Search results for: clinical nursing practice guideline

Authors: Mohammad Ehsani, Elham Karimi, Hashem Koozechian

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Aim: The purpose of current semi-experimental study was a survey on effect of 16 week walking on psychosocial function related quality of life among 60 to 75 years old men. Methodology: For this reason, short from of health – related quality of life questionnaire (SF – 36) and Geriatric Depression Scale (GDS) had been distributed to the subjects at 2 times of pre – test and posttest. Statistical sample of current study was 60 to 75 years old men who placed at Kahrizak house and assessed by considering physically and medical background. Also factors of entrance to the intervention like age range, have satisfaction and have intent to participating in walking program, lack of having diabetic, cardiovascular, Parkinsonism diseases and postural, neurological, musculoskeletal disorders, lack of having clinical background like visual disorders or disordering on equilibrium system, lack of motor limitation, foot print disorders, having surgery and mental health had been determined and assessed. Finally after primary studies, 80 persons selected and categorized accidentally to the 3 experimental group (1, 2, 3 sessions per week, 30 min walking with moderate intension at every sessions) and one control group (without physical activity in period of 16 weeks). Data analysed by employing ANOVA, Pearson coefficient and Scheffe Post – Hoc tests at the significance level of p < 0.05. Results: Results showed that psychosocial function of men with 60 to 75 years old increase by influence of 16 week walking and increase of exercise sessions lead to more effectiveness of walking. Also there was no significant difference between psychosocial function of subjects within 1 session and 3 sessions experimental groups (p > 0.05). Conclusion: On the basis of results, we can say that doing regular walking with efficient and standard dosage for elderly people, can increase their quality of life. Furthermore, designing and action operation regular walking program for elderly men on the basis of special, logical and systematic pattern under the supervision of aware coaches have been recommended on the basis of results.

Keywords: walking, quality of life, psychosocial function, elders

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Authors: Pablo Cid Galache, Laura Zamorano Bonilla

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Mauriac syndrome (MS) is a rare complication of type 1 diabetes mellitus (DM1). It is rela-ted to low insulin concentrations. Therefore is a complication mainly found in developing countries. The main clinical features are hepatomegaly, edema, growth and puberty delay, and the presence of elevated transaminases and serum lipids. The MS incidence is de-creasing due to the new types of insulin and intensive glycemic control. Therefore is a rare diagnosis in Europe nowadays, being described mainly in developing countries or with so-cioeconomic limitations to guarantee an adequate management of diabetes. Edema secondary to fluid retention is a rare complication of insulin treatment, especially in young patients. Its severity is variable and is mainly related to the start of a proper treatment and the improvement in glycemic control after diagnosis or after periods of poor metabolic control. Edema resolves spontaneously without requiring treatment in most cases. The Pediatric Endocrinology Unit of Hospital Motril could diagnose a 14-year-old girl who presented very poor metabolic control during the last 3 years as a consequence of the socioeconomic conditions of the country of origin during the last years. Presents up to 4 admissions for ketoacidosis during the last 12 months. After the family moved to Spain our patient began to be followed up in our Hospital. Initially presented glycated hemoglobin figures of 11%. One week after the start of treatment, the patient was admitted in the emergency room due to the appearance of generalized edema and pain in the limbs. The main laboratory abnormalities include: blood glucose 225mg/dl; HbA1C 10.8% triglycerides 543 mg/dl, total cholesterol 339 mg/dl (LDL 225) GOT 124 U/l, GPT 89U/l. Abdominal ultrasound shows mild hepatomegaly and no signs of ascites were shown. The patient presented a progressive improvement with resolution of the edema and analitical abnormalities during the next two weeks. During admission, the family received diabetes education, achieving adequate glycemic control at discharge. Nowadays the patient has a good glycemic control having glycated hemoglobin levels around 7%.

Keywords: Mauriac, diabetes, complication, developing countries

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Authors: Amir Hamed Abd-Elrahman, Mohamed Bessat

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450 fattening cattle and buffaloes aged from 6 to 30 months old were examined clinically to determine patterns of occurrence of hemoparasitic diseases and the efficacy of different anti theilerial drugs. 420 animals examined clinically to determine relation between different outbreak of FMD and LSD in Egypt 2012- 2013 and haemoprotozoal diseases. The clinical pictures of haemoprotozoal diseases are variable, from sever to mild, depending on the endemic situation which governed by frequent previous exposure and tick infestation. B. bigemina is the most common haemoprotozoal diseases in the area of study and the infection rate in a descending manner for B. bigemina, A. marginale and T. annulata were 20%, 9.7% and 6.6% respectively. The species susceptibility of B. bigemina and T. annulata showed a higher incidence in cattle than buffaloes while in A. marginale showed a little difference in cattle and buffaloes susceptibility by 10% and 9.2% respectively. The breed susceptibility of B. bigemina and T. annulata showed a higher incidence in crossbred cattle than native baladi cattle while A. marginale showed a higher incidence in native baladi cattle than crossbred cattle. The maximal infection rates were recorded during summer months. The infection rates of B. bigemina and A. marginale were higher among young animals over 6 months and declined above 2 year old while in T. annulata the infection rates were lower among young animals and increased above 2 year old. The case fatality of T. annulata was higher than A. marginale and B. bigemina. Efficacy of different anti theilerial drugs were studied, cure rate of chlouroquine group and Butalex group were 60% disappearance of schizont in lymph node smear after 9 days and 5 days respectively while cure rate of Oxytetracycline Dihydrate (Alamycine) group 20% with disappearance of schizont in lymph node smear after 14 days. FMD and LSD infection enhancement the occurrence of bovine haemoprotozoal diseases.

Keywords: Babesia bigemina, Anaplasma marginale, Theileria annulata, FMD, LSD, ephemeral fever

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Authors: Hala Raslan, Noha Eltaweel, Hanaa Rasmi, Solaf Kamel, May Magdy, Sherif Ismail, Khalda Amr

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Introduction: Rheumatoid arthritis (RA) is an inflammatory, autoimmune disorder with progressive joint damage. Osteoarthritis (OA) is a degenerative disease of the articular cartilage that shows multiple clinical manifestations or symptoms resembling those of RA. Genetic predisposition is believed to be a principal etiological factor for RA and OA. In this study, we aimed to measure the expression of the top deregulated miRNAs that might be the cause of pathogenesis in both diseases, according to our latest NGS analysis. Six of the deregulated miRNAs were selected as they had multiple target genes in the RA pathway, so they are more likely to affect the RA pathogenesis.Methods: Eighty cases were recruited in this study; 45 rheumatoid arthiritis (RA), 30 osteoarthiritis (OA) patients, as well as 20 healthy controls. The selection of the miRNAs from our latest NGS study was done using miRwalk according to the number of their target genes that are members in the KEGG RA pathway. Total RNA was isolated from plasma of all recruited cases. The cDNA was generated by the miRcury RT Kit then used as a template for real-time PCR with miRcury Primer Assays and the miRcury SYBR Green PCR Kit. Fold changes were calculated from CT values using the ΔΔCT method of relative quantification. Results were compared RA vs Controls and OA vs Controls. Target gene prediction and functional annotation of the deregulated miRNAs was done using Mienturnet. Results: Six miRNAs were selected. They were miR-15b-3p, -128-3p, -194-3p, -328-3p, -542-3p and -3180-5p. In RA samples, three of the measured miRNAs were upregulated (miR-194, -542, and -3180; mean Rq= 2.6, 3.8 and 8.05; P-value= 0.07, 0.05 and 0.01; respectively) while the remaining 3 were downregulated (miR-15b, -128 and -328; mean Rq= 0.21, 0.39 and 0.6; P-value= <0.0001, <0.0001 and 0.02; respectively) all with high statistical significance except miR-194. While in OA samples, two of the measured miRNAs were upregulated (miR-194 and -3180; mean Rq= 2.6 and 7.7; P-value= 0.1 and 0.03; respectively) while the remaining 4 were downregulated (miR-15b, -128, -328 and -542; mean Rq= 0.5, 0.03, 0.08 and 0.5; P-value= 0.0008, 0.003, 0.006 and 0.4; respectively) with statistical significance compared to controls except miR-194 and miR-542. The functional enrichment of the selected top deregulated miRNAs revealed the highly enriched KEGG pathways and GO terms. Conclusion: Five of the studied miRNAs were greatly deregulated in RA and OA, they might be highly involved in the disease pathogenesis and so might be future therapeutic targets. Further functional studies are crucial to assess their roles and actual target genes.

Keywords: MiRNAs, expression, rheumatoid arthritis, osteoarthritis

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Authors: Paola Villoria Sáez, Mercedes Del Río Merino, Jaime Santa Cruz Astorqui, Antonio Rodríguez Sánchez

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The Spanish construction industry generates large volumes of waste. However, despite the legislative improvements introduced for construction and demolition waste (CDW), construction waste recycling rate remains well below other European countries and also below the target set for 2020. This situation can be due to many difficulties. i.e.: The difficulty of onsite segregation or the estimation in advance of the total amount generated. Despite these difficulties, the proper management of CDW must be one of the main aspects to be considered by the construction companies. In this sense, some large national companies are implementing Integrated Management Systems (IMS) including not only quality and safety aspects, but also environment issues. However, although this fact is a reality for large construction companies still the vast majority of companies need to adopt this trend. In short, it is common to find in small and medium enterprises a decentralized management system: A single system of quality management, another for system safety management and a third one for environmental management system (EMS). In addition, the EMSs currently used address CDW superficially and are mainly focus on other environmental concerns such as carbon emissions. Therefore, this research determines and implements a specific best practice management system for CDW based on eight procedures in a Spanish Construction company. The main advantages and drawbacks of its implementation are highlighted. Results of this study show that establishing and implementing a CDW management system in building works, improve CDW quantification as the company obtains their own CDW generation ratio. This helps construction stakeholders when developing CDW Management Plans and also helps to achieve a higher adjustment of CDW management costs. Finally, integrating this CDW system with the EMS of the company favors the cohesion of the construction process organization at all stages, establishing responsibilities in the field of waste and providing a greater control over the process.

Keywords: construction and demolition waste, waste management, best practices, waste minimization, building, quality management systems

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Authors: V. Suganya, V. Balasuriya

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The functioning of Micro and Small Scale (MSS) businesses in the northern part of Sri Lanka was vulnerable due to three decades of internal conflict and the subsequent post-war economic openings has resulted new market prospects for MSS businesses. MSS businesses survive and operate with limited resources and struggle to access finance, raw material, markets, and technology. This study attempts to identify the manner in which entrepreneurial orientation puts into practice by the business operators to overcome these business challenges. Business operators in the traditional food processing sector are taken for this study as this sub-sector of the food industry is developing at a rapid pace. A review of the literature was done to recognize the concepts of entrepreneurial orientation, defining MMS businesses and the manner in which business performance is measured. Direct interview method supported by a structured questionnaire is used to collect data from 80 respondents; based on a fixed interval random sampling technique. This study reveals that more than half of the business operators have opted to commence their business ventures as a result of identifying a market opportunity. 41 per cent of the business operators are highly entrepreneurial oriented in a scale of 1 to 5. Entrepreneurial orientation shows significant relationship and strongly correlated with business performance. Pro-activeness, innovativeness and competitive aggressiveness shows a significant relationship with business performance while risk taking is negative and autonomy is not significantly related to business performance. It is evident that entrepreneurial oriented business practices contribute to better business performance even though 70 per cent prefer the ideas/views of the support agencies than the stakeholders when making business decisions. It is recommended that appropriate training should be introduced to develop entrepreneurial skills focusing to improve business networks so that new business opportunities and innovative business practices are identified.

Keywords: Micro and Small Scale (MMS) businesses, entrepreneurial orientation (EO), food processing, business operators

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Authors: Alok Madan, Arshad K. Hashmi

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The paper presents a plastic analysis procedure based on the energy balance concept for performance based seismic retrofit of multi-story multi-bay masonry infilled reinforced concrete (R/C) frames with a ‘soft’ ground story using passive energy dissipation (PED) devices with the objective of achieving a target performance level of the retrofitted R/C frame for a given seismic hazard level at the building site. The proposed energy based plastic analysis procedure was employed for developing performance based design (PBD) formulations for PED devices for a simulated application in seismic retrofit of existing frame structures designed in compliance with the prevalent standard codes of practice. The PBD formulations developed for PED devices were implemented for simulated seismic retrofit of a representative code-compliant masonry infilled R/C frame with a ‘soft’ ground story using friction dampers as the PED device. Non-linear dynamic analyses of the retrofitted masonry infilled R/C frames is performed to investigate the efficacy and accuracy of the proposed energy based plastic analysis procedure in achieving the target performance level under design level earthquakes. Results of non-linear dynamic analyses demonstrate that the maximum inter-story drifts in the masonry infilled R/C frames with a ‘soft’ ground story that is retrofitted with the friction dampers designed using the proposed PBD formulations are controlled within the target drifts under near-field as well far-field earthquakes.

Keywords: energy methods, masonry infilled frame, near-field earthquakes, seismic protection, supplemental damping devices

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Authors: Florence Ncube

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This paper examines the military and post-military experiences of soldiers who deserted from the Rwanda Defence Force (RDF) and tried to make a living in South Africa. Because they are deserters, they try to hide their military identity, yet it is simultaneously somewhat coercively ascribed to them by the Rwandan state and can put them in potential danger. The paper attends to the constructions, experiences, practices, and subjective understanding of the deserters’ being in exile to examine how, under circumstances of perceived threat, these men navigate real or perceived state-sponsored surveillance and threat in non-military settings in South Africa where they have become potential political and disciplinary targets. To make sense of the deserters’ experiences in these circumstances, the paper stitches together a number of useful theoretical concepts, including Bourdieu’s (1992) theory of practice and Vigh’s (2009; 2018) concept of social navigation because no single approach can coherently analyze the specificity of this study. Conventional post-military literature privileges an understanding of army desertion as a malignancy and somewhat problematic. Little is known about the military and post-military experiences of deserters who believe that army desertion is in fact a building block towards achieving subjective peace, even in the context of exile. The paper argues that the presence of Rwandan state agents in South Africa strips the context of the exile of its capacity to provide the deserters with peace, safety, and security. This paper recenters army desertion in analyses of militarism, soldiering, and transition in African contexts and complicates commonsense understandings of army desertion which assume that it is entirely problematic. This paper is drawn from an ethnography conducted among 30 junior-rank Rwandan army deserters exiled in Johannesburg and Cape Town. The researcher employed life histories, in-depth interviews, and deep hangouts to collect data.

Keywords: army deserter, military, identity, exile, peacebuilding, South Africa

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Authors: Bishnu Prasad Dulal, Sushil Chandra Baral, Radheshyam Bhattarai, Meera Tandan

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Background: Non-use of contraceptives is a leading cause of unintended pregnancy. This study was done to explore the potential predictors of contraceptive used by young women, and the findings can inform policy makers to design the program to reduce unintended pregnancy for younger women who have a longer time of fecundity. Methodology: A nationally representative cross-sectional household survey was conducted by Health Research and Social Development Forum in 2012. Total 2259 currently married young women (15-24 years) were selected for the analysis out of 8578 women of reproductive age interviewed from the total 10260 households using systematic sampling. Binary logistic regression was used to identify factors associated with the use of modern contraceptive methods. Findings: The prevalence of modern contraceptive methods among young women was 25.2 %. Use of contraceptives was significantly associated with age at first marriage <15 year of age (OR:1.95) and ever delivered (OR: 1.8). Muslim women were significantly less likely to use contraceptives. Development region, wealth quintile, and awareness of abortion site were also statistically associated factors to use of contraceptives. Conclusion: The prevalence of contraceptives uses among young married women (25.2%) was lower than national prevalence (43%) of contraceptives use among married women of reproductive age. Our analysis focused on examining the association between women’s characteristics-related factors and use and nonuse of modern contraceptives. Awareness of safe abortion site is significantly associated while level of education was not. It is an interesting finding but difficult to interpret which needs further analysis on the basis of education. Maybe due to the underlying socio-religious practice of Muslim people, they had lower use of contraceptives. Programmers and policy makers could better help young women by increasing intervention activities to have a regular use of contraceptive-covering poor, Dalit and Muslim, and low aged women in order to reduce unintended pregnancy.

Keywords: unintended pregnancy, contraceptive, young women, Nepal

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Authors: Omran Al Balushi, Haitham Al Rawahi

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Enterprise Asset Management (eAM) has been implemented across different Generation, Transmission and Distribution subsidiaries in Nama Group companies. As part of Nama group, Oman Electricity Transmission Company (OETC) was the first company to implement this system. It was very important for OETC to implement and maintain such a system to achieve its business objectives and for effective operations, which will also support the delivery of the asset management strategy. Enterprise Asset Management (eAM) addresses the comprehensive asset maintenance requirements of Oman Electricity Transmission Company (OETC). OETC needs to optimize capacity and increase utilization, while lowering unit production. E-AM will enable OETC to adopt this strategy. Implementation of e-AM has improved operation performance with preventive and scheduled maintenance as well as it increased safety. Implementation of e-AM will also enable OETC to create optimal asset management strategy which will increase revenue and decrease cost by effectively monitoring operational data such as maintenance history and operation conditions. CMMS (Computerised Maintenance Management System) is the main software and the back-bone of e-AM system. It is used to provide an improved working practice to properly establish information and data flow related to maintenance activities. Implementation of e-AM system was one of the factors that supported OETC to achieve ISO55001 Certificate on fourth quarter of 2016. Also, full implementation of e-AM system will result in strong integration between CMMS and Geographical Information Systems (GIS) application and it will improve OETC to build a reliable maintenance strategy for all asset classes in its Transmission network. In this paper we will share our experience and knowledge of implementing such a system and how it supported OETC’s management to make decisions. Also we would highlight the challenges and difficulties that we encountered during the implementation of e-AM. Also, we will list some features and advantages of e-AM in asset management, preventive maintenance and maintenance cost management.

Keywords: CMMS, Maintenance Management, Asset Management, Maintenance Strategy

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Authors: Robin V. Cupido

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Online dispute resolution has been identified in many countries as a viable alternative for resolving conflicts which have arisen in the so-called digital age. This system of dispute resolution is developing alongside the Internet, and as new types of transactions are made possible by our increased connectivity, new ways of resolving disputes must be explored. Developed nations, such as the United States of America and the European Union, have been involved in creating these online dispute resolution mechanisms from the outset, and currently have sophisticated systems in place to deal with conflicts arising in a number of different fields, such as e-commerce, domain name disputes, labour disputes and conflicts arising from family law. Specifically, in the field of e-commerce, the Internet’s borderless nature has served as a way to promote cross-border trade, and has created a global marketplace. Participation in this marketplace boosts a country’s economy, as new markets are now available, and consumers can transact from anywhere in the world. It would be especially advantageous for developing nations to be a part of this global marketplace, as it could stimulate much-needed investment in these nations, and encourage international co-operation and trade. However, for these types of transactions to proliferate, an effective system for resolving the inevitable disputes arising from such an increase in e-commerce is needed. Online dispute resolution scholarship and practice is flourishing in developed nations, and it is clear that the gap is widening between developed and developing nations in this regard. The potential for implementing online dispute resolution in developing countries has been discussed, but there are a number of obstacles that have thus far prevented its continued development. This paper aims to evaluate the various political, infrastructural and socio-economic challenges faced in developing nations, and to question how these have impacted the acceptance and development of online dispute resolution, scholarship and training of online dispute resolution practitioners and, ultimately, developing nations’ readiness to participate in cross-border e-commerce.

Keywords: developing countries, feasibility, online dispute resolution, progress

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Authors: E. Bittar, A. Quiñonez, F. Mencia, E. Aguero, M. Delgado, V. Arriola, R. López

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In the western region of Paraguay, the poor condition of the roads has negatively affected the development of this zone, where the absence of petrous material has led engineers to opt for the stabilization of soils with lime or cement as the main structure for bases and subbases of these roads. In several areas of this region, high sulfate contents have been found both in groundwater and in soils, which, when reacted with lime or cement, generate a new problem instead of solving it. On the other hand, the use of industrial waste as granulated slag and fly ash proved to be a sustainable practice widely used in the manufacture of cement, and now also, in the stabilization of soils worldwide. Works related to soils containing sulfates stabilized either with granulated slag or fly ash and lime shown a good performance in their mechanical behaviour. This research seeks to evaluate the mechanical behaviour of soils with high contents of sulfates stabilized with lime by curing them both, at the normalized temperature (23 ± 2 °C) and at 40 ± 2 °C. Moreover, it attempts to asses if the addition of rice husk ash has a positive influence on the new geomaterial. The 40 ± 2 °C curing temperature was selected trying to simulate the average local temperature in summer and part of spring session whereas rice husk ash is an affordable waste produced in the region. An extensive experimental work, which includes unconfined compression, durability and free swell tests were carried out considering different dry unit weights, lime content and the addition of 20% of rice husk ash. The results showed that the addition of rice husk ash increases the resistance and durability of the material and decreases the expansion of this, moreover, the specimens cured at a temperature of 40 ± 2 °C showed higher resistance, better durability and lower expansion compared to those cured at the normalized temperature of 23 ± 2 °C.

Keywords: durability, expansion, lime stabilization, rice husk ash, sulfate

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Authors: Sunil K. Jena, Sanjaya K. Samal, Mahesh Chand, Abhay T. Sangamwar

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Tamoxifen (TMX) and its analogues are approved as a first line therapy for the treatment of estrogen receptor-positive tumors. However, clinical development of TMX has been hampered by its low bioavailability and severe hepatotoxicity. Herein, we attempt to design a new drug delivery vehicle that could enhance the pharmacokinetic performance of TMX. Initially, high-molecular weight carboxymethyl chitosan was hydrolyzed to low-molecular weight carboxymethyl chitosan (LMW CMC) with hydrogen peroxide under the catalysis of phosphotungstic acid. Amphiphilic block copolymers of LMW CMC were synthesized via amidation reaction between the carboxyl group of α-tocopherol succinate (TS) and an amine group of LMW CMC. These amphiphilic block copolymers were self-assembled to nanosize core-shell-structural micelles in the aqueous medium. The critical micelle concentration (CMC) decreased with the increasing substitution of TS on LMW CMC, which ranged from 1.58 × 10-6 to 7.94 × 10-8 g/mL. Maximum TMX loading up to 8.08 ± 0.98% was achieved with Cmc-TS4.5 (TMX/Cmc-TS4.5 with 1:8 weight ratio). Both blank and TMX-loaded polymeric micelles (TMX-PM) of Cmc-TS4.5 exhibits spherical shape with the particle size below 200 nm. TMX-PM has been found to be stable in the gastrointestinal conditions and released only 44.5% of the total drug content by the first 72 h in simulated gastric fluid (SGF), pH 1.2. However, the presence of pepsin does not significantly increased the TMX release in SGF, pH 1.2, released only about 46.2% by the first 72 h suggesting its inability to cleave the peptide bond. In contrast, the release of TMX from TMX-PM4.5 in SIF, pH 6.8 (without pancreatin) was slow and sustained, released only about 10.43% of the total drug content within the first 30 min and nearly about 12.41% by the first 72 h. The presence of pancreatin in SIF, pH 6.8 led to an improvement in drug release. About 28.09% of incorporated TMX was released in the presence of pancreatin in 72 h. A cytotoxicity study demonstrated that TMX-PM exhibited time-delayed cytotoxicity in human MCF-7 breast cancer cells. Pharmacokinetic studies on Sprague-Dawley rats revealed a remarkable increase in oral bioavailability (1.87-fold) with significant (p < 0.0001) enhancement in AUC0-72 h, t1/2 and MRT of TMX-PM4.5 than that of TMX-suspension. Thus, the results suggested that CMC-TS micelles are a promising carrier for TMX delivery.

Keywords: carboxymethyl chitosan, d-α-tocopherol succinate, pharmacokinetic, polymeric micelles, tamoxifen

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Authors: Janet Ige, Paul Pilkington, Selena Gray, Jane Powell

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Older adults from socially disadvantaged groups and Black and Minority Ethnic (BME) groups experience a higher burden of physical inactivity. Physical inactivity among BME groups is associated with the disproportionately higher level of health inequalities. People from minority ethnic groups encounter more barriers to physical activity. However, this is not often reported. There is very limited review-level evidence on the barriers and facilitators of physical activity among older adults from BME groups in the UK. This study aims to answer the following research question: what are the barriers and facilitators of physical activity participation among adults and older adults from BME background in the UK? To address this, we conducted a review of qualitative studies investigating the barriers and opportunities for physical activity among of BME adults and older adults in the UK. Method: This study is nested in an interpretive paradigm of meta-ethnography. A structured search for published literature was conducted on 6 electronic databases (MEDLINE, PsychINFO, Cumulative Index to Nursing & Allied Health Literature, Applied Social Sciences Index and Abstracts, Cochrane Database of Systematic Reviews, Allied and Complementary Medicine) from January 2007 to July 2017. Hand searching of the reference list of publications was performed in addition to a search conducted on Google Scholar to identify grey literature. Studies were eligible provided they employed any qualitative method and included participants identified as being BME, aged 50 and above, living in any community within the UK. In total, 1036 studies were identified from the structured search for literature, 718 studies were screened by titles after duplicates were removed. On applying the inclusion and exclusion criteria, a final selection of 10 studies was considered eligible for synthesis. Quality assessment was performed using the Critical Appraisal Skills Programme tool. Logic maps were used to show the relationship between factors that impact on physical activity participation among adults and older adults Result: Six key themes emerged from the data: awareness of the links between physical activity and health, interaction, and engagement with health professionals, cultural expectations and social responsibilities, appropriate environment, religious fatalism and practical challenges. Findings also showed that the barriers and facilitators of physical activity exist at the individual, community, and socio-economic, cultural and environmental level. There was a substantial gap in research among Black African groups. Findings from the review also informed the design of an ongoing survey investigating the experience and attitude of adults from Somali backgrounds towards physical activity in the UK. Conclusion: Identifying the barriers and facilitators of physical activity among BME groups is a crucial step in addressing the widening inequality gap. Findings from this study highlight the importance of engaging local BME residents in the design of exercise facilities within the community. This will ensure that cultural and social concerns are recognized and properly addressed.

Keywords: BME, UK, meta-ethnographic, adults

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Authors: Mehrnaz Mostafavi

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Lung cancer is one of the most harmful forms of cancer. The long-term survival rate of lung cancer patients treated by conventional modalities such as surgical resection, radiation, and chemotherapy remains far from satisfactory. Systemic drug delivery is rarely successful because only a limited amount of the chemotherapeutic drug targets lung tumor sites, even when administered at a high dose. Targeted delivery of drug molecules to organs or special sites is one of the most challenging research areas in pharmaceutical sciences. By developing colloidal delivery systems such as liposomes, micelles and nanoparticles a new frontier was opened for improving drug delivery. Nanoparticles with their special characteristics such as small particle size, large surface area and the capability of changing their surface properties have numerous advantages compared with other delivery systems. Targeted nanoparticle delivery to the lungs is an emerging area of interest.Multimodal or combination therapy represents a promising new method to fight disease. Therefore, a combination of different therapeutic strategies may be the best alternative to improve treatment outcomes for lung cancer. Photothermal therapy was proposed as a novel approach to treatment. In this work, photothermal therapy with gold nanoparticles and near infrared laser (NIR) irradiation was investigated.Four types of small (<100nm), NIR absorbing gold nanoparticles (nanospheres, nanorods) were synthesized using wet chemical methods and characterized by transmission electron microscopy, dynamic light scattering and UV-vis spectroscopy. Their synthesis and properties were evaluated, to determine their feasibility as a photothermal agent for clinical applications. In vitro cellular uptake studies of the nanoparticles into lung cancer cell lines was measured using light scattering microscopy.Small gold nanorods had good photothermal properties and the greatest cellular uptake, and were used in photothermal studies. Under 4W laser irradiation, an increase in temperature of 10°C and decrease in cell viability of up to 80% were obtained.

Keywords: photothermal, therapy, cancer, gold nanorods

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Authors: Muhammad Adeel Arshad, Shaukat Ali Bhatti, Faiz-ul Hassan

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Manipulating microbial ecosystem in the rumen is considered as an important strategy to optimize production efficiency in ruminants. In the past, antibiotics and synthetic chemical compounds have been used for the manipulation of rumen fermentation. However, since the non-therapeutic use of antibiotics has been banned, efforts are being focused to search out safe alternative products. In tropics, crop residues and forage grazing are major dietary sources for ruminants. Poor digestibility and utilization of these feedstuffs by animals is a limiting factor to exploit the full potential of ruminants in this area. Hence, there is a need to enhance the utilization of these available feeding resources. One of the potential strategies in this regard is the use of direct-fed microbes. Bacteria and fungi are mostly used as direct-fed microbes to improve animal health and productivity. Commonly used bacterial species include lactic acid-producing and utilizing bacteria (Lactobacillus, Streptococcus, Enterococcus, Bifidobacterium, and Bacillus) and fungal species of yeast are Saccharomyces and Aspergillus. Direct-fed microbes modulate microbial balance in the gastrointestinal tract through the competitive exclusion of pathogenic species and favoring beneficial microbes. Improvement in weight gain and feed efficiency has been observed as a result of feeding direct-fed bacteria. The use of fungi as a direct-fed microbe may prevent excessive production of lactate and harmful oxygen in the rumen leading to better feed digestibility. However, the mechanistic mode of action for bacterial or fungal direct-fed microbes has not been established yet. Various reports have confirmed an increase in dry matter intake, milk yield, and milk contents in response to the administration of direct-fed microbes. However, the application of a direct-fed microbe has shown variable responses mainly attributed to dosages and strains of microbes. Nonetheless, it is concluded that the inclusion of direct-fed microbes may mediate the rumen ecosystem to manage lactic acid production and utilization in both clinical and sub-acute rumen acidosis.

Keywords: microbes, roughages, rumen, feed efficiency, production, fermentation

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Authors: Deniz Guven, Wil Ward, Jinming Duan, Li Bai

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Over the past two decades or so, Optical Coherence Tomography (OCT) has been used to diagnose retina and optic nerve diseases. The retinal nerve fibre layer, for example, is a powerful diagnostic marker for detecting and staging glaucoma. With the advances in optical imaging hardware, the adoption of OCT is now commonplace in clinics. More and more OCT images are being generated, and for these OCT images to have clinical applicability, accurate automated OCT image segmentation software is needed. Oct image segmentation is still an active research area, as OCT images are inherently noisy, with the multiplicative speckling noise. Simple edge detection algorithms are unsuitable for detecting retinal layer boundaries in OCT images. Intensity fluctuation, motion artefact, and the presence of blood vessels also decrease further OCT image quality. In this paper, we introduce a new method for segmenting three-dimensional (3D) OCT images. This involves the use of a Kalman filter, which is commonly used in computer vision for object tracking. The Kalman filter is applied to the 3D OCT image volume to track the retinal layer boundaries through the slices within the volume and thus segmenting the 3D image. Specifically, after some pre-processing of the OCT images, points on the retinal layer boundaries in the first image are identified, and curve fitting is applied to them such that the layer boundaries can be represented by the coefficients of the curve equations. These coefficients then form the state space for the Kalman Filter. The filter then produces an optimal estimate of the current state of the system by updating its previous state using the measurements available in the form of a feedback control loop. The results show that the algorithm can be used to segment the retinal layers in OCT images. One of the limitations of the current algorithm is that the curve representation of the retinal layer boundary does not work well when the layer boundary is split into two, e.g., at the optic nerve, the layer boundary split into two. This maybe resolved by using a different approach to representing the boundaries, such as b-splines or level sets. The use of a Kalman filter shows promise to developing accurate and effective 3D OCT segmentation methods.

Keywords: optical coherence tomography, image segmentation, Kalman filter, object tracking

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Authors: Sachin, Shantanu Arya, Gunjan Mehta, Md. Shamim Ansari

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The cross-modal influence of visual information on speech perception can be illustrated by the McGurk effect which is an illusion of hearing of syllable /ta/ when a listener listens one syllable, e.g.: /pa/ while watching a synchronized video recording of syllable, /ka/. The McGurk effect is an excellent tool to investigate multisensory integration in speech perception in both normal hearing and hearing impaired populations. As the visual cue is unaffected by noise, individuals with hearing impairment rely more than normal listeners on the visual cues.However, when non congruent visual and auditory cues are processed together, audiovisual interaction seems to occur differently in normal and persons with hearing impairment. Therefore, this study aims to observe the audiovisual interaction in speech perception in Cochlear Implant users compares the same with normal hearing children. Auditory stimuli was routed through calibrated Clinical audiometer in sound field condition, and visual stimuli were presented on laptop screen placed at a distance of 1m at 0 degree azimuth. Out of 4 presentations, if 3 responses were a fusion, then McGurk effect was considered to be present. The congruent audiovisual stimuli /pa/ /pa/ and /ka/ /ka/ were perceived correctly as ‘‘pa’’ and ‘‘ka,’’ respectively by both the groups. For the non- congruent stimuli /da/ /pa/, 23 children out of 35 with normal hearing and 9 children out of 35 with cochlear implant had a fusion of sounds i.e. McGurk effect was present. For the non-congruent stimulus /pa/ /ka/, 25 children out of 35 with normal hearing and 8 children out of 35 with cochlear implant had fusion of sounds.The children who used cochlear implants for less than three years did not exhibit fusion of sound i.e. McGurk effect was absent in this group of children. To conclude, the results demonstrate that consistent fusion of visual with auditory information for speech perception is shaped by experience with bimodal spoken language during early life. When auditory experience with speech is mediated by cochlear implant, the likelihood of acquiring bimodal fusion is increased and it greatly depends on the age of implantation. All the above results strongly support the need for screening children for hearing capabilities and providing cochlear implants and aural rehabilitation as early as possible.

Keywords: cochlear implant, congruent stimuli, mcgurk effect, non-congruent stimuli

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Authors: Huixuan Xu

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The present study was set out to investigate the extent to which and how service-learning fostered a sample of 138 Hong Kong undergraduates’ interpersonal competence and cooperative orientation development. Interpersonal competence is presented when an individual shows empathy with others, provides intelligent advice to others and has practical judgment. Cooperative orientation reflects individuals’ willingness to work with others to achieve common goals. A quality service-learning programme may exhibit the features of provision of meaningful service, close link to curriculum, continuous reflection, youth voice, and diversity. Mixed methods were employed in the present study. Pre-posttest survey was administered to capture individual undergraduates’ development of interpersonal competence and cooperative orientation over a period of four months. The respondents’ evaluation of service-learning elements was administered in the post-test survey. Focus groups were conducted after the end of the service-learning to further explore how the certain service-learning elements promoted individual undergraduates’ development of interpersonal competence and cooperative orientation. Three main findings were reported from the study. (1) The scores of interpersonal competence increased significantly from the pretest to the posttest, while the change of cooperative orientation was not significant. (2) Cooperative orientation and interpersonal competence were correlated positively with the overall course quality respectively, which suggested that the more a service-learning course complied with quality practice, the students became more competent in interpersonal competence and cooperative orientation. (3) The following service-learning elements showed higher impacts: (a) direct contact with service recipients, which engaged students in practicing interpersonal skills; (b) individual participants’ being exposed to a situation that required communication and dialogue with people from diverse backgrounds with different views; (c) experiencing interpersonal conflicts among team members and having the conflicts solved; (d) students’ taking a leading role in a project-based service. The present study provides compelling evidence about what elements in a service-learning program may foster undergraduates’ development of cooperative orientation and interpersonal competence. Implications for the design of service-learning programmes are provided.

Keywords: undergraduates, interpersonal competence, cooperation orientation, service-learning

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Authors: Tanya Keni

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Efforts to link culture and self, have been the focus, initially of Anthropology and later of Psychology in the first half of the 20th century. In doing so, cross-cultural researchers have endeavored to identify factors valuable for classifying cultures. One such central classification is that of individualism and collectivism which remains prominent. However, it overlooks certain other cultural dimensions that can be of interest and need attention. The current paper tries to move beyond this classic distinction, to cultures that are termed to be honor and dignity oriented. Both honor and dignity, refer to the worth of a person but bear different connotations and psychological consequences. While dignity is an independent concept of self-worth whose locus lies deep within the individual, honor is an interdependent concept that needs both personal as well as societal acknowledgment. This research takes an exploratory and qualitative approach to draw the individual, structural and contextual understanding of personal honor and dignity in broad cultures that are conceptualized as honor and dignity aimed. The aim is to understand the cultural influence on an individual’s self-worth, considering gender. 12 Focus group discussions were conducted across North India and Germany with four participants each. The research process was inspired by the approaches of social constructivism and critical realism. These discussions were transcribed and further analyzed using thematic analysis and the results have revealed differential themes for the concepts of honor and dignity. Certain dimensional similarities were also observed for both the cultural groups, however with differential usage of language. In particular, the North Indian group was seen using phrases that were oriented towards safeguarding against loss of honor or dignity. While the phrases of the German group were aligned towards worth-enhancement. The research also gives an illustration of how honor and dignity translate into behavioral practice that can exert an influence on important life decisions, especially about self and family for both males and females. In addition to these, the study also contributes to the literature on self-worth by developing the concept of ‘dignity’ for which there exists a dearth of research.

Keywords: culture, dignity, honor, self, self-worth

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Authors: Marjan Moradi Fard, Hossein Rassi, Masoud Houshmand

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Aim: Breast cancer is one of the most common cancers affecting the morbidity and mortality of Iranian women. This disease is a result of collective alterations of oncogenes and tumor suppressor genes. Studies have produced conflicting results concerning the role of p53 codon 72 polymorphism (G>C) and miR-146a rs2910164 polymorphism (G>C) on the risk of several cancers; therefore, a research was performed to estimate the association between the p53 codon 72 polymorphism and miR-146a rs2910164 polymorphism in breast cancer. Methods and Materials: A total of 45 archival breast cancer samples from khatam hospital and 40 healthy samples were collected. Verification of each cancer reported in a relative was sought through the pathology reports of the hospital records. Then, DNA extracted from all samples by standard methods and p53 codon 72 polymorphism genotypes and miR-146a rs2910164 polymorphism genotypes were analyzed using multiplex PCR. The tubules, mitotic activity, necrosis, polymorphism and grade of breast cancer were staged by Nottingham histological grading and immunohistochemical staining of the sections from the paraffin wax embedded tissues for the expression of ER, PR and p53 was carried out using a standard method. Finally, data analysis was performed using the 7 version of the Epi Info(TM) 2012 software and test chi-square(x2) for trend. Results: Successful DNA extraction was assessed by PCR amplification of b-actin gene (99 bp). According to the results, p53 GG genotype and miR-146a rs2910164 CC genotype was significantly associated with increased risk of breast cancer in the study population. In this study, we established that tumors of p53 GG genotype and miR-146a rs2910164 CC genotype exhibited higher mitotic activity, higher polymorphism, lower necrosis, lower tubules, higher ER- and PR-negatives and lower TP53-positives than the other genotypes. Conclusion: The present study provided preliminary evidence that a p53 GG genotype may effect breast cancer risk in the study population, interacting synergistically with miR-146a rs2910164 CC genotype. Our results demonstrate that the testing of p53 codon 72 polymorphism genotypes and miR-146a rs2910164 polymorphism genotypes in combination with clinical parameters can serve as major risk factors in the early identification of breast cancers.

Keywords: breast cancer, p53 codon 72 polymorphism, miR-146a rs2910164 polymorphism, genotypes

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Authors: Shohoni Mahabub

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Health Information Systems (HIS) are essential to contemporary healthcare; nonetheless, they frequently encounter challenges such as data fragmentation, inefficiencies, and an absence of real-time analytics. The advent of machine learning (ML) and artificial intelligence (AI) provides a revolutionary potential to address these difficulties via AI-driven data fusion ecosystems. These ecosystems integrate many health data sources, including electronic health records (EHRs), wearable devices, and genetic data, with sophisticated machine learning techniques such as natural language processing (NLP) and predictive analytics to produce actionable insights. Through the integration of strong data intake layers, secure interoperability protocols, and privacy-preserving models, these ecosystems provide individualized treatment, early illness diagnosis, and enhanced operational efficiency. This paradigm change enhances clinical decision-making and rectifies systemic inefficiencies in healthcare delivery. Nonetheless, adoption presents problems such as data privacy concerns, ethical considerations, and scalability constraints. The study examines options such as federated learning for safe, decentralized data sharing, explainable AI for transparency, and cloud-based infrastructure for scalability to address these issues. These ecosystems aim to address health equity disparities, particularly in resource-limited environments, and improve public health surveillance, notably in pandemic response initiatives. This article emphasizes the revolutionary potential of AI-driven data fusion ecosystems in redefining Health Information Systems by providing an implementation roadmap and showcasing successful deployment case studies. The suggested method promotes a cooperative initiative among legislators, healthcare professionals, and technology to establish a cohesive, efficient, and patient-centric healthcare model.

Keywords: AI-powered healthcare systems, data fusion ecosystem, predictive analytics, digital health interoperability

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Authors: Ashraf Mohammadzadeh, Ahmad Shah Farhat, Azin Vaezi, Aradokht Vaezi

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Background & Aim: Preterm infants born at less than 34 weeks postconceptional age are not as neurologically mature as their term counterparts and thus have difficulty coordinating sucking, swallowing and breathing. As a result, they are traditionally gavage fed until they are able to oral feed successfully. The aim of study was to evaluate comparative effect of orogastric and breast feeding on oxygen saturation in very low birth weight infant (<1500gm). Patients and Methods: In this clinical trial all babies admitted in the Neonatal Research Center of Imamreza Hospital, Mashhad during a 4 months period were elected. Criteria for entrance to study included birth weight ≤ 1500 grams, exclusive breastfeeding, having no special problem after 48 hours, receivinge only routine care and intake of milk was 100cc/kg/day. Each neonate received two rounds of orogastric and breast feeding in the morning and in the afternoon, during which mean oxygen saturation was measured by pulse-oxymetry. During the study the heart rate and temperature of the neonates were monitored, and in case of hypothermia, bradycardia(less than 100 per minute) or apnea the feeding was discontinued and the study was repeated the following day. Data analysis was carried out using SPSS. Results: Fifty neonates were studied. The average birth weight was 1267.20±165.42 grams and average gestational age was 31.81±1.92 and female/male ratio was 1.2. There was no significant statistical difference in arterial oxygen saturation in orogastric and breast feeding in the morning and in the afternoon. (p=0.16 in the morning and p=0.6 in the afternoon). There was no complication of apnea, hypothermia or bradycardia. Conclusion: There was no significant statistical difference between the two methods in arterial oxygen saturation. It seems that oral feeding (which is a natural route) and skin contact between the mother and neonate causes a strong emotional bonding between the two and brings about better social adaptation for the neonate. Also shorter period of stay in hospital is more preferred, and breast feeding should be started at the earliest possible time after birth.

Keywords: Very low birth weight (V.L.B.W), O2 Saturation, Breast Feeding, Tube Feeding

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Authors: Chinyere Ori Elom, Ikechukwu Ogeze Ukeje, Chukwudum Collins Umoke

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This paper aims to stimulate scholarly interest in AI, ICT and the existing (complex) systems trajectory- theory, practice, and aspirations within the African continent and to shed fresh light on the shortcomings of the higher education sector (HEs) through the prism of AI-driven Solutions for enhancing Guidance and Counseling and sound governance framework (SGF) in higher education modeling. It further seeks to investigate existing prospects yet to be realized in Nigerian universities by probing innovation neglect in the localities, exploring practices in the global ICT spaces neglected by Nigeria universities’ governance regimes (UGRs), and suggesting area applicability, sustainability and solution modeling in response to peculiar ‘wicked ICT-driven problems’ and or issues facing the continent as well as other universities in emerging societies. This study will adopt a mixed-method approach to collect both qualitative and quantitative data. This paper argues that it will command great relevance in the local and global university system by developing ICT relevance sustainability policy initiatives (SPIs) powered by a multi-stakeholder engagement governance model (MSEGm) that is sufficiently dynamic, eclectic and innovative to surmount complex and constantly rising challenges of the modern-developing world. Hence, it will consider diverse actors both as producers and users alike as victims and beneficiaries of common concerns in the ICT world; thereby providing pathways on how AI’s integration into education governance can significantly reduce counseling gaps, ensuring more students are attended to especially when human counselors are unavailable.

Keywords: AI-counseling solution, stakeholder engagement, university governance, higher education

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Authors: A. Hira Masood, B. Umer Hameed, C. Ezza Nasir

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Contemporary studies support the strong co-relation between psychology and design. This study elaborates how different psychological personality test can help a fashion designer to judge the needs of their clients with respect to have products which will satisfy the client's request concerning costumised clothing. This study will also help the designer to improve the lacking in the personality and will enable him to put his effort in required areas for grooming the customer, control and direct organization regarding quality maintenance. The use of psychology test to support the choice of certain design strategies that how the right clothing can make client a better intellectual with enhanced self-esteem and confidence. Different projective personality test are being used to suggest to evaluate personality traits. The Rorschach Inkblot Test is projective mental comprising of 10 ink-blots synonymous with the clinical brain research. Lüsher Color Diagnostics measures a person’s psycho physical state, his or her ability to withstand stress to perform and communicate. HTP is a projective responsibility test measuring self-perception, attitudes. The TAT test intend to evaluate a person’s patterns of thoughts, attitudes, observation, capacity and emotional response to this ambiguous test materials. No doubt designers are already crucially redesigning the individuals by their attires, but to expose the behavioral mechanism of the customer, designers should be able to recognize the hidden complexity behind his client by using the above mentioned methods. The study positively finds the design and psychology need to become substantially contacted in order to create a new regime of norms to groom a personality under the concentration and services of a fashion designer in terms of clothing, This interactive activity altimately upgrade design team to help customers to find the suited way to satisfy their needs and wishes, offer client relible relationship and quality management services, and to become more disereable.

Keywords: projective personality tests, customized clothing, Rorschach Inkblot test, TAT, HTP, Lüsher color diagnostics, quality management services

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Authors: Isabel Lopez-Oliva, Akshay Paropkari, Shweta Saraswat, Stefan Serban, Paola de Pablo, Karim Raza, Andrew Filer, Iain Chapple, Thomas Dietrich, Melissa Grant, Purnima Kumar

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Objective: We aimed to explicate the role of the subgingival microbiome in the causal link between rheumatoid arthritis (RA) and periodontitis (PD). Methods: Subjects with/without RA and with/without PD were randomized for treatment with scaling and root planing (SRP) or oral hygiene instructions. Subgingival biofilm, gingival crevicular fluid, and serum were collected at baseline and at 3- and 6-months post-operatively. Correlations were generated between 72 million 16S rDNA sequences, immuno-inflammatory mediators, circulating antibodies to oral microbial antigens, serum inflammatory molecules, and clinical metrics of RA. The dynamics of inter-microbial and host-microbial interactions were modeled using differential network analysis. Results: RA superseded periodontitis as a determinant of microbial composition, and DAS28 score superseded the severity of periodontitis as a driver of microbial assemblages (p=0.001, ANOSIM). RA subjects evidenced higher serum anti-PPAD (p=0.0013), anti-Pg-enolase (p=0.0031), anti-RPP3, anti- Pg-OMP and anti- Pi-OMP (p=0.001) antibodies than non-RA controls (with and without periodontitis). Following SRP, bacterial networks anchored by IL-1b, IL-4, IL-6, IL-10, IL-13, MIP-1b, and PDGF-b underwent ≥5-fold higher rewiring; and serum antibodies to microbial antigens decreased significantly. Conclusions: Our data suggest a circular relationship between RA and PD, beginning with an RA-influenced dysbiosis within the healthy subgingival microbiome that leads to exaggerated local inflammation in periodontitis and circulating antibodies to periodontal pathogens and positive correlation between severity of periodontitis and RA activity. Periodontal therapy restores host-microbial homeostasis, reduces local inflammation, and decreases circulating microbial antigens. Our data highlights the importance of integrating periodontal care into the management of RA patients.

Keywords: rheumatoid arthritis, periodontal, subgingival, DNA sequence analysis, oral microbiome

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Authors: Maatouk Mohamed, Nouira Mariem, Hamdi Kbir Gh, Mahjoubi M. F., Ben Moussa M.

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Background and aim: Preoperative biliary drainage (PBD) has been introduced to lower bilirubin levels and to control the negative effects of obstructive jaundice in patients with malignant obstructive jaundice undergoing pancreaticoduodenectomy (PD). The optimal time interval between PBD and PD is still not clear. Delaying surgery by 4 to 6 weeks is the commonly accepted practice. However, delayed PD has been shown to decrease the rate of resection and adversely affect the tumor grading and prognosis. Thus, the purpose of our systematic review and meta-analysis was to evaluate the optimal period for PBD prior to PD: short or prolonged in terms of postoperative morbidity and survival outcomes. Methods: Trials were searched in PubMed, Science Direct, Google Scholar, and Cochrane Library until November 2022. Studies using PBD in patients with malignant obstructive jaundice that compared short duration group (SDG) (surgery performed within 3-4 weeks) with prolonged duration group (PDG) (at least 3-4 weeks after PBD) were included in this study. The risk of bias was assessed using the Rob v2 and Robins-I tools. The priori protocol was published in PROSPERO (ID: CRD42022381405). Results: Seven studies comprising 1625 patients (SDG 870, PDG 882) were included. All studies were non-randomized, and only one was prospective. No significant differences were observed between the SDG and PDG in mortality (OR= 0.59; 95% CI [0.30, 1.17], p=0.13), major morbidity (Chi² = 30.28, p <0.00001; I² = 87%), pancreatic fistula (Chi² = 6.61, p = 0.25); I² = 24%), post pancreatectomy haemorrhage (OR= 1.16; 95% CI [0.67, 2.01], p=0.59), positive drainage culture (OR= 0.36; 95% CI [0.10, 1.32], p=0.12), septic complications (OR= 0.78; 95% CI [0.23, 2.72], p=0.70), wound infection (OR= 0.08, p=0.07), operative time (MD= 0.21; p=0.21). Conclusion: Early surgery within 3 or 4 weeks after biliary drainage is both safe and effective. Thus, it is reasonable to suggest early surgery following PBD for patients having resectable periampullary cancers.

Keywords: preoperative biliary drainage, pancreatic cancer, pancreatic surgery, complication

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Authors: Brigita Mieziene, Arunas Emeljanovas, Vida Cesnaitiene, Ingunn Fjortoft, Lise Kjonniksen

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Background. Health-related physical fitness refers to the favorable health status, i.e. ability to perform daily activities with vigor, as well as capacities that are associated with a low risk for development of chronic diseases and premature death. However, in school-aged children it is constantly declining, while some aspects of fitness declined as much as 50 percent during the last two decades, which prognosticates increasingly earlier onset of health problems, decreasing the quality of life of the population and financial burden for the society. Therefore, the goal of the current study was to indicate nationally representative age- and gender-specific reference values of anthropometric measures, musculoskeletal, motor and cardiorespiratory fitness in Lithuanian primary school children from 6 to 10 years. Methods. The study included 3556 students in total, from 73 randomly selected schools. Ethics approval for research by the Kaunas Regional Ethics Committee (No. BE-2-42) was obtained. Physical fitness was measured by the 9-item test battery, developed by Fjørtoft and colleagues. Height and weight were measured and body mass index calculated. Smoothed centile charts were derived using the LMS method. Results. The numerical age- and gender-specific percentile values (3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentile) for anthropometric measures, musculoskeletal, motor and cardiorespiratory fitness were provided. The equivalent smoothed LMS curves were performed. The study indicated 12.5 percent of overweight and 5 percent of obese children in accordance with international gender and age specific norms of body mass index. This data could be used in clinical and educational settings in order to identify the level of individual physical fitness within its different components.

Keywords: fitness, overweight, primary school children, reference values, smoothed percentile curves

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Authors: Min-Feng Hsieh

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Nowadays, we are facing a highly competitive environment in which the situation for survival has come even more critical than ever before. The challenge we will be confronted with is no longer can be dealt with the single system of knowledge. The abilities we urgently need to acquire is something that can lead us to cross over the boundaries between different disciplines and take us to a neutral ground that gathers and integrates powers and intelligence that surrounds us. This paper aims at discussing how a trans-disciplinary design course organized by the College of Design at Chaoyang University can react to this modern challenge. By orchestrating an experimental course format and by developing a series of coaching strategies, a trans-disciplinary learning environment has been created and practiced in which students selected from five different departments, including Architecture, Interior Design, Visual Design, Industrial Design, Landscape and Urban Design, are encouraged to think outside their familiar knowledge pool and to learn with/from each other. In the course of implementing this program, a parallel research has been conducted alongside by adopting the theory and principles of Action Research which is a research methodology that can provide the course organizer emergent, responsive, action-oriented, participative and critically reflective insights for the immediate changes and amendments in order to improve the effect of teaching and learning experience. In the conclusion, how the learning and teaching experience of this trans-disciplinary design studio can offer us some observation that can help us reflect upon the constraints and division caused by the subject base curriculum will be pointed out. A series of concepts for course design and teaching strategies developed and implemented in this trans-disciplinary course are to be introduced as a way to promote learners’ self-motivated, collaborative, cross-disciplinary and student-centered learning skills. The outcome of this experimental course can exemplify an alternative approach that we could adopt in pursuing a remedy for dealing with the problematic issues of the current educational practice.

Keywords: course design, coaching strategy, subject base curriculum, trans-disciplinary

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Authors: Joyce Joas Kahembe

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The implementation of education assessment reforms in developing countries has been claimed to be problematic and difficult. The socio-economic teaching and learning environment has pointed to constraints in the education reform process. Nevertheless, there are existing assessment practices that if enhanced, can have potential to foster formative assessment practices in those contexts. The present study used the sociocultural perspective to explore teachers’ assessment practices and factors influencing them in Tanzania. Specifically, the sociocultural perspective helped to trace social, economic and political histories imparted to teachers’ assessment practices. The ethnographic oriented methods like interviews, observations and document reviews was used in this exploration. Teachers used assessment practices, such as questioning and answering, tests, assignments and examinations, for evaluating, monitoring and diagnosing students’ understanding, achievement and performance and standards and quality of instruction practices. The obtained assessment information functioned as feedback for improving students’ understanding, performance, and the standard and quality of teaching instruction and materials. For example, teachers acknowledged, praised, approved, disapproved, denied, graded, or marked students’ responses to give students feedback and aid learning. Moreover, teachers clarified and corrected or repeated students’ responses with worded/added words to improve students’ mastery of the subject content. Teachers’ assessment practices were influenced by the high demands of passing marks in the high stakes examinations and the contexts of the social economic teaching environment. There is a need to ally education assessment reforms with existing socio-economic teaching environments and society and institutional demands of assessment to make assessment reforms meaningful and sustainable. This presentation ought to contribute on ongoing strategies for contextualizing assessment practices for formative uses.

Keywords: assessment, feedback, practices, formative assessment

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