Search results for: sample hospital

Authors: Anit S. Malhotra, Ajay Duseja, Neelam Chadha

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Endothelial dysfunction is a precursor to atherosclerosis, and flow-mediated dilatation (FMD) in the brachial artery is the commonest method to evaluate endothelial function in humans. Non-alcoholic fatty liver disease (NAFLD) is one of the most common liver disorders encountered in clinical practice. An earlier meta-analysis had quantitatively assessed the degree of endothelial dysfunction using FMD. However, the largest study investigating the relation of FMD with NAFLD was published after that meta-analysis. In addition, that meta-analysis did not include some studies, including one from our centre. Therefore, an updating the previous meta-analysis was considered important. We searched PubMed, Cochrane Library, Embase, Scopus, SCI, Google Scholar, conference proceedings, and references of included studies till June 2017 to identify observational studies evaluating endothelial function using FMD in patients with non-alcoholic fatty liver disease. Data was analyzed using MedCalc. Fourteen studies were found eligible for inclusion in the meta-analysis. Patients with NAFLD had lower brachial artery FMD as compared to controls, standardized mean difference (random effects model) being –1.279%; 95% confidence interval (CI), –1.478 to –0.914. The effect size became smaller after addition of the recent study with the largest sample size was included compared with the earlier meta-analysis. In conclusion, patients with NAFLD had low FMD values indicating that they are at a higher risk of cardiovascular disease although our results suggest the effect size is not as large as reported previously.

Keywords: endothelial dysfunction, flow-mediated dilatation, meta-analysis, non-alcoholic fatty liver disease

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Authors: Idowu R. Akomolafe, Naven Chetty

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Background: The widespread medical application of ionizing radiation has raised public concern about radiation exposure and, thus, associated cancer risk. The production of reactive oxygen species and free radicals as a result of radiation exposure can cause severe damage to deoxyribonucleic acid (DNA) of cells, thus leading to biological effect. Radiotherapy is an excellent modality in the treatment of cancerous cells, comes with a few challenges. A significant challenge is the exposure of healthy cells surrounding the tumour to radiation. The last few decades have witnessed lots of attention shifted to plants, herbs, and natural product as an alternative to synthetic compound for radioprotection. Thus, the study investigated the radioprotective efficacy of Costus afer against whole-body radiation-induced haematological, histopathological disorder in mice. Materials and Method: Fifty-four mice were randomly divided into nine groups. Animals were pretreated with the extract of Costus afer by oral gavage for six days before irradiation. Control: 6 mice received feed and water only; 6 mice received feed, water, and 3Gy; 6 mice received feed, water, and 6Gy; experimental: 6 mice received 250 mg/kg extract; 6 mice received 500 mg/kg extract; 6 mice received 250 mg/kg extract and 3Gy; 6 mice received 500 mg/kg extract and 3Gy; 6 mice received 250 mg/kg extract and 6Gy; 6 mice received 500 mg/kg extract and 6Gy in addition to feeding and water. The irradiation was done at the Radiotherapy and Oncology Department of Grey's Hospital using linear accelerator (LINAC). Thirty-six mice were sacrificed by cervical dislocation 48 hours after irradiation, and blood was collected for haematology tests. Also, the liver and kidney of the sacrificed mice were surgically removed for histopathology tests. The remaining eighteen (18) mice were used for mortality and survival studies. Data were analysed by one-way ANOVA, followed by Tukey's multiple comparison test. Results: Prior administration of Costus afer extract decreased the symptoms of radiation sickness and caused a significant delay in the mortality as demonstrated in the experimental mice. The first mortality was recorded on day-5 post irradiation, and this happened to the group E- that is, mice that received 6Gy but no extract. There was significant protection in the experimental mice, as demonstrated in the blood counts against hematopoietic and gastrointestinal damage when compared with the control. The protection was seen in the increase in blood counts of experimental animals and the number of survivor. The protection offered by Costus afer may be due to its ability to scavenge free radicals and restore gastrointestinal and bone marrow damage produced by radiation. Conclusions: The study has demonstrated that exposure of mice to radiation could cause modifications in the haematological and histopathological parameters of irradiated mice. However, the changes were relieved by the methanol extract of Costus afer, probably through its free radical scavenging and antioxidant properties.

Keywords: costus afer, hematological, mortality, radioprotection, radiotherapy

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Authors: Ester Ato, Maria Angeles Fernández-Vilar, Maria Dolores Galián

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The aim of this work was to analyze the relation between children´s effortful control, marital adjustment and parenting practices in a sample of 345 Spanish children aged between 6 and 8 years. Traditionally, the literature confirms that a higher level of marital conflict has been associated with less effective and less positive parenting, but there are few studies that include the effect that children´s effortful control exert to this relation. To measure marital adjustment, parenting practices and children’s temperament, parents were given the Marital Adjustment Test (MAT), the Spanish version of the PCRI (Parent-Child Relationship Inventory), and the TMCQ (Temperament in Middle Childhood Questionnaire). The results confirmed that higher marital satisfaction predicted more positive parenting practices, whereas lower marital adjustment scores predicted less parenting support and control. Using a statistical modeling approach, we tested a moderation model that revealed the moderating role of effortful control in the relation between marital adjustment and parenting. Concretely, higher marital satisfaction predicts higher parenting communication and involvement, but only in children with low levels of effortful control. Therefore, a difficult temperament interferes in a less negative way in the family system when parents are satisfied and united. And a better self-regulated child predicts more effective parenting practice regardless of the parents´ marital satisfaction. The clinical implications of the present findings should be considered. Specifically, difficult children must be detected and evaluated in community settings, such as school or community programs, in order to take into account the marital adjustment and parenting practices of their parents, and to be able to design adequate family interventions and prevent future pathologizing patterns.

Keywords: effortful control, marital adjustment, parenting, moderation

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Authors: Piyanee Klainin-Yobas, Debbie Ramirez, Zenaida Fernandez, Jenneth Sarmiento, Wareerat Thanoi, Jeanette Ignacio, Ying Lau

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In many countries, university students experience various stressors that may negatively affect their psychological well-being (PWB). Hence, they are at risk for physical and mental problems. This research aimed to examine the predicting effects of mindfulness, self-efficacy, and social support on psychological well-being among undergraduate students. A non-experimental research was conducted at a university in the Philippines. All students enrolled in undergraduate programs were eligible for this study unless they had chronic medical or mental health problems. Power analysis was used to calculate an adequate sample size and a convenience sampling of 630 was recruited. Data were collected through online self-reported questionnaires from year 2013 to 2015. All self-reported scales used in this study had sound psychometric properties. Descriptive statistics, correlational analyses, and structural equation modeling were performed to analyze the research data. Results showed that the participants were mostly Filipino, female, Christian, and in Schools of Nursing. Mindfulness, self-efficacy, support from family, support from friends, and support from significant others were significant predictors of psychological well-being. Mindfulness was the strongest predictor of positive psychological well-being whereas self-efficacy was the strongest predictor of negative psychological well-being. In conclusion, findings from this study add knowledge to the existing literature regarding the predictors of psychological well-being. Psychosocial interventions, with the focus on strengthening mindfulness and self-efficacy, could be delivered to undergraduate students to help them enhance psychological well-being. More studies can be undertaken to test the interventions and multi-centered research can be conducted to enhance generalizability of research findings.

Keywords: mindfulness, self-efficacy, social support, psychological wellbeing

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Authors: Prabir Patel, Eugene Ming Han Lim

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Introduction: Current literature shows that postoperative pulmonary complications following abdominal surgery may be reduced by using lower than conventional tidal volumes intraoperatively together with moderate levels of positive end expiratory pressure (PEEP). The recent studies demonstrated significant reduction demonstrated significant reduction in major complications in elective abdominal surgery through the use of lower tidal volumes (6-8 ml/kg predicted body weight), PEEP of 5 cmH20 and recruitment manoeuvres compared to higher ‘conventional’ volumes (10-12 mls/kg PBW) without lung recruitment. Our objective was to retrospectively audit current practice for patients undergoing major abdominal surgery in Sir Charles Gairdner Hospital. Methods: Patients over 18 undergoing elective general surgery lasting more than 3 hours and intubated during the duration of procedure were included in this audit. Data was collected over a 6 month period. Patients who had hepatic surgery, procedures necessitating one-lung ventilation, transplant surgery, documented history of pulmonary or intracranial hypertension were excluded. Results: 58 suitable patients were identified and notes were available for 54 patients. Key findings: Average peak airway pressure was 21cmH20 (+4), average peak airway pressure was less than 30 cmH20 in all patients, and less than 25 cmH20 in 80% of the cases. PEEP was used in 81% of the cases. Where PEEP was used, 75% used PEEP more than or equal to 5 cmH20. Average tidal volume per actual body weight was 7.1 ml/kg (+1.6). Average tidal volume per predicted body weight (PBW) was 8.8 ml/kg (+1.5). Average tidal volume was less than 10 ml/kg PBW in 90% of cases; 6-8 ml/kg PBW in 40% of the cases. There was no recorded use of recruitment manoeuvres in any cases. Conclusions: In the vast majority of patients undergoing prolonged abdominal surgery, a lung protective strategy using moderate levels of PEEP, peak airway pressures of less than 30 cmH20 and tidal volumes of less than 10 cmH20/kg PBW was utilised. A recent randomised control trial demonstrated benefit from utilising even lower volumes (6-8 mls/kg) based on findings in critical care patients, but this was compared to volumes of 10-12 ml/kg. Volumes of 6-8 ml/kg PBW were utilised in 40% of cases in this audit. Although theoretically beneficial, clinical benefit of lower volumes than what is currently practiced in this institution remains to be seen. The incidence of pulmonary complications was much lower than in the other cited studies and a larger data set would be required to investigate any benefit from lower tidal volume ventilation. The volumes used are comparable to results from published local and international data but PEEP utilisation was higher in this audit. Strategies that may potentially be implemented to ensure and maintain best practice include pre-operative recording of predicted body weight, adjustment of default ventilator settings and education/updates of current evidence.

Keywords: anaesthesia, intraoperative ventilation, PEEP, tidal volume

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Authors: Rafael Felipe Guatura da Silva, José Luis Gomes da Silva, Luiz Antonio, Ferreira Perrone de Brito

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Noise can cause serious damage to human health, such as hearing loss, stress, irritability, fatigue, and others. Aviation is a place where your entire process should be work out with the utmost attention and commitment of human resources, thus the need to study the effects of noise in this sector, as aeronautical noise levels are high. This study aimed to evaluate the impact of noise pollution on the performance of professionals regarding the fatigue generated by aeronautical noise and time to noise exposure. The methodology used consists of measurements of sound pressure levels at 42 points of the aerodrome. The selected points are located inside the hangars and outside the airfield hangars. All points chosen are close to the professionals' work areas, seeking to identify the sound pressure levels to which they submitted. The other part of the research used the principle on the application of a self-report questionnaire to a sample of 207 people working inside the aerodrome. The 207 professionals surveyed consist of aircraft mechanics, pilots, maintenance managers, and administrative professionals. The questionnaire was intended to evaluate the knowledge that professionals have about health risks caused by sound exposure as well as to identify diseases that professionals have, and that may be associated with exposure to high levels of sound pressure. Preliminary results identify points with sound pressure levels of up to 91.7 dB, thus highlighting the need for the use of personal protective equipment that reduces noise exposure. It was also identified a large number of professionals who are bothered by the sound exposure and approximately 25% of professionals interviewed reported having a hearing disorder.

Keywords: aeronautical noise, fatigue, noise and health, noise management

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Authors: Kanika S. Raheja, A. Pandey, Shaila Bahl, Pratik Kumar, S. P. Lochab

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The subject of undertaking for this paper is the study of BaSO4 nanophosphor doped with Europium in which mainly the concentration of the rare earth impurity Eu (0.05, 0.1, 0.2, 0.5, and 1 mol %) has been varied. A comparative study of the thermoluminescence(TL) properties of the given nanophosphor has also been done using a well-known standard dosimetry material i.e. TLD-100.Firstly, a number of samples were prepared successfully by the chemical co-precipitation method. The whole lot was then compared to a well established standard material (TLD-100) for its TL sensitivity property. BaSO4:Eu ( 0.2 mol%) showed the highest sensitivity out of the lot. It was also found that when compared to the standard TLD-100, BaSo4:Eu (0.2mol%) showed surprisingly high sensitivity for a large range of doses. The TL response curve for all prepared samples has also been studied over a wide range of doses i.e 10Gy to 2kGy for gamma radiation. Almost all the samples of BaSO4:Eu showed a remarkable linearity for a broad range of doses, which is a characteristic feature of a fine TL dosimeter. The graph remained linear even beyond 1kGy for gamma radiation. Thus, the given nanophosphor has been successfully optimised for the concentration of the dopant material to achieve its highest TL sensitivity. Further, the comparative study with the standard material revealed that the current optimised sample shows an astonishingly better TL sensitivity and a phenomenal linear response curve for an incredibly wide range of doses for gamma radiation (Co-60) as compared to the standard TLD-100, which makes the current optimised BaSo4:Eu quite promising as an efficient gamma radiation dosimeter. Lastly, the present phosphor has been optimised for its annealing temperature to acquire the best results while also studying its fading and reusability properties.

Keywords: gamma radiation, nanoparticles, radiation dosimetry, thermoluminescence

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Authors: Deepanjali Gurav, Kun Qian

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In-vitro metabolic diagnosis relies on designed materials-based analytical platforms for detection of selected metabolites in biological samples, which has a key role in disease detection and therapeutic evaluation in clinics. However, the basic challenge deals with developing a simple approach for metabolic analysis in bio-samples with high sample complexity and low molecular abundance. In this work, we report a designer plasmonic nanoshells based platform for direct detection of small metabolites in clinical samples for in-vitro metabolic diagnostics. We first synthesized a series of plasmonic core-shell particles with tunable nanoshell structures. The optimized plasmonic nanoshells as new matrices allowed fast, multiplex, sensitive, and selective LDI MS (Laser desorption/ionization mass spectrometry) detection of small metabolites in 0.5 μL of bio-fluids without enrichment or purification. Furthermore, coupling with isotopic quantification of selected metabolites, we demonstrated the use of these plasmonic nanoshells for disease detection and therapeutic evaluation in clinics. For disease detection, we identified patients with postoperative brain infection through glucose quantitation and daily monitoring by cerebrospinal fluid (CSF) analysis. For therapeutic evaluation, we investigated drug distribution in blood and CSF systems and validated the function and permeability of blood-brain/CSF-barriers, during therapeutic treatment of patients with cerebral edema for pharmacokinetic study. Our work sheds light on the design of materials for high-performance metabolic analysis and precision diagnostics in real cases.

Keywords: plasmonic nanoparticles, metabolites, fingerprinting, mass spectrometry, in-vitro diagnostics

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Authors: Raad Nari, Maura Moriaty, Maha T. Barakat

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Introduction: Sodium-glucose co-transporter-2 (SGLT2) inhibitors are a new class of oral anti-diabetic drugs with a unique mechanism of action. They are used to improve glycaemic control in adults with type 2 diabetes by enhancing urinary glucose excretion. In the UAE, there has been certainly an increased use of these medications. As with any new medication, there are safety considerations related to their use in patients with type two diabetes. A retrospective study was conducted at the three main centres of the Imperial College London Diabetes Centre. Methodology: All patients in electronic database (Diamond) from October 2014 to October 2017 were included with a minimum of six months usage of sodium glucose co-transporter inhibitors that comprise canagliflozin, dapagliflozin and empagliflozin. There were 15 paired sample biochemical and clinical correlations. The analysis was done at the start of the study, three months and six months apart. SPSS version 24 was used for this study. Conclusion: This study of sodium glucose co-transporter-2 inhibitors used showed significant reductions in weight, glycated haemoglobin A1C, systolic and diastolic blood pressures. As the case with systematic reviews, there were similar changes in liver enzymes, raised total cholesterol, low density lipopoptein and high density lipoprotein. There was slight improvement in estimated glomerular filtration rate too. Our analysis also showed that they increased in the incidence of urinary tract symptoms and incidence of urinary tract infections.

Keywords: SGLT2 inhibitors dapagliflozin empagliflozin canagliflozin, adverse effects, amputation diabetic ketoacidosis DKA, urinary tract infection

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Authors: Diana A. Dobreva, Veselina Panayotova, Albena Merdzhanova, Lubomir Makedonski, Mona Stancheva

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Many studies suggest that marine mollusks are healthy food, characterized by low fat and high digestible proteins content. They are one of the most important dietary sources of fat soluble vitamins. The most common species of mollusks in the Bulgarian Black Sea waters are the black mussel (Mytilus galloprovincialis) and the sea snail Rapana (Rapana venosa). One of the main problems of the region is the lack of information about chemical composition of these important marine species. Due to these facts, the aim of the present work was to determine the fat soluble vitamins A, D2, D3, and E, carotenoids–β-carotene and astaxanthin, and total cholesterol contents of mollusk samples and compare them to sample of green algae (Ulva rigida). Samples were collected during autumn from north region of the Black Sea coast, and their wet tissues were used for evaluation of vitamins A, D2, D3, and E, astaxanthin, β-carotene and cholesterol compositions. All fat soluble analytes were simultaneously analyzed by RP- HPLC/UV/FL system. The results were calculated as milligrams per gram total lipid (mg.g-1TL). Alpha-tocopherol and b-carotene were most abundant in algae samples, while mussel samples presented the highest amounts of vitamin D3 (several times higher than the recommended daily intake in Bulgaria (Ordinance № 23 / 19.07.2005)). In all samples, cholesterol content was significantly low, which falls within recommendation of the same ordinance (upper daily consumption should not exceed 300 mg per day). From data, it can be concluded that all samples were characterized as beneficial sources of biologically active compounds.

Keywords: fat soluble vitamins, carotenoids, mussel, rapana, algae

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Authors: Roman Graf, Sergiu Gordea, Heather M. Ryan

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This paper presents an approach for the easy creation of an institutional risk profile for endangerment analysis of file formats. The main contribution of this work is the employment of data mining techniques to support risk factors set up with just the most important values that are important for a particular organisation. Subsequently, the risk profile employs fuzzy models and associated configurations for the file format metadata aggregator to support digital preservation experts with a semi-automatic estimation of endangerment level for file formats. Our goal is to make use of a domain expert knowledge base aggregated from a digital preservation survey in order to detect preservation risks for a particular institution. Another contribution is support for visualisation and analysis of risk factors for a requried dimension. The proposed methods improve the visibility of risk factor information and the quality of a digital preservation process. The presented approach is meant to facilitate decision making for the preservation of digital content in libraries and archives using domain expert knowledge and automatically aggregated file format metadata from linked open data sources. To facilitate decision-making, the aggregated information about the risk factors is presented as a multidimensional vector. The goal is to visualise particular dimensions of this vector for analysis by an expert. The sample risk profile calculation and the visualisation of some risk factor dimensions is presented in the evaluation section.

Keywords: digital information management, file format, endangerment analysis, fuzzy models

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Authors: Akumeyam Elvis Akum, Njanjo Thecla Anyongo Mukete, Fonkeng George Epah

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Globally, the goal of higher education is to enhance graduate employability skills. Paradoxically, Cameroon’s graduate employability rate is far below the graduation rate. This worrisome situation caused the researcher to hypothesize that the teaching and learning experiences account for this increasing disparity. The study sought to investigate the effect on graduate employability of the teaching of organizational, problem-solving, innovation, and risk management skills on graduate employability. The study adopted a descriptive survey design with a quantitative approach. Data was collected by quantitative techniques from a random sample of 385 graduates using closed-ended structured questionnaire. Generally, findings revealed that entrepreneurship education does not sufficiently enhance graduate employability in the University of Buea. Specifically, the teaching of organizational skills does not significantly enhance their employability, as an average of 55% of graduates indicated that the course did not sufficiently help them develop skills for planning, management of limited resources, collaboration, and the setting of priorities. Also, 60% of the respondents indicated that the teaching of problem-solving skills does not significantly enhance graduate employability at the University of Buea. Contrarily, 57% of the respondents agreed that through their experiences in entrepreneurship education, their innovation skills were improved. The study recommended that a practical approach to teaching should be adopted, with attention to societal needs. A framework to ensure the teaching of entrepreneurship to students at the undergraduate level is recommended, such that those who do not continue with university studies after their Bachelor’s degree would have acquired the needed skills for employability.

Keywords: employability, entrepreneurship education, graduate, innovative skills, organizational skills, problem-solving skills, risk management skills

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Authors: Yajun Qiao, Yaner Yan, Ning Li, Shuqing An

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In order to relieve the pressure on a land resource from a huge population, reclamation has occurred in many coastal wetlands. Plants can maintain their elemental composition within normal limits despite the variations of external conditions. Reclamation may affect carbon (C), nitrogen (N) and phosphorus (P) stoichiometry in the plant to some extent by altering physical and chemical properties of soil in a coastal wetland. We reported the seasonal dynamic of C, N and P stoichiometry in root, stem and leaf of Suaeda salsa (L.) Pall. and in soil between reclamation plots and natural plots. Our results of three-way ANOVA indicated that sampling season always had significant effect on C, N, P concentrations and their ratios; organ had no significant effect on N, P concentration and N:P; plot type had no significant effect on N concentration and C:N. Sampling season explained the most variability of tissue N and P contents, C:N, C:P and N:P, while it’s organ for C using the restricted maximum likelihood (REML) method. By independent sample T-test, we found that reclamation affect more on C, N and P stoichiometry of stem than that of root or leaf on the whole. While there was no difference between reclamation plots and natural plots for soil in four seasons. For three organs, C concentration had peak values in autumn and minimum values in spring while N concentration had peak values in spring and minimum values in autumn. For P concentration, three organs all had peak values in spring; however, the root had minimum value in winter, the stem had that in autumn, and leaf had that in summer. The seasonal dynamic of C, N and P stoichiometry in a leaf of Suaeda salsa were much steadier than that in root or stem under the drive of reclamation.

Keywords: nitrogen, phosphorus, reclamation, seasonal dynamic, Suaeda salsa

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Authors: Mahani Razali, Nordin Mamat

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The purpose of the study is to explore how computer technology is integrated into pre-school activities and its relationship with children’s social interaction behaviour in pre-school classroom. The major question of interest in the present study is to investigate the social interaction behaviour of children when using computers in the Malaysian pre-school classroom. This research is based on three main objectives which are to identify children`s social interaction during computer play activities, teacher’s role and parent’s participation to develop children`s social interaction. This qualitative study was carried out among 25 pre-school children, three teachers and three parents as the research sample. On the other hand, parent’s support was obtained from their discussions, supervisions and communication at home. The data collection procedures involved structured observation which was to identify social interaction behaviour among pre-school children through computer play activities; as for semi-structured interviews, it was done to study the perception of the teachers and parents on the acquired social interaction behaviour among the children. Besides, documentation analysis method was used as to triangulate acquired information with observations and interviews. In this study, the qualitative data analysis was tabulated in descriptive manner with frequency and percentage format. This study primarily focused on social interaction behaviour elements among the pre-school children. Findings revealed that the children showed positive outcomes on the social interaction behaviour during their computer play. This research summarizes that teacher’s role and parent’s support can improve children`s social interaction behaviour through computer play activities. As a whole, this research highlighted the significance of computer play activities as to stimulate social interaction behavior among the pre-school children.

Keywords: early childhood, emotional development, parent support, play

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Authors: S. Nikpour, S. Vahidi, H. Haghani

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Introduction: Exercise has mental and physical health benefits for patients with advanced stage cancer who actively receive chemotherapy, yet little is known about patients’ levels of interest in becoming more active or their confidence in increasing their activity level. Methods and materials: A convenience sample of 200 patients with advanced-stage cancer who were receiving chemotherapy completed self-report measures assessing physical activity level, mood, and quality-of-life variables. Qualitative data on patient-perceived benefits of, and barriers to, physical activity also were collected, coded by independent raters, and organized by predominant themes. Results: Current physical activity level, physical activity outcome expectations, and positive mood were significantly associated with self-efficacy. Fatigue was the most frequently listed barrier to physical activity; improved physical strength and health were the most commonly listed benefits. Participants identified benefits related to both general health and cancer-symptom management that were related to exercise. 59.5% of participants reported that they were seriously planning to increase or maintain their physical activity level, and over 40% reported having interest in receiving an intervention to become more active. Conclusion: These results suggested that many advanced-stage cancer patients who receive chemotherapy are interested in maintaining or increasing their physical activity level and in receiving professional support for exercise. In addition, these individuals identified general health and cancer-specific benefits of, and barriers to, physical activity. Future research will investigate how these findings may be incorporated into physical activity interventions for advanced-stage oncology patients receiving medical treatment.

Keywords: physical activity, cancer, self-efficacy

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Authors: Reham Algheshairy, Khaled Tayeb, Christopher Smith, Rebecca Gregg, Haruna Musa

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Background: Diabetes is a medical condition that refers to the pancreas’ inability to secrete sufficient insulin levels, a hormone responsible for controlling glucose levels in the body. Any surplus glucose in the blood stream is excreted through the urinary system. Insulin resistance in blood cells can also cause this condition despite the fact that the pancreas is producing the required amount of insulin A number of researchers claim that the prevalence of diabetes in Saudi Arabia has reached epidemic proportions, although one study did observe one positive in the rise in the awareness of diabetes, possibly indicative of Saudi Arabia’s improving healthcare system. While a number of factors can cause diabetes, the ever-increasing incidence of the disease in Saudi Arabia has been blamed primarily on low levels of physical activity and high levels of obesity. Objectives: The project has two aims. The first aim of the project is to investigate the regulatory effects of consumption of Nigella seeds and Ajwah dates on blood glucose levels in diabetic patients with type 2 diabetes. The second aim of the project is to investigate whether these dietary factors may have potentially beneficial effects in controlling the complications that associated with type 2 diabetes. Methods: This use a random-cross intervention trail of 75 Saudi male and female with type 2 diabetes in Al-Noor hospital in Makkah ( KSA) aged between 18 and 70 years were divided into 3 groups. Group 1 will consume 2g of Nigella Sativa seeds daily along with a modified diet for 12 weeks, group 2 will be given Ajwah dates daily with a modified diet for 12 weeks and group 3 will follow a modified diet for 12 weeks. Anthropometric measurements were taken at baseline, along with bloods for HbA1c, fasting blood sugar and at the end of 12 weeks. Results: This study found significant decrease in blood level (FBG & 2PPBG) and HbA1c in the groups with diet and Nigella seeds) compared to Ajwa date. However, there is no significant change were found in HbA1c, FBG and 2hrpp regarding Ajwa group. Conclusion: This study illustrated a significant improvement in some markers of glycaemia following 2 g of Ns and diet for 12 weeks. The dose of 2g/day of consumed Nigella seeds was found to be more effective in controlling BGL and HbA1c than control and Ajwa groups. This suggests that Nigella seeds and following a diet may have a potential effect (a role in controlling outcomes for type 2 diabetes and controlling the disease). Further research is needed on a large scale to determine the optimum dose and duration of Nigella and Ajwa in order to achieve the desired results.

Keywords: type 2 diabetes, Nigella seeds, Ajwa dates, fasting blood glucose, control

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Authors: Kadiri Kayode Ibrahim, Kadiri Omowunmi

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The research study was concerned with an evaluation of the effect of marketing strategy on the performance of SMEs in Abuja. This was achieved, specifically, through the examination of the effect of disaggregated components of Marketing Strategy (Product, Price, Promotion, Placement and Process) on Sales Volume (as a proxy for performance). The study design was causal in nature, with the use of quantitative methods involving a cross-sectional survey carried out with the administration of a structured questionnaire. A multistage sample of 398 respondents was utilized to provide the primary data used in the study. Subsequently, path analysis was employed in processing the obtained data and testing formulated hypotheses. Findings from the study indicated that all modeled components of marketing strategy were positive and statistically significant determinants of performance among businesses in the zone. It was, therefore, recommended that SMEs invest in continuous product innovation and development that are in line with the needs and preferences of the target market, as well as adopt a dynamic pricing strategy that considers both cost factors and market conditions. It is, therefore, crucial that businesses in the zone adopt marker communication measures that would stimulate brand awareness and increase engagement, including the use of social media platforms and content marketing. Additionally, owner-managers should ensure that their products are readily available to their target customers through an emphasis on availability and accessibility measures. Furthermore, a commitment to consistent optimization of internal operations is crucial for improved productivity, reduced costs, and enhanced customer satisfaction, which in turn will positively impact their overall performance.

Keywords: product, price, promotion, placement

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Authors: Simeon Adebayo Oladipo

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Institutional administrators are currently facing pressure and challenges in their daily operations. Reasons for this may include the increasing multiplicity, uncertainty and tension that permeate institutional leadership. Authentic engagement for institutional leadership is premised on the ethical foundation that the leaders in the schools are engaged. The institutional effectiveness is dependent on the relationship that exists between the leaders and employees in the workplace. Leader’s self-awareness, relational transparency, emotional control, strong moral code and accountability have a positive influence on authentic engagement which variably determines leadership effectiveness. This study therefore examined the role of authentic engagement in effective school leadership; explored the interrelationship of authentic engagement indices in school leadership. The study adopted the descriptive research of the survey type using a quantitative method to gather data through a questionnaire among school leaders in Lagos State Tertiary Institutions. The population for the study consisted of all Heads of Departments, Deans and Principal Officers in Lagos State Tertiary Institutions. A sample size of 255 Heads of Departments, Deans and Principal Officers participated in the study. The data gathered were analyzed using descriptive and inferential statistical tools. The findings indicated that authentic engagement plays a crucial role in increasing leadership effectiveness amongst Heads of Departments, Deans and Principal Officers. The study recommended among others that there is a need for effective measures to enhance authentic engagement of institutional leadership practices through relevant educational support systems and effective quality control.

Keywords: authentic engagement, self-awareness, relational transparency, emotional control

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Authors: Muhammad Idnan, Arshad Javid, Muhammad Nadeem

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The present study was conducted from April 2013 to March 2014 to observe the behavioral parameters of Chinkara (Gazella bennettii) under captive conditions by comparing the captive-born and wild-caught animals for conservation strategies. Understanding the behavioral conformations plays a significant role in captive management. Due to human population explosion and mechanized hunting, the captive breeding seems to be the best way for sports hunting, bush meat, for leather industry and horns for traditional medicinal usage. Primarily, captive management has been used on trial and error basis due to deficiency of ethology of this least concerned species. Behavior of [(20 wild-caught (WC) and 10 captive-bred (CB)] adult Chinkara was observed at captive breeding facilities for ungulates at Ravi Campus, University of Veterinary and Animal Sciences at Kasur district which is situated on southeast side of Lahore. The average annual rainfall is about 650 mm, with frequent raining during monsoon. A focal sample was used to observe the various behavioral patterns for CB and WC chinkara. A similarity was observed in behavioral parameters in WC and CB animals, however, when the differences were considered, WC male deer showed a significantly higher degree of agonistic interaction as compared to the CB male chinkara. These findings suggest that there is no immediate impact of captivity on behavior of chinkara nevertheless 10 generations of captivity. It is suggested that the Chinkara is not suitable for domestication and for successful deer farming, a further study is recommended for ethology of chinkara.

Keywords: Chinkara (Gazella bennettii), domestication, deer farming, ex-situ conservation

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Authors: Alonso-Cañadas J., Galán-Valdivieso F., Saraite-Sariene L., García-Tabuyo M., Alonso-Morales N.

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Green Public Procurement (GPP) has recently gained attention in the academic and policy arenas since climate change has shown the need to be addressed by both private companies and public entities. Such growing interest motivates this article, aiming to explore the most influential journals, publishers, categories, and topics, as well as the recent trends and future research lines in GPP. Based on the Web of Science database, 578 articles from 2004 to February 2022 devoted to GPP are analyzed using Bibliometrix, an R-tool to perform bibliometric analysis, and Google’s Big Query and Data Studio. This article introduces a variety of findings. First, the most influential journals by far are “Journal of Cleaner Production” and “Sustainability,” differing in that the latter is open access while the former publishes via traditional subscription. This result also occurs regarding the main publishers (Elsevier and MDPI). These features lead us to split the sample into open-access journals and traditional journals to deepen into the similarities and differences between them, confirming that traditional journals exhibit a higher degree of influence in the literature than their open-access counterparts in terms of the number of documents, number of citations and impact (according to the H index). Second, this research also highlights the recent emergence of green-related terms (sustainable, environment) and, parallelly, the increase in categorizing GPP papers in “green” WoS categories, particularly since 2019. Finally, a number of related topics are emerging and will lead the research, such as food security, infrastructures, and implementation barriers of GPP.

Keywords: bibliometric analysis, green public procurement, open access, traditional journals

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Authors: Bárbara Durão, Pedro Almeida, David Ramilo, André Meneses, Rute Canejo-Teixeira

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The importance of quality of life (QoL) assessment in veterinary medicine is an integral part of patient care. This is especially true in cases of chronic diseases, such as chronic kidney disease (CKD), where the ever more advanced treatment options prolong the patient’s life. Whether this prolongment of life comes with an acceptable quality of life remains has been called into question. The aim of this study was to evaluate the relationship between CKD disease biomarkers and QoL in cats. Thirty-seven cats diagnosed with CKD and with no known concurrent illness were enrolled in an observational study. Through the course of several evaluations, renal biomarkers were assessed in blood and urine samples, and owners retrospectively described their cat’s quality of life using a validated instrument for this disease. Correlations between QoL scores (AWIS) and the biomarkers were assessed using Spearman’s rank test. Statistical significance was set at p-value < 0.05, and every serial sample was considered independent. Thirty-seven cats met the inclusion criteria, and all owners completed the questionnaire every time their pet was evaluated, giving a total of eighty-four questionnaires, and the average-weighted-impact-score was –0.5. Results showed there was a statistically significant correlation between the quality of life and most of 17 the studied biomarkers and confirmed that CKD has a negative impact on QoL in cats especially due to the management of the disease and secondary appetite disorders. To our knowledge, this is the attempt to assess the correlation between renal biomarkers and QoL in cats. Our results reveal a strong potential of this type of approach in clinical management, mainly in situations where it is not possible to measure biomarkers. Whilst health-related QoL is a reliable predictor of mortality and morbidity in humans; our findings can help improve the clinical practice in cats with CKD.

Keywords: chronic kidney disease, biomarkers, quality of life, feline

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Authors: F. O’Dowd, G. Murphy, M. Roche, E. Shudell, F. Keane, M. O’Kane

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Intoduction: Apremilast (Otezla®) is an oral phosphodiesterase-4 (PDE4) inhibitor indicated for treatment of adult patients with moderate to severe plaque psoriasis who have contraindications to have failed or intolerant of standard systemic therapy and/or phototherapy; and adult patients with active psoriatic arthritis. Apremilast influences intracellular regulation of inflammatory mediators. Two randomized, placebo-controlled trials evaluating apremilast in 1426 patients with moderate to severe plague psoriasis (ESTEEM 1 and 2) demonstrated that the commonest adverse reactions (AE’s) leading to discontinuation were nausea (1.6%), diarrhoea (1.0%), and headaches (0.8%). The overall proportion of subjects discontinuing due to adverse reactions was 6.1%. At week 16 these trials demonstrated significant more apremilast-treated patients (33.1%) achieved the primary end point PASI-75 than placebo (5.3%). We began prescribing apremilast in July 2015. Aim: To evaluate efficacy and tolerability of apremilast in an Irish teaching hospital psoriasis population. Methods: A proforma documenting clinical evaluation parameters, prior treatment experience and AE’s; was completed prospectively on all patients commenced on apremilast since July 2015 – July 2017. Data was collected at week 0,6,12,24,36 and week 52 with 20/71 patients having passed week 52. Efficacy was assessed using Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI). AE’s documented included GI effects, infections, changes in weight and mood. Retrospective chart review and telephone review was utilised for missing data. Results: A total of 71 adult subjects (38 male, 33 female; age range 23-57), with moderate to severe psoriasis, were evaluated. Prior treatment: 37/71 (52%) were systemic/biologic/phototherapy naïve; 14/71 (20%) has prior phototherapy alone;20/71 (28%) had previous systemic/biologic exposure; 12/71 (17%) had both psoriasis and psoriatic arthritis. PASI responses: mean baseline PASI was 10.1 and DLQI was 15.Week 6: N=71, n=15 (21%) achieved PASI 75. Week 12: N= 48, n=6 (13%) achieved a PASI 100%; n=16 (34.5%) achieved a PASI 75. Week 24: N=40, n=10 (25%) achieved a PASI 100; n=15 (37.5%) achieved a PASI 75. Week 52: N= 20, n=4 (20%) achieved a PASI 100; n= 16 (80%) achieved a PASI 75. (N= number of pts having passed the time point indicated, n= number of pts (out of N) achieving PASI or DLQI responses at that time). DLQI responses: week 24: N= 40, n=30 (75%) achieved a DLQI score of 0; n=5 (12.5%) achieved a DLQI score of 1; n=1 (2.5%) achieved a DLQI score of 10 (due to lack of efficacy). Adverse Events: The proportion of patients that discontinued treatment due to AE’s was n=7 (9.8%). One patient experienced nausea alleviated by dose reduction; another developed significant dysgeusia for certain foods, both continued therapy. Two patients lost 2-3 kg. Conclusion: Initial Irish patient experience of Apremilast appears comparable to that observed in trials with good efficacy and tolerability.

Keywords: Apremilast, introduction, Ireland, clinical audit

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Authors: Aloysius Hardoko, Susilo

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The root cause of the problem after the environmental damage due to coal mining activities defined as the province of East Kalimantan corridor masterplan economic activity accelerated the expansion of Indonesia's economic development (MP3EI) is the behavior of adults. Adult behavior can be changed through knowledge management and attitude. Based on the root of the problem, the objective of the research is to apply knowledge management and attitude based on holistic approach in learning andragogy as an effort to solve environmental problems after coal mining activities. Research methods to achieve the objective of using quantitative research with pretest postes group design. Knowledge management and attitudes based on a holistic approach in adult learning are applied through initial learning activities, core and case-based cover of environmental damage. The research instrument is a description of the case of environmental damage. The data analysis uses t-test to see the effect of knowledge management attitude based on holistic approach before and after adult learning. Location and sample of representative research of adults as many as 20 people in Kutai Kertanegara District, one of the districts in East Kalimantan province, which suffered the worst environmental damage. The conclusion of the research result is the application of knowledge management and attitude in adult learning influence to adult knowledge and attitude to overcome environmental problem post-coal mining activity.

Keywords: knowledge management and attitude, holistic approach, andragogy learning, environmental Issue

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Authors: Cath Grimley, Debra Bick, Sarah Hillman, Louise Clarke, Helen Atherton, Jo Parsons

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The problem: Women in the UK are offered influenza (flu), pertussis (whooping cough) and COVID-19 vaccinations during their pregnancy but uptake of all three vaccines is below the desired rate. These vaccines are offered during pregnancy as pregnant women are at an increased risk of hospitalisation, morbidity, and mortality from these illnesses. Exposure to these diseases during pregnancy can also have a negative impact on the unborn baby with an increased risk of serious complications both while in utero and following birth. The research aims to explore perceptions about the vaccinations offered in pregnancy both from the perspectives of pregnant women and midwives. To determine factors that influence pregnant women’s decisions about whether or not to accept the vaccines following the Covid-19 pandemic and to explore midwives’ experiences of recommending and delivering vaccines. The approach: This research follows a qualitative design involving semi-structured interviews with pregnant women and midwives in the UK. Interviews with midwives explored vaccination discussions they routinely have with pregnant women and identified some of the barriers to vaccination that pregnant women discuss with them. Interviews with pregnant women explored their views since the COVID-19 pandemic about vaccinations offered during pregnancy, and whether the pandemic has influenced perceptions of vulnerability to illness in pregnant women. Midwives were recruited via participating hospitals and midwife specific social media groups. Pregnant women were recruited via participating hospitals and community groups. All interviews were conducted remotely (using telephone or Microsoft Teams) and analysed using thematic analysis. Findings: 43 pregnant women and 16 midwives were recruited and interviewed. The findings presented here will focus on data from midwives. Topics identified included three key themes for midwives. These were 1) Delivery of vaccinations which includes the convenience of offering vaccinations while attending standard antenatal appointments and practical barriers faced in delivering these vaccinations at hospital. 2) Messages and guidance included the importance of up-to-date informational needs for midwives to deliver vaccines and that uncertainty and conflicting messages about the COVID-19 vaccine during pregnancy were a barrier to delivery. 3) Recommendations to have vaccines look at all aspects of recommendations such as how recommendations are communicated, the contents of the recommendation, the importance of the vaccine and the impact of those recommendations on whether women accept the vaccine. Implications: Findings highlight the importance for midwives to receive clear and consistent information so they can feel confident in relaying this information while recommending and delivering vaccines to pregnant women. Emphasising why vaccines are important when recommending vaccinations to pregnant women in addition to standard information on the availability and timing will add to the strength and impact of that recommendation in helping women to make informed decisions about accepting vaccines. The findings of this study will inform the development of an intervention to increase vaccination uptake amongst pregnant women.

Keywords: vaccination, pregnancy, qualitative, interviews, Covid-19, midwives

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Authors: Leila Karshenas, Hamid Reza Khodaei, Behnaz Mahdavi

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We know that nitric oxide (NO) plays an important role in all sexual activities of animals. It is made in body from NO synthase enzyme and L-arginin molecule. NO can bound with sulfur-iron complexes and because production of steroid sexual hormones is related to enzymes which have this complex, NO can change the activity of these enzymes. NO affects many cells including endothelial cells of veins, macrophages and mast cells. These cells are found in testis leydig cells and therefore are important source of NO in testis tissue. Minimizing damages to sperm at the time of sperm freezing and thawing is really important. The goal of this study was to determine the function of NO before freezing and its effects on quality and viability of sperms after thawing and incubation. 4 Holstein bulls were selected from the age of 4, and artificial insemination was done for 3 weeks (2 times a week). Treatments were 0, 10, 50 and 100 nm of sodium nitroprusside (SNP). Data analysis was performed by SAS98 program. Also, mean comparison was done using Duncan's multiple ranges test (P<0.05). Concentrations used was found to increase motility and viability of spermatozoa at 1, 2 and 3 hours after thawing significantly (P<0.05), but there was no significant difference at zero time. SNP levels reduced the amount of lipid peroxidation in sperm membrane, increased acrosome health and improved sample membranes especially in 50 and 100 nm treatments. According to results, adding SNP to semen diluents increases motility and viability of spermatozoa. Also, it reduces lipid peroxidation in sperm membrane and improves sperm function.

Keywords: sperm motility, nitric oxide, lipid peroxidation, spermatozoa

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Authors: Famuwagun A. A., Abiona O. O., Gbadamosi S.O., Adeboye O. A., Adebooye O. C.

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The need to provide more information on the perceived bioactive status of the peel of plantain fruit informed the design of this research. Matured Plantain fruits were harvested, and fruits were allowed to ripen spontaneously. Samples of plantain fruit were taken every fortnight, and the peels were removed. The peels were dried using two different drying techniques (Oven drying and sun drying) and milled into powdery forms. Other samples were picked and processed in a similar manner on the first, third, seventh and tenth day until the peels of the fruits were fully ripped, resulting in eight different samples. The anti-oxidative properties of the samples using different assays (DPPH, FRAP, MCA, HRSA, SRSA, ABTS, ORAC), inhibitory activities against enzymes related to diabetes (alpha-amylase and glucosidase) and inhibition against angiotensin-converting enzymes (ACE) were evaluated. The result showed that peels of plantain fruits on the 7th day of ripening and sundried exhibited greater inhibitions against free radicals, which enhanced its antioxidant activities, resulting in greater inhibitions against alpha-amylase and alpha-glucosidase enzymes. Also, oven oven-dried sample of the peel of plantain fruit on the 7th day of ripening had greater phenolic contents than the other samples, which also resulted in higher inhibition against angiotensin converting enzymes when compared with other samples. The results showed that even though the unripe peel of plantain fruit is assumed to contain excellent bioactive activities, consumption of the peel should be allowed to ripen for seven days after maturity and harvesting so as to derive maximum benefit from the peel.

Keywords: functional ingredient, diabetics, hypertension, functional foods

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Authors: Sifatullah Bahij, Safiullah Omary, Francoise Feugeas, Amanullah Faqiri

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Plastic packages have been broadly used for a long time. Such widespread usage of plastic has resulted in an increased amount of plastic wastes and many environmental impacts. Plastic wastes are one of the most significant types of waste materials because of their non-degradation and low biodegradability. It is why many researchers tried to find a safe and environmentally friendly solution for plastic wastes. In this goal, in the civil engineering industry, many types of plastic wastes have been incorporated, as a partial substitution of aggregates or as additive materials (fibers) in concrete mixtures because of their lengthier lifetime and lower weight. This work aims to study the mechanical properties (compressive, split tensile and flexural strengths) of concrete with a water-cement ratio (w/c) of 0.45 and with the incorporation of non-woven PET plastic sheets. Five configurations -without PET (reference), 1-layer sheet, 2-side, 3-side, and full sample wrapping- were applied. The 7, 14 and 28-days samples’ compressive strengths, flexural strength and split tensile strength were measured. The outcomes of the study show that the compressive strength was improved for the wrapped samples, particularly for the cylindrical specimens. Also, split tensile and flexural behaviors of the wrapped samples improved significantly compared to the reference ones. Moreover, reference samples were damaged into many parts after mechanical testing, while wrapped specimens were taken by the applied configurations and were not divided into many small fragments. Therefore, non-woven fabrics appeared to improve some properties of the concrete.

Keywords: solid waste plastic, non-woven polyethylene terephthalate sheets, mechanical behaviors, crack pattern

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Authors: Pui-Lai To, Chechen Liao, Ming-Chi Sung

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Work and family life are the most important areas for men and women today. Every professional is required to meet and fulfill the responsibilities of work and family roles. Although the development and popularity of communication technology bring a lot of benefits, including effective and efficient communication, may also generate conflicts between work and family life. Since mobile devices and the applications of mobile devices, such as instant messages, are ubiquitous, the boundaries of work and family roles are increasingly blurred. Professionals may be in the risk of work over-loading and work-family conflict. This study examines the impact of work stress on professionals’ life and health in the context of instant messaging application of smart phone. This study uses a web-based questionnaire to collect samples. The questionnaires are sent via virtual community sites, instant messaging applications, and e-mail. The study develops and empirically validates a work-family conflict model by integrating the pressure theory and technostress factors. The causal relationship between variables in the research model is tested. In terms of data analysis, Partial Least Square (PLS) in Structural Equation Modeling (SEM) is used for sample analysis and research model testing. The results of this study are as follows. First, both the variables of work-related stress and technological violations positively affect the work-family conflict. Second, both the variables of work-loading and technology-overloading have no effect on work-family conflict. Third, work-family conflict has negative effect on job satisfaction, family satisfaction, physical health, and mental health.

Keywords: mental health, physical health, technostress, work-family conflict, work-related stress

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Authors: Yasin Tadayonrad

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Most of the supply chain networks have many nodes starting from the suppliers’ side up to the customers’ side that each node sends/receives the raw materials/products from/to the other nodes. One of the major concerns in this kind of supply chain network is finding the best schedule for loading /unloading the shipments through the whole network by which all the constraints in the source and destination nodes are met and all the shipments are delivered on time. One of the main constraints in this problem is loading/unloading capacity in each source/ destination node at each time slot (e.g., per week/day/hour). Because of the different characteristics of different products/groups of products, the capacity of each node might differ based on each group of products. In most supply chain networks (especially in the Fast-moving consumer goods industry), there are different planners/planning teams working separately in different nodes to determine the loading/unloading timeslots in source/destination nodes to send/receive the shipments. In this paper, a mathematical problem has been proposed to find the best timeslots for loading/unloading the shipments minimizing the overall delays subject to respecting the capacity of loading/unloading of each node, the required delivery date of each shipment (considering the lead-times), and working-days of each node. This model was implemented on python and solved using Python-MIP on a sample data set. Finally, the idea of a heuristic algorithm has been proposed as a way of improving the solution method that helps to implement the model on larger data sets in real business cases, including more nodes and shipments.

Keywords: supply chain management, transportation, multiple-multiple network, timeslots management, mathematical modeling, mixed integer programming

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Authors: Lilian A. Okeke, I. Okeke, N. Waziri, S. Balogun, P. Nguku, O. Fawole

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Background: Access to ante-natal care services promotes safe motherhood and delivery with improved maternal and neonatal outcome. We conducted this study to identify factors influencing the utilization of antenatal care (ANC) and health delivery services. Methods: We conducted a cross sectional study. Households were numbered and a one in three sample was selected using a systematic sampling method. One hundred and ninety eight women who were either pregnant or had previous deliveries were interviewed using pretested structured questionnaires to obtain information on their socio-demographic characteristics, and reasons for non-utilization of ANC and health delivery services. We performed univariate and bivariate analysis using Epi info version 3.5.3. Results: The age of respondents ranged from (17-55 years) with a median age of 29 years. One hundred and ninety two (97%) utilized antenatal care services. Ninety three (47.9%) attended ANC at second trimester. More than half (58.6%) had ≥ 4 visits to ANC. One hundred and thirty one (66.2%) had their last delivery at home by a traditional birth attendant. Factors associated with ANC and health facility delivery services utilization were: age group 45-55 (OR 0.01; 95% CI: 0.00-0.16) and > 55 years (OR 0.03; 95% CI: 0.00-0.60), wife’s educational status (OR 3.17; 95% CI: 1.66-8.30), husband’s permission (OR 11.8; 95% CI 2.19-63.62), and distance ≥ 5km (OR 0.33; 95% CI: 0.16-0.60). Conclusion: ANC services were well utilized. Most women did not book early and had their last delivery at home. Predictors of ANC use and health facility delivery were age, wife’s educational status, husband's permission and long distance from health facility. A one-day health sensitization of the benefits of ANC utilization and the dangers of delivering at home was implemented.

Keywords: ante natal care, health facility, delivery services, rural area, Plateau state

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