Search results for: early intervention services

Authors: T. Valdbjørn Rasmussen

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Design criteria for achieving an acceptable indoor radon concentration are presented in this paper. The paper suggests three design criteria. These criteria have to be considered at the early stage of the building design phase to meet the latest recommendations from the World Health Organization in most countries. The three design criteria are; first, establishing a radon barrier facing the ground; second, lowering the air pressure in the lower zone of the slab on ground facing downwards; third, diluting the indoor air with outdoor air. The first two criteria can prevent radon from infiltrating from the ground, and the third criteria can dilute the indoor air. By combining these three criteria, the indoor radon concentration can be lowered achieving an acceptable level. In addition, a cheap and reliable method for measuring the radon concentration in the indoor air is described. The provision on radon in the Danish Building Regulations complies with the latest recommendations from the World Health Organization. Radon can cause lung cancer and it is not known whether there is a lower limit for when it is not harmful to human beings. Therefore, it is important to reduce the radon concentration as much as possible in buildings. Airtightness is an important factor when dealing with buildings. It is important to avoid air leakages in the building envelope both facing the atmosphere, e.g. in compliance with energy requirements, but also facing the ground, to meet the requirements to ensure and control the indoor environment. Infiltration of air from the ground underneath a building is the main providing source of radon to the indoor air.

Keywords: radon, natural radiation, barrier, pressure lowering, ventilation

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Authors: Emmanuel Iyamuremye, Irenee Ndayambaje

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This study investigated the influence of Concrete Pictorial Abstract (CPA) teaching approach on mathematics achievement based on a sample of eighth-grade students (N = 10,345) from the Rwandan Lower Secondary School quasi-experimental study with pre-test and post-test control group of 2019 (RLSQES19). Key aspects studied included mathematics concept understanding and mathematics concept retention and how these are influenced by teacher's teaching approach. Specifically, the study aimed to a.) investigate students' concept understanding and concept retention in mathematics when exposed to CPA approach and to those exposed to non-CPA approach before and after the intervention, and b.) ascertain the significant difference between the performance of the students exposed to CPA approach and those exposed to non-CPA approach in terms of post-test scores and retention test scores. Two groups (control and experimental) undergone pre-test, post-test, and retention test. The assignment of control and experimental group among senior two classes from 10 schools was done randomly. The materials used to determine the performance of the students is a teacher-made test. Descriptive statistics and ANCOVA were used for the analysis of the study. For determining the improvement in concept understanding of mathematics, Hakes methods of calculating gain were used to analyze the pre-test and post test score. The level of performance of the two groups in the pre-test is below average level. During the post-test and retention test, the performance of students in non-CPA group is on average level, and students in CPA group are on above average level. Hakes methods of calculating gain revealed higher significant performance in the post-test and retention test of CPA group of students than non-CPA group of students.

Keywords: concept understanding, concept retention, performance, teaching approach

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Authors: Muhammad Imran Hussain, Ramisha Ibtisam, Tayyaba Fatima, Huba Khalid, Ayesha Aziz, Khansa, Adan Sitara, Anam Shahzad, Aymen Jabeen

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Vitamin D supports the immune system fight TB by inhibiting Interferon-gamma (IFN-γ) and lowering host inflammation. The purpose of the research was to see if giving the vitamin D supplements to TB patients affected their prognosis. A randomized placebo control study of 200 TB patients was performed among which 106 received 400,000 IU of injectable vitamin D3 and 94 received placebo for 2 doses. Assessment was carried out at the end of every month for 3 months. IFN-γ responses to whole blood stimulation generated by the Mycobacterium tuberculosis sonicate (MTBs) antigen and early secreted and T cell activated 6 kDa (ESAT6) were assessed at 0 and 12 weeks. The statistical analysis used descriptive statistics (mean and standard deviation), Friedman's test and Fisher's test. The vitamin D group gained significantly more weight (+3.90 pounds) and had less persistent lung disease on imaging (1.33 zones vs. 1.84 zones). They also had a 50% decrease in cavity size. Additionally, patients with low baseline serum concentrations of 25-(OH)D had a significant increase in MTB-induced IFN-γ production after taking vitamin D supplements. Vitamin D administration in large amounts can hasten the recovery of TB patients. The findings point is a therapeutically useful activity of Vitamin D's in the management for tuberculosis.

Keywords: tuberculosis, vitamin D, interferon gamma, protein, infection

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Authors: Amina Babou

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Gender and language is a moot and miscellaneous arena in the sphere of socio-linguistics, which has been proliferated so widely and rapidly in recent years. The dawn of research on gender and foreign language education was against the feminist researchers who allowed space for the bustling concourse of voices and perspectives in the arena of gender and language differences, in the early to the mid-1970. The objective of this scrutiny is to explore to what extent teaching gender and language in the English as a Foreign Language (EFL) classroom plays a pivotal role in learning language information and skills. Moreover, the gist of this paper is to investigate how EFL students in Algeria conflate their gender identities with the linguistic practices and scholastic expertise. To grapple with the full range of issues about the EFL students’ awareness about the negotiation of meanings in the classroom, we opt for observing, interviewing, and questioning later to check using ‘how-do-you do’ procedure. The analysis of the EFL classroom discourse, from five Algerian universities, reveals that speaking strategies such as the manners students make an abrupt topic shifts, respond spontaneously to the teacher, ask more questions, interrupt others to seize control of conversations and monopolize the speaking floor through denying what others have said, do not sit very lightly on 80.4% of female students’ shoulders. The data indicate that female students display the assertive style as a strategy of learning to subvert the norms of femininity, especially in the speaking module.

Keywords: EFL students, gender identity, linguistic styles, foreign language

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Authors: Kyosuke Kamada, Christoph Kapeller, Michael Jordan, Mostafa Mohammadpour, Christy Li, Christoph Guger

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Cortico-cortical evoked potentials (CCEP) refer to responses generated by cortical electrical stimulation at distant brain sites. These responses provide insights into the functional networks associated with language or motor functions, and in the context of epilepsy, they can reveal pathological networks. Locating the origin and spread of seizures within the cortex is crucial for pre-surgical planning. This process can be enhanced by employing cortical stimulation at the seizure onset zone (SOZ), leading to the generation of CCEPs in remote brain regions that may be targeted for disconnection. In the case of a 24-year-old male patient suffering from intractable epilepsy, corpus callosotomy was performed as part of the treatment. DTI-MRI imaging, conducted using a 3T MRI scanner for fiber tracking, along with CCEP, is used as part of an assessment for surgical planning. Stimulation of the SOZ, with alternating monophasic pulses of 300µs duration and 15mA current intensity, resulted in CCEPs on the contralateral frontal cortex, reaching a peak amplitude of 206µV with a latency of 31ms, specifically in the left pars triangularis. The related fiber tracts were identified with a two-tensor unscented Kalman filter (UKF) technique, showing transversal fibers through the corpus callosum. The CCEPs were monitored through the progress of the surgery. Notably, the SOZ-associated CCEPs exhibited a reduction following the resection of the anterior portion of the corpus callosum, reaching the identified connecting fibers. This intervention demonstrated a potential strategy for mitigating the impact of intractable epilepsy through targeted disconnection of identified cortical regions.

Keywords: CCEP, SOZ, Corpus callosotomy, DTI

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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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Authors: Bahago I. N., Oyewole O. E.

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Nigeria has the second highest prevalence of intestinal worms globally, which has not declined since the 1970s, especially in rural communities. Identifying the gaps in self-care practice will pave a way for a suitable intervention. This study investigated the knowledge, perception, and practice of deworming among mothers of under-five children in rural communities of Lafia Local Government Area, Nasarawa State. This study was descriptive cross-sectional and involved 419 mothers selected by systematic sampling technique. Information was obtained using a valid interviewer-questionnaire. Knowledge, perception, and practice was measured using a 10-point scale for each variable, respectively. Scores of 0-4, >4-6, and >6 were categorised as poor, average/fair, and good, respectively, at p<0.05 level of significance. Respondents’ age was 30.3±9.2 years; 46.5% were into trading, 26.7% were unemployed, 9.3% were skilled labour, and 7.4% were farmers. On literacy, secondary school (25.5%) while 9.1% above secondary school. Many (51.1%) had 2-3 children, while 42.2% had 5 or more children. Most of the respondents (96.2%) had good knowledge of deworming, and 3.8% had fair knowledge. Using multivariate model, Mothers between the ages of 25-34 years were 20 times likely to be more knowledgeable, given they have access to health information (O.R 2.39 -164.31). Most (62.3%) had good perception scores, 33.2% had fair scores, while 4.5% had poor perception scores. Majority (66.4%) had a good deworming practice of deworming, 66.4% had good, 28.4% had fair, and 5.3% had poor practice. The test of association between Parent's literacy level, religion, and age were significantly associated with the level of knowledge of deworming. Knowledge of deworming was above average; perception and practice was good. Women of ages 25-34 years could be trained as community volunteers to propagate the right information about deworming in rural communities, especially among young women of ages 13-19 years. Preferred channels to obtaining health information identified in the study should be explored.

Keywords: deworming, mothers of under-five, intestinal worms, rural communities

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Authors: Aseela Alhinaai, Suliman Abdullah, Adil Albusaidi

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Knowledge has been considered an important asset in private and public organizations. It is utilized in the libraries sector to run different operations of technical services and administrative works. As a result, the International Federation of Library Association (IFLA) established a department “Knowledge Management” in December 2003 to provide a deep understanding of the KM concept for professionals. These are implemented through different programs, workshops, and activities. This study aims to identify the impact of the knowledge-sharing factors (technology, collaboration, management support) to improve decision-making at Sultan Qaboos University Libraries. This study conducted a quantitative method using a questionnaire instrument to measure the impact of technology, collaboration, and management support on knowledge sharing that lead to improved decision-making. The study population is the (SQU) libraries (Main Library, Medical Library, College of Economic and political science library, and Art Library). The results showed that management support, collaboration, and technology use have a positive impact on the knowledge-sharing process, and knowledge-sharing positively affects the decision making process.

Keywords: knowledge sharing, decision-making, information technology, management support, corroboration, Sultan Qaboos University

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Authors: María Molinos-Senante, Giulia Romano

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This paper aims at investigating the effect of ownership in the efficiency assessment of municipal solid waste management. In doing so, the Data Envelopment Analysis meta-frontier approach integrating unsorted waste as undesirable output was applied. Three different clusters of municipalities have been created on the basis of the ownership type of municipal waste operators. In the second stage of analysis, the paper investigates factors affecting efficiency, in order to provide an outlook of levers to be used by policy and decision makers to improve efficiency, taking into account different management models in force. Results show that public waste management firms have better performance than mixed and private ones since their efficiency scores are significantly larger. Moreover, it has been demonstrated that the efficiency of waste management firms is statistically influenced by the age of population, population served, municipal size, population density and tourism rate. It evidences the importance of economies of scale on the cost efficiency of waste management. This issue is relevant for policymakers to define and implement policies aimed to improve the long-term sustainability of waste management in municipalities.

Keywords: data envelopment analysis, efficiency, municipal solid waste, ownership, undesirable output

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Authors: Natalia Marulanda, Henry González, Gonzalo León, Alejandro Hincapié

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Continuous improvement tools are the result of a set of studies that developed theories and methodologies. These methodologies enable organizations to increase their levels of efficiency, effectiveness, and productivity. Based on these methodologies, lean manufacturing philosophy, which is based on the optimization of resources, waste disposal, and generation of value to products and services, was developed. Lean application has been massive globally, but Colombian companies have been made it incipiently. Therefore, the purpose of this article is to identify the impacts generated by the implementation of lean manufacturing tools in five companies located in Colombia and Medellín metropolitan area. It also seeks to make a comparison of the results obtained from the implementation of lean philosophy and Theory of Constraints. The methodology is qualitative and quantitative, is based on the case study interview from dialogue with the leaders of the processes that used lean tools. The most used tools by research companies are 5's with 100% and TPM with 80%. The less used tool is the synchronous production with 20%. The main reason for the implementation of lean was supply chain management with 83.3%. For the application of lean and TOC, we did not find significant differences between the impact, in terms of methodology, areas of application, staff initiatives, supply chain management, planning, and training.

Keywords: business strategy, lean manufacturing, theory of constraints, supply chain

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Authors: Sylvia Acquah

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The assumption that social enterprises are empowering has strong theoretical support, but empirical verification is anecdotal at best. Social enterprises blend social goal with an enterprising idea and therefore in theory these enterprises should provide meaningful jobs that are empowering. Whether jobs created are meaningful, or whether these organizations are practicing social entrepreneurship remains unexplored key questions. This paper addresses these key questions through a comprehensive literature review and an ethnographical study of a Domiciliary Home Care Social Enterprise in the UK. The social entrepreneurs, management and 9 staff members were observed, interviewed and achieves were reviewed and analyzed. In this study, the social entrepreneur’s vision was lost in transition during management change and the organization was only identified as a social enterprise by name. The organization that was set up to tackle lack of continuity in care and create a family of independent carers, was eventually closed down overnight and subjected to investigation by social services and the local council. Also, the ineffectiveness of the organization led to staff being stressed and without the support of the management to help rectify the issues; staff started displaying symptoms of burnout. Social enterprise managers should not only focus on profit maximization or generation, but should equally live up to the core tenets of the enterprise and effectively communicate and gain buy-in of all employees for any changes. Further, there ought to be an independent organization that regulates social enterprises to ensure that they are adhering to their social goals.

Keywords: ethnography, carer, social, enterprise

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Authors: Forbah Julius Ajamah

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The protection of human rights and respect of the rule of law in Sub-Saharan African is a constant challenge due to ongoing and protracted conflict situations, political instability, shrinking democratic space and allegations of large-scale corruption in some countries. Conflict and/or crisis is most often resulting from constant violations of individual rights, with the risk increasing when many human rights are violated in a systematic or widespread fashion. Violations related to economic, social and cultural rights at times are as significant as violations of civil and political rights. Cameroon a country in Sub-Saharan African, for many years now has been confronted by numerous crises across different regions. Despite measures carried out, it has been reported that lesser and lesser attention has been placed on various conflict/crisis across Cameroon. To reach a common understanding of how both the economic, social and cultural rights has been violated and related impact on the quality of life, this paper evaluates justice, security and human rights violations in the present crisis situations. Without the prevention of human rights violations, wider conflict and/or crisis, will continue to have a negative impact in the lives of the inhabitants. This paper aims at providing evidence to support the fact that effective prevention requires early identification of risks that could allow for preventive and/or mitigatory measures to be designed and implemented.

Keywords: justice, security, human rights abuses, conflicts, crisis

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Authors: Aleksandra Ristic

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The Coronavirus Disease – 2019 hit Europe in February 2020, and infections took place in four waves. It left consequences and demanded changes for the future. More than half of European countries responded quickly by declaring a state of emergency and introducing various containment measures that have had a major impact on individuals’ lives in recent years. Closing public lives was largely achieved by limited access and/or closing public institutions and services, including the closure of educational institutions. Teaching in classrooms converted to distance learning. In the research, we used a quantitative study to analyze various factors of distance learning that influenced pupils in different segments: teachers’ availability, family support, entire online conference learning, successful distance learning, time for themselves, reliable sources, teachers’ feedback, successful distance learning, online participation classes, motivation and teachers’ communication and theoretical review of the importance of digital skills, e-learning Index, World comparison of e-learning in the past, digital education plans for the field of Europe. We have gathered recommendations and distance learning solutions to improve the learning process by strengthening teachers and creating more tiered strategies for setting and achieving learning goals by the children.

Keywords: availability, digital skills, distance learning, resources

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Authors: Evelyn Smith, Susan Simpson

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Background: Eating disorder (ED) treatment is complicated by high rates of chronicity, comorbidity, complex personality traits and client dropout. Given these complexities, Schema Therapy (ST) has been identified as a suitable treatment option. The study primarily aims to evaluate the efficacy of group ST for the treatment of EDs. The study further evaluated the effectiveness of ST in reducing schemas and improving quality of life. Method: Participant suitability was ascertained using the Eating Disorder Examination. Following this, participants attended 90-minute weekly group sessions over 25 weeks. Groups consisted of six to eight participants and were facilitated by two psychologists, at least one of who is trained in ST. Measures were completed at pre, mid and post-treatment. Measures assessed ED symptoms, cognitive schemas, schema mode presentations, quality of life, self-compassion and psychological distress. Results: As predicted, measures of ED symptoms were significantly reduced following treatment. No significant changes were observed in early maladaptive schema severity; however, reductions in schema modes were observed. Participants did not report improvements in general quality of life measures following treatment, though improvement in psychological well-being was observed. Discussion: Overall, the findings from the current study support the use of group ST for the treatment of EDs. It is expected that lengthier treatment is needed for the reduction in schema severity. Given participant dropout was considerably low, this has important treatment implications for the suitability of ST for the treatment of EDs.

Keywords: eating disorders, schema therapy, treatment, quality of life

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Authors: Sundaresan Sivapatham, B. Prabhu

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Cancer results from a multistage, multi-mechanism carcinogenesis process that involves mutagenic, cell death and epigenetic mechanisms, during the three distinguishable but closely allied stages: initiation, promotion, and progression. Chemoprevention is promising in the realm of cancer prevention and it has been shown to reduce the risk of development of carcinoma in highly susceptible individuals such as those with known genetic mutations or high level of risk factors. The present study is aimed at the need of early detection of bladder cancer in order to improve performance in the treatment of this disease. Consumption of certain natural products like DIM is associated with a reduction in cancer incidence in humans. The study showed the protective effects of Diindolylmethane in N-Butyl-N-(4-hydroxybutyl) nitrosamine treated rats. Results of the study had shown the changes in the tumor markers, biomarkers and histopathological alterations in experimental rats when compared to control rats. The protective effects of DIM were shown from the results of cell proliferation, apoptotic markers and histopathological findings when compared with experimental control animals. Hence, our results speculate that the tumor markers, apoptotic markers, histopathological changes and cell proliferation index measured as PCNA serves as an indicator suggestive of protective effects of DIM in BBN induced urinary bladder carcinogenesis.

Keywords: bladder cancer, N-Butyl-N-(4-hydroxybutyl) nitrosamine, diindolylmethane, histopathology

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Authors: Mohamed Alzarug Aburugba, Rashid Mohamed Eltanashi

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Rainwater is considered an essential water resource, as it contributes to filling the deficit in water resources, especially in countries that suffer from a scarcity of natural water sources. One of the important issues facing the Water and Gas Services Department at the Libyan Iron and Steel Company is the large loss of quantities of industrial water, both direct and indirect cooling water (DCW, ICW), produced within the company due to leaks in the cooling systems of the factories of the Libyan Iron and Steel Company. These amounts of polluted industrial water leakage are mixed with rainwater collected by stormwater stations (6 stations) in LISCO, which is pumped to the sea through pumps with a very high flow rate, and thus, this will carry a lot of waste, heavy metals, and oils to the sea, which negatively affects marine environmental resources. This paper assesses the environmental impact of the quantities of rainwater and mixed industrial water in stormwater stations in the Libyan Iron and Steel Company and methods of mitigation, treating pollutants and reusing them as industrial water in the production processes of the steel industry.

Keywords: rainwater, mitigation, impact, sewage, heavy metals, assessment, pollution, environment, natural resources, industrial water.

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Authors: Syahruddin Sumardi Samindjaya, Indra Fajar Alamsyah, Junaidah Hashim

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Purpose: This study attempts to explore and presents a proposed recruitment model in Islamic university which aligned with holistic role. Design/methodology/approach: It is a conceptual paper in nature. In turn, this study is designed to utilize exploratory approach. Literature and document review that related to this topic are used as the methods to analyse the content found. Findings: Recruitment for any organization is fundamental to achieve its goal effectively. Staffing in universities is vital due to the important role of lecturers. Currently, Islamic universities still adopt the common process of recruitment for their academic staffs. Whereas, they have own characteristics which are embedded in their institutions. Furthermore, the FCWC (Foundation, Capability, Worldview and Commitment) model of recruitment proposes to suit the holistic character of Islamic university. Research limitation/implications: Further studies are required to empirically validate the concept through systematic investigations. Additionally, measuring this model by a designed means is appreciated. Practical implications: The model provides the map and alternative tool of recruitment for Islamic universities to determine the process of recruitment which can appropriate their institutions. In addition, it also allows stakeholders and policy makers to consider regarding Islamic values that should inculcate in the Islamic higher learning institutions. Originality/value: This study initiates a foundational contribution for an early sequence of research.

Keywords: academic staff, Islamic values, recruitment model, university

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Authors: Mengmeng Liu, J. David Frost

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Interstate highway system within the Atlanta Perimeter plays an important role in residents’ daily life. The serious influence of Atlanta I-85 Collapses implies that transportation system in the region lacks a cohesive and comprehensive transportation plan. Therefore, disaster resilience analysis of the transportation system is necessary. Resilience is the system’s capability to persist or to maintain transportation services when exposed to changes or shocks. This paper analyzed the resilience of the whole transportation system within the Perimeter and see how removing interstates within the Perimeter will affect the resilience of the transportation system. The data used in the paper are Atlanta transportation networks and LEHD Origin-Destination Employment Statistics data. First, we calculate the traffic flow on each road section based on LEHD data assuming each trip travel along the shortest travel time paths. Second, we calculate the measure of resilience, which is flow-based connectivity and centrality of the transportation network, and see how they will change if we remove each section of interstates from the current transportation system. Finally, we get the resilience function curve of the interstates and identify the most resilient interstates section. The resilience analysis results show that the framework of calculation resilience is effective and can provide some useful information for the transportation planning and sustainability analysis of the transportation infrastructures.

Keywords: connectivity, interstate highway system, network analysis, resilience analysis

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Authors: Daniella Arieli

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As human population is ageing, globally, we are faced with the need to find solutions for the care of older people who have reached the stage of needing full-time nursing care. Basically, there are two basic alternatives: 1. moving the individual to an institutional setting, a care home, or other form of residency, and 2. Arranging care for them in their own home, what is known as “ageing in place”. As ageing in place is becoming popular in many parts of the world, there is a need to understand its’ everyday consequences for all the involved parties: the care recipient, her/his family members and the live-in care workers. This is crucial because choosing home care means that the role of the care recipient’s relatives becomes very demanding and requires a level of support and responsibility that is often beyond what families can offer. This is particularly challenging when the older person faces dementia. While most Western countries offer a range of social services, many citizens around the world find the care provided by governments and associated social support structures insufficient. Individuals and families find themselves in the position of having to take on the responsibility themselves and find a path for the care of frail members, while facing considerable personal burdens and challenging dilemmas. The aim of this work is to discuss those challenges. The study is based on an ethnographic study of home care for older people in Israel.

Keywords: aging in place, family caregivers, policy making, qualitative research

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Authors: Francesca Favero, Despina Learmonth

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Carbohydrate addiction is said to be the sustained dependence on hyperpalatable foods rich in carbohydrates and sugar. This addiction manifests in increased consumption of carbohydrates through binging: a behaviour typically associated with eating disorders. There is a lack of consensus amongst relevant experts as to whether carbohydrates are physiologically or psychologically addictive. With an increased focus on carbohydrate addiction, an outpatient treatment programme, HELP, has been established in Cape Town, South Africa, to specifically address this issue. This research aimed to explore, pre-and post-intervention, the possible presence of, and subsequent shifts in, the maintaining mechanisms identified in the transdiagnostic model for eating disorders. However, the potential for the emergence of other perpetuating factors was not discounted and the nature of the analysis allowed for this possibility. Eight women between the ages of twenty-two and fifty, who had completed the outpatient treatment programme in the last six months, were interviewed. They were asked to speak retrospectively about their personal difficulties, eating and food, and their experience of the treatment. Thematic analysis was employed to identify themes arising from the data. Five themes congruent with the transdiagnostic model’s factors emerged: over-evaluation of weight and shape, core low self-esteem, interpersonal difficulties, clinical perfectionism and mood intolerance. A variety of sub-themes, elaborating upon the various ways in which the disordered eating was maintained, also emerged from the data. Shifts in these maintaining mechanisms were identified. Although not necessarily indicative of recovery, the results suggest that the outpatient HELP programme had a positive overall influence on the participants; and that the transdiagnostic model may be useful in understanding and guiding the treatment of clients who engage in this type of treatment programme.

Keywords: eating disorders, binge eating disorder, carbohydrate addiction, transdiagnostic model, maintaining mechanisms, thematic analysis, outpatient treatment

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Authors: Mohammad Abdel Fattah Mohammad Kewisha

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Microbial deterioration of ancient materials became one of the biggest problems facing the workers in the field of cultural heritage protection because the microbial deterioration of artifacts causes detrimental effects on the aesthetic value of the monuments due to colonization, whether they are made of inorganic materials such as stone or organic like wood, textiles, wall paintings, and paper. So, the early identification of the bacterial strains that caused deterioration is the most important point for the protection of monument objects. The present study focuses on the Bacillus spp. group, which was isolated from some biodeterioration monuments from different areas of Egypt. The investigated objects in this study were made from organic materials (cellulose), paper, textile, and wood. Isolated strains were identified up to the species level biochemically. Eleven bacterial isolates were obtained from collected samples. They were taken from different archaeological objects, four microbicides, cetrimonium bromide, sodium azide, tetraethyl ammonium bromide, and dichloroxylenol, at various concentrations ranging from 25 ppm to 500 ppm. They were screened for their antibacterial activity against the Bacillus spp. isolates, and detection of Minimum inhibitory concentration (MIC). It was also necessary to indicate the ideal Minimum inhibitory concentration for each strain for the purpose of biotreatment of the infected monuments with less damaging effect on monument materials.

Keywords: microbial deterioration, ancient materials, heritage protection, protection of monuments, biodeteriorative monuments

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Authors: Adam Kok Wey Leong

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Special operations were supposedly a new way of irregular warfare that was officially formed during World War 2. For example, the famous British Special Operations Executive (SOE) and the Americans’ Office for Strategic Services (OSS) – the forerunners of modern day CIA were born in World War 2. These special operations units were tasked with the conduct of sabotage and subversion activities behind enemy lines, placing great importance in forming Fifth Column activities and supporting resistance movements. This pointed to a paradoxical argument that modern day special operations is a product of Western modern military innovation but utilizing Eastern ways of ‘ungentlemanly’ warfare. This thesis is superfluous as special operations had been well practised by both ancient Western empires such as the Greeks and Romans, and around the same time in the East, such as in China, and Japan. This paper will describe the practice of special operations, first from the Western military history of the Greeks during the Peloponnesian war. It will then highlight the similar practice of special operations by the Near Eastern Assassins and Eastern militaries by using examples from the Chinese and the Japanese. This paper propounds that special operations, or ways of warfare as a whole, has no cultural and geographical divide, but rather very similarly practiced by men from all over the world. Ideas of fighting, killing and ultimately winning a war have similar undertones – attempts to find ways to win economically and at the least time.

Keywords: special operations, strategic culture, ways of warfare, Sun Tzu, Frontinus

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Authors: Lima Priscila, Gianotto Raiza, Arruda Leonan, Magalhães Filho Fernando

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Industrialization and especially the accentuated population growth in developing countries and the lack of drainage, public cleaning, water and sanitation services has caused concern about the need for expansion of water treatment units and sewage. However, these units have been generating by-products, such as the sludge. This paper aims to investigate aspects of operation and maintenance of sludge from a wastewater treatment plant (WWTP - 90 L.s-1) and two water treatment plants (WTPs; 1.4 m3.s-1 and 0.5 m3.s-1) for the purpose of proper disposal and reuse, evaluating their qualitative and quantitative characteristics, the Brazilian legislation and standards. It was concluded that the sludge from the water treatment plants is directly related to the quality of raw water collected, and it becomes feasible for use in construction materials, and to dispose it in the sewage system, improving the efficiency of the WWTP regarding precipitation of phosphorus (35% of removal). The WTP Lageado had 55,726 kg/month of sludge production, more than WTP Guariroba (29,336 kg/month), even though the flow of WTP Guariroba is 1,400 L.s-1 and the WTP Lagedo 500 L.s-1, being explained by the quality that influences more than the flow. The WWTP sludge have higher concentrations of organic materials due to their origin and could be used to improve the fertility of the soil, crop production and recovery of degraded areas. The volume of sludge generated at the WWTP was 1,760 ton/month, with 5.6% of solid content in the raw sludge and in the dewatered sludge it increased its content to 23%.

Keywords: disposal, sludge, water treatment, wastewater treatment

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Authors: Setareh Yousife

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Introduction: Studies suggest that Extramarital Infidelity (EMI) variants, such as sexual and emotional infidelities are increasing in marriage relationships. To our knowledge, less is known about what therapies and mental-hygiene factors can prevent more effective this behavior and address it. Spiritual and cognitive-behavioural health have proven to reduce marital conflict, Increase marital satisfaction and commitment. Objective: This study aims to discuss the effectiveness of spiritual counseling combined with Cognitive-behavioural techniques in addressing Extramarital Infidelity. Method: Descriptive, analytical, and intervention articles indexed in SID, Noormags, Scopus, Iranmedex, Web of Science and PubMed databases, and Google Scholar were searched. We focused on Studies in which Women with extramarital relationships, including heterosexual married couples-only studies and spirituality/religion and CBT as coping techniques used as EMI therapy. Finally, the full text of all eligible articles was prepared and discussed in this review. Results: 25 publications were identified, and their textual analysis facilitated through four thematic approaches: The nature of EMI in Women, the meaning of spirituality in the context of mental health and human behavior as well as psychotherapy; Spirituality integrated into Cognitive-Behavioral approach, The role of Spirituality as a deterrent to EMI. Conclusions: The integration of the findings discussed herein suggests that the application of cognitive and behavioral skills in addressing these kinds of destructive family-based relationships is inevitable. As treatments based on religion/spirituality or cognition/behavior do not seem adequately effective in dealing with EMI, the combination of these approaches may lead to higher efficacy in fewer sessions and a shorter time.

Keywords: spirituality, religion, cognitive behavioral therapy, extramarital relation, infidelity

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Authors: K. Julia Rose Mary, Victor Arokia Doss

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Electrical and chemical stimulations up-regulate phosphorylaion of CREB, a transcriptional factor that induces its target gene production for memory consolidation and Late Long-Term Potentiation (L-LTP) in CA1 region of the hippocampus. L-LTP requires complex interactions among second-messenger signaling cascade molecules such as cAMP, CAMKII, CAMKIV, MAPK, RSK, PKA, all of which converge to phosphorylate CREB which along with CBP induces the transcription of target genes involved in memory consolidation. A differential equation based model for L-LTP representing stimulus-mediated activation of downstream mediators which confirms the steep, supralinear stimulus-response effects of activation and inhibition was used. The same was extended to accommodate the inhibitory effect of the Inducible cAMP Early Repressor (ICER). ICER is the natural inducible CREB antagonist represses CRE-Mediated gene transcription involved in long-term plasticity for learning and memory. After verifying the sensitivity and robustness of the model, we had simulated it with various empirical levels of repressor concentration to analyse their effect on the gene induction. The model appears to predict the regulatory dynamics of repression on the L-LTP and agrees with the experimental values. The flux data obtained in the simulations demonstrate various aspects of equilibrium between the gene induction and repression.

Keywords: CREB, L-LTP, mathematical modeling, simulation

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Authors: Aidan Jacobsen, Morgan Motia, David Sam, Jonathan Mudge

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Background: The Centers for Disease Control (CDC) lists vaccine requirements for children under two years old to correlate with development markers. CDC lists the coverage by age 24 months to be at least 90% nationally and 84% for Rhode Island Blackstone Valley Community Health Center (BVCHC) in Central Falls, Rhode Island, currently has a completed vaccination rate of 51% for children by the age of 24 months. Current barriers to care for up to date well child vaccinations include lack of transportation, parental work, childcare, and other social stressors. Objective: Increase the vaccination rate of children under the age of 24 months at BVCHC. Conduct a literature review to identify the common barriers preventing children under 24 months from receiving vaccinations. Reduce the barriers to expand access to vaccination care for infants Methods: Setting: Blackstone Valley Community Health Center, Pawtucket, RI Participants: (n=41), Patients between the age of 20-24 months, not up to date with the CDC vaccination recommendations and without a future appointment. QI Intervention: Patients were contacted via phone and offered an appointment during extra Saturday clinic hours in order to receive up to date vaccine care. A Saturday vaccine clinic was established specifically for patients in need of vaccines and having identified barriers to care. Conclusions: Expanding clinic hours and targeting non vaccine up –to-date patients can increase the current standard of childhood immunizations at BVCHC. Overcoming barriers preventing childhood immunization can improve access to providing up to date vaccinations. Other barriers still deter from reaching the national standard of immunizations rates.

Keywords: vaccinations, well child care, barriers to care, social determinants of health

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Authors: Julita D. L. Nainggolan, Cindy Novita Ongkowijoyo, Veli Sungono, Dyana Safitri Velies, Ernestine Vivie Sadeli, Jimmy

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Introduction: Normal menstrual cycle in women ranges from 21-34 days. Menopause is defined as the time when there have been no menstrual periods for 12 consecutive months and no other biological or physiological cause can be identified. Caffeine might increase the estradiol in the early of follicular phase and possibly increase the progesterone and shorten menstruation cycle. Women with shorter menstrual cycle, (below 26 days) would likely get to menopause 1.4 years earlier than those who are normal, and 2.2 years earlier than women with longer menstrual cycle. Purpose: To study the association of caffeine consumption in coffee, tea, and soft drinks with the age of menopause. Design Study: A cross-sectional study using purposive sampling of 132 menopause women from elderly nursing, hospitals and students’ relatives from August 2015-December 2015. The mean difference of age of menopause among the caffeine intake was analyzed by using the unpaired t-test and logistic regression. Results: Mean current age of the respondents are 61.4 years ± SD 9.8; and age of menopause was 47.7 years ± SD 4.2. There are 49.6% who drink coffee, 62.6% of tea and 7.6% of soft drinks. The analysis of t-test showed no significant mean difference in age of menopause among women who drink coffee, tea and soft drinks, mean age of 47.63 ± 4.3 in coffee with p=0.392, mean age of 47.8 ± 4 in tea with p=0.373; and mean age of 46 ± 5.5 with p=0.083 after adjustment of smoking history. Conclusion: Consumption of caffeine among women who drink coffee, tea, and soft drinks did not show significant mean difference in age of menopause.

Keywords: caffeine, menopause, coffee, tea, soda, soft drinks

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Authors: Mohamed Aly, Aliaa Rehan Youssef, Emad Sawerees, Mounir Guirgis

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Relevance: Osteoarthritis (OA) is the most common degenerative disease seen in all populations. It causes disability and substantial socioeconomic burden. Evidence supports that exercise are the most effective conservative treatment for patients with OA. Therapists experience and clinical judgment play major role in exercise prescription and scientific evidence for this regard is lacking. The development of clinical prediction rules to identify patients who are most likely benefit from exercise may help solving this dilemma. Purpose: This study investigated whether body mass index and functional ability at baseline can predict patients’ response to a selected exercise program. Approach: Fifty-six patients, aged 35 to 65 years, completed an exercise program consisting of open kinetic chain strengthening and passive stretching exercises. The program was given for 3 sessions per week, 45 minutes per session, for 6 weeks Evaluation: At baseline and post treatment, pain severity was assessed using the numerical pain rating scale, whereas functional ability was being assessed by step test (ST), time up and go test (TUG) and 50 feet time walk test (50 FTW). After completing the program, global rate of change (GROC) score of greater than 4 was used to categorize patients as successful and non-successful. Thirty-eight patients (68%) had successful response to the intervention. Logistic regression showed that BMI and 50 FTW test were the only significant predictors. Based on the results, patients with BMI less than 34.71 kg/m2 and 50 FTW test less than 25.64 sec are 68% to 89% more likely to benefit from the exercise program. Conclusions: Clinicians should consider the described strengthening and flexibility exercise program for patents with BMI less than 34.7 Kg/m2 and 50 FTW faster than 25.6 seconds. The validity of these predictors should be investigated for other exercise.

Keywords: clinical prediction rule, knee osteoarthritis, physical therapy exercises, validity

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Authors: Kuan-Hao Tsui, Li-Te Lin, Chia-Jung Li

Abstract:

The combination of Y-27632 and Vitamin C significantly enhances the quality of aging germ cells by reducing reactive oxygen species (ROS) production, restoring mitochondrial membrane potential balance, and promoting mitochondrial fusion. The age-related decline in oocyte quality contributes to reduced fertility, increased aneuploidy, and diminished embryo quality, with mitochondrial dysfunction in both oocytes and granulosa cells being a key factor in this decline. Experiments on aging germ cells investigated the effects of the Y-27632 and Vitamin C combination. In vivo studies involved aged mice to assess oocyte maturation and ROS accumulation during culture. The assessment included mitochondrial activity, ROS levels, mitochondrial membrane potential, and mitochondrial dynamics. Cellular energy metabolism and ATP production were also measured. The combination treatment effectively addressed mitochondrial dysfunction and regulated cellular energy metabolism, promoting oxygen respiration and increasing ATP production. In aged mice, this supplement treatment enhanced in vitro oocyte maturation and prevented ROS accumulation in aging oocytes during culture. While these findings are promising, further research is needed to explore the long-term effects and potential side effects of the Y-27632 and Vitamin C combination. Additionally, translating these findings to human subjects requires careful consideration. Overall, the study suggests that the Y-27632 and Vitamin C combination could be a promising intervention to mitigate aging-related dysfunction in germ cells, potentially enhancing oocyte quality, particularly in the context of in vitro fertilization.

Keywords: ovarian aging, supplements, ROS, mitochondria

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

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

Keywords: pasurgrel, PCI, NICE, STEMI

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