Search results for: public hospital

Authors: Kalayanee Senasu

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This research investigates the influences of different factors on the happiness of Thai people, including both general factors and sustainable ones. Additionally, this study also monitors Thai people’s happiness via Thai Happiness Index developed in 2017. Besides reflecting happiness level of Thai people, this index also identifies related important issues. The data were collected by both secondary related data and primary survey data collected by interviewed questionnaires. The research data were from stratified multi-stage sampling in region, province, district, and enumeration area, and simple random sampling in each enumeration area. The research data cover 20 provinces, including Bangkok and 4-5 provinces in each region of the North, Northeastern, Central, and South. There were 4,960 usable respondents who were at least 15 years old. Statistical analyses included both descriptive and inferential statistics, including hierarchical regression and one-way ANOVA. The Alkire and Foster method was adopted to develop and calculate the Thai happiness index. The results reveal that the quality of household economy plays the most important role in predicting happiness. The results also indicate that quality of family, quality of health, and effectiveness of public administration in the provincial level have positive effects on happiness at about similar levels. For the socio-economic factors, the results reveal that age, education level, and household revenue have significant effects on happiness. For computing Thai happiness index (THaI), the result reveals the 2018 THaI value is 0.556. When people are divided into four groups depending upon their degree of happiness, it is found that a total of 21.1% of population are happy, with 6.0% called deeply happy and 15.1% called extensively happy. A total of 78.9% of population are not-yet-happy, with 31.8% called narrowly happy, and 47.1% called unhappy. A group of happy population reflects the happiness index THaI valued of 0.789, which is much higher than the THaI valued of 0.494 of the not-yet-happy population. Overall Thai people have higher happiness compared to 2017 when the happiness index was 0.506.

Keywords: happiness, quality of life, sustainability, Thai Happiness Index

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Authors: Vephkhvia Grigalashvili

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This paper provides an overview of criteria for good governance in Georgian defense sector and scientific outcomes of comparative research. A respect for good governance and its realization into Georgian national defense sector represents a fundamental institutional necessity as well as country`s politico-legal obligation within the framework of the existing collaboration mechanisms with NATO (especially Building Integrity (BI) Programme) and the Association Agreement between the EU and Georgia. Furthermore good governance is considered as a democracy measuring criterion in country`s Euro-Atlantic integration process. Accordingly, integration and further development of the contemporary approaches of good governance into Georgian defense management model represents a burning issue of the country. The assessment of an existing model of the country, identification of defects and determination of course of institutional reforms in a mutual comparison format of good governance mechanisms of NATO or/and the EU member Eastern European or Baltic countries positively assessed by the international organizations is considered as a precondition for its effective realization. Scientific aims of this study are: (a) to conduct comparative analysis of Georgian national principles and generalized standards of NATO or/and the EU member Eastern European and Baltic countries in following segments of good governance: open governance; anticorruption policy; conflict of interests; integrity; internal and external control bodies; (b) to formulate theoretical and practical recommendations on reforms to be implemented in the country`s national defence sector. As research reveals, although, institutional / legal pillars of good governance in Georgian defense sector generally are in compliance with international principles, the quality of implementation of good government norms still remains as an area that needs further development by raising awareness of public servants and community.

Keywords: anti-corruption policy within Georgian defense governance, conflict of interests within Georgian defense governance, good governance in Georgian defense sector, principles of integrity in Georgian defense management

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Authors: Hasan Muslemani, Xi Liang, Kathi Kaesehage, Francisco Ascui, Jeffrey Wilson

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The creation of a market for lower-carbon steel products, here called ‘green steel’, has been identified as an important means to support the introduction of breakthrough emission reduction technologies into the steel sector. However, the definition of what ‘green’ entails in the context of steel production, the implications on the competitiveness of green steel products in local and international markets, and the necessary market mechanisms to support their successful market penetration remain poorly explored. This paper addresses this gap by holding semi-structured interviews with international sustainability experts and commercial managers from leading steel trade associations, research institutes and steelmakers. Our findings show that there is an urgent need to establish a set of standards to define what ‘greenness’ means in the steelmaking context; standards that avoid market disruptions, unintended consequences, and opportunities for greenwashing. We also highlight that the introduction of green steel products will have implications on product competitiveness on three different levels: 1) between primary and secondary steelmaking routes, 2) with traditional, lesser green steel, and 3) with other substitutable materials (e.g. cement and plastics). This paper emphasises the need for steelmakers to adopt a transitional approach in deploying different low-carbon technologies, based on their stage of technological maturity, applicability in certain country contexts, capacity to reduce emissions over time, and the ability of the investment community to support their deployment. We further identify market mechanisms to support green steel production, including carbon border adjustments and public procurement, highlighting a need for implementing a combination of complementary policies to ensure the products’ roll-out. The study further shows that the auto industry is a likely candidate for green steel consumption, where a market would be supported by price premiums paid by willing consumers, such as those of high-end luxury vehicles.

Keywords: green steel, decarbonisation, business model innovation, market analysis

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Authors: Jyun-Huei Huang, Ting-I Lee

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Urban heat island effect is derived from the reduction of vegetative cover by urban development. Because plants can improve air quality and microclimate, green walls have been applied as a sustainable design approach to cool building temperature. By using plants to green vertical surfaces, they decrease room temperature and, as a result, decrease the energy use for air conditioning. Based on their structures, green walls can be divided into two categories, green façades and living walls. A green façade uses the climbing ability of a plant itself, while a living wall assembles planter modules. The latter one is widely adopted in public space, as it is time-effective and less limited. Although a living wall saves energy spent on cooling, it is not necessarily cost-effective from the perspective of a lifecycle analysis. The Italian study shows that the overall benefit of a living wall is only greater than its costs after 47 years of its establishment. In Taiwan, urban greening policies encourage establishment of green walls by referring to their benefits of energy saving while neglecting their low performance on cost-effectiveness. Thus, this research aims at understanding the perception of appliers and consumers on the cost-effectiveness of their living wall products from the lifecycle viewpoint. It adopts semi-structured interviews and field observations on the maintenance of the products. By comparing the two results, it generates insights for sustainable urban greening policies. The preliminary finding shows that stakeholders do not have a holistic sense of lifecycle or cost-effectiveness. Most importantly, a living wall well maintained is often with high input due to the availability of its maintenance budget, and thus less sustainable. In conclusion, without a comprehensive sense of cost-effectiveness throughout a product’s lifecycle, it is very difficult for suppliers and consumers to maintain a living wall system while achieve sustainability.

Keywords: case study, maintenance, post-occupancy evaluation, vertical greening

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Authors: Mara A. C. Lopes

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Hiring a second teacher to accompany deaf students inserted at Brazilian inclusive school system has raised questions about its role in the educational process of deaf students. Federal policies determine that deaf students inserted in regular education are accompanied by sign language interpreters, which leads to the understanding that the second teacher should assume this function. However, what those professionals do is to assume the function of teaching deaf student, instead of the classroom main teacher. Historical-Cultural Psychology was used as a reference for analysis, which aimed to identify the social function of the second teacher in the classroom. Two studies were accomplished in the public schools of Sao Paulo State: In Study 1, videotaped lectures provided by the Department of Education for collective reflection about the second teacher's role were examined, to identify the social meaning of that professional activity. Study 2 aimed to analyze the process of assigning personal sense to the teacher activity, considering the opinions of 21 professionals from Sao Paulo. Those teachers were interviewed individually with the support of a semi-structured interview. The analysis method utilized was: empirical description of data; development of categories, for reality abstraction; identifying the unit analysis; and return to reality, in order to explain it. Study 1 showed that the social meaning of the second teacher's activity is, also, to teach. However, Study 2 showed that this meaning is not shared among professionals of the school, so they understand that they must act as sign language interpreters. That comprehension causes a disruption between social meaning and the personal sense they attach to their activity. It also shows the need of both teachers at the classroom planning and executing activity together. On the contrary, a relationship of subordination of one teacher to another was identified, excluding the second teacher and the deaf student of the main activity. Results indicate that the second teacher, as a teacher, must take the responsibility for deaf student education, consciously, and to promote the full development of the subjects involved.

Keywords: deaf education, historical-cultural psychology, inclusion, teacher function

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Authors: Robert Dutkiewicz, Monika Szpringer, Mariola Wojciechowska

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Physical activity is one of the factors greatly influencing healthy lifestyle. The recent research into physical activity of the Polish society reveals that contribution of physical culture to healthy lifestyle is insufficient. Students, regardless of age, spend most of free-time in front of a TV or computer. The research attempted to identify the level of physical activity and healthy lifestyle among students of medical sciences and other students doing their teaching degrees. The findings of physical activity research conducted in 2014, which covered 364 students of medical sciences and future teachers from the University of Jan Kochanowski in Kielce were analysed. The research involved the method of diagnostic survey based on a questionnaire. It attempted to establish to what extent such factors as the field of studies, the place of residence and BMI affect students’ physical activity. Empirical material was analysed by means of SPSS/PC, the leading statistical software. The field of study significantly influences physical activity of the respondents. The students of physiotherapy and public health tend to be more physically active than students of biology and geography: 46.8% students of geography and 51.8 % biology students seldom take up physical activity. Obesity and overweight are currently serious problems of university students: 6.6% of them are obese and 19% overweight. It is alarming that these students are not willing to find ways to be more physically active. Most of the obese and overweight respondents study biology or geography and live in a rural area. Unequal chances in terms of youth physical culture are determined by the differences between rural and urban environments. Young people living in rural areas are less physically active, particularly in terms of the frequency and the amount of time devoted to physical activity. This is caused by poor infrastructure to perform physical activity, the lack of or limited number of sports clubs and centres. It is thought-provoking that most of the students claim that they do not have enough time to do sports or other activities, but at the same time they spend a lot of time at a computer or watching TV.

Keywords: BMI, healthy lifestyle, sports activity, students

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Authors: Kushal Patel, Manasa Dittakavi, Cyrus Falsafi, Gretchen Lovett

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Rural America has seen a surge in opioid addiction rates and overdose deaths in recent years, becoming a significant public health crisis. This may be due to a variety of factors, such as lack of access to healthcare or other economic and social factors that can contribute to addiction such as poverty, unemployment, and social isolation. As the opioid epidemic has disproportionately affected rural communities, pregnant women in these areas may be highly susceptible and face additional difficulties in facing the appropriate care they need. Opioid use disorder has many negative effects on prenatal infants. These include changes in their microbiome, mental health, neurodevelopment and cognition. These can affect how the child performs in various activities in life and how they interact with others. It has been demonstrated that using cognitive behavioral therapy improves not just pain-related results but also mobility, quality of life, disability, and mood outcomes. This indicates that cognitive behavioral therapy (CBT) may be a useful therapeutic strategy for enhancing general health and wellbeing in people with opioid use problems. In terms of treating psychiatric diseases, CBT carries fewer dangers than opioids. One study that illustrates the potential for CBT to promote a reduction in opioid use disorder used self-reported drug use patterns 6 months prior to and during their pregnancy. At the beginning of the study, participants reported an average of 3.78 drug or alcohol use days in the previous 28 days, which decreased to 1.63 days after treatment. The study also found a decrease in depression scores, as measured by IDS scores, from 23.9 to 17.1 at the end of treatment. These and other results show that CBT can have meaningful impacts on pregnant women in Rural America who struggle with an opioid use disorder. This project has been approved by the West Virginia School of Osteopathic Medicine- Office of Research and Sponsored Programs and deemed non-research scholarly work.

Keywords: appalachia, CBT, opiods, pregnancy

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Authors: Saeid Gharechelou, Ryutaro Tateishi

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Earthquake is an inevitable catastrophic natural disaster. The damages of buildings and man-made structures, where most of the human activities occur are the major cause of casualties from earthquakes. A comparison of optical and SAR data is presented in the case of Kathmandu valley which was hardly shaken by 2015-Nepal Earthquake. Though many existing researchers have conducted optical data based estimated or suggested combined use of optical and SAR data for improved accuracy, however finding cloud-free optical images when urgently needed are not assured. Therefore, this research is specializd in developing SAR based technique with the target of rapid and accurate geospatial reporting. Should considers that limited time available in post-disaster situation offering quick computation exclusively based on two pairs of pre-seismic and co-seismic single look complex (SLC) images. The InSAR coherence pre-seismic, co-seismic and post-seismic was used to detect the change in damaged area. In addition, the ground truth data from field applied to optical data by random forest classification for detection of damaged area. The ground truth data collected in the field were used to assess the accuracy of supervised classification approach. Though a higher accuracy obtained from the optical data then integration by optical-SAR data. Limitation of cloud-free images when urgently needed for earthquak evevent are and is not assured, thus further research on improving the SAR based damage detection is suggested. Availability of very accurate damage information is expected for channelling the rescue and emergency operations. It is expected that the quick reporting of the post-disaster damage situation quantified by the rapid earthquake assessment should assist in channeling the rescue and emergency operations, and in informing the public about the scale of damage.

Keywords: Sentinel-1A data, Landsat-8, earthquake damage, InSAR, rapid damage monitoring, 2015-Nepal earthquake

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Authors: A. F. Agboola, B. R. O. Omidiwura, A. Oyeyemi, E. A. Iyayi, A. S. Adelani

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Dietary cholesterol has elicited the most public interest as it relates with coronary heart disease. Thus, humans have been paying more attention to health, thereby reducing consumption of cholesterol enriched food. Egg is considered as one of the major sources of human dietary cholesterol. However, an alternative way to reduce the potential cholesterolemic effect of eggs is to modify the fatty acid composition of the yolk. The effect of palm oil (PO), soybean oil (SO), sesame seed oil (SSO) and fish oil (FO) supplementation in the diets of layers on egg yolk fatty acid, cholesterol, egg production and egg quality parameters were evaluated in a 42-day feeding trial. One hundred and five Isa Brown laying hens of 34 weeks of age were randomly distributed into seven groups of five replicates and three birds per replicate in a completely randomized design. Seven corn-soybean basal diets (BD) were formulated: BD+No oil (T1), BD+1.5% PO (T2), BD+1.5% SO (T3), BD+1.5% SSO (T4), BD+1.5% FO (T5), BD+0.75% SO+0.75% FO (T6) and BD+0.75% SSO+0.75% FO (T7). Five eggs were randomly sampled at day 42 from each replicate to assay for the cholesterol, fatty acid profile of egg yolk and egg quality assessment. Results showed that there were no significant (P>0.05) differences observed in production performance, egg cholesterol and egg quality parameters except for yolk height, albumen height, yolk index, egg shape index, haugh unit, and yolk colour. There were no significant differences (P>0.05) observed in total cholesterol, high density lipoprotein and low density lipoprotein levels of egg yolk across the treatments. However, diets had effect (P<0.05) on TAG (triacylglycerol) and VLDL (very low density lipoprotein) of the egg yolk. The highest TAG (603.78 mg/dl) and VLDL values (120.76 mg/dl) were recorded in eggs of hens on T4 (1.5% sesame seed oil) and was similar to those on T3 (1.5% soybean oil), T5 (1.5% fish oil) and T6 (0.75% soybean oil + 0.75% fish oil). However, results revealed a significant (P<0.05) variations on eggs’ summation of polyunsaturated fatty acid (PUFA). In conclusion, it is suggested that dietary oils could be included in layers’ diets to produce designer eggs low in cholesterol and high in PUFA especially omega-3 fatty acids.

Keywords: dietary oils, egg cholesterol, egg fatty acid profile, egg quality parameters

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Authors: N. Reza Pour, S. Chuah, T. Vo

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Background: Vertebral artery dissection (VAD) is a rare complication of pregnancy. It can occur spontaneously or following a traumatic event. The pathogenesis is unclear. Predisposing factors include chronic hypertension, Marfan’s syndrome, fibromuscular dysplasia, vasculitis and cystic medial necrosis. Physiological changes of pregnancy have also been proposed as potential mechanisms of injury to the vessel wall. The clinical presentation varies and it can present as a headache, neck pain, diplopia, transient ischaemic attack, or an ischemic stroke. Isolated cases of VAD in pregnancy and puerperium have been reported in the literature. One case was found to have posterior circulation stroke as a result of bilateral VAD and labour was induced at 37 weeks gestation for preeclampsia. Another patient at 38 weeks with severe neck pain that persisted after induction for elevated blood pressure and arteriography showed right VAD postpartum. A single case of lethal VAD in pregnancy with subsequent massive subarachnoid haemorrhage has been reported which was confirmed by the autopsy. Case Presentation: We report two cases of vertebral artery dissection in pregnancy. The first patient was a 32-year-old primigravida presented at the 38th week of pregnancy with the onset of early labour and blood pressure (BP) of 130/70 on arrival. After 2 hours, the patient developed a severe headache with blurry vision and BP was 238/120. Despite treatment with an intravenous antihypertensive, she had eclamptic fit. Magnesium solfate was started and Emergency Caesarean Section was performed under the general anaesthesia. On the second day after the operation, she developed left-sided neck pain. Magnetic Resonance Imaging (MRI) angiography confirmed a short segment left vertebral artery dissection at the level of C3. The patient was treated with aspirin and remained stable without any neurological deficit. The second patient was a 33-year-old primigavida who was admitted to the hospital at 36 weeks gestation with BP of 155/105, constant headache and visual disturbances. She was medicated with an oral antihypertensive agent. On day 4, she complained of right-sided neck pain. MRI angiogram revealed a short segment dissection of the right vertebral artery at the C2-3 level. Pregnancy was terminated on the same day with emergency Caesarean Section and anticoagulation was started subsequently. Post-operative recovery was complicated by rectus sheath haematoma requiring evacuation. She was discharged home on Aspirin without any neurological sequelae. Conclusion: Because of collateral circulation, unilateral vertebral artery dissections may go unrecognized and may be more common than suspected. The outcome for most patients is benign, reflecting the adequacy of the collateral circulation in young patients. Spontaneous VAD is usually treated with anticoagulation or antiplatelet therapy for a minimum of 3-6 months to prevent future ischaemic events, allowing the dissection to heal on its own. We had two cases of VAD in the context of hypertensive disorders of pregnancy with an acceptable outcome. A high level of vigilance is required particularly with preeclamptic patients presenting with head/neck pain to allow an early diagnosis. This is as we hypothesize, early and aggressive management of vertebral artery dissection may potentially prevent further complications.

Keywords: eclampsia, preeclampsia, pregnancy, Vertebral Artery Dissection

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Authors: Kabiru Adamu

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The Nigerian electricity industry was deregulated and privatized in 2005 and 2014 in line with global trend and practice. International and multilateral lending institutions advised developing countries, Nigeria inclusive, to adopt deregulation and privatization as part of reforms in their electricity sectors. The ideological basis of these reforms are traceable to neoliberalism. Neoliberalism is an ideology that believes in the supremacy of free market and strong non-interventionist competition law as against government ownership of the electricity market. This ideology became a state practice and a blue print for the deregulation and privatization of the electricity markets in many parts of the world. The blue print was used as a template for the privatization of the Nigerian electricity industry. In this wise, this paper, using documentary analysis and review of academic literatures, examines neoliberalism as an ideology and model of economic governance for the electricity supply industry in Nigeria. The paper examines the origin of the ideology, it features and principles and how it was used as the blue print in designing policies for electricity reforms in both developed and developing countries. The paper found out that there is gap between the ideology in theory and in practice because although the theory is rational in thinking it is difficult to be implemented in practice. The paper argues that the ideology has a mismatched effect and this has made its application in the electricity industry in many developing countries problematic and unsuccessful. In the case of Nigeria, the article argues that the template is also not working. The article concludes that the electricity sectors in Nigeria have failed to develop into competitive market for the benefit of consumers in line with the assumptions and promises of the ideology. The paper therefore recommends the democratization of the electricity sectors in Nigeria through a new system of public ownership as the solution to the failure of the neoliberal policies; but this requires the design of a more democratic and participatory system of ownership with communities and state governments in charge of the administration, running and operation of the sector.

Keywords: electricity, energy governance, neo-liberalism, regulation

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Authors: Miroslav Dumbrovsky

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The paper deals with positive impacts of land consolidation on decreasing soil degradation with the main emphasis on soil and water conservation in the landscape. The importance of land degradation is very high because of its impact on crop productivity and many other adverse effects. Soil degradation through soil erosion is causing losses in crop productivity and quality of the environment, through decreasing quality of soil and water (especially water resources). Negative effects of conventional farming practices are increased water erosion, as well as crusting and compaction of the topsoil and subsoil. Soil erosion caused by water destructs the soil’s structure, reduces crop productivity due to deterioration in soil physical and chemical properties such as infiltration rate, water holding capacity, loss of nutrients needed for crop production, and loss of soil carbon. Recently, a new process of complex land consolidation in the Czech Republic has provided a unique opportunity for improving the quality of the environment and sustainability of the crop production by means a better soil and water conservation. The present process of the complex land consolidation is not only a reallocation of plots, but this system consists of a new layout of plots within a certain territory, aimed at establishing the integrated land-use economic units, based on the needs of individual landowners and land users. On the other hand, the interests of the general public and the environmental protection have to be solved, too. From the general point of view, a large part of the Czech landscape shall be reconstructed in the course of complex land consolidation projects. These projects will be based on new integrated soil-economic units, spatially arranged in a designed multifunctional system of soil and water conservation measures, such as path network and a territorial system of ecological stability, according to structural changes in agriculture. This new approach will be the basis of a rational economic utilization of the region which will comply with the present ecological and aesthetic demands at present.

Keywords: soil degradation, land consolidation, soil erosion, soil conservation

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Authors: Thomas Weber, Nina Strobel, Thomas Kohne, Eberhard Abele

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In context of the energy transition in Germany, the importance of so-called virtual power plants in the energy supply continues to increase. The progressive dismantling of the large power plants and the ongoing construction of many new decentralized plants result in great potential for optimization through synergies between the individual plants. These potentials can be exploited by mathematical optimization algorithms to calculate the optimal application planning of decentralized power and heat generators and storage systems. This also includes linear or linear mixed integer optimization. In this paper, procedures for reducing the number of decision variables to be calculated are explained and validated. On the one hand, this includes combining n similar installation types into one aggregated unit. This aggregated unit is described by the same constraints and target function terms as a single plant. This reduces the number of decision variables per time step and the complexity of the problem to be solved by a factor of n. The exact operating mode of the individual plants can then be calculated in a second optimization in such a way that the output of the individual plants corresponds to the calculated output of the aggregated unit. Another way to reduce the number of decision variables in an optimization problem is to reduce the number of time steps to be calculated. This is useful if a high temporal resolution is not necessary for all time steps. For example, the volatility or the forecast quality of environmental parameters may justify a high or low temporal resolution of the optimization. Both approaches are examined for the resulting calculation time as well as for optimality. Several optimization models for virtual power plants (combined heat and power plants, heat storage, power storage, gas turbine) with different numbers of plants are used as a reference for the investigation of both processes with regard to calculation duration and optimality.

Keywords: CHP, Energy 4.0, energy storage, MILP, optimization, virtual power plant

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Authors: Hatice Idil Gorgen

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Turkey has been investing in its national defence industrial base since the 1980s. State’s role in defence industry showed differences in Turkey. Parallel with this, ruling group’s attitude toward companies in defence sector varied. These changes in policies and behaviors of the state have occurred throughout such milestones as political and economic turmoil in domestic and international level. Hence, it is argued that state’s role, relations with private companies in defense sector and its policies towards the defense industry has shown differences due to the international system, political institutions, ideas and political coalitions in Turkey since the 1980s. Therefore, in order to see changes in the role of the state in defence sector, this paper aims to indicate first, history of state’s role in production and defence industry in the post-1980s era. Secondly, to comprehend the changes in the state’s role in defence industry, Stephan Haggard’s sources of policy change will be provided in the theoretical ground. Thirdly, state cooperated, and joint venture defence firms, state’s actions toward them will be observed. The remaining part will explore the underlying reasons for the changes in the role of the state in defence industry, and it implicitly or explicitly impacts on state business relations. Major findings illustrate that targeted idea of self-sufficient or autarky Turkey to attract domestic audience and to raise the prestige through defence system; ruling elites can regard defence industry and involved business groups as a mean for their ends. State dominant value, sensitive perception which has been ever since Ottoman Empire, prioritizes business groups in defence industry compared to others and push the ruling elites to pursue hard power in defence sectors. Through the globally structural transformation in defence industry, integration of Turkey to liberal bloc deepened and widened interdependence among states. Although it is a qualitative study, it involves the numerated data and descriptive statistics. Data will be collected by searching secondary sources from the literature, examining official documents of ministry of defence, and other appropriate ministries.

Keywords: defense industry, state and business relations, public private relations, arm industry

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Authors: Olga Smilevska Spasova, Katerina Boshkovska, Gorica Popova, Mirjana Popovska

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Introduction: Pneumonia is an infection of the pulmonary parenchyma. HPIV 3 is one of four viruses that is a member of the Paramyxoviridae family designated types 1-4 that have a nonsegmented, single-stranded RNA genome with a lipid-containing envelope. They are spread from the respiratory tract by aerosolized secretions or by direct contact with secretions. Type 3 is endemic and can cause serious illness in immunocompromised patients. Illness caused by parainfluenza occurs shortly after inoculation with the virus. The level of immunoglobulin A antibody in serum is the best predictor of susceptibility to infection. Streptococcus pneumonia or pneumococcus is a Gram-positive, spherical bacteria, usually found in pairs and it is a member of the genus Streptococcus. Streptococcus pneumonia resides asymptomatically in healthy carriers typically colonizing the respiratory tract, sinuses, and nasal cavity. In individuals with weaker immune systems like young infants, pneumococcal bacterium is the most common cause of community-acquired pneumonia in the world. Case Report: The aim is to present a case of lower respiratory tract infection in an infant caused by parainfluenza virus 3, S. pneumonia and undifferentiated gram-negative bacteria that was successfully treated. The infant is with a history of recurrent episodes of wheezing in the past 3mounts.Infant of 10months presents 2weeks before admittance with high fever, runny nose, and cough. The primary pediatrician prescribed oral cefpodoxime for 10days and inhaled salbutamol. Two days before admittance in hospital the infant with high fever, cough, and difficulty breathing. At admittance, infant is pale, anxious with rapid respirations, cough, wheezing and tachycardia. On auscultation: vesicular breathing sounds with high pitched wheezing and on the right coarse crackles. Investigations: Blood analysis: RBC: 4, 7 x1012L, WBC: 8,3x109L: Neut: 42.73% Lym: 41.57%, Hgb: 9.38 g/dl MCV: 62.7fl, MCH: 20.0pg MCHC: 31.8 g/dl RDW: 18.7% Plt-307.9 x109LCRP: 2,5mg/l, serum iron-7.92umol/l, O2sat-97% on blood gas analysis, puls-125/min.X-ray of chest with hyperinflationand right pericardial consolidation. Microbiological analysis of sputum sample is positive for undifferentiated gram-negative bacteria (colonizer)–resistant to cefotaxime, ampicillin, cefoxitin, sulfamet.+trimetoprim and sensitive to amikacin, gentamicin, and ciprofloxacin. Molecular multiplex RT-PCR for 19 viruses and multiplex PCR for 7 bacteria test for respiratory pathogens positive for Parainfluenza virus 3(Ct=22.73), Streptococcus pneumonia (Ct=26.75).IED: IgG-9.31g/l, IgA-0.351g/l, IgM-0.86g/l. Therapy: Treatment was started with inhaled salbutamol, intravenous antibiotic cefotaxime as well as systemic corticosteroids. On day 7 because of slow clinical resolution of chest auscultation findings and an etiologic clue with a positive sputum sample for resistant undifferentiated gram negative bacteria, a second intravenous antibiotic was administered amikacin. The infant is discharged on day 14 with resolution of clinical findings. Conclusion: Mixed co-infections with respiratory viruses and bacteria in immunocompromised infants are likely to lead to a more severe form of community acquired pneumonia that will need hospitalization.

Keywords: HPIV- 3, infant, pneumonia, S. pneumonia, x-ray chest

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Authors: Abanda Wilfred Chick

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Background: According to World Health Organization (WHO), the role of Information and Communication Technologies (ICT) in health sectors of developing nations has been demonstrated to have had a great improvement of fifty percent reduction in mortality and or twenty-five-fifty percent increase in productivity. The objective of this study was to assess the use of information and communication technologies in enhancing health care delivery for Human Immunodeficiency Virus (HIV) patients in Bamenda Health District. Methods: This was a descriptive-analytical cross-sectional study in which 388 participants were consecutively selected amongst health personnel and HIV patients from public and private health institutions involved in Human Immunodeficiency Virus management. Data on socio-demographic variables, the use of information and communication technologies tools, and associated challenges were collected using structured questionnaires. Descriptive statistics with a ninety-five percent confidence interval were used to summarize findings, while Cramer’s V test, logistic regression, and Chi-square test were used to measure the association between variables, Epi info version7.2, MS Excel, and SPSS version 25.0 were utilized for data entry and statistical analysis respectively. Results: Of the participants, one-quarter were health personnel, and three-quarters were HIV patients. For both groups of participants, there was a significant relationship between the use of ICT and demographic information such as level of education, marital status, and age (p<0.05). For the impediments to using ICT tools, a greater proportion identified the high cost of airtime or internet bundles, followed by an average proportion that indicated inadequate training on ICT tools; for health personnel, the majority said inadequate training on ICT tools/applications and half said unavailability of electricity. Conclusion: Not up to half of the HIV patients effectively make use of ICT tools/applications to receive health care. Of health personnel, three quarters use ICTs, and only one quarter effectively use mobile phones and one-third of computers, respectively, to render care to HIV patients.

Keywords: ICT tools, HIV patients, health personnel, health care delivery

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Authors: Thuraya Ahmed Al Shidhani, Yahya Al Farsi, Alya Al Husni, Samir Al Adawi

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Background: Knee osteoarthritis (knee OA) represents a major public health burden worldwide, particularly among older adults. However, little has been documented from Arabian Gulf countries, which have left an information gap. Objective: This study describes the socio-demographic, clinical risk factors, and use of herbal medicine among men and women seeking consultation for knee OA at two secondary healthcare facilities in Muscat, Oman. Methods: A cross-sectional study was conducted among 213 Omani adults with knee OA attending a referral polyclinic in Muscat, Oman, over 12 months from January to December. Socio-demographic data were collected from the participants who are seeking consultation for knee OA. Results: Among the 213 study participants, 171 were females and 42 males. The females were comparatively older than the males, had lower education and lower-income, and more overweight. The majority of the participants were normal weight or underweight. About one-third of participants reported OA in other joints as well. Most participants recalled that they had knee OA for less than a year. About 12% reported a history of trauma. The majority (63%) concurrently had other chronic illnesses, and 33% reported having at least one complication. About 22% were using herbal medicines. About 77% are using herbal local applications in form of powder and creams. Conclusion: This study, to our knowledge, is the first to explore socio-demographic characteristics, clinical risk factors and use of herbal medicine among sufferers of knee OA in Oman. Knee OA tended to occur among our participants at younger ages than reported elsewhere, while obesity appeared orthogonal to the severity of knee OA. Women were more affected than men. About one quarter of Omani patients are using herbal medicine. More studies are needed to understand the causal factors and development of knee OA in Oman. Targeted health education and rehabilitation programs are needed, particularly among Omani women, to improve their physical quality of life.

Keywords: knee joint, osteoarthritis, herbal medicine, Oman

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Authors: Antonia Syn

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Politicians’ outlooks on the nature of energy futures and an ‘Energy Transition’ have evolved considerably alongside a steady movement towards renewable energies, buttressed by lower technology costs, rising environmental concerns, and favourable national policy decisions. This paper seeks to examine the degree to which an energy transition has become an incontrovertible ‘status quo’ in parliament, and whether politicians share similar understandings of energy futures or narrate different stories under the same label. Parliamentarians construct different understandings of the same reality, in the form of co-existing and competing discourses, shaping and restricting how policy problems and solutions are understood and tackled. Approaching energy policymaking from a parliamentary discourse perspective draws directly from actors’ concrete statements, offering an alternative to policy literature debates revolving around inductive policy theories. This paper uses computer-assisted discourse analysis to describe fundamental discursive changes in British parliamentary debates around energy futures. By applying correspondence cluster analyses to Hansard transcripts from 1986 to 2010, we empirically measure the policy positions of Labour and Conservative politicians’ parliamentary speeches during legislatively salient moments preceding significant energy transition-related policy decisions. Results show the concept of a technology-based, market-driven transition towards fossil-free and nuclear-free renewables integration converged across Labour and the Conservatives within three decades. Specific storylines underwent significant change, particularly in relation to international outlooks, environmental framings, treatments of risk, and increases in rhetoric. This study contributes to a better understanding of the role politics plays in the energy transition, highlighting how politicians’ values and beliefs inevitably determine and delimit creative policymaking.

Keywords: quantitative discourse analysis, energy transition, renewable energy, British parliament, public policy

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Authors: Craig Wight

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Tourism visits to sites associated to varying degrees with death and dying have for some time inspired academic debate and research into what has come to be popularly described as ‘dark tourism’. Research to date has been based on the mobilisation of various social scientific methodologies to understand issues such as the motivations of visitors to consume dark tourism experiences and visitor interpretations of the various narratives that are part of the consumption experience. This thesis offers an alternative conceptual perspective for carrying out research into dark tourism by presenting a discourse analysis of Lithuanian occupation-themed museums using Foucault’s concept of ‘discursive formation’ from ‘Archaeology of Knowledge’. A constructivist methodology is therefore applied to locate the rhetorical representations of Lithuanian and Jewish subject positions and to identify the objects of discourse that are produced in five museums that interpret a historical era defined by occupation, the persecution of people and genocide. The discourses and consequent cultural function of these museums are examined, and the key finding of the research proposes that they authorise a particular Lithuanian individualism which marginalises the Jewish subject position and its related objects of discourse into abstraction. The thesis suggests that these museums create the possibility to undermine the ontological stability of Holocaust and the Jewish-Lithuanian subject which is produced as an anomalous, ‘non-Lithuanian’ cultural reference point. As with any Foucauldian archaeological research, it cannot be offered as something that is ‘complete’ since it captures only a partial field, or snapshot of knowledge, bound to a specific temporal and spatial context. The discourses that have been identified are perhaps part of a more elusive ‘positivity’ which is salient across a number of cultural and political surfaces which are ripe for a similar analytical approach in future. It is hoped that the study will motivate others to follow a discourse-analytical approach to research in order to further understand the critical role of museums in public culture when it comes to shaping knowledge about ‘inconvenient’ pasts.

Keywords: genocide heritage, foucault, Lithuanian tourism, discursive formatoin

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Authors: Khan Md. Abdus Subhan, Rabeya Bushra

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Bangladesh has already seen significant growth in Islamic banking and finance, contributing to the rapid expansion of this sector in the global banking and finance industry. The objective of this study is to analyse the Islamic finance and banking industry's ability to contribute to sustainable development in Bangladesh. It aims to assess the current state, potential, and limitations of Islamic banking and finance in the country. Bangladesh has significant growth potential for Islamic banking and finance. However, addressing several challenges is imperative. These challenges include the absence of a well-developed infrastructure for Islamic banking and finance, a lack of a solid legal framework, limited attention from the central bank, the absence of an Islamic capital market, and a shortage of experts in Sharia law as well as public awareness. Bangladesh, a nation characterized by a primarily Muslim populace, has acknowledged the importance of Islamic finance and banking in promoting sustainable development. Islamic banking principles advocate for ethical practices, risk sharing, and the avoidance of interest-based transactions. This article examines the impact of Islamic finance and banking on promoting sustainable development in Bangladesh and emphasizes its capacity to tackle socio-economic difficulties. The Islamic banking sector, as a trailblazer in funding sustainable development, has the potential to play a significant role in facilitating the shift toward a circular economy. According to Shari'ah rules and the Sustainable Development Goals (SDGs), Islamic finance principles will help change the linear economy into a circular one. They will also provide a strong framework and a lot of funding sources. This study aims to offer crucial recommendations and techniques for the successful implementation of Islamic finance institutions in Bangladesh. The study will use quantitative research methodology, collecting data from secondary sources. This research offers a thorough understanding of the reasoning for the payment of Zakat and its socio-economic importance. Furthermore, the study provides significant insights that could assist Bangladeshi policymakers and governments in implementing Islamic financing systems.

Keywords: sustainable development, Islamic fintech, Islamic banking, Bangladesh

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Authors: Anh Nguyen, Jane Fisher, Thach Tran, Anh T. T. Tran

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Trait Emotional Intelligence is the knowledge, beliefs, and attitudes an individual has about their own and other people’s emotions. It is believed that trait emotional intelligence is a component of personality. Petrides’ Trait Emotional Intelligence Questionnaire (TEIQue) is well regarded and well-established, with validation data about its functioning among adults from many countries. However, there is little data yet about its use among Asian populations, including adolescents. The aims were to translate and culturally verify the Trait Emotional Intelligence Adolescent Short Form (TEIQue-ASF) and investigate content validity, construct validity, and reliability among adolescents attending high schools in Vietnam. Content of the TEIQue-ASF was translated (English to Vietnamese) and back-translated (Vietnamese to English) in consultation with bilingual and bicultural health researchers and pilot tested among 51 potential respondents. Phraseology and wording were then adjusted and the final version is named the VN-TEIQue-ASF. The VN-TEIQue-ASF’s properties were investigated in a cross-sectional elf-report survey among high school students in Central Vietnam. In total 1,546 / 1,573 (98.3%) eligible students from nine high schools in rural, urban, and coastline areas completed the survey. Explanatory Factor Analysis yielded a four-factor solution, including some with facets that loaded differently compared to the original version: Well-being, Emotion in Relationships, Emotion Self-management, and Emotion Sensitivity. The Cronbach’s alpha of the global score for the VN-TEIQue-ASF was .77. The VN-TEIQue-ASF is comprehensible and has good content and construct validity and reliability among adolescents in Vietnam. The factor structure is only partly replicated the original version. The VN-TEIQue-ASF is recommended for use in school or community surveys and professional study in education, psychology, and public health to investigate the trait emotional intelligence of adolescents in Vietnam.

Keywords: adolescents, construct validity, content validity, factor analysis, questionnaire validity, trait emotional intelligence, Vietnam

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Authors: Zhang Dongqing

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Concern for students' mental health and the application of intelligent advanced technologies are driving changes in teaching models. The traditional teacher-centered classroom is beginning to transform into a student-centered smart interactive learning environment. Nowadays, smart classrooms are compatible with constructivist learning. This theory emphasizes the role of teachers in the teaching process as helpers and facilitators of knowledge construction, and students learn by interacting with them. The spatial design of classrooms is closely related to the teaching model and should also be developed in the direction of smart classroom design. The goal is to explore the impact of smart classroom layout on student-centered teaching environment and teacher-student interaction under the guidance of constructivist learning theory, by combining the design process and feedback analysis of the smart transformation project on the campus of Tongji University in Shanghai. During the research process, the theoretical basis of constructivist learning was consolidated through literature research and case analysis. The integration and visual field analysis of the traditional and transformed indoor floor plans were conducted using space syntax tools. Finally, questionnaire surveys and interviews were used to collect data. The main conclusions are as followed: flexible spatial layouts can promote students' learning effects and mental health; the interactivity of smart classroom layouts is different and needs to be combined with different teaching models; the public areas of teaching buildings can also improve the interactive learning atmosphere by adding discussion space. This article provides a data-based research basis for improving students' learning effects and mental health, and provides a reference for future smart classroom design.

Keywords: spatial layout, smart classroom, space syntax, renovation, educational environment

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Authors: Armando T. Zúñiga

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As the number of English Language Learners (ELLs) in public schools continues to grow, so does the achievement gap between ELLs and other student populations. In an effort to support classroom teachers with effective instructional strategies for this student population, many districts have created instructional coaching positions specifically to support classroom teachers of ELLs—ELL Teachers on Special Assignment (ELL TOSAs). This study employed a gap analysis framework to the ELL TOSA professional support program in one California school district to examine knowledge, motivation, and organizational influences (KMO) on the ELL TOSAs’ goal of supporting classroom teachers of ELLs. Three themes emerged as a result of data analysis. First, there was evidence to illustrate the interaction between knowledge and the organization. Data from ELL TOSAs indicated an understanding of the role that collaboration plays in coaching and how to operationalize it in their support of teachers. Further, all of the ELL TOSAs indicated they have received professional development on effective strategies for instructional coaching. Additionally, a large percentage of the ELL TOSAs indicated a knowledge of modeling as an effective coaching practice. Accordingly, all of the ELL TOSAs indicated that they had knowledge of feedback as an effective coaching strategy. However, there was not sufficient evidence to support that they learned the latter two strategies through professional development. A second theme surfaced as there was evidence to illustrate an interaction between motivation and the organization. Some ELL TOSAs indicated that their sense of self-efficacy was affected by conflicting roles and expectations for the job. Most of the ELL TOSAs indicated that their sense of self-efficacy was affected by an increased workload brought about by fiscal decision making. Finally, there was evidence illustrating the interaction between the organization and motivation. The majority of the of ELL TOSAs indicated that there is confusion about how their roles are perceived, leaving the ELL TOSAs to feel that their actions did not contribute to instructional change. In conclusion, five research-based recommendations to support ELL TOSA goal attainment and considerations for future research on instructional coaches for classroom teachers of ELLs are provided.

Keywords: English language development, English language acquisition, language and leadership, language coaching, English language learners, second language acquisition

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Authors: Tomasz Zarebski

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A very important element of the education system is its evaluation procedure. Each education system should be systematically evaluated and improved. Among the criteria subject to evaluation, attention should be paid to the following: structure of the study programme, implementation of the study programme, admission to studies, verification of learning outcomes achievement by students, giving credit for individual semesters and years, and awarding diplomas, competence, experience, qualifications and the number of staff providing education, staff development, and in-service training, education infrastructure, cooperation with social and economic stakeholders on the development, conditions for and methods of improving the internationalisation of education provided as part of the degree programme, supporting learning, social, academic or professional development of students and their entry on the labour market, public access to information about the study programme and quality assurance policy. Concerning the assessment process and the individual assessment indicators, the participation of students in these processes is essential. The purpose of this paper is to analyse the rules of student participation in accreditation processes on the example of individual countries in Europe. The rules of students' participation in the work of accreditation committees and their influence on the final grade of the committee were analysed. Most of the higher education institutions follow similar rules for accreditation. The general model gives the individual institution freedom to organize its own quality assurance, as long as the system lives up to the criteria for quality and relevance laid down in the particular provisions. This point also applies to students. The regulations of the following countries were examined in the legal-comparative aspect: Poland (Polish Accreditation Committee), Denmark (The Danish Accreditation Institution), France (High Council for the Evaluation of Research and Higher Education), Germany (Agency for Quality Assurance through Accreditation of Study Programmes) and Italy (National Agency for the Evaluation of Universities and Research Institutes).

Keywords: accreditation, student, study programme, quality assurance in higher education

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Authors: Adam M. Yates, Julie E. Byles

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Hypertension has been identified as a prominent co-morbidity of obesity. To improve clinical intervention of hypertension, it is critical to identify metrics that most accurately reflect risk for increased morbidity. Two of the most relevant and accurate measures for increased risk of hypertension due to excess adipose tissue are Body Mass Index (BMI) and Waist-Height Ratio (WHtR). Previous research has examined these measures in cross-national and cross-ethnic studies, but has most often relied on secondary means such as meta-analysis to identify and evaluate the efficacy of individual body mass measures. In this study, we instead use cross-sectional analysis to assess the cross-ethnic discriminative power of BMI and WHtR to predict risk of hypertension. Using the WHO SAGE survey, which collected anthropometric and biometric data from respondents in six middle-income countries (China, Ghana, India, Mexico, Russia, South Africa), we implement logistic regression to examine the discriminative power of measured BMI and WHtR with a known population of hypertensive and non-hypertensive respondents. We control for gender and age to identify whether optimum cut-off points that are adequately sensitive as tests for risk of hypertension may be different between groups. We report results for OR, RR, and ROC curves for each of the six SAGE countries. As seen in existing literature, results demonstrate that both WHtR and BMI are significant predictors of hypertension (p < .01). For these six countries, we find that cut-off points for WHtR may be dependent upon gender, age and ethnicity. While an optimum omnibus cut-point for WHtR may be 0.55, results also suggest that the gender and age relationship with WHtR may warrant the development of individual cut-offs to optimize health outcomes. Trends through multiple countries show that the optimum cut-point for WHtR increases with age while the area under the curve (AUROC) decreases for both men and women. Comparison between BMI and WHtR indicate that BMI may remain more robust than WHtR. Implications for public health policy are discussed.

Keywords: hypertension, obesity, Waist-Height ratio, SAGE

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Authors: Rahul Ravindranathan, R. P. Gokul

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India, in its efforts towards economic and social development, is currently experiencing a heavy demand for energy. Due to the lack of sufficient domestic energy reserves, the country is highly dependent on energy imports which has increased rapidly at a rate of about 12 % per annum since 2005. Hence, India is currently focusing its efforts to manage this energy supply and demand gap and eventually achieve energy security. One of the most cost effective means to reduce this gap is by adopting Energy efficiency measures in the country. Initial assessments have shown that Energy efficiency measures have an energy conservation potential of about 23%. For an estimated investment potential of USD 8 Billion, the annual energy savings was estimated to be about 180 Billion Units per annum. In order to explore this huge energy conservation potential, many critical factors need to be considered to achieve practical energy savings. Financing options for these investments is one such major factor. Not only has India come out with various policy level as well as technology level drives to promote Energy efficiency but it has also developed various financing schemes to promote investment in Energy Efficiency projects. The Public sector has already come out with certain financing schemes such as the Partial Risk Guarantee Fund (PRGF), Venture Capital Fund (VCF), Partial Risk Sharing Fund (PRSF) etc., and various sectors are gradually utilizing these schemes to implement energy saving measures. However, additional financing options are required in order to explore the untouched energy conservation potential in the country. Hence, there is a need to develop some innovative financing options for India which would motivate the private sectors as well as financing institutions to invest in these energy saving measures. This paper shall review the existing financing schemes launched by the Government of India and highlight the key benefits as well as challenges with respect to these schemes. In addition to this, the paper would also review new and innovative financing schemes for India and how the same could be adopted in other parts of the globe especially in South and South East Asia. This review would provide an insight to the various Governments as well as Financial Institutions in coming out with new financing schemes for their country.

Keywords: energy, efficiency, financing, India

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Authors: Peifang Hsieh

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New Taipei city faces increasing number of migrant families, in which the needs of children are sometimes neglected due to insufficient support from communities. Moreover, the traditional mindset of disengagement discourages citizens from preemptively identifying families in need in their communities, resulting in delay of prompt intervention from authorities concerned. To safeguard these vulnerable families, New Taipei city develops the 'Integrated Safety-Net Program for High-Risk Families' from 2011 by implementing the following measures: (A) New attitude and action: Instead of passively receiving reported case of high-risk families, the program takes proactive and preemptive approach to detect and respond at early stage, so the cases are prevented from worsening. In addition, cross-departmental integration mechanism is established to meet multiple needs of high-risk families. The children number added to the government care network is greatly increased to over 10,000, which is around 4.4 times the original number before the program. (B) New service points: 2000 city-wide convenience stores are added as service stations so that children in less privileged families can go to any of 24-hour convenience stores across the city to pick up free meals. This greatly increases the approachability to high-risk families. Moreover, the social welfare institutes will be notified with information left in convenience stores by children and follow up with further assistance, greatly enhancing chances of less privileged families being identified. (C) New Key Figures: Mobilize community officers and volunteers to detect and offer on-site assistance. Volunteer organizations within communities are connected to report and offer follow-up services in a more active manner. In total, from 2011 to 2015, 54,789 cases are identified through active care, benefiting 82,124 children. In addition, 87.49% family-cases in the program receiving comprehensive social assistance are no longer at high risk.

Keywords: cross department, high-risk families, public-private partnership, integrated safety net

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Authors: Mukul Sharma, Madhusmita Das, Sundeep Chaitanya Vedithi

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Leprosy is a chronic human disease caused by Mycobacterium leprae, that cannot be cultured in vitro. Though treatable with multidrug therapy (MDT), recently, bacteria reported resistance to multiple antibiotics. Targeting DNA replication and repair pathways can serve as the foundation of developing new anti-leprosy drugs. Due to the absence of an axenic culture medium for the propagation of M. leprae, studying cellular processes, especially those belonging to DNA repair pathways, is challenging. Genomic understanding of M. Leprae harbors several protein-coding genes with no previously assigned function known as 'hypothetical proteins'. Here, we report identification and expression of known and hypothetical DNA repair genes from a human skin biopsy and mouse footpads that are involved in base excision repair, direct reversal repair, and SOS response. Initially, a bioinformatics approach was employed based on sequence similarity, identification of known protein domains to screen the hypothetical proteins in the genome of M. leprae, that are potentially related to DNA repair mechanisms. Before testing on clinical samples, pure stocks of bacterial reference DNA of M. leprae (NHDP63 strain) was used to construct standard graphs to validate and identify lower detection limit in the qPCR experiments. Primers were designed to amplify the respective transcripts, and PCR products of the predicted size were obtained. Later, excisional skin biopsies of newly diagnosed untreated, treated, and drug resistance leprosy cases from SIHR & LC hospital, Vellore, India were taken for the extraction of RNA. To determine the presence of the predicted transcripts, cDNA was generated from M. leprae mRNA isolated from clinically confirmed leprosy skin biopsy specimen across all the study groups. Melting curve analysis was performed to determine the integrity of the amplification and to rule out primer‑dimer formation. The Ct values obtained from qPCR were fitted to standard curve to determine transcript copy number. Same procedure was applied for M. leprae extracted after processing a footpad of nude mice of drug sensitive and drug resistant strains. 16S rRNA was used as positive control. Of all the 16 genes involved in BER, DR, and SOS, differential expression pattern of the genes was observed in terms of Ct values when compared to human samples; this was because of the different host and its immune response. However, no drastic variation in gene expression levels was observed in human samples except the nth gene. The higher expression of nth gene could be because of the mutations that may be associated with sequence diversity and drug resistance which suggests an important role in the repair mechanism and remains to be explored. In both human and mouse samples, SOS system – lexA and RecA, and BER genes AlkB and Ogt were expressing efficiently to deal with possible DNA damage. Together, the results of the present study suggest that DNA repair genes are constitutively expressed and may provide a reference for molecular diagnosis, therapeutic target selection, determination of treatment and prognostic judgment in M. leprae pathogenesis.

Keywords: DNA repair, human biopsy, hypothetical proteins, mouse footpads, Mycobacterium leprae, qPCR

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Authors: M. Velana, G. Rinkenauer

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Nowadays, nurses are facing unprecedented amounts of pressure due to the ongoing global health demands. Work-related stress can cause a high physical and psychological workload, which can lead, in turn, to burnout. On the physiological level, stress triggers an initial activation of the sympathetic nervous and adrenomedullary systems resulting in increases in cardiac activity. Furthermore, activation of the hypothalamus-pituitary-adrenal axis provokes endocrine and immune changes leading to the release of cortisol and cytokines in an effort to re-establish body balance. Based on the current state of the literature, it has been identified that resilience and mindfulness exercises among nurses can effectively decrease stress and improve mood. However, it is still unknown what relaxation techniques would be suitable for and to what extent would be effective to decrease psychophysiological arousal deriving from either a physiological or a psychological stressor. Moreover, although cardiac activity and cortisol are promising candidates to examine the effectiveness of relaxation to reduce stress, it still remains to shed light on the role of cytokines in this process so as to thoroughly understand the body’s response to stress and to relaxation. Therefore, the main aim of the present study is to develop a comprehensive experimental paradigm and assess different relaxation techniques, namely progressive muscle relaxation and a mindfulness exercise originating from cognitive therapy by means of biofeedback, under highly controlled laboratory conditions. An experimental between-subject design will be employed, where 120 participants will be randomized either to a physiological or a psychological stress-related experiment. Particularly, the cold pressor test refers to a procedure in which the participants have to immerse their non-dominant hands into ice water (2-3 °C) for 3 min. The participants are requested to keep their hands in the water throughout the whole duration. However, they can immediately terminate the test in case it would be barely tolerable. A pre-test anticipation phase and a post-stress period of 3 min, respectively, are planned. The Trier Social Stress Test will be employed to induce psychological stress. During this laboratory stressor, the participants are instructed to give a 5-min speech in front of a committee of communication specialists. Before the main task, there is a 10-min anticipation period. Subsequently, participants are requested to perform an unexpected arithmetic task. After stress exposure, the participants will perform one of the relaxation exercises (treatment condition) or watch a neutral video (control condition). Electrocardiography, salivary samples, and self-report will be collected at different time points. The preliminary results deriving from the pilot study showed that the aforementioned paradigm could effectively induce stress reactions and that relaxation might decrease the impact of stress exposure. It is of utmost importance to assess how the human body responds under different stressors and relaxation exercises so that an evidence-based intervention could be transferred in a clinical setting to improve nurses’ general health. Based on suggestive future laboratory findings, the research group plans to conduct a pilot-level randomized study to decrease stress and promote well-being among nurses who work in the stress-riddled environment of a hospital located in Northern Germany.

Keywords: nurses, psychophysiology, relaxation, stress

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Authors: Herng-Sheng Lee, Chi-Yi Chen, Wan-Ting Huang, Li-Jen Chang, Solomon Chih-Cheng Chen, Hsin-Yi Yang

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A variety of gastrointestinal disorders, such as Crohn’s disease, ulcerative colitis, and coeliac disease, are recognized as risk factors for osteoporosis and osteoporotic fractures. One recent study suggests that individuals with irritable bowel syndrome (IBS) might also be at increased risk of osteoporosis and osteoporotic fractures. Up to now, the association between IBS and the risk of fractures at different anatomic sites occurrences is not completely clear. We conducted a population-based cohort analysis to investigate the fracture risk of IBS in comparison with non-IBS group. We identified 29,505 adults aged ≥ 20 years with newly diagnosed IBS using the Taiwan National Health Insurance Research Database in 2000-2012. A comparison group was constructed of patients without IBS who were matched according to gender and age. The occurrence of fracture was monitored until the end of 2013. We analyzed the risk of fracture events to occur in IBS by using Cox proportional hazards regression models. Patients with IBS had a higher incidence of osteoporotic fractures compared with non-IBS group (12.34 versus 9.45 per 1,000 person-years) and an increased risk of osteoporotic fractures (adjusted hazard ratio [aHR] = 1.27, 95 % confidence interval [CI] = 1.20 – 1.35). Site specific analysis showed that the IBS group had a higher risk of fractures for spine, forearm, hip and hand than did the non-IBS group. With further stratification for gender and age, a higher aHR value for osteoporotic fractures in IBS group was seen across all age groups in males, but seen in elderly females. In addition, female, elderly, low income, hypertension, coronary artery disease, cerebrovascular disease, and depressive disorders as independent osteoporotic fracture risk factors in IBS patients. The IBS is considered as a risk factor for osteoporotic fractures, particularly in female individuals and fracture sites located at the spine, forearm, hip and hand.

Keywords: irritable bowel syndrome, fracture, gender difference, longitudinal health insurance database, public health

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