance, e-services, information technology, public administration

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Authors: Meinrad Haule Lembuka

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Social work profession one of its primary mission is to restore and maintain human rights where social workers recognise all humanity as equal, and so too the philosophies that have developed across the world’s regions. Ubuntu means African Humanism, where realization of human rights has been a primary role for every member of community to protect other member. Before Universal declaration of human rights, African societies had a long history of embracing human rights through Ubuntu approach model. The article used Ubuntu theory to guide the review process of existing literature since Ubuntu theory since is grounded in African cultural values and ecology, and it was thought that application of Ubuntu theory was relevant to reflect reality of Ubuntu model and indigenization of social work in African context. Results have shown that in realization of human rights, Ubuntu was practiced is termed as model, philosophy, cultural values, way of life or framework originated in sub-sahara Africa and some of remarkably practice model in several African communities such as Angola, (gimuntu), Botswana (muthu), Burkina Faso (maaya), Ghana (biako ye), Malawi (umunthu), Mali (maaya/hadama de ya), Namibia (omundu), Nigeria (mutunchi/iwa/agwa), (bantu), Sierra Leonne (maaya), South Africa (ubuntu/botho) and Tanzania (utu/obuntu/bumuntu). Collective and holistic mechanism of Ubuntu is found through an Ubuntu framework that is contributed by individual, family, community and spirit that is characterised by interconnectedness of all things and beings. Each society has its own name but the practice remained the same and realization of human rights in Africa context was centred through human dignity, Ubuntu is built under cultural values of humanism that brings implications for African social worker to integrate this indigenous model into social work practice in restoring and maintain human rights. Social workers should promote policies and practices that demonstrate respect for human life, difference, support and expansion of cultural knowledge and resources, advocate for programmes and institutions that demonstrate cultural competence and promote policies that safeguard the rights and confirm equity and social justice for all people.

Keywords: African ubuntu, indigenous practice, African humanism, African human rights, social work and human rights

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Authors: Shireen Bhatti, M. Asif Shaikh, Atif Khan

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Sexually abusive behavior is seen as a social phenomenon across different societies and different territories. An institution of sport has its own uniqueness. It is different from other workplaces and academia. The challenges in sports raised are different, which require a call to action for specific sexual harassment policies and practices. Many sportswomen who are members of team games or individual games experience sexually abusive behavior from their male counterparts, including trainers, coaches, and lower staff. The power of the coach over the athlete is massive due to the coach’s position. The power can be disguised for possible abuse, whether physical or emotional. Female athletes are victims in most offensive situations that occur in collegiate settings by male coaches. The objective of the study is to identify the relationship between the sexually abusive behavior of male coaches and the motivation of female athletes at public sector universities in Sindh, Pakistan. The descriptive approach was used, whereas The cross-sectional survey design was used to support the study. Intercollegiate, intervarsity, provincial, and national level female athletes of public sector universities of Sindh province were the subject of this study. The tool of research was a self-developed scale that encompassed the relationship between the sexually abusive behaviors of coaches and the motivation of female athletes. Frequency, percentage, and mean and Pearson Correlation, chi square, and ANOVA were used. The results indicate that there is a strong negative relationship between the sexually abusive behavior of male coaches and female athletes’ sports motivation. The Pearson correlation shows that there is a strong negative relation between the sexually abusive behavior of male athletes and female athletes’ sports motivation. The significant level is (r = -.741); however, The findings confirmed that the coach’s power, authority, decision-making position, the threat of rejection on the refusal of sexual cooperation, the ready availability of inexperienced female athletes, and lack of implication of policies regarding sexual misconducts in public sector universities decline motivation of female athletes witnessed. Based on the findings, the study recommended that the family background, career history, and participation record of coaches should be investigated to ensure that they have ever been involved in any criminal activity or sexual misconduct during their career or participation.

Keywords: abusive, athlete, coach, motivation

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Authors: Ola Jon Mork, Lars Andre Giske, Emil Bjørlykhaug

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Stabilization of critical processes in order to have the right quality of the products, more efficient production and smoother flow is a key issue in lean production. This paper presents how simulation of key welding processes can stabilize complicated welding processes in small scale production, and how simulation can impact the entire production concept seen from the perspective of lean production. First, a field study was made to learn the production processes in the factory, and subsequently the field study was transformed into a value stream map to get insight into each operation, the quality issues, operation times, lead times and flow of materials. Valuable practical knowledge of how the welding operations were done by operators, appropriate tools and jigs, and type of robots that could be used, was collected. All available information was then implemented into a simulation environment for further elaboration and development. Three researchers, the management of the company and skilled operators at the work floor where working on the project over a period of eight months, and a detailed description of the process was made by the researchers. The simulation showed that simulation could solve a number of technical challenges, the robot program can be tuned in off line mode, and the design and testing of the robot cell could be made in the simulator. Further on the design of the product could be optimized for robot welding and the jigs could be designed and tested in simulation environment. This means that a key issue of lean production can be solved; the welding operation will work with almost 100% performance when it is put into real production. Stabilizing of one key process is critical to gain control of the entire value chain, then a Takt Time can be established and the focus can be directed towards the next process in the production which should be stabilized. Results show that industrial parameters like welding time, welding cost and welding quality can be defined on the simulation stage. Further on, this gives valuable information for calculation of the factories business performance, like manufacturing volume and manufacturing efficiency. Industrial impact from simulation is more efficient implementation of lean manufacturing, since the welding process can be stabilized. More research should be done to gain more knowledge about simulation as a tool for implementation of lean, especially where there complex processes.

Keywords: simulation, lean, stabilization, welding process

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Authors: Subhanan Mandal, Bidisha Hore

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The linguistic process whereby repetition of all or part of the base word with or without internal change before or after the base itself takes place is regarded as reduplication. The reduplicated morphological construction annotates with itself a new grammatical category and meaning. Reduplication is a very frequent and abundant phenomenon in the eastern Indian languages from the states of West Bengal and Odisha, i.e. Bengali and Odia respectively. Bengali, an Indo-Aryan language and a part of the Indo-European language family is one of the largest spoken languages in India and is the national language of Bangladesh. Despite this classification, Bengali has certain influences in terms of vocabulary and grammar due to its geographical proximity to Tibeto-Burman and Austro-Asiatic language speaking communities. Bengali along with Odia belonged to a single linguistic branch. But with time and gradual linguistic changes due to various factors, Odia was the first to break away and develop as a separate distinct language. However, less of contrasts and more of similarities still exist among these languages along the line of linguistics, leaving apart the script. This paper deals with the procedure of echo word formations in Bengali and Odia. The morphological research of the two languages concerning the field of reduplication reveals several linguistic processes. The revelation is based on the information elicited from native language speakers and also on the analysis of echo words found in discourse and conversational patterns. For the purpose of partial reduplication analysis, prefixed class and suffixed class word formations are taken into consideration which show specific rule based changes. For example, in suffixed class categorization, both consonant and vowel alterations are found, following the rules: i) CVx à tVX, ii) CVCV à CVCi. Further classifications were also found on sentential studies of both languages which revealed complete reduplication complexities while forming echo words where the head word lose its original meaning. Complexities based on onomatopoetic/phonetic imitation of natural phenomena and not according to any rule-based occurrences were also found. Taking these aspects into consideration which are very prevalent in both the languages, inferences are drawn from the study which bring out many similarities in both the languages in this area in spite of branching away from each other several years ago.

Keywords: consonant alteration, onomatopoetic, partial reduplication and complete reduplication, reduplication, vowel alteration

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Authors: Ayse Ozturk Samur, Gozde Inal Kiziltepe

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No matter what level of education it is, starting a school is an exciting process as it includes new experiences. In this process, child steps into a different environment and institution except from the family institution which he was born into and feels secure. That new environment is different from home; it is a social environment which has its own rules, and involves duties and responsibilities that should be fulfilled and new vital experiences. The children who have a positive attitude towards school and like school are more enthusiastic and eager to participate in classroom activities. Moreover, a close relationship with the teacher enables the child to have positive emotions and ideas about the teacher and school and helps children adapt to school easily. In this study, it is aimed to identify children’s perceptions of academic competence, attitudes towards school and ideas about their teachers. In accordance with the aim a mixed method that includes both qualitative and quantitative data collection methods are used. The study is supported with qualitative data after collecting quantitative data. The study group of the research consists of randomly chosen 250 children who are 60-72 month old and attending a preschool institution in a city center located West Anatolian region of Turkey. Quantitative data was collected using Feelings about School scale. The scale consists of 12 items and 4 dimensions; school, teacher, mathematic, and literacy. Reliability and validity study for the scale used in the study was conducted by the researchers with 318 children who were 60-72 months old. For content validity experts’ ideas were asked, for construct validity confirmatory factor analysis was utilized. Reliability of the scale was examined by calculating internal consistency coefficient (Cronbach alpha). At the end of the analyses it was found that FAS is a valid and reliable instrument to identify 60-72 month old children’ perception of their academic competency, attitude toward school and ideas about their teachers. For the qualitative dimension of the study, semi-structured interviews were done with 30 children aged 60-72 month. At the end of the study, it was identified that children’s’ perceptions of their academic competencies and attitudes towards school was medium-level and their ideas about their teachers were high. Based on the semi structured interviews done with children, it is identified that they have a positive perception of school and teacher. That means quantitatively gathered data is supported by qualitatively collected data.

Keywords: feelings, preschool education, school, teacher, thoughts

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Authors: Siobhan Hegarty, Michael Bloomfield, Kim Entholt, Dorothy Williams, Helen Kennerley

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Complex Post-Traumatic Stress Disorder (CPTSD) confers greater risk of poor outcomes than does Post-Traumatic Stress Disorder (PTSD). Despite this, the current treatment guidelines for CPTSD aim to reduce only the ‘core’ symptoms of re-experiencing, hyper-vigilance and avoidance, while not addressing the Disturbances of Self Organisation (DSO) symptoms that distinguish this novel diagnosis from PTSD. The Recovering from Child Abuse Programme (RCAP) is a group protocol, based on the principles of cognitive behavioural therapy (CBT). Preliminary evidence suggests the program is effective at reducing DSO symptoms. This pilot study is the first to investigate the potential effectiveness of the RCAP for the specific treatment of CPTSD. This study was conducted as a service evaluation in a secondary care, traumatic stress service. Treatment was delivered once a week, in two-hour sessions, to ten existing female CPTSD patients of the service, who had experienced sexual abuse in childhood. The programme was administered by two therapists and two additional facilitators, following the RCAP protocol manual. Symptom severity was measured before the administration of therapy and was tracked across a range of measures (International Trauma Questionnaire; Patient Health Questionnaire; Community Assessment of Psychic Experience; Work and Social Adjustment Scale) at five time points, over the course of treatment. Qualitative appraisal of the programme was gathered via weekly feedback forms and from audio-taped recordings of verbal feedback given during group sessions. Preliminary results suggest the programme causes a slight reduction in CPTSD and depressive symptom severity and preliminary qualitative analysis suggests that the RCAP is both helpful and acceptable to group members. Final results and conclusions will follow completed thematic analysis of results.

Keywords: Child sexual abuse, Cognitive behavioural therapy, Complex post-traumatic stress disorder, Recovering from child abuse programme

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Authors: Ahmed Torad

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Background: Knee osteoarthritis (OA) is a prevalent musculoskeletal condition characterized by pain and functional impairment. While various rehabilitation approaches have been employed, the effectiveness of high-intensity interval training (HIIT) compared to traditional rehabilitation exercises remains unclear. Objective: This randomized controlled trial aimed to compare the effects of HIIT and traditional rehabilitation exercises on pain reduction, functional improvement, and quality of life in individuals with knee OA. Methods: A total of 120 participants diagnosed with knee OA were randomly allocated into two groups: the HIIT group (n=60) and the traditional rehabilitation group (n=60). The HIIT group participated in a 12-week supervised program consisting of high-intensity interval exercises, while the traditional rehabilitation group followed a conventional physiotherapy regimen. Outcome measures included visual analog scale (VAS) pain scores, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Short Form-36 Health Survey (SF-36) at baseline and after the intervention period. Results: Both groups showed significant improvements in pain scores, functional outcomes (WOMAC), and quality of life (SF-36) after 12 weeks of intervention. However, the HIIT group demonstrated superior pain reduction (p<0.001), functional improvement (p<0.001), and physical health-related quality of life (p=0.002) compared to the traditional rehabilitation group. No significant differences were observed in mental health-related quality of life between the two groups. Conclusion: High-intensity interval training appears to be a more effective rehabilitation approach than traditional exercises for individuals with knee osteoarthritis, resulting in greater pain reduction, improved function, and enhanced physical health-related quality of life. These findings suggest that HIIT may represent a promising intervention strategy for managing knee OA and enhancing the overall well-being of affected individuals.

Keywords: knee osteoarthritis, high-intensity interval training, traditional rehabilitation exercises, randomized controlled trial, pain reduction, functional improvement, quality of life

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Authors: G.–A. Constantin, G. Voicu, E.–M. Stefan, P. Tudor, G. Paraschiv, M.–G. Munteanu

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In the activity of handling and transport of food products, the products may be subjected to mechanical stresses that may lead to their deterioration by deformation, breaking, or crushing. This is the case for biscuits, regardless of their type (gluten-free or sugary), the addition of ingredients or flour from which they are made. However, gluten-free biscuits have a higher mechanical resistance to breakage or crushing compared to easily shattered sugar biscuits (especially those for children). The paper presents the results of the experimental evaluation of the texture for four varieties of commercial biscuits, using the penetrometer equipped with needle cone at five different additional weights on the cone-rod. The assortments of biscuits tested in the laboratory were Petit Beurre, Picnic, and Maia (all three manufactured by RoStar, Romania) and Sultani diet biscuits, manufactured by Eti Burcak Sultani (Turkey, in packs of 138 g). For the four varieties of biscuits and the five additional weights (50, 77, 100, 150 and 177 g), the experimental data obtained were subjected to regression analysis in the MS Office Excel program, using Velon's relationship (h = a∙ln(t) + b). The regression curves were analysed comparatively in order to identify possible differences and to highlight the variation of the penetration depth h, in relation to the time t. Based on the penetration depth between two-time intervals (every 5 seconds), the curves of variation of the penetration speed in relation to time were then drawn. It was found that Velon's law verifies the experimental data for all assortments of biscuits and for all five additional weights. The correlation coefficient R2 had in most of the analysed cases values over 0.850. The values recorded for the penetration depth were framed, in general, within 45-55 p.u. (penetrometric units) at an additional mass of 50 g, respectively between 155-168 p.u., at an additional mass of 177 g, at Petit Beurre biscuits. For Sultani diet biscuits, the values of the penetration depth were within the limits of 32-35 p.u., at an additional weight of 50 g and between 80-114 p.u., at an additional weight of 177g. The data presented in the paper can be used by both operators on the manufacturing technology flow, as well as by the traders of these food products, in order to establish the most efficient parametric of the working regimes (when packaging and handling).

Keywords: biscuits resistance/texture, penetration depth, penetration velocity, sharp pin penetrometer

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Authors: Jerzy Slowik, Elzbieta Grochowska-Niedworok

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The analysis of the market needs and trends in both treatment and prophylaxis shows the growing need to implement comprehensive solutions that would enable safe contact of the beneficiaries with the therapeutic and diagnostic support group. Based on the evaluation of the medical and sports industry services market, projects co-financed by the EFRR in the form of comprehensive care systems using IT tools for patients under treatment in the field of obesity and metabolism using the system were implemented under the Regional Operational Program of the Silesian Voivodeship for 2014-2020. SFAO 1.0 (Support for the Fight Against Obesity) number of the WND-RPSL project. 01.02.00-24-06EA / 16) as well as for competitors in qualified sports SK system (qualified sports) project number WND-RPSL. 01.02.00-24-0630 / 17-002. The service provided in accordance with SFAO 1.0 has shown a wide range of therapy possibilities - from monitoring the body's reactions during sports activities of healthy people to remote care for sick patients. As a result of the introduction of an innovative service, it was possible to increase the effectiveness of the therapy, which was manifested in the reduction of the starting doses of drugs by 10%, improvement of the efficiency of the respiratory and blood circulation system, and a 10% increase in bone density. Innovation in the provision of medical services in the field of qualified sports SK was a response to the needs of the athletes and their parents, coaches, physiotherapists, dieticians, and doctors who take care of people actively practicing qualified sports. The creation of the platform made it possible to constantly monitor the trainers necessary for both the proper training process and the control over the health of patients. Monitoring the patient's health by a specialized team in the field of various specialties allows for the proper targeting of the treatment and training process due to the increase in the availability of medical counseling. Specialists taking care of the patient can provide additional advice and modify the medical treatment of the patient on an ongoing basis, which is why we are dealing with a holistic approach.

Keywords: innovation of medical services, sport, obesity, innovation

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Authors: Joanna Estkowska

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Sensory integration methods are very useful and improve daily functioning autistic and mentally disabled children. Autism is a neurobiological disorder that impairs one's ability to communicate with and relate to others as well as their sensory system. Children with autism, even highly functioning kids, can find it difficult to process language with surrounding noise or smells. They are hypersensitive to things we can ignore such as sight, sounds and touch. Adolescents with highly functioning autism or Asperger Syndrome can study Science and Math but the social aspect is difficult for them. Nature science is an area of study that attracts many of these kids. It is a systematic field in which the children can focus on a small aspect. If you follow these rules you can come up with an expected result. Sensory integration program and systematic classroom observation are quantitative methods of measuring classroom functioning and behaviors from direct observations. These methods specify both the events and behaviors that are to be observed and how they are to be recorded. Our students with and without autism attended the lessons in the classroom of nature science in the school and in the laboratory of University of Science and Technology in Bydgoszcz. The aim of this study is investigation the effects of sensory integration methods in teaching to students with autism. They were observed during experimental lessons in the classroom and in the laboratory. Their physical characteristics, sensory dysfunction, and behavior in class were taken into consideration by comparing their similarities and differences. In the chemistry classroom, every autistic student is paired with a mentor from their school. In the laboratory, the children are expected to wear goggles, gloves and a lab coat. The chemistry classes in the laboratory were held for four hours with a lunch break, and according to the assistants, the children were engaged the whole time. In classroom of nature science, the students are encouraged to use the interactive exhibition of chemical, physical and mathematical models constructed by the author of this paper. Our students with and without autism attended the lessons in those laboratories. The teacher's goals are: to assist the child in inhibiting and modulating sensory information and support the child in processing a response to sensory stimulation.

Keywords: autism spectrum disorder, science education, sensory integration techniques, student with special educational needs

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Authors: Mareli Fischer, Kevin G. F. Thomas

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Although Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most prevalent childhood neurobehavioural disorders, little empirical research has been published on its clinical presentation in Africa, and, globally, few studies evaluate ADHD intervention programs that emphasize parent training. Hence, Stage 1 of this research programme aimed to describe the functional impairment of South African children with ADHD, and also sought to investigate the influence of sociodemographic variables (e.g., sex, age, socioeconomic status, family environment) and clinical variables (e.g., ADHD subtype and comorbidity) on the degree of that impairment. We used the Mini International Neuropsychiatric Interview for Children and Adolescents as a diagnostic tool, and the Child Behavior Checklist, the Strengths and Difficulties Questionnaire, and the Impairment Rating Scale as measures of functional impairment. Results from this stage of the research indicated that South African children and adolescents who meet diagnostic criteria for ADHD experience most functional impairment in the school domain, as well as in the area of social functioning. None of the measured sociodemographic variables had a significant detrimental or protective effect on how ADHD symptoms impacted on functioning. In terms of comorbidity, the presence of Major Depressive Disorder, Conduct Disorder, and Oppositional Defiant Disorder were all associated with significantly impaired overall functioning. Stage 2 of the research programme aimed to design, implement, and evaluate a child-specific intervention that targeted the primary areas of impairment identified in Stage 1. Existing literature suggests that a positive parent-training programme, in the group format, is one of the best options for cost-effective and successful ADHD intervention. Hence, the intervention took that form. Parents were taught basic behaviour analysis concepts within a supportive group context. Evaluation of the intervention’s efficacy used many of the same measures as in Stage 1, but also featured semi-structured interviews with participants and naturalistic observation of parent-child interaction. We will discuss preliminary results of that evaluation. Studying functional impairment and designing intervention plans in this way will pave the way for evidence-based treatment plans for children and adolescents diagnosed with ADHD.

Keywords: attention deficit/hyperactivity disorder, children, intervention, parenting groups

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Authors: Anamika Sahu

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The Himalayas, like many mountainous regions, is susceptible to multiple hazards. In recent times, the frequency of such disasters is continuously increasing due to extreme weather phenomena. These natural hazards are responsible for irreparable human and economic loss. The Indian Himalayas has repeatedly been ruptured by great earthquakes in the past and has the potential for a future large seismic event as it falls under the seismic gap. Damages caused by earthquakes are different in different localities. It is well known that, during earthquakes, damage to the structure is associated with the subsurface conditions and the quality of construction materials. So, for sustainable mountain development, prior estimation of site characterization will be valuable for designing and constructing the space area and for efficient mitigation of the seismic risk. Both geotechnical and geophysical investigation of the subsurface is required to describe the subsurface complexity. In mountainous regions, geophysical methods are gaining popularity as areas can be studied without disturbing the ground surface, and also these methods are time and cost-effective. The MASW method is used to calculate the Vs30. Vs30 is the average shear wave velocity for the top 30m of soil. Shear wave velocity is considered the best stiffness indicator, and the average of shear wave velocity up to 30 m is used in National Earthquake Hazards Reduction Program (NEHRP) provisions (BSSC,1994) and Uniform Building Code (UBC), 1997 classification. Parameters obtained through geotechnical investigation have been integrated with findings obtained through the subsurface geophysical survey. Joint interpretation has been used to establish inter-relationships among mineral constituents, various textural parameters, and unconfined compressive strength (UCS) with shear wave velocity. It is found that results obtained through the MASW method fitted well with the laboratory test. In both conditions, mineral constituents and textural parameters (grain size, grain shape, grain orientation, and degree of interlocking) control the petrophysical and mechanical properties of rocks and the behavior of shear wave velocity.

Keywords: MASW, mechanical, petrophysical, site characterization

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Authors: Ahmed E. Hodaib, Mohamed A. Hashem

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In engineering applications, a design has to be as fully perfect as possible in some defined case. The designer has to overcome many challenges in order to reach the optimal solution to a specific problem. This process is called optimization. Generally, there is always a function called “objective function” that is required to be maximized or minimized by choosing input parameters called “degrees of freedom” within an allowed domain called “search space” and computing the values of the objective function for these input values. It becomes more complex when we have more than one objective for our design. As an example for Multi-Objective Optimization Problem (MOP): A structural design that aims to minimize weight and maximize strength. In such case, the Pareto Optimal Frontier (POF) is used, which is a curve plotting two objective functions for the best cases. At this point, a designer should make a decision to choose the point on the curve. Engineers use algorithms or iterative methods for optimization. In this paper, we will discuss the Evolutionary Algorithms (EA) which are widely used with Multi-objective Optimization Problems due to their robustness, simplicity, suitability to be coupled and to be parallelized. Evolutionary algorithms are developed to guarantee the convergence to an optimal solution. An EA uses mechanisms inspired by Darwinian evolution principles. Technically, they belong to the family of trial and error problem solvers and can be considered global optimization methods with a stochastic optimization character. The optimization is initialized by picking random solutions from the search space and then the solution progresses towards the optimal point by using operators such as Selection, Combination, Cross-over and/or Mutation. These operators are applied to the old solutions “parents” so that new sets of design variables called “children” appear. The process is repeated until the optimal solution to the problem is reached. Reliable and robust computational fluid dynamics solvers are nowadays commonly utilized in the design and analyses of various engineering systems, such as aircraft, turbo-machinery, and auto-motives. Coupling of Computational Fluid Dynamics “CFD” and Multi-Objective Evolutionary Algorithms “MOEA” has become substantial in aerospace engineering applications, such as in aerodynamic shape optimization and advanced turbo-machinery design.

Keywords: mathematical optimization, multi-objective evolutionary algorithms "MOEA", computational fluid dynamics "CFD", aerodynamic shape optimization

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Authors: Yasmeen Coaxum

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The year 2020 became synonymous with the words “Emergency Remote Teaching,” which was imposed upon educators during the COVID-19 pandemic. Consequently, teachers were compelled to find new and engaging ways to educate their students outside of the face-to-face classroom setting. Now online instruction has become more of the norm rather than a way to manage educational expectations during a crisis. Therefore, implementing a strategic way to create online environments for students to thrive, create, and fully engage in their learning process is essential. The Synchronous Online Flipped Learning Approach or SOFLA® is a distance learning model that most closely replicates actual classroom teaching. SOFLA® includes structured, interactive, multimodal activities in an eight-step learning cycle with both asynchronous and synchronous components that foster autonomous and interactive learning among today’s online learners. The results of a pilot study in an Intensive English Program at a university, using SOFLA® methodology to facilitate podcasting in an online learning environment will be shared. Previous findings on student-produced podcasting projects have shown that students felt they improved their pronunciation, vocabulary, and speaking skills. However, few if any studies have been conducted on using a structured online flipped learning approach to facilitate such projects. Therefore, the purpose of this study is to assess the effect of using the SOFLA® framework to enhance optimum engagement in the online environment while using podcasts as the primary tool of instruction. Through data from interviews, questionnaires, and the results of formative and summative assessments, this study also investigates the affective and academic impact this flipped learning method combined with podcasting has on the students in terms of speaking confidence and vocabulary retention, and production. The steps of SOFLA will be illustrated, a video demonstration of the Anchor podcasting app will be shown, and final student projects and questionnaire responses will be shared. The specific context is a 14-week advanced level conversation and listening class. Participants vary in age but are all adult language learners representing a diverse array of countries.

Keywords: mall online flipped learning, podcasting, productive vocabulary

Procedia PDF Downloads 159

Authors: Nezihe Şengün, Ragip Pala

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To prevent overweight and obesity, individuals need to consume food and beverages according to their nutritional needs, engage in regular exercises, and regularly monitor their body weight. This study aimed to examine the effects of exercise, diet, or combined intervention on changes in blood lipid parameters (total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides) and the level of malondialdehyde (MDA), a marker of oxidative stress, in parallel with the increase in body weight due to poor nutrition and sedentary lifestyle conditions. The study included a total of 48 female students aged 18-28 years with a BMI between 25.0 and 29.9 kg/m². They were divided into four groups: control (C), exercise (Ex), diet (D), and exercise+diet (Ex+D). Those in the exercise groups received aerobic exercises at 60-70% intensity (10 minutes warm-up, 30 minutes running, 10 minutes cool-down), while those in the diet groups were provided with a diet program based on the calculation of energy needs considering basal metabolic rate, physical activity level, age, and BMI. The students’ body weight, body fat mass, Body Mass Index (BMI), and waist-hip ratios were measured at the beginning (day 1) and end (day 60) of the 8-week intervention period. Their total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, and MDA levels were evaluated and analyzed, considering a statistical significance level of p<0.05. As a result, female students in the Ex+D group had the largest difference in body weight, body fat mass, BMI, and waist-hip ratios, and this difference was statistically significant. Except for those in the C group, those in the other groups experienced a decrease in their total cholesterol, LDL cholesterol, and triglyceride levels and an increase in their HDL cholesterol levels. The decrease in total cholesterol, LDL cholesterol, and triglyceride levels was statistically significant for those in the D group, and the increase in HDL cholesterol level was statistically significant for those in the Ex+D group (p<0.05). A decrease in MDA level was found in all groups except those in the C group, and this decrease was significantly higher in the Ex group. In conclusion, our study revealed that the most effective way to achieve weight loss is through a combination of exercise and diet. The application of Ex+D is considered to balance blood lipid levels and suppress oxidative stress.

Keywords: obesity, exercise, diet, body mass index, blood lipids

Procedia PDF Downloads 63

Authors: Amrit Vasdev, Edwin Rho, Gurinder Vasdev

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Robotic surgery has enabled a new spectrum of minimally invasive breast reconstruction by improving visualization, surgeon posturing, and improved patient outcomes.1 The DaVinci robot system can be utilized in nipple sparing mastectomies and reconstructions. The process involves the insufflation of the subglandular space and a dissection of the mammary gland with a combination of cautery and blunt dissection. This case outlines a 35-year-old woman who has a long-standing family history of breast cancer and a diagnosis of a deleterious BRCA2 genetic mutation. She has decided to proceed with bilateral nipple sparing mastectomies with implants. Her perioperative mammogram and MRI were negative for masses, however, her left internal mammary lymph node was enlarged. She has taken oral contraceptive pills for 3-5 years and denies DES exposure, radiation therapy, human replacement therapy, or prior breast surgery. She does not smoke and rarely consumes alcohol. During the procedure, the patient received a standardized anesthetic for out-patient surgery of propofol infusion, succinylcholine, sevoflurane, and fentanyl. Aprepitant was given as an antiemetic and preoperative Tylenol and gabapentin for pain management. Concerns for the patient during the procedure included CO2 insufflation into the subcutaneous space. With CO2 insufflation, there is a potential for rapid uptake leading to severe acidosis, embolism, and subcutaneous emphysema.2To mitigate this, it is important to hyperventilate the patient and reduce both the insufflation pressure and the CO2 flow rate to the minimal acceptable by the surgeon. For intraoperative monitoring during this 6-9 hour long procedure, it has been suggested to utilize an Arterial-Line for end-tidal CO2 monitoring. However, in this case, it was not necessary as the patient had excellent cardiovascular reserve, and end-tidal CO2 was within normal limits for the duration of the procedure. A BIS monitor was also utilized to reduce anesthesia burden and to facilitate a prompt discharge from the PACU. Minimal Invasive Robotic Surgery will continue to evolve, and anesthesiologists need to be prepared for the new challenges ahead. Based on our limit number of patients, robotic mastectomy appears to be a safe alternative to open surgery with the promise of clearer tissue demarcation and better cosmetic results.

Keywords: anesthesia, mastectomies, robotic, hypercarbia

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Authors: Calvince Okome Odeny

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There is a current action to increase radiotherapy services in Kenya. The National government of Kenya, in collaboration with the county governments, has embarked on building radiotherapy centers in all 47 regions of the country. As these new centers are established in Kenya, it has to be ensured that minimum radiation safety standards are in place prior to operation. For full implementation of this, it is imperative that more Research and training for regulators are done on radiation protection, and safety and national regulatory infrastructure is geared towards ensuring radiation protection and safety in all aspects of the use of external radiotherapy practices. The present work aims at reviewing the level of protection and safety for patients and staff during external beam radiotherapy using Linac in Kenya and provides relevant guidance to improve protection and safety. A retrospective evaluation was done to verify whether those occupationally exposed workers and patients are adequately protected from the harmful effect of radiation exposure during the treatment procedures using Linac. The project was experimental Research, also including an analysis of resource documents obtained from the literature and international organizations. The critical findings of the work revealed that the key elements of protection of occupationally exposed workers and patients include a comprehensive quality Management system governing all planned activities from siting, safety, and design of the Facility, construction, acceptance testing, commissioning, operation, and decommissioning of the Facility; Government empowering the Regulatory Authority to license Medical Linear facilities and to enforce the applicable regulations to ensure adequate protection; A comprehensive Radiation Protection and Safety program must be established to ensure adequate safety and protection of workers and patients during treatment planning and treatment delivery of patients and categories of staff associated with the Facility must be well educated and trained to perform professionally with a commitment to sound safety culture. Relevant recommendations from the findings are shared with the Medical Linear Accelerator facilities and the regulatory authority to provide guidance and continuous improvement of protection and safety to improve regulatory oversight.

Keywords: oncology, radiotherapy, protection, staff

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Authors: Agbortoko Manyigbe Ayuk Nkem, Eno Cynthia Osuh

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This paper sets to examine the relationship between climate change and urban livelihood through a vulnerability assessment of the urban poor in Douala. Urban development in Douala places priority towards industrial and city-centre development with little focus on the urban poor in terms of housing units and areas of sustenance. With the high rate of urbanisation and increased land prices, the urban poor are forced to occupy marginal lands which are mainly wetlands, wastelands and along abandoned neighbourhoods prone to natural hazards. Due to climate change and its effects, these wetlands are constantly flooded thereby destroying homes, properties, and crops. Also, most of these urban dwellers have found solace in urban agriculture as a means for survival. However, since agriculture in tropical regions like Cameroon depends largely on seasonal rainfall, the changes in rainfall pattern has led to misplaced periods for crop planting and a huge wastage of resources as rainfall becomes very unreliable with increased temperature levels. Data for the study was obtained from both primary and secondary sources. Secondary sources included published materials related to climate change and vulnerability. Primary data was obtained through focus-group discussions with some urban farmers while a stratified sampling of residents within marginal lands was done. Each stratum was randomly sampled to obtain information on different stressors related to climate change and their effect on livelihood. Findings proved that the high rate of rural-urban migration into Douala has led to increased prevalence of the urban poor and their vulnerability to climate change as evident in their constant fight against flood from unexpected sea level rise and irregular rainfall pattern for urban agriculture. The study also proved that women were most vulnerable as they depended solely on urban agriculture and its related activities like retailing agricultural products in different urban markets which to them serves as a main source of income in the attainment of basic needs for the family. Adaptation measures include the constant use of sand bags, raised makeshifts as well as cultivation along streams, planting after evidence of constant rainfall has become paramount for sustainability.

Keywords: adaptation, Douala, Cameroon, climate change, development, livelihood, vulnerability

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Authors: Fatma Mohamed Magdy Badr El Dine, Amr Mohamed Abd Allah

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Introduction: Age estimation of individuals is one of the crucial steps in forensic practice. Different traditional methods rely on the length of the diaphysis of long bones of limbs, epiphyseal-diaphyseal union, fusion of the primary ossification centers as well as dental eruption. However, there is a growing need for the development of precise and reliable methods to estimate age, especially in cases where dismembered corpses, burnt bodies, purified or fragmented parts are recovered. Teeth are the hardest and indestructible structure in the human body. In recent years, assessment of pulp/tooth area ratio, as an indirect quantification of secondary dentine deposition has received a considerable attention. However, scanty work has been done in Egypt in terms of applicability of pulp/tooth ratio for age estimation. Aim of the Work: The present work was designed to assess the Cameriere’s method for age estimation from pulp/tooth ratio of maxillary canines, central and lateral incisors among a sample from Egyptian population. In addition, to formulate regression equations to be used as population-based standards for age determination. Material and Methods: The present study was conducted on 270 peri-apical X-rays of maxillary canines, central and lateral incisors (collected from 131 males and 139 females aged between 19 and 52 years). The pulp and tooth areas were measured using the Adobe Photoshop software program and the pulp/tooth area ratio was computed. Linear regression equations were determined separately for canines, central and lateral incisors. Results: A significant correlation was recorded between the pulp/tooth area ratio and the chronological age. The linear regression analysis revealed a coefficient of determination (R² = 0.824 for canine, 0.588 for central incisor and 0.737 for lateral incisor teeth). Three regression equations were derived. Conclusion: As a conclusion, the pulp/tooth ratio is a useful technique for estimating age among Egyptians. Additionally, the regression equation derived from canines gave better result than the incisors.

Keywords: age determination, canines, central incisors, Egypt, lateral incisors, pulp/tooth ratio

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Authors: Tsu-Yin Wu, Jenni Hoffman, Lydia McMurrows, Sarah Lally

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Recent events of the Flint Water Crisis and elevated lead levels in Detroit public school water have highlighted a specific public health disparity and shown the need for better education of healthcare providers on lead education. Identifying children and pregnant women with a high risk for lead poisoning and ensuring lead testing is completed is critical. The purpose of this study is to explore the impact of an educational intervention on knowledge and confidence levels among nursing students enrolled in the prelicensure Bachelor of Science in Nursing (BSN) and Registered Nurse to BSN program (R2B). The study used both quantitative and qualitative research methods to assess the impact of multi-modal pedagogy on knowledge and confidence of lead screening and prevention among prelicensure and R2B nursing students. The students received lead poisoning and prevention content in addition to completing an e-learning module developed by the Pediatric Environmental Health Specialty Units. A total of 115 students completed the pre-and post-test instrument that consisted of demographic, lead knowledge, and confidence items. Despite the increase of total knowledge, three dimensions of lead poisoning, and confidence from pre- to post-test scores for both groups, there was no statistical significance on the increase between prelicensure and R2B students. Thematic analysis of qualitative data showed five themes from participants' learning experiences: lead exposure, signs and symptoms of lead poisoning, screening and diagnosis, prevention, and policy and statewide issues. The study is limited by a small sample and participants recalling some correct answers from the pretest, thus, scoring higher on the post-test. The results contribute to the minimally existent literature examining a critical public health concern regarding lead health exposure and prevention education of nursing students. Incorporating such content area into the nursing curriculum is essential in ensuring that such public health disparities are mitigated.

Keywords: lead poisoning, emerging public health issue, community health, nursing edducation

Procedia PDF Downloads 176