Search results for: Heather Clark

Authors: Liliane Clark

Abstract:

Immigrating to a different country may imply having to handle many difficult exertions. There is a particular issue that has to be endured by some immigrants: the children they had to leave behind. It is a phenomenon that occurs with certain frequency. Surprisingly, despite the fact that immigration in the United States is such a large proceeding, there is not much research about the topic in America exploring the trauma of the abandonment caused by this separation and its consequences on the mental health of those children. The term “left behind children” is usually applied to children who were left behind by their parents in their original nation under the care of a noteworthy relative, frequently the grandparents, when they moved to another country. This preliminary research, which is a partial study projected for a doctoral thesis, investigated whether the trauma of abandonment experienced by ten left behind children had affected their emotional development. The Strengths and Difficulties Questionnaire (SDQ) and a brief interview were utilized to assess the information. The SDQ explored scales such as emotional symptoms, conduct problems, hyperactivity, peer problems and prosocial behavior. In this pilot study, the results indicated that all these issues had some sort of significant correlation between them. During the interviews, the participants or their parents identified a range of symptoms: anxiety disorder, eating disorders, panic attacks, psychotic-like experiences, drug use and depression. Hence, it seems that there is a connection between the trauma of abandonment suffered due to the separation and the children’s consequent symptomatic behavior. Further studies are indeed necessary to validate the initial results of this investigation.

Keywords: abandonment, parent migration, psychological problems, trauma

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Authors: Ann Vibert, Heather Hemming

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This paper presentation summarizes the findings and implications of research on the plight and practices of women educational leaders in public school systems and in one university. The authors, both women university administrators, are also scholars and researchers of education. The research project on which this paper presentation is based proposed to examine how women educational leaders imagined, experienced, and carried out their leadership roles in the context of a growing local and global accountability-based performativity discourse which is reshaping educational work especially for women, we argue, in both public school and post-secondary sites. The research employed critical ethnographic interviews with 20 women educational leaders in P-12 school systems and three women university level educational leaders. Data were collected on women educational leaders’ perceptions of the effects of accountability and performativity discourses on the nature of their work. Specifically, leaders were asked to speak to whether they experienced a growth in managerial work as a consequence of increased accountability demands; how they experienced their work changing as a consequence of accountability and performativity demands; how these changes impacted the central values they enacted in their work as women educational leaders changes; and how they responded to/negotiated/accommodated changes in the nature of their work developing as a consequence of accountability and performativity frameworks. Findings from the research data and analyses confirm and extend recent scholarly work on the gendered nature of performativity and accountability discourses and frameworks, and their differential effects across differing genders. The oral presentation we propose here focusses on those findings in terms of similarities for women educational leaders across different educational contexts.

Keywords: women in educational leadership, gender and educational performativity, accountability and women leaders, gender and educational leadership

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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: Akudo Ejelonu, Sarah Willig, J. Anthony Sauder, Heather Murphy, Frances Shofer

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Background: The high prevalence of diarrheal diseases in the village of Tzununá, Guatemala is linked to lack of sanitation facilities and handwashing practices. Diarrheal diseases are preventable and improved access to latrines, hygiene education and clean water may improve sanitation by reducing the spread of disease. Objective: Between May 2015-January 2017, the University of Pennsylvania Chapter of Engineers Without Border (PennEWB) and local partners designed an intervention to reduce diarrheal disease by building pour flush latrines in 50 individual households and providing education on the importance of handwashing practice. Design/Methods: Through convenient sampling, we surveyed 45 households to evaluate the community’s knowledge of diarrheal disease, handwashing practices, and maintenance of the latrines. Results: 92% of the study participants experienced decrease of new cases of diarrheal disease after receiving a latrine. Only 11% washed their hands after defecating in the latrine. There was gap in understanding the health outcome of latrine sanitation and handwashing education. The respondents did not connect the reduction of diarrheal disease with latrine use and maintenance. Instead, they associated their motivation for latrine use with aesthetics, proximity to their home, ease and comfort, and reduction of shame. We recommend that PennEWB adopt UNICEF or WHO education on hand washing practice. Conclusion: Social interaction and social pressure drove the household use of latrines. The latrines are being valued and cleaned. The education that the residents received did not target norms and behaviors. Latrines could be used to create a new social norm that supports behavioral change.

Keywords: diarrheal disease, latrine, open defecation, water, sanitation and hygiene

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Authors: Hamna Choudhary

Abstract:

Background: This clinical case report follows the orthodontic journey of a teenage girl being treated in the Oxfordshire Community Dental Service. She presents with a rare genetic disorder – Moebius syndrome – characterised by unilateral or bilateral facial (CN VII) and abducens (CN VI) nerve palsy. This report seeks to educate Dental professionals on the impact of Moebius syndrome on Dental treatment, and how to make reasonable adjustments to make orthodontic care accessible to these patients. Methodology: Moebius syndrome is a very rare genetic disorder. Across the Oxfordshire Community Dental Service, only two patients with this condition have been identified who are undergoing orthodontic treatment. One of these patients was selected and observed, while the orthodontist (Heather Nevard) was providing orthodontic treatment with fixed appliances. The patient is undergoing treatment to correct her class II division 2 incisor relationship complicated by buccally excluded, transposed maxillary canines. Conclusions: Specific oral presentations of Moebius syndrome include microstomia, micrognathia, tongue malformation, high or cleft palate, bifid uvula and Dental malocclusion. Orthodontics plays a major role in managing and correcting many of these conditions. This emphasises the importance for Dental professionals to be informed on the condition and highlights the need for Dental input in multidisciplinary teams responsible for the care of these patients. Receiving corrective treatment has a significant impact on an individual’s quality of life. In this case, the patient felt much more confident in herself, and having aligned teeth will allow her to better maintain a healthy dentition throughout life. By understanding and educating oneself on Moebius syndrome, one is able to better cater to patient needs and make orthodontic treatment accessible.

Keywords: dentistry, facial palsy, moebius syndrome, orthodontics

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Authors: Yagahira E. Castro-Sesquen, Robert H. Gilman, Carolina Mejia, Daniel E. Clark, Jeong Choi, Melissa J. Reimer-Mcatee, Rocio Castro, Jorge Flores, Edward Valencia-Ayala, Faustino Torrico, Ricardo Castillo-Neyra, Lance Liotta, Caryn Bern, Alessandra Luchini

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Early diagnosis of reactivation of Chagas disease in HIV patients could be lifesaving; however, in Latin American the diagnosis is performed by detection of parasitemia by microscopy which lacks sensitivity. To evaluate if levels of T. cruzi antigens in urine determined by Chunap (Chagas urine nanoparticle test) are correlated with parasitemia levels in T. cruzi/HIV co-infected patients. T. cruzi antigens in urine of HIV patients (N=55: 31 T. cruzi infected and 24 T. cruzi serology negative) were concentrated using hydrogel particles and quantified by Western Blot and a calibration curve. The percentage of Chagas positive patients determined by Chunap compared to blood microscopy, qPCR, and ELISA was 100% (6/6), 95% (18/19) and 74% (23/31), respectively. Chunap specificity was 91.7%. Linear regression analysis demonstrated a direct relationship between parasitemia levels (determined by qPCR) and urine T. cruzi antigen concentrations (p<0.001). A cut-off of > 105 pg was chosen to determine patients with reactivation of Chagas disease (6/6). Urine antigen concentration was significantly higher among patients with CD4+ lymphocyte counts below 200/mL (p=0.045). Chunap shows potential for early detection of reactivation and with appropriate adaptation can be used for monitoring Chagas disease status in T. cruzi/HIV co-infected patients.

Keywords: antigenuria, Chagas disease, Chunap, nanoparticles, parasitemia, poly N-isopropylacrylamide (NIPAm)/trypan blue particles (polyNIPAm/TB), reactivation of Chagas disease.

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

Abstract:

This paper presents an approach for easy creation and classification of institutional risk profiles supporting endangerment analysis of file formats. The main contribution of this work is the employment of data mining techniques to support set up of the most important risk factors. Subsequently, risk profiles employ risk factors classifier and associated configurations to support digital preservation experts with a semi-automatic estimation of endangerment group for file format risk profiles. Our goal is to make use of an expert knowledge base, accuired through a digital preservation survey in order to detect preservation risks for a particular institution. Another contribution is support for visualisation of risk factors for a requried dimension for analysis. Using the naive Bayes method, the decision support system recommends to an expert the matching risk profile group for the previously selected institutional risk profile. The proposed methods improve the visibility of risk factor values and the quality of a digital preservation process. The presented approach is designed to facilitate decision making for the preservation of digital content in libraries and archives using domain expert knowledge and values of file format risk profiles. 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 and to define its profile group. The sample risk profile calculation and the visualisation of some risk factor dimensions is presented in the evaluation section.

Keywords: linked open data, information integration, digital libraries, data mining

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Authors: Brody R. Clark, Chaminda Gallage, John Yeaman

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Multigrade bitumen asphalt is a quality asphalt product that is not utilised in many places globally. Multigrade bitumen is believed to be less sensitive to temperature, which gives it an advantage over conventional binders. Previous testing has shown that asphalt temperature changes greatly with depth, but currently the industry standard is to nominate a single temperature for design. For detailed design of asphalt roads, perhaps asphalt layers should be divided into nominal layer depths and different modulus and fatigue equations/values should be used to reflect the temperatures of each respective layer. A collaboration of previous laboratory testing conducted on multigrade bitumen asphalt beams under a range of temperatures and loading conditions was analysed. The samples tested included 0% or 15% recycled asphalt pavement (RAP) to determine what impact the recycled material has on the fatigue life and stiffness of the pavement. This paper investigated the temperature susceptibility of multigrade bitumen asphalt pavements compared to conventional binders by combining previous testing that included conducting a sweep of fatigue tests, developing complex modulus master curves for each mix and a study on how pavement temperature changes through pavement depth. This investigation found that the final design of the pavement is greatly affected by the nominated pavement temperature and respective material properties. This paper has outlined a potential revision to the current design approach for asphalt pavements and proposes that further investigation is needed into pavement temperature and its incorporation into design.

Keywords: asphalt, complex modulus, fatigue life, flexural stiffness, four point bending, multigrade bitumen, recycled asphalt pavement

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Authors: Reinzo Vittorio B. Cardenas, Heather Venice L. Abogado, Andrea Therese V. Afable, Rhea D. Avillanoza, Marie Abegail P. Ayagan, Catherine D. Bantayan

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As the Internet provides fast and reliable health-related information, the tendency to self-diagnose increases to further understand medical jargon in a diagnosis with a physician and decreases costly consultation fees. The study aimed to explore and understand the factors affecting online health-seeking behaviors in middle-income class adults in Metro Manila. The study was conducted from March to April of 2021 with a sample size of 200 individuals aged 20 to 49 years old. The study was delivered via an online survey that used a questionnaire adapted from the research of Lee et al. (2015). Specifically, the survey consisted of three sections: assessing web-based health-seeking behaviors, consultation with health professionals, and participants' hesitancy to consult with physicians, which used a mix of a 5-point Likert-type scale with multiple responses and multiple-choice options. The results showed that the age and educational attainment of the respondents had a negative effect while presenting a positive effect of socio-economic status on health-seeking behavior. Lastly, there was a significant effect of participant’s hesitancy for professional consultation on their health-seeking behavior. The results gleaned from the study indicated that various individual and socio-economic factors might significantly affect one’s health-seeking behaviors. Although hesitancy had a significant effect on the spectrum of health-seeking behaviors, this does not imply that certain factors are specifically related to an individual’s tendency to seek health information. This information instead becomes essential in understanding the patient-physician relationship and giving patients a more holistic treatment.

Keywords: health-seeking behavior, health information, Internet, physician consultation

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Authors: Patricia M. Boechler, Heather M. Gautreau

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In this research study, postsecondary students completed an information learning task in an avatar-based 3D virtual learning environment. Three factors were of interest in relation to learning; 1) the influence of collaborative vs. independent conditions, 2) the influence of the spatial arrangement of the virtual environment (linear, random and clustered), and 3) the relationship of individual differences such as spatial skill, general computer experience and video game experience to learning. Students completed pretest measures of prior computer experience and prior spatial skill. Following the premeasure administration, students were given instruction to move through the virtual environment and study all the material within 10 information stations. In the collaborative condition, students proceeded in randomly assigned pairs, while in the independent condition they proceeded alone. After this learning phase, all students individually completed a multiple choice test to determine information retention. The overall results indicated that students in pairs did not perform any better or worse than independent students. As far as individual differences, only spatial ability predicted the performance of students. General computer experience and video game experience did not. Taking a closer look at the pairs and spatial ability, comparisons were made on pairs high/matched spatial ability, pairs low/matched spatial ability and pairs that were mismatched on spatial ability. The results showed that both high/matched pairs and mismatched pairs outperformed low/matched pairs. That is, if a pair had even one individual with strong spatial ability they would perform better than pairs with only low spatial ability individuals. This suggests that, in virtual environments, the specific individuals that are paired together are important for performance outcomes. The paper also includes a discussion of trends within the data that have implications for virtual environment education.

Keywords: avatar-based, virtual environment, paired learning, individual differences

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Authors: Lukman Ahmad Jamil, Heather M. Wallace

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Introduction: Numerous epidemiological studies have shown a positive as well as negative association and no association in some cases between chronic use of calcium channel blockers and the increased risk of developing cancer. However, these associations were enmeshed with controversies in the absence of laboratory based studies to back up those claims. Aim: The aim of this study was to determine in mechanistic terms the association between the long-term administration of nifedipine and diltiazem and increased risk of developing cancer using the human embryonic kidney (HEK293) cell line. Methods: Cell counting using the Trypan blue dye exclusion and 3-4, 5-Dimethylthiazol-2-yl-2, 5-diphenyl-tetrazolium bromide (MTT) assays were used to investigate the effect of nifedipine and diltiazem on the growth pattern of HEK293 cells. Protein assay using modified Lowry method and analysis of intracellular polyamines concentration using Liquid Chromatography – Tandem Mass Spectrometry (LC-MS) were performed to ascertain the mechanism through which chronic use of nifedipine increases the risk of developing cancer. Results: Both nifedipine and diltiazem significantly increased the proliferation of HEK293 cells dose and time dependently. This proliferative effect after 24, 48 and 72-hour incubation period was observed at 0.78, 1.56 and 25 µM for nifedipine and 0.39, 1.56 and 25 µM for diltiazem, respectively. The increased proliferation of the cells was found to be statistically significantly (p<0.05). Furthermore, the increased proliferation of the cells induced by nifedipine was associated with the increase in the protein content and elevated intracellular polyamines concentration level. Conclusion: The chronic use of nifedipine is associated with increased proliferation of cells with concomitant elevation of polyamines concentration and elevated polyamine levels have been implicated in many malignant transformations and hence, these provide a possible explanation on the link between long term use of nifedipine and development of some human cancers. Further studies are needed to evaluate the cause of this association.

Keywords: cancer, nifedipine, polyamine, proliferation

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Authors: Sitarrine Thongpussawal, Hui Shao, Clark Gantzer

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Terracing is a conservation practice to reduce erosion and widely used for soil and water conservation throughout the world but is relatively expensive. A modification of the Soil and Water Assessment Tool (called SWAT-Terrace or SWAT-T) explicitly aims to improve the simulation of the hydrological process of erosion from the terraces. SWAT-T simulates erosion from the terraces by separating terraces into three segments instead of evaluating the entire terrace. The objective of this work is to evaluate the terrace benefits on erosion from the Goodwater Creek Experimental Watershed (GCEW) at watershed and Hydrologic Response Unit (HRU) scales using SWAT-T. The HRU is the smallest spatial unit of the model, which lumps all similar land uses, soils, and slopes within a sub-basin. The SWAT-T model was parameterized for slope length, steepness and the empirical Universal Soil Erosion Equation support practice factor for three terrace segments. Data from 1993-2010 measured at the watershed outlet were used to evaluate the models for calibration and validation. Results of SWAT-T calibration showed good performance between measured and simulated erosion for the monthly time step, but poor performance for SWAT-T validation. This is probably because of large storms in spring 2002 that prevented planting, causing poorly simulated scheduling of actual field operations. To estimate terrace benefits on erosion, models were compared with and without terraces. Results showed that SWAT-T showed significant ~3% reduction in erosion (Pr <0.01) at the watershed scale and ~12% reduction in erosion at the HRU scale. Studies using the SWAT-T model indicated that the terraces have advantages to reduce erosion from terraced-agricultural watersheds. SWAT-T can be used in the evaluation of erosion to sustainably conserve the soil and water.

Keywords: Erosion, Modeling, Terraces, SWAT

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Authors: Syena Moltaji, Stephanie Posa, Sander Hitzig, Amanda Mayo, Heather Baltzer

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Purpose: To critically assess deficits following thumb amputation and delineate elements of an ideal thumb prosthesis from the end-user perspective. Methods: This was a qualitative study based on grounded theory. End-user stakeholder groups of thumb amputees and prosthetists were interviewed. Transcripts were reviewed whole first for familiarity. Data coding was then performed by two individual authors. Coded units were grouped by similarity and reviewed to reach a consensus. Codes were then analyzed for emergent themes by each author. A consensus meeting was held with all authors to finalize themes. Results: Three patients with traumatic thumb amputation and eight prosthetists were interviewed. Seven themes emerged. First was the significant impact of losing a thumb, in which codes of functional impact, mental impact, and occupational impact were included. The second theme was the unique nature of each thumb amputee, including goals, readiness for prosthesis, nature of the injury, and insurance. The third emergent theme was cost, surrounding government funding, insurability, and prosthetic pricing. The fourth theme was patient frustration, which included mismatches of prosthetic expectations and realities, activity limitations, and causes of devices abandonment. Themes five and six surrounded the strengths and weaknesses of current prosthetics, respectively. Theme seven was the ideal design for a thumb prosthetic, including abilities, suspension, and materials. Conclusions: Representative data from stakeholders mapped the current status of thumb prosthetics. Preferences for an ideal thumb prosthetic emerged, with suggestions for a simple, durable design. The ability to oppose, grasp and sense pressure was reported as functional priorities. Feasible cost and easy fitting emerged as systemic objectives. This data will be utilized in the development of a sensate thumb prosthetic.

Keywords: smart thumb, thumb prosthetic, sensate prosthetic, amputation

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Authors: Jing-Jing Wang, Yang Gao, Heather H. M. Kwok, Wendy Y. J. Huang

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Objectives: Intellectual disability (ID) ranks among the top 20 most costly disorders. A child with ID creates a wide set of challenges to the individual, family, and society, and overweight and obesity aggravate those challenges. People with ID have the right to attain optimal health like the rest of the population. They should be given priority to eliminate existing health inequities. Childhood obesity epidemic and associated factors among children, in general, has been well documented, while knowledge about overweight and obesity in children with ID is scarce. Methods: A cross-sectional study was conducted among 524 Chinese children with ID (males: 68.9%, mean age: 12.2 years) in Hong Kong in 2015. Children’s height and weight were measured at school. Parents, in the presence of their children, completed a self-administered questionnaire at home about the children’s physical activity (PA), eating habits, and sleep duration in a typical week as well as parenting practices regarding children’s eating and PA, and their socio-demographic characteristics. Multivariate logistic regression estimated the potential risk factors for children being overweight. Results: The prevalence of overweight and obesity in children with ID was 31.3%, which was higher than their general counterparts (18.7%-19.9%). Multivariate analyses revealed that the risk factors of overweight and obese in children with ID included: comorbidity with autism, the maternal side being overweight or obese, parenting practices with less pressure to eat more, children having shorter sleep duration, longer periods of sedentary behavior, and higher intake frequencies of sweetened food, fried food, and meats, fish, and eggs. Children born in other places, having snacks more frequently, and having irregular meals were also more likely to be overweight or obese, with marginal significance. Conclusions: Children with ID are more vulnerable to being overweight or obese than their typically developing counterparts. Identified risk factors in this study highlight a multifaceted approach to the involvement of parents as well as the modification of some children’s questionable behaviors to help them achieve a healthy weight.

Keywords: prevalence, risk factors, obesity, children with disability

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Authors: Amina Beldjazia, Djamel Alatou, Khaled Missaoui

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The forest of Mahouna is a part of the mountain range of the Tell Atlas in the northeast of Algeria. It is characterized by a significant biodiversity. The management of this resource requires thorough the understanding of the current state of the vegetation (inventories), degradation factors and ongoing monitoring of the various long-term ecological changes. Digital mapping is a very effective way to in-depth knowledge of natural resources. The realization of a vegetation map based on satellite images, aerial photographs and the use of geographic information system (GIS), shows large values results of the vegetation of the massif in the scientific view point (the development of a database of the different formations that exist on the site, ecological conditions) and economic (GIS facilitate our task of managing the various resources and diversity of the forest). The methodology is divided into three stages: the first involves an analysis of climate data (1988 to 2013); the second is to conduct field surveys (soil and phytoecological) during the months of June and July 2013 (10 readings), the third is based on the development of different themes and synthetic cards by software of GIS (ENVI 4.6 and 10 ARCMAP). The results show: cork oak covers an area of 1147 ha. Depending on the environmental conditions, it rests on sandstone and individualizes between 3 layers of vegetation from thermo-mediterranean (the North East part with 40ha), meso-Mediterranean (1061 ha) and finally the supra-Mediterranean (46ha ). The map shows the current actual state of the cork oak forest massif of Mahouna, it is an older forest (>150 years) where regeneration is absent because of several factors (fires, overgrazing, leaching, erosion, etc.). The cork oak is in the form of dense forest with Laburnum and heather as the dominant species. It may also present in open forest dominated by scrub species: Daphne gniduim, Erica arborea, Calycotome spinosa, Phillyrea angustifolia, Lavandula stoechas, Cistus salvifolius.

Keywords: biodiversity, environmental, Mahouna, Cork oak

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Authors: Anna Curtin, Matthew Thibodeau, Heather Buckley

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Water scarcity is characterized by a lack of access to clean and affordable drinking water, as well as water for hygienic and economic needs. The amount of people effected by water scarcity is expected to increase in the coming years due to climate change, population growth, and pollution, amongst other things. In response, scientists are pursuing cost effective drinking water treatment methods, often with a focus on alternative water sources. Desalination of seawater via reverse osmosis is one promising alternative method. Desalination of seawater via reverse osmosis, however, is limited significantly by biofouling of the filtration membrane. Biofouling is the buildup of microorganisms in a biofilm at the water-membrane interface. It clogs the membrane, decreasing the efficiency of filtration, consequently increasing operational and maintenance costs. Although effective, existing chemical treatment methods can damage the membrane, decreasing the lifespan of the membrane; create antibiotic resistance; and cause harm to humans and the environment if they pass through the membrane into the permeate. The current project focuses on applying safer preservatives used in home and personal care products to RO membranes to investigate the biofouling treatment efficacy. Currently, many of these safer preservatives have only been tested on cells in planktonic phase in suspension cultures, not on cells in biofilms. The results of suspension culture tests are not applicable to biofouling scenarios because organisms in planktonic phase in suspension cultures exhibit different morphological, chemical, and metabolic characteristics than those in a biofilm. Testing antifoulant efficacy of safer preservatives on biofilms will provide more applicable results to biofouling on RO membranes. To do this, biofilms will be grown on 96-well-plates and minimum inhibitory concentrations (MIC90) and log-reductions will be calculated for various safer preservatives. Results from these tests will be used to guide doses for tests of safer preservatives in a bench-scale RO system.

Keywords: reverse osmosis, biofouling, preservatives, antimicrobial, safer alternative, green chemistry

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Authors: Shima Taheri, Simon Clark

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Concrete is an essential building material used in the majority of structures. Degradation of concrete over time increases the life-cycle cost of an asset with an estimated annual cost of billions of dollars to national economies. Most of the concrete failure occurs due to cracks, which propagate through a structure and cause weakening leading to failure. Stopping crack propagation is thus the key to protecting concrete structures from failure and is the best way to prevent inconveniences and catastrophes. Furthermore, the majority of cracks occur deep within the concrete in inaccessible areas and are invisible to normal inspection. Few materials intrinsically possess self-healing ability, but one that does is concrete. However, self-healing in concrete is limited to small dormant cracks in a moist environment and is difficult to control. In this project, we developed a method for self-healing of nascent fractures in concrete components through the automatic release of self-curing healing agents encapsulated in breakable nano- and micro-structures. The Poly(methyl methacrylate) (PMMA) based two-part adhesive is encapsulated in core-shell structures with brittle/weak inert shell, synthesized via miniemulsion/solvent evaporation polymerization. Stress fields associated with propagating cracks can break these capsules releasing the healing agents at the point where they are needed. The shell thickness is playing an important role in preserving the content until the final setting of concrete. The capsules can also be surface functionalized with carboxyl groups to overcome the homogenous mixing issues. Currently, this formulated self-healing system can replace up to 1% of cement in a concrete formulation. Increasing this amount to 5-7% in the concrete formulation without compromising compression strength and shrinkage properties, is still under investigation. This self-healing system will not only increase the durability of structures by stopping crack propagation but also allow the use of less cement in concrete construction, thereby adding to the global effort for CO2 emission reduction.

Keywords: self-healing concrete, concrete crack, concrete deterioration, durability

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Authors: Areej Alosimi, Heather Wharrad, Katharine Whittingham

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

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

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Authors: Colleen McMillan, Alice Schmidt-Hanbidge, Beth Archer-Kuhn, Heather Boynton, Judith Hughes

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It is well known that social work students enter the profession with higher scores of adverse childhood experiences (ACE). Add to that the fact that COVID-19 has forced higher education institutions to shift to online teaching and learning, where students, faculty and field educators in social work education have reported increased stressors as well as posing challenges in developing relationships with students and being able to identify mental health challenges including those related to trauma. This multi-institutional project included three Canadian post-secondary institutions at five sites (the University of Waterloo, the University of Calgary and the University of Manitoba) and partners; Desire To Learn (D2L), The Centre for Teaching Excellence at the University of Waterloo and the Taylor Institute for Teaching and Learning. A sequential mixed method research design was used. Survey data was collected from students, faculty and field education staff from the 3 universities using the Qualtrics Insight Platform, followed by virtual focus group data with students to provide greater clarity to the quantitative data. Survey data was analyzed using SPSS software, while focus group data was transcribed verbatim and organized with N-Vivo 12. Thematic analysis used line-by-line coding and constant comparative methods within and across focus groups. The following three objectives of the study were achieved: 1) Establish a Canadian baseline on trauma informed pedagogy and student experiences of trauma informed teaching in the online higher education environment during a pandemic; 2) Identify and document educator and student experiences of online learning regarding the ability to process trauma experiences; and, 3) Transfer the findings into a trauma informed pedagogical model for Social Work as a first step toward developing a universal trauma informed teaching model. The trauma informed pedagogy model would be presented in relation to the study findings.

Keywords: trauma informed pedagogy, higher education, social work, mental health

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Authors: Ludmila A. Gavriliuc, Jerry McLarty, Heather E. Kleiner, J. Michael Mathis

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Abstract -- Background: The citrus coumarine Auraptene (Aur) is an effective chemopreventive agent, as manifested in many models of diseases and cancer. Nuclear factor erythroid 2-related factor (Nrf2) is an important regulator of genes induced by oxidative stress, such as glutathione S-transferases, heme oxygenase-1, and peroxiredoxin 1, by activating the antioxidant response element (ARE). Genetic and biochemical evidence has demonstrated that glutathione (GSH) and glutathione-dependent enzymes, glutathione reductase (GR), glutathione peroxidases (GPs), glutathione S-transferases (GSTs) are responsible for the control of intracellular reduction-oxidation status and participate in cellular adaptation to oxidative stress. The effect of Aur on the activity of GR, GPs (Se-GP and Se-iGP), and content of GSH in the liver, kidney, and spleen is insufficiently explored. Aim: Our goal was the examination of the Aur influence on the redox-system of GSH in Nrf2 wild type and Nrf2 knockout mice via activation of Nrf2 and ARE. Methods: Twenty female mice, 10 Nrf2 wild-type (WT) and 10 Nrf2 (-/-) knockout (KO), were bred and genotyped for our study. The activity of GR, Se-GP, Se-iGP, GST, G6PD, CytP450 reductase, catalase (Cat), and content of GSH were analyzed in the liver, kidney, and spleen using Spectrophotometry methods. The results of the specific activity of enzymes and the amount of GSH were analyzed with ANOVA and Spearman statistical methods. Results: Aur (200 mg/kg) treatment induced hepatic GST, GR, Se-GP activity and inhibited their activity in the spleen of mice, most likely via activation of the ARE through Nrf2. Activation in kidney Se-GP and G6PD by Aur is also controlled, apparently through Nrf2. Results of the non-parametric Spearman correlation analysis indicated the strong positive correlation between GR and G6PD only in the liver in WT control mice (r=+0.972; p < 0.005) and in the kidney KO control mice (r=+0.958; p < 0.005). The observed low content of GSH in the liver of KO mice indicated an increase in its participation in the neutralization of toxic substances with the absence of induction of GSH-dependent enzymes, such as GST, GR, Se-GP, and Se-iGP. Activation of CytP450 in kidney and spleen and Cat in the liver in KO mice probably revealed another regulatory mechanism for these enzymes. Conclusion: Thereby, obtained results testify that Aur can modulate the activity of genes and antioxidant enzymatic redox-system of GSH, responsible for the control of intracellular reduction-oxidation status.

Keywords: auraptene, glutathione, GST, Nrf2

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Authors: R. F. Vieira, D. Lopes, I. Baptista, S. A. Figueiredo, V. F. Domingues, R. Jorge, C. Delerue-matos, O. M. Freitas

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Odours are generated in municipal solid wastes management plants as a result of decomposition of organic matter, especially when anaerobic degradation occurs. Information was collected about the substances and respective concentration in the surrounding atmosphere of some management plants. The main components which are associated with these unpleasant odours were identified: ammonia, hydrogen sulfide and mercaptans. The first is the most common and the one that presents the highest concentrations, reaching values of 700 mg/m3. Biofiltration, which involves simultaneously biodegradation, absorption and adsorption processes, is a sustainable technology for the treatment of these odour emissions when a natural packing material is used. The packing material should ideally be cheap, durable, and allow the maximum microbiological activity and adsorption/absorption. The presence of nutrients and water is required for biodegradation processes. Adsorption and absorption are enhanced by high specific surface area, high porosity and low density. The main purpose of this work is the exploitation of natural waste materials, locally available, as packing media: heather (Erica lusitanica), chestnut bur (from Castanea sativa), peach pits (from Prunus persica) and eucalyptus bark (from Eucalyptus globulus). Preliminary batch tests of ammonia removal were performed in order to select the most interesting materials for biofiltration, which were then characterized. The following physical and chemical parameters were evaluated: density, moisture, pH, buffer and water retention capacity. The determination of equilibrium isotherms and the adjustment to Langmuir and Freundlich models was also performed. Both models can fit the experimental results. Based both in the material performance as adsorbent and in its physical and chemical characteristics, eucalyptus bark was considered the best material. It presents a maximum adsorption capacity of 0.78±0.45 mol/kg for ammonia. The results from its characterization are: 121 kg/m3 density, 9.8% moisture, pH equal to 5.7, buffer capacity of 0.370 mmol H+/kg of dry matter and water retention capacity of 1.4 g H2O/g of dry matter. The application of natural materials locally available, with little processing, in biofiltration is an economic and sustainable alternative that should be explored.

Keywords: ammonia removal, biofiltration, natural materials, odour control

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Authors: Ishith Seth, Lyndel Hewitt, Takako Yabe, James Wykes, Jonathan Clark, Bruce Ashford

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Background: Vastus lateralis (VL) can be used to reconstruct defects of the head and neck. Whilst the advantages are documented, donor-site morbidity is not well described. This study aimed to assess donor-site morbidity after VL flap harvest. The results will determine future directions for preventative and post-operative care to improve patient health outcomes. Methods: Ten participants (mean age 55 years) were assessed for the presence of donor-site morbidity after VL harvest. Musculoskeletal (pain, muscle strength, muscle length, tactile sensation), quality of life (SF-12), and lower limb function (lower extremity function, gait (function and speed), sit to stand were assessed using validated and standardized procedures. Outcomes were compared to age-matched healthy reference values or the non-operative side. Analyses were conducted using descriptive statistics and non-parametric tests. Results: There was no difference in muscle strength (knee extension), muscle length, ability to sit-to-stand, or gait function (all P > 0.05). Knee flexor muscle strength was significantly less on the operated leg compared to the non-operated leg (P=0.02) and walking speed was slower than age-matched healthy values (P<0.001). Thigh tactile sensation was impaired in 89% of participants. Quality of life was significantly less for the physical health component of the SF-12 (P<0.001). The mental health component of the SF-12 was similar to healthy controls (P=0.26). Conclusion: There was no effect on donor site morbidity with regards to knee extensor strength, pain, walking function, ability to sit-to-stand, and muscle length. VL harvest affected donor-site knee flexion strength, walking speed, tactile sensation, and physical health-related quality of life.

Keywords: vastus lateralis, morbidity, head and neck, surgery, donor-site morbidity

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Authors: Morteza Esfandiari, Shabnam Jabari, Heather MacGrath, David Coleman

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Flood is a severe issue in different places in the world as well as the city of Fredericton, New Brunswick, Canada. The downtown area of Fredericton is close to the Saint John River, which is susceptible to flood around May every year. Recently, the frequency of flooding seems to be increased, especially after the fact that the downtown area and surrounding urban/agricultural lands got flooded in two consecutive years in 2018 and 2019. In order to have an explicit vision of flood span and damage to affected areas, it is necessary to use either flood inundation modelling or satellite data. Due to contingent availability and weather dependency of optical satellites, and limited existing data for the high cost of hydrodynamic models, it is not always feasible to rely on these sources of data to generate quality flood maps after or during the catastrophe. Height Above the Nearest Drainage (HAND), a state-of-the-art topo-hydrological index, normalizes the height of a basin based on the relative elevation along with the stream network and specifies the gravitational or the relative drainage potential of an area. HAND is a relative height difference between the stream network and each cell on a Digital Terrain Model (DTM). The stream layer is provided through a multi-step, time-consuming process which does not always result in an optimal representation of the river centerline depending on the topographic complexity of that region. HAND is used in numerous case studies with quite acceptable and sometimes unexpected results because of natural and human-made features on the surface of the earth. Some of these features might cause a disturbance in the generated model, and consequently, the model might not be able to predict the flow simulation accurately. We propose to include a previously existing stream layer generated by the province of New Brunswick and benefit from culvert maps to improve the water flow simulation and accordingly the accuracy of HAND model. By considering these parameters in our processing, we were able to increase the accuracy of the model from nearly 74% to almost 92%. The improved model can be used for generating highly accurate flood maps, which is necessary for future urban planning and flood damage estimation without any need for satellite imagery or hydrodynamic computations.

Keywords: HAND, DTM, rapid floodplain, simplified conceptual models

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Authors: Caroline Bradbury-Jones, Maria Clark, Eleanor Molloy, Nicki Ward

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Background: Significant developments in the protection of Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ) rights culminated in their inclusion in the Equality Act 2010. This provides legal protection against discrimination including the Public Sector Equality Duty requiring public bodies to consider all individuals when carrying out their day-to-day work. In the UK, whilst the Higher Education sector has made some commitment to eliminating discrimination and addressing LGBTQ inclusivity, there are two particular problems specifically affecting students on professional programmes: -All students will come into contact with LGBTQ patients/clients/students and need to be equipped to respond appropriately to their diverse needs but evidence suggests that this is not always the case. -Many LGBTQ students have specific concerns on professional placements; often ‘going back in the closet’ or feeling uncertain how to respond to questions about their personal lives and being reticent to challenge discrimination against LGBTQ patients/clients/students for fear of reprisal. Study aim: To investigate how best to prepare all students to deal with the issue of gender and sexual diversity and to support LGBTQ students in negotiating (non) disclosure in practice placements. Methods: This multi-method study was conducted in 2017 in the UK. It comprised a student survey, focus group interview with students and a national benchmarking exercise. Findings: Preliminary findings are that there is considerable variation across professional programmes regarding the preparation of students to respond to LGBTQ issues. Similarly, there is considerable difference between the level of preparedness experienced by students irrespective of whether they identify as LGBTQ. Discussion: Nationally there are a number of ‘best practice’ examples that we share in this presentation. These contain important details and guidance about how to better prepare university students for professional practice, and to contribute to eliminating discrimination and addressing LGBTQ inclusivity. Conclusions: The presentation will appeal to delegates who are interested in the equality agenda regarding LGBTQ people. The study findings will be discussed and debated to explore their impact on higher education and learning and to identify ways to integrate best practice into professional curricula across the UK and beyond.

Keywords: diversity, equality, practice, sexuality, students, university

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Authors: Jonix Owino, Heather Fuller

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Refugees flee from their home countries due to civil unrest, war, persecution and migrate to Western countries such as the United States in search of a safe haven. Transitioning into a new society and culture can be challenging, thereby affecting refugee’s quality of life and well-being in the host communities. Moreover, as individuals age, they experience physical, cognitive and socioemotional changes that may impact their quality of life. However, little is known about the predictors of quality of life among aging refugees. It is not clear how quality of life varies by age, that is, between midlife refugees in comparison to their older counterparts. In addition to age, other sociodemographic factors such as gender, socioeconomic status, or country of origin are likely to have differential associations to quality of life, yet research on such variations among older refugees is sparse. Thus the present study seeks to explore factors associated with quality of life by asking the following research questions: 1) Do sociodemographic factors (such as age and gender) predict quality of life among older refugees, 2) Is there an association between social integration and quality of life, and 3) Is there an association between migratory related experiences (such as post migratory adjustments) and quality of life. The present study recruited 90 refugees (primarily originating from Bhutan, Somalia, Burundi, and Sudan) aged 50 or older living in the US. The participants completed a structured questionnaire which assessed factors such as participant’s sociodemographic attributes (e.g., age, gender, length of residence in the US, country of origin, employment, level of education, and marital status), and validated measures of social integration, post-migration living difficulties, and quality of life. Preliminary results suggest sociodemographic variability in quality of life among these refugees. Further analyses will be conducted using hierarchical regression analyses to address the following hypotheses: first, it is hypothesized that quality of life will vary by age and gender such that younger refugees and men will report higher quality of life. Second, it is expected that refugees with greater levels of social integration will also report better quality of life. Finally, post-migration factors such as language barriers and family stress are hypothesized to predict poorer quality of life. Further results will be analyzed, including potential moderating effects of age and gender, and resulting findings will be interpreted and discussed. The findings from this study have potential implications for communities on how they can better support older refugees as well as develop social programs that can effectively cater to their well-being. Conclusions will be drawn and discussed in light of policies related to both aging and refugee migration within the context of the US.

Keywords: aging out of place, migration, older refugees, quality of life, social integration

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Authors: Rahat Zaman

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The present study was conducted to investigate psychological well-being and positive and negative affect among adults. The sample comprised 221 adults; the sample was collected from all over Pakistan. Psychological well-being was measured with the help of the psychological well-being scale developed by Ryff and Keyes (1995). Lifestyle was measured with the help of the Health Promoting Lifestyle Profile Scale developed by Walker et al. (1995). Positive and negative effects were measured by PANAS, developed by Watson, Clark, and Tellegen (1998). To check the properties of scale, the alpha reliability coefficient was calculated. To test the hypotheses of the research, correlation, independent sample t-rest, and ANOVA were computed. It was hypothesized that there would be a positive relationship between psychological well-being and lifestyles and positive affect. The results show that psychological well-being, lifestyle, and positive affect are positively related. This also supports our hypothesis. The research also searched for relationships in the study variables according to the demographics of the sample. The respondents varied according to their dominant affect levels with respect to their psychological well-being and lifestyles. The research found significant differences for the genders in life appreciation, nutrition, and negative affect. Single and married individuals differed significantly on autonomy, environmental mastery, life appreciation, nutrition, and stress management. Individuals showed significant differences with respect to their living situation, joint and nuclear family members showed significant differences in personal growth, autonomy, health responsibilities, social support, physical activities, and stress management. The sample showed significant differences in environmental mastery, personal growth, purpose in life, life appreciation, health responsibilities, physical activities, stress management, and negative affect when divided in socioeconomic status. Age-wise analysis showed significant differences in autonomy, personal growth, purpose in life, life appreciation, nutrition, and stress management. Provincially significant differences were found in life appreciation, nutrition, social support, physical activities, and stress management, and both positive and negative effects were experienced. Implications of the results are discussed.

Keywords: wellbeing, healthy lifestyle, self acceptance, positive

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Authors: Reshma Parvin Nuri, Heather Michelle Aldersey, Setareh Ghahari

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Objectives: Worldwide, it is well known that taking care of children with disabilities (CWD) can have a significant impact on the entire family unit. Over the last few decades, an increased number of studies have been conducted on families of CWD in higher income countries, and much of this research has identified family needs and strategies to meet those needs. However, family needs are incredibly under-studied in developing countries. Therefore, the aims of this study were to: (a) explore the needs of families of children with cerebral palsy (CP) in Bangladesh; (b) investigate how some of the family needs have been met and (c) identify the sources of supports that might help the families to meet their needs in the future. Methods: A face to face, semi-structured in-depth interview was conducted with 20 family members (12 mothers, 4 fathers, 1 sister, 2 grandmothers, and 1 aunt) who visited the Centre for the Rehabilitation of the Paralysed (CRP), Bangladesh between June and August 2016. Constant comparison method of grounded theory approach within the broader spectrum of qualitative study was used to analyze the data. Results: Participants identified five categories of needs: (a) financial needs, (b) access to disability-related services, (c) family and community cohesion, (d) informational needs, and (e) emotional needs. Participants overwhelmingly reported that financial need is their greatest family need. Participants noted that families encountered additional financial expenses for a child with CP, beyond what they would typically pay for their other children. Participants were seeing education as their non-primary need as they had no hope that their children would be physically able to go to school. Some participants also shared their needs for social inclusion and participation and receiving emotional support. Participants further expressed needs to receive information related to the child’s health condition and availability/accessibility of governmental support programs. Besides unmet needs, participants also highlighted that some of their needs have been met through formal and informal support systems. Formal support systems were mainly institution-based and run by non-governmental organizations, whereas participants identified informal support coming from family, friends and community members. Participants overwhelmingly reported that they receive little to no support from the government. However, participants identified the government as the key stakeholder who can play vital role in meeting their unmet needs. Conclusions: In the next phase of this research, the plan is to understand how the Government of the People’s Republic of Bangladesh is working to meet the needs of families of CWD. There is also need for further study on needs of families of children with conditions other than CP and those who live in the community and do not have access to the CRP Services. There is clear need to investigate ways to enable children with CP have better access to education in Bangladesh.

Keywords: Bangladesh, children with cerebral palsy, family needs, support

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Authors: Heather Fulford, Melanie Liddell

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The recruitment and retention of high quality employees can prove to be challenging for social enterprises, particularly in some of the core business support functions such as marketing, communications, IT and finance. This holds true for social enterprises in urban contexts, where roles with more attractive remuneration in these business functions can often be found quite readily in the private sector. For social enterprises situated in rural locations, the challenges of staff recruitment and retention are even more acute. Such challenges can lead to a skills deficit in rural social enterprises, which can, at best, hinder their growth potential, and worse, jeopardise their chances of survival. This in turn, can have a negative impact on the sustainability and resilience of the surrounding rural community in which the social enterprise is located. The purpose of this paper is to report on aspects of a collaborative initiative established to stimulate innovation and business growth in remote rural businesses in Scotland. Launched in 2010, this initiative was designed to attract young students and graduates from the region to stay in the region upon completion of their studies, and to attract others from outside the region to re-locate there post-university. To facilitate this, SMEs in the region were offered wage subsidies to encourage them to recruit a student or graduate on a work placement for up to one year to participate in an innovation or business growth-oriented project. A number of the employers offering work placements were social enterprises. Through analysis of the placement project and role specifications devised by the participating social enterprises, an overview is provided of their business development needs and the skills they require to stimulate innovation and growth. Scrutiny of the reflective accounts compiled by the students and graduates at the close of their work placements highlights the benefits they derived from being able to put their academic knowledge and skills into action within a social enterprise. Examination of interviews conducted with a sample of placement employers reveals the contribution the students and graduates made during the business development projects with the social enterprises. The challenges of hosting such placements are also discussed. The paper concludes with indications of the lessons learned and an outline of the wider implications for other remote rural locations in which social enterprises play an important role in the local economy and life of the community.

Keywords: resilience, rural development, regeneration, regional development, recruitment, resource management, retention, remuneration

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Authors: Bryan Clark B. Hernandez, Eugene C. Herrera, Kazuo Nadaoka

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Mangrove forests thriving in intertidal zones in tropical and subtropical regions of the world offer a range of ecosystem services including carbon storage and sequestration. They can regulate the detrimental effects of climate change due to carbon releases two to four times greater than that of mature tropical rainforests. Moreover, they are effective natural defenses against storm surges and tsunamis. However, their proliferation depends significantly on the prevailing hydroperiod at the coast. In the Philippines, these coastal ecosystems have been severely threatened with a 50% decline in areal extent observed from 1918 to 2010. The highest decline occurred in 1950 - 1972 when national policies encouraged the development of fisheries and aquaculture. With the intensive land use conversion upstream, changes in the freshwater-saltwater envelope at the coast may considerably impact mangrove growth conditions. This study investigates a developing urban watershed in Kalibo, Aklan province with a 220-hectare mangrove forest replanted for over 30 years from coastal mudflats. Since then, the mangrove forest was sustainably conserved and declared as protected areas. Hybrid land cover classification technique was used to classify Landsat images for years, 1990, 2010, and 2017. Digital elevation model utilized was Interferometric Synthetic Aperture Radar (IFSAR) with a 5-meter resolution to delineate the watersheds. Using numerical modelling techniques, the hydrologic and hydraulic analysis of the influence of land cover change to flow and sediment dynamics was simulated. While significant land cover change occurred upland, thereby increasing runoff and sediment loads, the mangrove forests abundance adjacent to the coasts for the urban watershed, was somehow sustained. However, significant alteration of the coastline was observed in Kalibo through the years, probably due to the massive land-use conversion upstream and significant replanting of mangroves downstream. Understanding the hydrologic-hydraulic response of these watersheds to change land cover is essential to helping local government and stakeholders facilitate better management of these mangrove ecosystems.

Keywords: coastal mangroves, hydrologic model, land cover change, Philippines

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Authors: Recep Kesli, Huseyin Bilgin, Yasar Unlu, Gokhan Gungor

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Aim: The aim of this study, was to investigate the presence of Helicobacter pylori (H. pylori) infection by culture, histology, and RUT (Rapid Urease Test) in gastric antrum biopsy samples taken from patients presented with dyspeptic complaints and to determine resistance rates of amoxicillin, clarithromycin, levofloxacin and metronidazole against the H. pylori strains by E-test. Material and Methods: A total of 278 patients who admitted to Konya Education and Research Hospital Department of Gastroenterology with dyspeptic complaints, between January 2011-July 2013, were included in the study. Microbiological and histopathological examinations of biopsy specimens taken from antrum and corpus regions were performed. The presence of H. pylori in biopsy samples was investigated by culture (Portagerm pylori-PORT PYL, Pylori agar-PYL, GENbox microaer, bioMerieux, France), histology (Giemsa, Hematoxylin and Eosin staining), and RUT(CLOtest, Cimberly-Clark, USA). Antimicrobial resistance of isolates against amoxicillin, clarithromycin, levofloxacin, and metronidazole was determined by E-test method (bioMerieux, France). As a gold standard in the diagnosis of H. pylori; it was accepted that the culture method alone was positive or both histology and RUT were positive together. Sensitivity and specificity for histology and RUT were calculated by taking the culture as a gold standard. Sensitivity and specificity for culture were also calculated by taking the co-positivity of both histology and RUT as a gold standard. Results: H. pylori was detected in 140 of 278 of patients with culture and 174 of 278 of patients with histology in the study. H. pylori positivity was also found in 191 patients with RUT. According to the gold standard criteria, a false negative result was found in 39 cases by culture method, 17 cases by histology, and 8 cases by RUT. Sensitivity and specificity of the culture, histology, and RUT methods of the patients were 76.5 % and 88.3 %, 87.8 % and 63 %, 94.2 % and 57.2 %, respectively. Antibiotic resistance was investigated by E-test in 140 H. pylori strains isolated from culture. The resistance rates of H. pylori strains to the amoxicillin, clarithromycin, levofloxacin, and metronidazole was detected as 9 (6.4 %), 22 (15.7 %), 17 (12.1 %), 57 (40.7 %), respectively. Conclusion: In our study, RUT was found to be the most sensitive, culture was the most specific test between culture, histology, and RUT methods. Although we detected the specificity of the culture method as high, its sensitivity was found to be quite low compared to other methods. The low sensitivity of H. pylori culture may be caused by the factors affect the chances of direct isolation such as spoild bacterium, difficult-to-breed microorganism, clinical sample retrieval, and transport conditions.

Keywords: antimicrobial resistance, culture, histology, H. pylori, RUT

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