Search results for: clinical nursing practice guideline

Authors: Kingkan Chumjamras

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There are permanent and temporary tracheostomies, and in a permanent tracheostomy, care giver are important persons to know and be able to care for the tracheostomy patient. The objective of this quasi-experimental study was to evaluate outcomes of educating care giver in tracheostomy wound care for discharge planning of tracheostomy patients. The subjects of the study were relatives who directly cared for tracheostomy patients. Thirty subjects were selected according to specified criteria. The research instruments consisted of practice guidelines, manual for relatives in caring for the tracheostomy wound, an assisted model with a tracheostomy wound, a test, an observation form, and a patient’s relative satisfaction questionnaire. The instrument validity was tested by three experts, and the questionnaire reliability was tested with Cronbach’s alpha, and the reliability coefficient was 0.83; the data were analyzed using descriptive statistics, and paired t-test. The results of the study on educating relatives in tracheostomy wound care for discharge planning of tracheostomy patients revealed that the score for knowledge and ability in caring for the tracheostomy wound before receiving the education was at a low level (M= 19.23, SD= 1.57) compared with the very high score (M= 36.40, SD= 19.23) after receiving the education. The difference was statistically significant (p < .05), and relatives’ satisfaction was at a high level (80 percent). Knowledge and ability in caring for tracheostomy patients among patients’ relatives could cause tracheostomy wound complications for tracheostomy patients. One way to control such complications and returns to hospital from infection, in addition to care by the health care team, is educating relatives in tracheostomy wound care for discharge planning of tracheostomy patients.

Keywords: outcomes, educating, care giver, Tracheostomy Wound Care, discharge planning

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Authors: Muhammad Afiq Anaqi Bin Baharudin, Muhammad Izamuddin Bin Mohd Nasir, Syarifuddin Bin Sujuanda, Muhammad Syahmi Rusyaidi Bin Sham Suddin, Danish Hakimi Bin kamaruzaman, Muhammad Haqimi Nazim Bin Hasmanizam, Mohammad Akmal Zakwan Bin Amran, Muhammad Alparizi Bin Latif

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In particular, for small and medium enterprises (SMBs) in Malaysia, process safety management (PSM) is a crucial component of industrial safety. Limited resources, a lack of technical know-how, and linguistic and cultural obstacles are just a few of the difficulties SMBs in Malaysia encounter while putting PSM programmes into practice. A number of studies have emphasised the significance of leadership commitment, hazard identification and assessment, and employee involvement in the execution of effective PSM programmes, which are crucial for preventing accidents and incidents. In the literature, there has been a lot of discussion on the creation of specialised PSM frameworks for SMBs in Malaysia. Several studies have proposed implementation frameworks for PSM programmes that are based on recognised worldwide standards. Despite the significance of PSM in ensuring industrial safety, there are still a number of gaps in the literature on PSM in Malaysian SMBs. These gaps include the need for additional research on the efficiency of PSM programmes in reducing accidents and incidents in SMBs as well as the development of more specialised approaches to implementing PSM programmes in SMBs with limited resources and technical expertise. The goal of this review is to give a thorough overview of the body of research on PSM in Malaysian SMBs while highlighting important findings, points of contention, and knowledge gaps that need to be filled in.

Keywords: process safety management, occupational safety and health (OSH), small businesses, medium businesses, malaysia

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Authors: Vinodd Nayak

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10th & 12th are the most crucial period in a student’s life. It is the time when he or she has to make vital career choices and get the relevant professional education. Unfortunately most students are not aware of the multitudes of career options available to them. This leads to affect our social fabric of the society with issues like unemployment, stress etc. We have planned a guidance program for the youth in Maharashtra state which has 4 components; creating awareness about different career options, proper guidance and motivation, counseling for parents, and information on financial aid for unemployed youth we are conducting skill development programs. Currently we are conducting programs under 4 categories Uneducated Youth: Skill Development programs for unemployed youth in construction field (Carpentry/Masoning/Wlder/Electrician/Tiling etc..) in association with L&T Construction Training Institute Educated Youth: Il&FS: Training and Job Placement in the field of Finance and Customer Service NIS Sparta: Training and Job Placement in the field of Sales and Marketing Apeejay Inst. of Hotel Management: Training and Job Placement in the field of hospitality industry Skill India: Training and Job Placement in the field of IT Results: The results were really overwhelming. We were able to cater to approx. 10,000 students a year and the list is growing. Earlier we were only catering to schools and colleges, now we have started receiving invitations from other community organizations to conduct such programs for their communities Implications for Social Work and Social Development practice: It is a high time that Social work organisations need to get into such work as this will enhance people to improve their financial condition. We always believed that it is better to teach a man to fish than feed him.

Keywords: youth education, career guidance, skill development, parental guidance

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Authors: An-Na Li, Ying-Yu Chen, Yu-Lung Lin

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Food tourism is one of the growing industries in the tourism industry today. The Destination Marketing Organizations (DMOs) are aware of the importance of gastronomy to stimulate local and regional economic development. From the heritage and cultural aspects, gastronomy is becoming a more important part of the cultural heritage of the region. Heritage destinations provide culinary heritage, which fits the current interest in traditional food, and cuisine is a part of a general desire for authentic experience. However, few studies have empirically examined antecedents of food tourists’ behavioral intentions. This study examined the effects of cuisine experience; emotions, place attachment and tourists’ revisit behavioral intentions. A total of 408 individuals responded to the on-site survey in the historic town of Lu-Kang in Taiwan. The results indicated that tourists’ cuisine experience include place flavor, media recommendation, local learning, life transfer and interpersonal share. In addition, cuisine experience had significant impacts on emotions and place attachment, emotions had significant effects on place attachment, furthermore, which in turn place attachment had significant effects on tourists’ revisit behavioral intentions. The findings suggested that the cuisine experience is a multi-dimensions construct. On the other hands, the good quality of cuisine experience could evoke tourists’ positive emotions and it could play a significant role in promoting tourist revisit intentions or word of mouth. Implications for theory and practice are discussed.

Keywords: culinary tourism, cuisine experiences, emotions, revisit intentions

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Authors: Yegetaneh T. Dejenu, Delesa Kejela, Abdulak Alemu

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From the earliest time of humankind, the trenches were used for water to flow along and for soldiers to hide in during enemy attacks. Now a day due to civilization, the needs of the human being become endless, and the living condition becomes sophisticated. The unbalance between the needs and resource obligates them to find the way to manage this condition. The attempt to use the scares resource in very efficient and effective way makes the trench an endeavor practice in the world in all countries. A trencher is a construction equipment used to dig trenches, especially for laying pipes or cables, installing drainage, irrigation, installing fencing, and in preparation for trench warfare. It is a machine used to make a ditch by cutting the soil ground and effectively used in agricultural irrigation. The most common types of trencher are wheel trencher, chain trencher, micro trencher, portable trencher. In Ethiopia people have been trenching the ditch for many purposes and the tools they are using are Pickaxe, Shovel and some are using Micro Excavators. The adverse effect of using traditional equipment is, time and energy consuming, less productive, difficult and more man power is required. Hence it is necessary to design and produce low price, and simple machine to narrow this gap. Our objective is to design and model a light duty trencher that is used for trenching the ground or soil for making ditch and used for agricultural, ground cabling, ground piping, and drainage system. The designed machine trenches, maximum of 1-meter depth, 30 cm width, and the required length. The working mechanism is fully hydraulic, and the engine with 12.7 hp will provide suitable power for the pump that delivers 23 l/min at 1500 rpm to drive hydraulic motors and actuators.

Keywords: hydraulics, modelling, trenching, ditch

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Authors: Mario Spremic

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Despite the financial crisis and ongoing need for cost cutting, companies all around the world heavily invest in information systems (IS) and underlying information technology (IT). Information systems (IS) play very important role in modern business organizations supporting its organizational efficiency or, under certain circumstances, fostering business model innovation and change. IS can influence organization competitiveness in two ways: supporting operational efficiency (IS as a main infrastructure for the current business), or differentiating business through business model innovation and business process change. In either way, IS becomes very important to the business and needs to be aligned with strategic objectives in order to justify massive investments. A number of studies showed that investments in IS and underlying IT resulted in added business value if they are truly connected with strategic business objectives. In that sense proliferation of governance of enterprise IT helps companies manage, or rather, governs IS as a primary business function with executive management involved in making a decision about IS and IT. The quality of IT governance is rising with the large number of decisions about IS made by executive management, not IT departments. The more executive management is engaged in making a decision about IS and IT, the IT governance is of better quality. In this paper, the practice of governing the enterprise IT will be investigated on a sample of the largest 100 Croatian companies. Research questions posed here will reveal if there are some formal IT governance mechanisms, are there any differences in perceived role of IS and IT between CIOs (Chief Information Officers) and CEOs (Chief Executive Officers) of the sampled companies and what are the mechanisms to govern massive investment in enterprise IT.

Keywords: IT governance, governance of enterprise IT, information system auditing, operational efficiency

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Authors: Elron Fouten

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Recently, debates surrounding the social relevance of psychology in South Africa have focussed on how the growing neoliberal rationality within academia has again resulted in the discipline catering to the needs of powerful social groupings to protect its own economic interests, rather than producing socially relevant knowledge. Consequently, this study aimed to conduct a content analysis of the recent research output of psychology masters students, to establish whether it has produced research that addresses local and national psychosocial issues and as such deemed socially relevant knowledge. The study sampled clinical, counselling, and research psychology masters theses from 16 South African universities submitted between 1998 and 2017. Overall, 2001 theses were sampled, which were analysed using qualitative content analysis predominantly based on the descriptive categories identified in similar studies using published journal articles. Results indicated that empirical qualitative theses, using systems-oriented theory and post-modern frameworks were most prevalent. Further, traditional topics within psychology had relatively more weighting compared to more social topics. Although a significant number of theses recruited participants from working-class or poor backgrounds, there was an overreliance on participants from urban areas located in some of the country’s wealthiest provinces. Despite a strong adult-centric focus, trends regarding participants’ race and gender roughly resembled current population demographics. Overall, the results indicate that psychology in South Africa, at least at university-level, is to some extent trying to engage with national psychosocial concerns. However, there are still several key areas which need to be addressed to ensure the continued social relevance of the discipline.

Keywords: adult-centric, content analysis, relevance, psychosocial

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Authors: Kidane Workelul, Yohans Tekle, Guesh Negash, Haftay Abraha, Nigus Abebe Shumuye, Yisehak Tsegaye Redda

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Bovine papillomatosis (wart) is one of the economically important bovine skin diseases worldwide, caused by a group of viruses named papillomaviruses (PVs). However, it has often been misdiagnosed as other skin diseases and remained untreated. In order to determine the status of the diseases, twenty-two farms were visited, and fourteen infected cattle with cutaneous papillomatosis were identified from a total of 235. Papilloma biopsies were taken for molecular and histopathological characterization, the therapeutic trial of an autogenous vaccine was evaluated on infected animals. The overall status of bovine papillomatosis in this study was calculated as 5.96% (14/235). The disease was found to be statistically significant in the age groups less than two years (X² = 26.69, P = 0.0001). The more prominent histologically characterized lesions in the sampled tissue were identified as squamous papilloma and fibro-papilloma. The Polymerase Chain Reaction (PCR) based identification revealed that all the clinically and histo-pathologically characterized papillomatosis cases were found to be infected with Bovine Papilloma Virus1(BPV1), indicating that BPV1 was the most common and sole causative agent of the diseases in the study area. In immunizing active bovine papillomatosis, an autogenous vaccine therapeutic trial demonstrated excellent results, with practically full recovery and no recurrence of the infection. Hence, it is concluded that bovine papillomatosis is an economically important disease of young age group cattle as well as a treatable disease. So, the production of marketable autogenous vaccines against bovine papillomatosis should be started and given at an early stage.

Keywords: autogenous vaccine, bovine papillomatosis, bovine papilloma virus1 clinical-pathology, polymerase chine reaction, wart

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Authors: Javier De La Torre Costa, Belen Rubio Ballester, Martina Maier, Paul F. M. J. Verschure

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After a stroke, a great number of patients experience persistent motor impairments such as hemiparesis or weakness in one entire side of the body. As a result, the lack of use of the paretic limb might be one of the main contributors to functional loss after clinical discharge. We aim to reverse this cycle by promoting the use of the paretic limb during activities of daily living (ADLs). To do so, we describe the key components of a system that is composed of a wearable bracelet (i.e., a smartwatch) and a mobile phone, designed to bring a set of neurorehabilitation principles that promote acquisition, retention and generalization of skills to the home of the patient. A fundamental question is whether the loss in motor function derived from learned–non–use may emerge as a consequence of decision–making processes for motor optimization. Our system is based on well-established rehabilitation strategies that aim to reverse this behaviour by increasing the reward associated with action execution as well as implicitly reducing the expected cost associated with the use of the paretic limb, following the notion of the reinforcement–induced movement therapy (RIMT). Here we validate an accelerometer–based measure of arm use, and its capacity to discriminate different activities that require increasing movement of the arm. We also show how the system can act as a personalized assistant by providing specific goals and adjusting them depending on the performance of the patients. The usability and acceptance of the device as a rehabilitation tool is tested using a battery of self–reported and objective measurements obtained from acute/subacute patients and healthy controls. We believe that an extension of these technologies will allow for the deployment of unsupervised rehabilitation paradigms during and beyond the hospitalization time.

Keywords: stroke, wearables, learned non use, hemiparesis, ADLs

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Authors: Catelyn Coyle, Helena Kwakwa

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Objective: As novel and better tolerated therapies become available, effective HCV testing and care models become increasingly necessary to not only identify individuals with active infection but also link them to HCV providers for medical evaluation and treatment. Our aim is to describe an effective HCV testing and linkage to care model piloted in a network of five community health centers located in Philadelphia, PA. Methods: In October 2012, National Nursing Centers Consortium piloted a routine opt-out HCV testing model in a network of community health centers, one of which treats HCV, HIV, and co-infected patients. Key aspects of the model were medical assistant initiated testing, the use of laboratory-based reflex test technology, and electronic medical record modifications to prompt, track, report and facilitate payment of test costs. Universal testing on all adult patients was implemented at health centers serving patients at high-risk for HCV. The other sites integrated high-risk based testing, where patients meeting one or more of the CDC testing recommendation risk factors or had a history of homelessness were eligible for HCV testing. Mid-course adjustments included the integration of dual HIV testing, development of a linkage to care coordinator position to facilitate the transition of HIV and/or HCV-positive patients from primary to specialist care, and the transition to universal HCV testing across all testing sites. Results: From October 2012 to June 2015, the health centers performed 7,730 HCV tests and identified 886 (11.5%) patients with a positive HCV-antibody test. Of those with positive HCV-antibody tests, 838 (94.6%) had an HCV-RNA confirmatory test and 590 (70.4%) progressed to current HCV infection (overall prevalence=7.6%); 524 (88.8%) received their RNA-positive test result; 429 (72.7%) were referred to an HCV care specialist and 271 (45.9%) were seen by the HCV care specialist. The best linkage to care results were seen at the test and treat the site, where of the 333 patients were current HCV infection, 175 (52.6%) were seen by an HCV care specialist. Of the patients with active HCV infection, 349 (59.2%) were unaware of their HCV-positive status at the time of diagnosis. Since the integration of dual HCV/HIV testing in September 2013, 9,506 HIV tests were performed, 85 (0.9%) patients had positive HIV tests, 81 (95.3%) received their confirmed HIV test result and 77 (90.6%) were linked to HIV care. Dual HCV/HIV testing increased the number of HCV tests performed by 362 between the 9 months preceding dual testing and first 9 months after dual testing integration, representing a 23.7% increment. Conclusion: Our HCV testing model shows that integrated routine testing and linkage to care is feasible and improved detection and linkage to care in a primary care setting. We found that prevalence of current HCV infection was higher than that seen in locally in Philadelphia and nationwide. Intensive linkage services can increase the number of patients who successfully navigate the HCV treatment cascade. The linkage to care coordinator position is an important position that acts as a trusted intermediary for patients being linked to care.

Keywords: HCV, routine testing, linkage to care, community health centers

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Authors: Alok Nahata

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Introduction: Nowadays, androgen-mediated diseases such as prostate cancer, hirsutism, acne, androgenic alopecia and benign prostatic hyperplasia (BPH) have become serious problems. The aim of the present study was to find out whether Ganoderma lucidum (GL) can be used as a clinically effective medicine for the management of prostatic hyperplasia. Methodology: In vitro studies were conducted to assess the 5α-reductase inhibitory potential of GL. Testosterone (3 mg/kg s.c.) was administered to the rats along with the test extracts (10, 20 and 50 mg/kg p.o for a period of 28 days. Finasteride was used as a positive control (1 mg/kg p.o.). Major Findings: GL extracts attenuated the increase in the prostate/body weight ratio (P/BW) induced by testosterone. Most of the values were significant when compared to testosterone-treated group and finasteride treated groups. Petroleum ether extract (50 mg/kg p.o.) exhibited the best activity (P < 0.01). Ethanolic extract (20 and 50 mg/kg p.o.) also exhibited significant activity (P < 0.01). The urine output also improved significantly (P < 0.01 in all groups as compared to standard finasteride), which emphasize the clinical implications of the study. Testosterone levels measured weekly and prostate-specific antigen (PSA) levels measured at the end of the study also support the findings. Histological studies suggested improvement in prostatic histoarchitecture in extract-treated groups as compared to the testosterone-treated group. Conclusion: Study clearly reflects the utility of extracts in BPH. Because of conversion of testosterone to dihydrotestosterone, the prostate size is increased, thereby causing obstruction in urinary output. The observed effect that extracts do not allow the increase as reflected by urinary output, P/BW ratios and histoarchitecture showed that activity of administered testosterone was blocked by the extract and resulted in recovery.

Keywords: benign prostatic hyperplasia, Ganoderma lucidum, prostate-specific antigen, 5α-reductase, testosterone

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Authors: Abeer Ahmed Abdehameed

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Background: Diabetic sensorimotor polyneuropathy (DSP) is one of the most common micro vascular complications of type 2 diabetes. Loss of sensation is thought to contribute to lake of static and dynamic stability and increased risk of falling. Purpose: The purpose of this study was to compare the effects of low level laser (LLL) and monochromatic near infrared photo energy (MIRE) on pain , cutaneous sensation, static stability and index of lower limb blood flow in diabetic with peripheral neuropathy. Methods: Forty subjects with diabetic peripheral neuropathy were recruited for study. They were divided into two groups: The ( MIRE) group that included (20) patients and (LLL) group included (20) patients. All patients in the study had been subjected to various physical assessment procedures including pain, cutaneous sensation, Doppler flow meter and static stability assessments. The baseline measurements were followed by treatment sessions that conducted twice a week for 6 successive weeks. Results: The statistical analysis of the data had revealed significant improvement of the pain in both groups, with significant improvement in cutaneous sensation and static balance in (MIRE) group compared to (LLL) group; on the other hand results showed no significant differences on lower limb blood flow in both groups. Conclusion: Low level laser and monochromatic near infrared therapy can improve painful symptoms in patients with diabetic neuropathy. On the other hand (MIRE) is useful in improving cutaneous sensation and static stability in patients with diabetic neuropathy.

Keywords: diabetic neuropathy, doppler flow meter, low level laser, monochromatic near infrared photo energy

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Authors: Michael R. Taber, Kristin Stanec

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This paper presents year-two of a longitudinal study on implementing Possibility Books into undergraduate courses to develop a student's creativity mindset: tolerating ambiguity, willingness to risk failure, curiosity, and openness to embrace possibility thinking through unexpected connections. Courses involved in this research span disciplines in the natural and social sciences and the humanities. Year one of the project developed indices from which baseline data could be analyzed. The two significant indices ( > 0.7) were "creativity mindset" and "intentional interactions." Preliminary qualitative and quantitative data analysis indicated that students found the new pedagogical intervention as a safe space to learn new strategies, recognize patterns, and define structures through innovative notetaking forms. Possibility Books in Natural Science courses were designed to develop students' conceptualization of science and math. Using Possibility Books in all disciplines provided a space for students to practice divergent thinking (i.e.,Possibilities), convergent thinking (i.e., forms that express meaning), and risk-taking (i.e., the vulnerability associated with expression). Qualitative coding of open responses on a post-survey revealed two major themes: 1) Possibility Books provided a mind space for learning about self, and 2) provided a calming opportunity to connect concepts. Quantitative analysis indicated significant correlations between focused headspace and notetaking (r = 0.555, p < 0.001), focused headspace, and connecting with others (r = 0.405, p < 0.001).

Keywords: pedagogy, science education, learning methods, creativity mindsets

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Authors: Nathan Reeves

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Aim: The aim of this study was to evaluate if there was an impact on student learning when peer role play was substituted for a professional actor in the role of simulated patient in a simulation-based scenario. Method: Third-year exercise science students enrolled in a field project course in 2015 (n=24), and 2016 (n=20) participated in a simulation-based case scenario designed to develop their client-centred exercise prescription skills. During the simulation, students were provided with feedback from the simulated patients. In 2015, three professional actors played the part of the simulated patient, and in 2016 one of the simulated patients was a student from another exercise science cohort (peer role play). The student learning experience, consistency in case fidelity and feedback provided by the simulated patients was evaluated using a 5-point Likert scale survey and collecting phenomenological data. Results: Improvements to student pre and post confidence remained constant between the 2015 and 2016 cohorts (1.04 and 0.85). The perceived usefulness and enjoyability also remained high across the two cohorts (4.96 and 4.71). The feedback provided by all three simulated patients in 2016 was seen to strongly support student learning experience (4.82), and was of a consistent level (4.47). Significance of the findings to allied health: Simulation-based education is rapidly expanding in the curricula across the allied health professions. The simulated patient methodology continues to receive support as a pedagogy to develop a range of clinical skills including communication, engagement and client-centeredness. Upskilling students to peer role play can be a reasonable alternative to engaging paid actors.

Keywords: exercise science, simulation-based learning, simulated patient, peer role play

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Authors: Md. Mizanur Rahman, Anquan Liu, Anna Frostegård, Johan Frostegård

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The role of the human immune system is essential in cardiovascular diseases and atherosclerosis. Activated cells in atherosclerosis produce abundant amounts of cytokines, but the exact mechanisms involved in the effects of these inflammatory cytokines are not clear in atherosclerosis. In a large clinical cohort, we have previously determined that antibodies against phosphorylcholine (anti-PC) are negatively and independently associated with both development of atherosclerosis and also a low risk of cardiovascular disease. Further, we reported that rheumatoid arthritis patients who were non-responders to TNF-inhibitors, where those with low anti-PC levels. Upon anti-TNF treatment, anti-PC levels increased. We, therefore, hypothesised that proinflammatory cytokines such as TNF could play a role in anti-PC regulation. Peripheral blood mononuclear cells (PBMC) were cultured with or without TNF and anti-TNF. The cell supernatants were collected after six days for ELISA measurements. In separate experiments, cells were cultured for 24 hours in both polystyrene plates and ELISPOT plates under a similar condition for ELISA and ELISPOT assays respectively. Total RNA was extracted after 6 hours of cell culture to perform RT-qPCR. Cell viability was confirmed by trypan blue staining and MTT assays. ELISA measurements detected less than 40% of anti-PC in TNF-treated cells, in comparison to control cells, whereas anti-PC production was recovered by anti-TNF treatment. ELISPOT assays showed that TNF suppresses anti-PC production by inhibiting anti-PC producing B-cells. In addition, RT-qPCR and ELISA showed that TNF also has effects also on B-cell activation as BAFF expression was inhibited by TNF treatment. Atherosclerosis is a major cause of cardiovascular diseases, but anti-PC is a protection marker for atherosclerosis development. Our findings show that TNF is a negative regulator of anti-PC production. Immune modulation and rising of anti-PC could be of major significance for the patients.

Keywords: anti-PC, Anti-TNF, atherosclerosis, cardiovascular diseases, phosphorylecholine

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Authors: Shutchapol Chopvitayakun

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Internship program is a compulsory course of many undergraduate programs in Thailand. It gives opportunities to a lot of senior students as interns to practice their working skills in the real organizations and also gives chances for interns to face real-world working problems. Interns also learn how to solve those problems by direct and indirect experiences. This program in many schools is a well-structured course with a contract or agreement made with real business organizations. Moreover, this program also offers opportunities for interns to get jobs after completing it from where the internship program takes place. Interns also learn how to work as a team and how to associate with other colleagues, trainers, and superiors of each organization in term of social hierarchy, self-responsibility, and self-disciplinary. This research focuses on senior students of Suan Sunandha Rajabhat University, Thailand whose studying major is information technology program. They practiced their working skills or took internship programs in the real business sector or real operating organizations in 2015-2016. Interns are categorized in to two types: normal program and special program. For special program, students study in weekday evening from Monday to Friday or Weekend and most of them work full-time or part-time job. For normal program, students study in weekday working hours and most of them do not work. The differences of these characters and the outcomes of internship performance were studied and analyzed in this research. This work applied some statistical analytics to find out whether the internship performance of each intern type has different performances statistically or not.

Keywords: internship, intern, senior student, information technology program

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Authors: K. S. Kan

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The main purpose of this paper is to deepen the current understanding of how a Teaching English as a Second Language (TESL) teacher trainee self is constructed. The present aim of Malaysian TESL teacher education is to train teacher trainees with established English Language Teaching methodologies of the four main language skills (listening, reading, writing and speaking) apart from building them up holistically. Therefore, it is crucial to learn more of the ways on how these teacher trainees construct their professional selves during their undergraduate years. The participants come from a class of 17 Semester 6 TESL students who had undergone a 3-month’s practicum practice during their fifth semester and going for their final 3 month’s practicum period from July 2018 onwards. Findings from a survey, interviews with the participants and lecturers, documentations such as the participants’ practicum record-books would be consolidated with the supervisory notes and comments. The findings suggest that these teacher trainees negotiate their identities and emotions that react with the socio-cultural factors. Periodical reflections on the teacher trainees’ practicum practices influence transformation.The findings will be further aligned to the courses that these teacher trainees have to take in order to equip them as future second language practitioners. It is hoped that the findings will be able to fill the gap from the teacher trainees’ perspectives on identity construction dealing. This study is much more significant now, in view of the new English Language Curriculum for Primary School (widely known as KSSR, its Malay acronym) which had been introduced and implemented in Malaysian primary schools recently. This research will benefit second language practitioners who is in the language education field, as well as, TESL undergraduates, on the knowledge of how teacher trainees respond to and negotiate their professional teaching identities as future second language educators.

Keywords: construction of selves, professional identities, second language, TEST teacher trainees

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Authors: Thinakar Mani Balusamy, Ratnakar S. Kini, Bharat Narasimhan, Venkateswaran A. R, Pugazhendi Thangavelu, Mohammed Ali, Prem Kumar K., Kani Sheikh M., Sibi Thooran Karmegam, Radhakrishnan N., Mohammed Noufal

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Introduction: Pancreatic injury remains a complicated condition requiring an individualized case by case approach to management. In this study, we aim to analyze the varied presentations and treatment outcomes of traumatic pancreatic injury in a tertiary care center. Methods: All consecutive patients hospitalized at our center with traumatic pancreatic injury between 2013 and 2017 were included. The American Association for Surgery of Trauma (AAST) classification was used to stratify patients into five grades of severity. Outcome parameters were then analyzed based on the treatment modality employed. Results: Of the 35 patients analyzed, 26 had an underlying blunt trauma with the remaining nine presenting due to penetrating injury. Overall in-hospital mortality was 28%. 19 of these patients underwent exploratory laparotomy with the remaining 16 managed nonoperatively. Nine patients had a severe injury ( > grade 3) – of which four underwent endotherapy, three had stents placed and one underwent an endoscopic pseudocyst drainage. Among those managed nonoperatively, three underwent a radiological drainage procedure. Conclusion: Mortality rates were clearly higher in patients managed operatively. This is likely a result of significantly higher degrees of major associated non-pancreatic injuries and not just a reflection of surgical morbidity. Despite this, surgical management remains the mainstay of therapy, especially in higher grades of pancreatic injury. However we would like to emphasize that endoscopic intervention definitely remains the preferred treatment modality when the clinical setting permits. This is especially applicable in cases of main pancreatic duct injury with ascites as well as pseudocysts.

Keywords: endotherapy, non-operative management, surgery, traumatic pancreatic injury

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Authors: Qiuyue Peng, Vladimir Zachar

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The application of adipose-derived stromal/stem cells (ASCs) in regenerative medicine is gaining more awareness due to their advanced translational potential and abundant source preparations. However, ASC-based translation has been confounded by high subpopulation heterogeneity, causing ambiguity about its precise therapeutic value. Some phenotypes defined by a unique combination of positive and negative surface markers have been found beneficial to the required roles. Therefore, the immunophenotypic repertoires of cultured ASCs and temporal changes of distinct subsets were investigated in this study. ASCs from three donors undergoing cosmetic liposuction were cultured in standard culturing methods, and the co-expression patterns based on the combination of selected markers at passages 1, 4, and 8 were analyzed by multi-chromatic flow cytometry. The results showed that the level of heterogeneity of subpopulations of ASCs became lower by in vitro expansion. After a few passages, most of the CD166⁺/CD274⁺/CD271⁺ based subpopulations converged to CD166 single positive cells. Meanwhile, these CD29⁺CD201⁺ double-positive cells, in combination with CD36/Stro-1 expression or without, feathered only the major epitopes and maintained prevailing throughout the whole process. This study suggested that, upon in vitro expansion, the phenotype repertoire of ASCs redistributed and stabilized in a way that cells co-expressing exclusively the strong markers remained dominant. These preliminary findings provide a general overview of the distribution of heterogeneous subsets residents within human ASCs during expansion in vitro. It is a critical step to fully characterize ASCs before clinical application, although the biological effects of heterogeneous subpopulations still need to be clarified.

Keywords: adipose-derived stromal/stem cells, heterogeneity, immunophenotype, subpopulations

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Authors: Bronwyn Bell, Lizelle Brink

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Workplaces of today are populated by employees from different generations; emerging adults being the most recent demographic group entering the workplace. These individuals form part of Generation Y and are between the ages of 18 to 25. Emerging adults bring unique and different characteristics to the workplace. These individuals also differ from other generations with regards to their employment desires and ways of working. Age-stereotypes of emerging adults is, therefore, a common occurrence within workplaces. The general objective of the study was therefore to explore age-related stereotypes experienced regarding emerging adults within the South African work context and to determine the influences thereof. A qualitative research design from the social constructivism paradigm was employed in order to reach the objectives of this research study. A phenomenological approach using a combination of purposive and snowball sampling was employed within this study. A sample of 25 employees (N = 25) from various South African organisations were interviewed for the purpose of this study and formed part of three generations namely Generation Y, Generation X and Baby Boomers. In order to analyse the collected data, the steps of thematic analysis were used. The main findings of this study indicated that emerging adults experience various positive and negative stereotypes within the workplace. Results further indicated that these stereotypes influence emerging adults in a behavioural, cognitive and emotional manner. These stereotypes also influence the way emerging adults are treated by older employees within the workplace. Recommendations based on the results of this study were made for future research and practice. This study creates awareness within organisations regarding age-stereotypes of emerging adults. By being aware, employees can manage the influences thereof within the workplace.

Keywords: age-stereotypes, baby boomers, emerging adults, generation x, generation y, South African work environment, stereotypes

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Authors: Helen K. Buteme, Rebecca Axelsson-Robertson, Moses L. Joloba, Henry W. Boom, Gunilla Kallenius, Markus Maeurer

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Background: The Ugandan population is heavily affected by infectious diseases and Human leukocyte antigen (HLA) diversity plays a crucial role in the host-pathogen interaction and affects the rates of disease acquisition and outcome. The identification of HLA class 1 alleles and determining which alleles are associated with tuberculosis (TB) outcomes would help in screening individuals in TB endemic areas for susceptibility to TB and to predict resistance or progression to TB which would inevitably lead to better clinical management of TB. Aims: To be able to determine the HLA class 1 phenotype distribution in a Ugandan TB cohort and to establish the relationship between these phenotypes and active and latent TB. Methods: Blood samples were drawn from 32 HIV negative individuals with active TB and 45 HIV negative individuals with latent MTB infection. DNA was extracted from the blood samples and the DNA samples HLA typed by the polymerase chain reaction-sequence specific primer method. The allelic frequencies were determined by direct count. Results: HLA-A*02, A*01, A*74, A*30, B*15, B*58, C*07, C*03 and C*04 were the dominant phenotypes in this Ugandan cohort. There were differences in the distribution of HLA types between the individuals with active TB and the individuals with LTBI with only HLA-A*03 allele showing a statistically significant difference (p=0.0136). However, after FDR computation the corresponding q-value is above the expected proportion of false discoveries (q-value 0.2176). Key findings: We identified a number of HLA class I alleles in a population from Central Uganda which will enable us to carry out a functional characterization of CD8+ T-cell mediated immune responses to MTB. Our results also suggest that there may be a positive association between the HLA-A*03 allele and TB implying that individuals with the HLA-A*03 allele are at a higher risk of developing active TB.

Keywords: HLA, phenotype, tuberculosis, Uganda

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Authors: Angel Champion, Sadia Kanwal, Rafat Siddiqui

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Harnessing phytochemicals from plant sources presents a novel opportunity to prevent or treat malignant diseases, including breast cancer. Chemotherapy lacks precision in targeting cancerous cells while sparing normal cells, but a phytopharmaceutical approach may offer a solution. Dandelion, a common weed plant, is rich in phytochemicals and provides a safer, more cost-effective alternative with lower toxicity than traditional pharmaceuticals for conditions such as breast cancer. In this study, an in-vitro experiment will be conducted using the ethanol extract of Dandelion on triple-negative MDA-231 breast cancer cell lines. The polyphenolic analysis revealed that the Dandelion extract, particularly from the root and leaf (both cut and sifted), had the most potent antioxidant properties and exhibited the most potent antioxidation activity from the powdered leaf extract. The extract exhibits prospective promising effects for inducing cell proliferation and apoptosis in breast cancer cells, highlighting its potential for targeted therapeutic interventions. Standardizing methods for Dandelion use is crucial for future clinical applications in cancer treatment. Combining plant-derived compounds with cancer nanotechnology holds the potential for effective strategies in battling malignant diseases. Utilizing liposomes as carriers for phytoconstituent anti-cancer agents offers improved solubility, bioavailability, immunoregulatory effects, advancing anticancer immune function, and reducing toxicity. This integrated approach of natural products and nanotechnology has significant potential to revolutionize healthcare globally, especially in underserved communities where herbal medicine is prevalent.

Keywords: apoptosis, antioxidant activity, cancer nanotechnology, phytopharmaceutical

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Authors: Driss Haddouche

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Pastoral crisis in Algeria has its origins in rangeland degradation which are the main factor in any activity in the steppe zones. Indeed, faced with the increasing human and animal population on a living space smaller and smaller, there is an overuse of what remains of the steppe range lands, consequently the not sustainability of biomass production. Knowing the amount of biomass available, the practice of grazing options, taking into account the use of "Use Factor" factor remains an essential method for managing pastoral resources. This factor has three options: at 40% Conservative pasture; at 60 % the beginning of overgrazing; at 80% destructive grazing. Accessibility on the pasture is based on our field observations of a type any flock along a grazing cycle. The main purpose of these observations is to highlight the speed of herd grazing situation. Several individuals from the herd were timed to arrive at an average duration of about 5 seconds to move between two tufts of grass, separated by a distance of one meter. This gives a rate of 5 s/m (0.72 km/h) flat. This speed varies depending on the angle of the slope. Knowing the speed and slope of each pixel of the study area, given by the digital elevation model of Spot Image (MNE) and whose pitch is 15 meters, a map of pasture according to the distances is generated. Knowing the stocking and biomass available, the examination of the common Mécheria at regular distances (8.64 km or 12 hours of grazing, 17.28 km or 24 hours of grazing and 25.92 Km or 36 hours of grazing), offers three different options (conservation grazing resource: utilization at 40%; overgrazing statements for use at 60% and grazing destructive for use by more than 80%) for each distance traveled by sheep from the starting point is the town of Mécheria.

Keywords: pastoral crisis, biomass, animal charge, use factor, Algeria

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Authors: Nerissa Gloria Balboa, Aire Yukdawan, Venice Gordula, Rhea Jannagen Curva

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This research examined the lived experiences and compared their similarities and differences of former Catholics turned Muslim converts in and out of prison. Qualitative comparative study with an Interpretative Phenomenological Analysis approach was used to explore the lives of Muslim converts. Interviews were conducted at Islamic Studies, Call and Guidance of the Philippines (ISCAG) and Tarbiyyah Islamic Female Institute for Muslim converts out of prison, New Bilibid Prison (NBP) and Correctional Institution for Women (CIW) for Muslim converts in prison. Results of the study show that first, for Muslim converts out of prison, exploration begins through (1) experiences of Catholicism as a norm in the family and eventual realization of its emptiness in practice, (2) experiences of Islam as a norm in the environment and discovery of meaningfulness of Islam (3) experiences of gradual holistic transformation of being a Muslim; and (4) experiences of extension of oneself towards family and society. Secondly, for Muslim converts in prison, exploration begins through (1) experiences of Apathy towards Catholicism and eventual deviation from moral standards, (2) experiences of prison condition as an environment of reflection on spirituality; and (3) experiences of positive effects of being a Muslim inside Prison. Comparisons show that there exists similarities and differences across the two settings in terms of (1) experiences of Catholicism and the degree of its internalization and actualization, (2) experiences of Islamic encounters and the process of conversion; and (3) experience of Islamic devotion and Islamic construct for the self. Theoretical bases of religious conversion found in unique contexts are discussed, initiating a paradigm shift of thinking that is needed to address the deeply rooted prejudices within Catholic and Islamic circles.

Keywords: Catholicism, Islamic conversion, social psychology, religion

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Authors: S. M. Abdul Khader, Anurag Ayachit, Raghuvir Pai, K. A. Ahmed, V. R. K Rao, S. Ganesh Kamath

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The numerical simulation has made tremendous advances in investigating the blood flow phenomenon through elastic arteries. Such study can be useful in demonstrating the disease progression and haemodynamics of cardiovascular diseases such as atherosclerosis. In the present study, patient specific case diagnosed with partially stenosed complete right ICA and normal left carotid bifurcation without any atherosclerotic plaque formation is considered. 3D patient specific carotid bifurcation model is generated based on CT scan data using MIMICS-4.0 and numerical analysis is performed using FSI solver in ANSYS-14.5. The blood flow is assumed to be incompressible, homogenous and Newtonian, while the artery wall is assumed to be linearly elastic. The two-way sequentially-coupled transient FSI analysis is performed using FSI solver for three pulse cycles. The haemodynamic parameters such as flow pattern, Wall Shear Stress, pressure contours and arterial wall deformation are studied at the bifurcation and critical zones such as stenosis. The variation in flow behavior is studied throughout the pulse cycle. Also, the simulation results reveals that there is a considerable increase in the flow behavior in stenosed carotid in contrast to the normal carotid bifurcation system. The investigation also demonstrates the disturbed flow pattern especially at the bifurcation and stenosed zone elevating the haemodynamics, particularly during peak systole and later part of the pulse cycle. The results obtained agree well with the clinical observation and demonstrates the potential of patient specific numerical studies in prognosis of disease progression and plaque rupture.

Keywords: fluid-structure interaction, arterial stenosis, wall shear stress, carotid artery bifurcation

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Authors: Gabriele Palumbo

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This research empirically examines some of the reasons behind the fact that recently the number of people giving up their American citizenship for tax purposes has recently increased drastically. The United States Jurisdiction represents a unicum in the practice of taxing worldwide income not only to residents of the United States but also to U.S. citizens living abroad. The worldwide income taxation also affects people defined as “Accidental Americans” who are unaware that they are U.S. citizens. Those people are considered Americans even though they have not been to the United States. American residents abroad can rely on United States income tax treaties and some national law provisions, such as the exclusion of foreign income and foreign tax credits, which are designed specifically to avoid double taxation. However, this mechanism may prove unsatisfactory for people who have not been linked anymore or individuals who have never had relations with the United States. U.S. citizens who are determined to cut all of the ties between themselves and the United States, especially those that involve tax implications, can renounce their U.S. citizenship with the expatriation procedure. The expatriation process represents the extrema ratio and implicates several steps which must be followed carefully. This paper shows the complexity of the procedure that a U.S. citizen who is resident in a foreign country would have to follow to relinquish U.S. citizenship for tax purposes. The mechanism is intended to discourage people from renounce. Going beyond the question of whether U.S. tax regulation is fair or not, this principle nowadays characterizes a popular topic that many scholars and lawyers are discussing. The outcome provides interesting implications that could induce the Congress to rethink the definition of citizenship for both fiscal and nationality law purposes. Indeed, even if a sort of checks and balances has the task of mitigating the renunciation of U.S. citizenship, more and more U.S. citizens desire to get rid of their citizenship.

Keywords: double taxation, expatriation tax, international taxation, relinquishment of United States citizenship

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Authors: Lazaro E. Nnko, Japhet J. Kashaigili, Gerald C. Monela, Pantaleo K. T. Munishi

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Agroforestry systems and practices are perceived to improve livelihood and sustainable management of natural resources. However, their adoption in various regions differs with the biophysical conditions and societal characteristics. This study was conducted in Kilombero District to investigate the factors influencing the adoption of different agroforestry systems and practices in agro-ecosystems and farming systems. A household survey, key informant interviews, and focus group discussion was used for data collection in three villages. Descriptive statistics and multinomial logistic regression in SPSS were applied for analysis. Results show that Igima and Ngajengwa villages had home garden practices dominated, as revealed by 63.3% and 66.7%, respectively, while Mbingu village had mixed intercropping practice with 56.67%. Agrosilvopasture systems were dominant in Igima and Ngajengwa villages with 56.7% and 66.7%, respectively, while in Mbingu village, the dominant system was agrosilviculture with 66.7%. The results from multinomial logistic regression show that different explanatory variable was statistical significance as predictors of the adoption of agroforestry systems and practices. Residence type and sex were the most dominant factor influencing the adoption of agroforestry systems. Duration of stay in the village, availability of extension education, residence, and sex were the dominant factor influencing the adoption of agroforestry practices. The most important and statistically significant factors among these were residence type and sex. The study concludes that agroforestry will be more successful if the local priorities, which include social-economic need characteristics of the society, will be considered in designing systems and practices. The socio-economic need of the community should be addressed in the process of expanding the adoption of agroforestry systems and practices.

Keywords: agroforestry adoption, agroforestry systems, agroforestry practices, agroforestry, Kilombero

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Authors: René Haarhoff

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Consumers are constantly reminded of their responsibility towards the environment in a world where words such as global warming, carbon footprint, recycling or ‘green’’ everything has become common language. What was previously considered to be ordinary practices are in many instances frowned upon today and consumers are expected to individually contribute towards a greener mother earth. However unused recycle bins, single travelers in luxury cars, busy airports and vast deforested areas for new developments tell another story. The question arises whether the everyday man in the street really takes the responsibility to balance the three pillars of sustainability: the planet, its people and profit. Undeniably our activities impact on the environment where a healthy economy is needed in a fast paced global environment. The situation is further gloomed in instances where the consumer has paid for inclusive services which directly impacts on the environment. A prime example of this is the tourism industry: accommodation establishments or resorts include clean, daily washed towels and bedding, large bath tubs, inclusive use of electricity and water to name a few. This research evaluates environmentally friendly practices consumers follow at home and also when on holiday. Respondents at Bloemfontein airport, often using tourism products were included in the study. Results reveal that the majority of respondents state that they are concerned about the environment yet when questioned on donation towards endangered species, switching off lights in hotel rooms or using water sparingly a significant difference in results are evident. From the research results it is evident that consumers do not practice what they preach towards a greener environment.

Keywords: green, environment, consumer, tourism, sustainable practices

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Authors: Yaya Gao, Jifeng Liu, Yafeng Liu

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Objectives: This study aimed to improve clinicians' understanding and diagnosis of the Mammary analogue secretory carcinoma of the salivary gland（MASC）. Methods: The clinical features of a MASC patient who was admitted to WestChina Hospital of Sichuan University in July 2020 were reviewed and analyzed. A 49-year-old woman with left upper neck pain for three months was admitted to the hospital. She underwent adenoma resection of the left submandibular gland 14 years ago and mucoepidermoid carcinoma resection surgery five years ago. Three months before admission, the patient developed pain in the left mandibular angle after "fatigue" and gradually developed radiation pain in the left ear, which could be relieved after rest. A mass of 1cm could be touched at the mandibular, with tenderness, poor mobility, and hard texture. No swelling, heat, pain, rupture, or pus was found on the surrounding skin. Color doppler ultrasonography of the salivary gland indicated a weak echo mass of 23*14*17mm in the left parotid gland. Results: Surgical excision was completed. Immunohistochemistry of the tumor samples after operation showed that P63（a few，+）, CK7（+）, S100（+）, DOG1（-）, Ki67（MIB-1）（+，5%），pan-TRK（+）, PAS(+) . ETV-6 gene translocation was detected in FISH in postoperative pathology, which indicated MASC. After this diagnosis, the patient sent the postoperative specimen of the second submandibular tumor to our hospital for consultation. The morphology of the two was similar. FISH detected ETV-6 gene translocation, so the second pathological diagnosis was revised to MASC. Conclusion: MASC of the salivary gland is a rare salivary gland tumor whose diagnosis depends on the result of the ETV6-NTRK3 fusion gene.

Keywords: mammary analogue secretory carcinoma, ETV6-NTRK3, salivary gland, misdiagnosed

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Authors: Wania Mohammad Akram, Swetha Kannan, Urooj Shahid, Aisha Sajjad

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Ovarian ectopic pregnancy, a rare manifestation of ectopic gestation, involves the implantation of a fertilized egg on the ovarian surface. This condition poses diagnostic challenges and is associated with significant maternal morbidity if not promptly managed. This report presents the case of a 33-year-old nulliparous woman with a history of polycystic ovary syndrome (PCOS) undergoing ovulation induction therapy. Following her first conception in October 2021, she presented with symptoms of per vaginal spotting and low back pain, prompting a diagnosis of left adnexal ectopic pregnancy confirmed by transvaginal ultrasound and serum beta-human chorionic gonadotropin (B-HCG) levels. Medical management with methotrexate was initiated successfully. In August 2022, the patient conceived again, with subsequent ultrasound revealing a large pelvic collection suggestive of a complex ectopic pregnancy involving both ovaries. Despite initial stability, she developed abdominal pain necessitating emergency laparoscopy, which revealed an ovarian ectopic pregnancy with hemoperitoneum. Laparotomy was performed due to the complexity of the presentation, and histopathology confirmed viable chorionic villi within ovarian tissue. This case underscores the clinical management challenges posed by ovarian ectopic pregnancies, particularly in patients with previous ectopic pregnancies. The discussion reviews current literature on diagnostic modalities, treatment strategies, and outcomes associated with ovarian ectopic pregnancies, emphasizing the role of surgical intervention in cases refractory to conservative management. Tailored approaches considering individual patient factors are crucial to optimize outcomes and preserve fertility in such complex scenarios.

Keywords: obgyn, ovarian ectopic pregnancy, laproscopy, pcos

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