Search results for: financial risk

Authors: Getiye Dejenu Kibret, Daniel Demant, Andrew Hayen

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Introduction: In Ethiopia, more than half of newborn babies do not have access to Emergency Obstetric and Neonatal Care (EmONC) services. Understanding the effect of distance to health facilities on service use and neonatal survival is crucial to recommend policymakers and improve resource distribution. We aimed to investigate the effect of distance to health services on maternal service use and neonatal mortality. Methods: We implemented a data linkage method based on geographic coordinates and calculated straight-line (Euclidean) distances from the Ethiopian 2016 demographic and health survey clusters to the closest health facility. We computed the distance in ESRI ArcGIS Version 10.3 using the geographic coordinates of DHS clusters and health facilities. Generalised Structural Equation Modelling (GSEM) was used to estimate the effect of distance on neonatal mortality. Results: Poor geographic accessibility to health facilities affects maternal service usage and increases the risk of newborn mortality. For every ten kilometres (km) increase in distance to a health facility, the odds of neonatal mortality increased by 1.33% (95% CI: 1.06% to 1.67%). Distance also negatively affected antenatal care, facility delivery and postnatal counselling service use. Conclusions: A lack of geographical access to health facilities decreases the likelihood of newborns surviving their first month of life and affects health services use during pregnancy and immediately after birth. The study also showed that antenatal care use was positively associated with facility delivery service use and that both positively influenced postnatal care use, demonstrating the interconnectedness of the continuum of care for maternal and neonatal care services. Policymakers can leverage the findings from this study to improve accessibility barriers to health services.

Keywords: acessibility, distance, maternal health service, neonatal mortality

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Authors: G. Kaushik, A. Gupta, S. Lalwani, K. D. Soni, S. Kumar, S. Sagar

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Objective: Alcohol is a leading risk factor associated with the disability and death due to RTI. Present study aims to demonstrate the demographic profile, injury pattern, physiological parameters of victims of trauma following alcohol consumption arriving in the emergency department (ED) and mortality in alcohol intoxicated trauma patients admitted to Apex Trauma Center in Delhi. Design and Methods: Present study was performed in randomly selected 182 alcohol breath analyzer tested RTI patients from the emergency department of Jai Prakash Narayan Apex Trauma Center (JPNATC), All India Institute of Medical Sciences, New Delhi for over a period of 3 months started from September 2013 to November 2013. Results: A total 182 RTI patients with blunt injury were selected between 30-40 years of age and equally distributed to male and female group. Of these, 93 (51%) were alcohol negative and 89 (49%) were alcohol positive. In 89 alcohol positive patients, 47 (53%) had Artificial Airway as compared to 17 (18%), (p < 0.001) in the other group. The Glasgow Coma Scale (GCS) score was lower (p < 0.001) and higher Injury Severity Score (ISS) was observed in alcohol positive group as compared to other group (p < 0.03). Increased number of patients (58%) were admitted to Intensive Care Unit (ICU), in alcohol positive group (p < 0.001) and they were in ICU for longer time compare to other group (p < 0.001). The alcohol positive patients were on ventilator support for longer duration as compared to non-alcoholic group (p < 0.001). Mortality rate was higher in alcohol intoxicated patients as compared to non-alcoholic RTI patients, however, the difference was not statistically significant. Conclusion: This study revealed that GCS, mean ISS, ICU stay, ventilation time etc. might have considerable impact on mortality in alcohol intoxicated patients as compared to non-alcoholic group.

Keywords: road traffic injuries, alcohol, trauma, emergency department

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Authors: Olajumoke Temilola Fatimat, Fasasi Fausat Kikelomo, Ishola Ganiyat Folasayo, Omayeka Mary

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Psychoactive substances are chemical substances that affect the normal functioning of the brain and cause changes in behavior, mood, and consciousness. Psychoactive substance abuse constitutes one of the most important risk–taking behavior among adolescents and young adults in secondary schools. The study, therefore, assessed the factors influencing the use of psychoactive substances among senior secondary students in Ibadan South–West Local Government Area, Oyo State. A descriptive non-experimental design was adopted; purposive and simple random sampling techniques were used to select 330 respondents, while questionnaires were used for data collection. The descriptive statistics of frequency count, percentages, inferential statistics of chi-square, and analysis of variance were used for the analysis. The results revealed that the majority of the respondents had heard of the term substance abuse before 226 (75.3%); it was also revealed that the majority of the respondents had good knowledge of psychoactive substances, 67.8%. There was no significant relationship between age and knowledge of psychoactive substances among senior secondary students, with a p-value of 0.199. The outcome of this study indicates that drug abuse is increasing day by day among secondary school students and may have greatly contributed to poor performance in examinations as well as undermining academic ability and performance among students. It was recommended that efforts should be made by the school authorities of the secondary schools in Ibadan South–West Local Government Area, Oyo State, and in Oyo State generally in collaboration with health personnel to educate adolescents on psychoactive substance abuse. This is to ensure that adolescents are adequately educated and updated on knowledge of psychoactive substance abuse.

Keywords: factors, influence, psychoactive substance, secondary school

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Authors: M. C. Pardo-Ferreira, J. C. Rubio-Romero, M. Martínez-Rojas

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Resilience Engineering is a new paradigm of safety management that proposes to change the way of managing the safety to focus on the things that go well instead of the things that go wrong. Many complex and high-risk sectors such as air traffic control, health care, nuclear power plants, railways or emergencies, have applied this new vision of safety and have obtained very positive results. In the construction sector, safety management continues to be a problem as indicated by the statistics of occupational injuries worldwide. Therefore, it is important to improve safety management in this sector. For this reason, it is proposed to apply Resilience Engineering to the construction sector. The Construction Phase Health and Safety Plan emerges as a key element for the planning of safety management. One of the key tools of Resilience Engineering is the Resilience Assessment Grid that allows measuring the four essential abilities (respond, monitor, learn and anticipate) for resilient performance. The purpose of this paper is to develop a questionnaire based on the Resilience Assessment Grid, specifically on the ability to learn, to assess whether a Construction Phase Health and Safety Plans helps companies in a construction site to implement this ability. The research process was divided into four stages: (i) initial design of a questionnaire, (ii) validation of the content of the questionnaire, (iii) redesign of the questionnaire and (iii) application of the Delphi method. The questionnaire obtained could be used as a tool to help construction companies to evolve from Safety-I to Safety-II. In this way, companies could begin to develop the ability to learn, which will serve as a basis for the development of the other abilities necessary for resilient performance. The following steps in this research are intended to develop other questions that allow evaluating the rest of abilities for resilient performance such as monitoring, learning and anticipating.

Keywords: resilience engineering, construction sector, resilience assessment grid, construction phase health and safety plan

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Authors: Gudrun Görlitz, Christian Schölzel, Alexander Vollmar

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Sites of Jewish Life in Berlin 1933-1945. Between Persecution and Self-assertion” was realized in a project funded by the European Regional Development Fund. A smartphone app, and a associated web site enable tourists and other participants of this educational offer to learn in a serious way more about the life of Jews in the German capital during the Nazi era. Texts, photos, video and audio recordings communicate the historical content. Interactive maps (both current and historical) make it possible to use predefined or self combined routes. One of the manifold challenges was to create a broad ranged guide, in which all detailed information are well linked with each other. This enables heterogeneous groups of potential users to find a wide range of specific information, corresponding with their particular wishes and interests. The multitude of potential ways to navigate through the diversified information causes (hopefully) the users to utilize app and web site for a second or third time and with a continued interest. Therefore 90 locations, a lot of them situated in Berlin’s city centre, have been chosen. For all of them text-, picture and/or audio/video material gives extensive information. Suggested combinations of several of these “site stories” are leading to the offer of detailed excursion routes. Events and biographies are also presented. A few of the implemented biographies are especially enriched with source material concerning the aspect of (forced) migration of these persons during the Nazi time. All this was done in a close and fruitful interdisciplinary cooperation of computer scientists and historians. The suggested conference paper aims to show the challenges shaping complex source material for practical use by different user-groups in a proper technical and didactic way. Based on the historical research in archives, museums, libraries and digital resources the quantitative dimension of the project can be sized as follows: The paper focuses on the following historiographical and technical aspects: - Shaping the text material didactically for the use in new media, especially a Smartphone-App running on differing platforms; - Geo-referencing of the sites on historical and current map material; - Overlay of old and new maps to present and find the sites; - Using Augmented Reality technologies to re-visualize destroyed buildings; - Visualization of black-/white-picture-material; - Presentation of historical footage and the resulting problems to need too much storage space; - Financial and juridical aspects in gaining copyrights to present archival material.

Keywords: smartphone app, history, tourists, German

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Authors: Byomakesh Debata, Jitendra Mahakud

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The recent financial crisis has been characterized by massive monetary policy interventions by the Central bank, and it has amplified the importance of liquidity for the stability of the stock market. This paper empirically elucidates the actual impact of monetary policy interventions on stock market liquidity covering all National Stock Exchange (NSE) Stocks, which have been traded continuously from 2002 to 2015. The present study employs a multivariate VAR model along with VAR-granger causality test, impulse response functions, block exogeneity test, and variance decomposition to analyze the direction as well as the magnitude of the relationship between monetary policy and market liquidity. Our analysis posits a unidirectional relationship between monetary policy (call money rate, base money growth rate) and aggregate market liquidity (traded value, turnover ratio, Amihud illiquidity ratio, turnover price impact, high-low spread). The impulse response function analysis clearly depicts the influence of monetary policy on stock liquidity for every unit innovation in monetary policy variables. Our results suggest that an expansionary monetary policy increases aggregate stock market liquidity and the reverse is documented during the tightening of monetary policy. To ascertain whether our findings are consistent across all periods, we divided the period of study as pre-crisis (2002 to 2007) and post-crisis period (2007-2015) and ran the same set of models. Interestingly, all liquidity variables are highly significant in the post-crisis period. However, the pre-crisis period has witnessed a moderate predictability of monetary policy. To check the robustness of our results we ran the same set of VAR models with different monetary policy variables and found the similar results. Unlike previous studies, we found most of the liquidity variables are significant throughout the sample period. This reveals the predictability of monetary policy on aggregate market liquidity. This study contributes to the existing body of literature by documenting a strong predictability of monetary policy on stock liquidity in an emerging economy with an order driven market making system like India. Most of the previous studies have been carried out in developing economies with quote driven or hybrid market making system and their results are ambiguous across different periods. From an eclectic sense, this study may be considered as a baseline study to further find out the macroeconomic determinants of liquidity of stocks at individual as well as aggregate level.

Keywords: market liquidity, monetary policy, order driven market, VAR, vector autoregressive model

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Authors: Muhammad Yasir Wadood, Fatemeh Babaeian

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By developing ultra-wideband (UWB) systems, there is a high demand for UWB filters with low insertion loss, wide bandwidth, and having a planar structure which is compatible with other components of the UWB system. A microstrip interdigital filter is a great option for designing UWB filters. However, the presence of via holes in this structure creates difficulties in the fabrication procedure of the filter. Especially in the higher frequency band, any misalignment of the drilled via hole with the Microstrip stubs causes large errors in the measurement results compared to the desired results. Moreover, in this case (high-frequency designs), the line width of the stubs are very narrow, so highly precise small via holes are required to be implemented, which increases the cost of fabrication significantly. Also, in this case, there is a risk of having fabrication errors. To combat this issue, in this paper, a via-less UWB microstrip filter is proposed which is designed based on a modification of a conventional inter-digital bandpass filter. The novel approaches in this filter design are 1) replacement of each via hole with a quarter-wavelength open circuit stub to avoid the complexity of manufacturing, 2) using a bend structure to reduce the unwanted coupling effects and 3) minimising the size. Using the proposed structure, a UWB filter operating in the frequency band of 3.9-6.6 GHz (1-dB bandwidth) is designed and fabricated. The promising results of the simulation and measurement are presented in this paper. The selected substrate for these designs was Rogers RO4003 with a thickness of 20 mils. This is a common substrate in most of the industrial projects. The compact size of the proposed filter is highly beneficial for applications which require a very miniature size of hardware.

Keywords: band-pass filters, inter-digital filter, microstrip, via-less

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Authors: John Acire, Wilfred Lajul, Ogwang Tom

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Using a qualitative research technique, this study investigates the influence of Early Childhood Education (ECE) on learning outcomes in lower primary schools in Gulu City, Uganda. The study, which is based on Vygotsky's sociocultural theory of human learning, fills gaps in the current literature on the influence of ECE on learning outcomes. The aims of the study include analyzing the state of learning outcomes, investigating ECE practices, and determining the influence of these practices on learning outcomes in lower primary schools. The findings highlight the critical significance of ECE in promoting children's overall development. Nursery education helps children improve their handwriting, reading abilities, and general cognitive development. Children who have received nursery education have improved their abilities to handle pencils, form letters, and engage in social interactions, highlighting the significance of fine motor skills and socializing. Despite the good elements, difficulties in implementing ECE practices were found, such as differences in teaching styles, financial limits, and potential weariness due to prolonged school hours. The study suggests focused interventions to improve the effectiveness of ECE practices, ensure their connection with educational goals and maximize their influence on children's development. The study's findings show that respondents agree on the importance of nursery education in supporting holistic development, socialization, language competency, and conceptual comprehension. Challenges in nursery education, such as differences in teaching techniques and insufficient resources, highlight the need for comprehensive measures to address these challenges. Furthermore, parental engagement in home learning activities was revealed as an important factor affecting early education outcomes. Children who were engaged at home performed better in lower primary, emphasizing the value of a supportive family environment. Finally, the report suggests measures to enhance parental participation, changes in teaching methods through retraining, and age-appropriate enrolment. Future studies might concentrate on the involvement of parents, ECE policy practice, and the influence of ECE teachers on lower primary school learning results. These ideas are intended to help create a more favorable learning environment by encouraging holistic development and preparing children for success in succeeding academic levels.

Keywords: early childhood education, learning outcomes in lower primary schools, early childhood education practices, how ECE practices influence learning outcomes in lower primary schools

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Authors: Faruk Aras, Melih Inal, Tansel Cinar

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The coordination of airport staff especially in the operations and maintenance departments is important for the airport operation. As a result, this coordination will increase the efficiency in all operation. Therefore, a Collaborative Decision-Making (CDM) system targets on improving the overall productivity of all operations by optimizing the use of resources and improving the predictability of actions. Enlarged productivity can be of major benefit for all airport operations. It also increases cost-efficiency. This study explains how predictive maintenance using IoT (Internet of Things), predictive operations and the statistical data such as Mean Time To Failure (MTTF) improves airport terminal operations and utilize airport terminal equipment in collaboration with collaborative decision making system/Airport Operation Control Center (AOCC). Data generated by the predictive maintenance methods is retrieved and analyzed by maintenance managers to predict when a problem is about to occur. With that information, maintenance can be scheduled when needed. As an example, AOCC operator would have chance to assign a new gate that towards to this gate all the equipment such as travellator, elevator, escalator etc. are operational if the maintenance team is in collaboration with AOCC since maintenance team is aware of the health of the equipment because of predictive maintenance methods. Applying predictive maintenance methods based on analyzing the health of airport terminal equipment dramatically reduces the risk of downtime by on time repairs. We can classify the categories as high priority calls for urgent repair action, as medium priority requires repair at the earliest opportunity, and low priority allows maintenance to be scheduled when convenient. In all cases, identifying potential problems early resulted in better allocation airport terminal resources by AOCC.

Keywords: airport, predictive maintenance, collaborative decision-making system, Airport Operation Control Center (AOCC)

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Authors: Seon-Young Lee, Harkiran Sagoo, Reem Farwana, Katharine Whitehurst, Alex Fowler, Riaz Agha

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Background/Aims: Systematic reviews and meta-analysis are becoming increasingly important way of summarizing research evidence. Researches in ophthalmology may represent further challenges, due to their potential complexity in study design. The aim of our study was to determine the reporting quality of systematic reviews and meta-analysis in ophthalmology with the PRISMA statement, by assessing the articles published between 2010 and 2015 from five major journals with the highest impact factor. Methods: MEDLINE and EMBASE were used to search systematic reviews published between January 2010 and December 2015, in 5 major ophthalmology journals: Progress in Retinal and Eye Research, Ophthalmology, Archives of Ophthalmology, American Journal of Ophthalmology, Journal of the American Optometric Association. Screening, identification, and scoring of articles were performed independently by two teams, followed by statistical analysis including the median, range, and 95% CIs. Results: 115 articles were involved. The median PRISMA score was 15 of 27 items (56%), with a range of 5-26 (19-96%) and 95% CI 13.9-16.1 (51-60%). Compliance was highest in items related to the description of rationale (item 3,100%) and inclusion of a structured summary in the abstract (item 2, 90%), while poorest in indication of review protocol and registration (item 5, 9%), specification of risk of bias affecting the cumulative evidence (item 15, 24%) and description of clear objectives in introduction (item 4, 26%). Conclusion: The reporting quality of systematic reviews and meta-analysis in ophthalmology need significant improvement. While the use of PRISMA criteria as a guideline before journal submission is recommended, additional research identifying potential barriers may be required to improve the compliance to the PRISMA guidelines.

Keywords: systematic reviews, meta-analysis, research methodology, reporting quality, PRISMA, ophthalmology

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Authors: Akanksha Dicholkar, Celin Jacob, Omkar More

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Work force instability, as demonstrated by high rates of staff turnover and lingering vacancy rates, continues to be a major challenge faced by health care organizations. The impact is manifested in workflow inefficiencies, delays in delivering patient care, and dissatisfaction among patients and staff, all of which can have significant negative effects on quality of care and patient safety. In addition, the staggering administrative costs created by a transient work force threaten health care organizations financial viability. One nurse retention strategy is to have newly hired nurses partake in Preceptorship. Precepting is a way to enculturate new employees into their role. Also good professional, collegial relationship between an experienced nurse and a newly hired nurse relations was evidenced. This study demonstrates impact of preceptor program on absconding rate, employee satisfaction & Patient satisfaction. Purpose of study: To decrease absconding rate. Objective: 1. To reduce the high absconding rate among nurses in Aster Medcity (AMC). 2. To facilitate the acclimatization of the newly hired nurse into their role, focusing on professional growth, inter-professional relationships and clinical skills required for the job. Methodology: Descriptive study by Convenience sampling method and collect data by direct observation, questionnaire, interviews. Sample size as per Sample size statistical table at 95 % CI. We conducted a pre and post intervention analysis to assess the impact of Preceptorship at AMC, with a daily occupancy of approx. 300 patients. Result: Preceptor program has had a significant improvement positive impact on all measured parameters. Absconding rate came down from 20% to 0% (P= 0.001). Patient satisfaction scores rose from 85% to 95%. Employee satisfaction rose form 65% to 85%. Conclusion: The project proved that Preceptor Development Programme and the steps taken in hand holding of the new joinees were effective in reducing the absconding rate among nurses and improved the overall satisfaction of new nurses. Preceptee satisfaction with the preceptorship experience was correlated with favorable evaluation of the relationship between the preceptee and preceptor. These findings indicate that when preceptors and preceptees have the benefit of formal preceptorship programs that are well supported, and when the preceptors’ efforts are rewarded, satisfaction is enhanced for both participants, preceptor commitment to the role is reinforced.

Keywords: absconding rate, preceptor, employee satisfaction index, satisfaction index

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Authors: Aminah Salim, Idrees Ahmed Nasir, Abdul Qayyum Rao, Muhammad Ali, Muhammad Sohail Anjum, Ayesha Hameed, Bushra Tabassum, Anwar Khan, Arfan Ali, Mariyam Zameer, Tayyab Husnain

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Risk assessment of transgenic herbicide tolerant sugarcane having CEMB codon optimized cp4EPSPS gene was done in present study. Fifteen days old chicks taken from K&Ns Company were randomly assorted into four groups with eight chicks in each group namely control chicken group fed with commercial diet, non-transgenic group fed with non-experimental sugarcane and transgenic group fed with transgenic sugarcane with minimum and maximum level. Body weights, biochemical analysis for Urea, alkaline phosphatase, alanine transferase, aspartate transferase, creatinine and bilirubin determination and histological examination of chicks fed with four types of feed was taken at fifteen days interval and no significant difference was observed in body weight biochemical and histological studies of all four groups. Protein isolated from the serum sample was analyzed through dipstick and SDS-PAGE, showing the absence of transgene protein in the serum sample of control and experimental groups. Moreover the amplification of cp4EPSPS gene with gene specific primers of DNA isolated from chicks blood and also from commercial diet was done to determine the presence and mobility of any nucleotide fragment of the transgene in/from feed and no amplification was obtained in feed as well as in blood extracted DNA of any group. Also no mRNA expression of cp4EPSPS gene was obtained in any tissue of four groups of chicks. From the results it is clear that there is no deleterious or harmful effect of the CEMB codon optimized transgenic cp4EPSPS sugarcane on the chicks health.

Keywords: chicks, cp4EPSPS, glyphosate, sugarcane

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Authors: Mohammad Mohammadi, Mohammad Pashmchi

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Background: Malnutrition commonly develops and worsens following gastric cancer surgery, particularly after discharge, which is associated with adverse outcomes. Former studies have primarily focused on patients during their hospital stay period, and there is limited evidence regarding the recommendation of nutritional interventions for patients after discharge from the hospital following gastric cancer surgery. This review is aimed to evaluate the efficiency of post-discharge dietary counseling with oral nutritional supplements (ONS), and dietary counseling alone on post-surgical nutritional outcomes in patients undergoing gastric cancer surgery. Methods: The four databases of Embase, PubMed, web of science, and google scholar were searched up to November 2022 for relevant randomized controlled trials. The Cochrane Collaboration’s assessment tool for randomized trials was used to evaluate the quality of studies. Results: Compared to patients who only received dietary counseling, patients who received both dietary counseling and ONS had considerably higher SMI, BMI, and less weight loss and sarcopenia occurrence rate. The patients who had received dietary counseling and ONS had significantly lower risk of chemotherapy intolerance. No differences in the readmission rate between the two groups was found. In terms of the quality of life, concomitant dietary advice and ONS significantly was associated with lower appetite loss and fatigue rate, but there was no difference in the other outcomes between the two groups. Conclusions: Post-discharge dietary advice with ONS following gastric cancer surgery may improve skeletal muscle maintenance, nutritional outcomes, quality of life variables, and chemotherapy tolerance. This evidence supports the recommendation of post-discharge dietary advice with ONS for patients who underwent gastric cancer surgery.

Keywords: gastric cancer surgery, oral nutritional supplements, malnutrition, gastric cancer

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Authors: Karen V. Lee

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The background and significance of this study involves autoethnographic research about a music teacher learning how education and curriculum planning can help her overcome harmful and lasting career consequences from sexual violence. Curriculum surrounding intervention resources from education helps her cope with consequences influencing her career as music teacher. Basic methodology involves the qualitative method of research as theoretical framework where the author is drawn into a deep storied reflection about political issues surrounding teachers who need to overcome social, psychological, and health risk behaviors from violence. Sub-themes involve counseling, curriculum, adult education to ensure teachers receive social, emotional, physical, spiritual, and intervention resources that evoke visceral, emotional responses from the audience. Major findings share how stories provide helpful resources to teachers who have been victims of violence. It is hoped the research dramatizes an episodic yet incomplete story that highlights the circumstances surrounding the protagonist’s life as teacher with previous sexual violence. In conclusion, the research has a reflexive storied framework with video and music from curriculum planning that embraces harmful and lasting consequences from sexual violence. The reflexive story of the sensory experience critically seeks verisimilitude by evoking lifelike and believable feelings from others. Thus, the scholarly importance of using education and curriculum as intervention resources to accompany storied research can provide transformative aspects that can contribute to social change. Overall, the circumstance surrounding the story about sexual violence is not uncommon in society. Thus, continued education and curriculum that supports the moral mission to help teachers overcome sexual violence that socially impacts their professional lives as victims.

Keywords: education, curriculum, sexual violence, storied autoethnography

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Authors: Chukwuka Justus Iwegbu

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Background: A major concern facing the world is providing senior citizens, individuals with disabilities, and other vulnerable groups with high-quality care. This issue is more serious in Nigeria's North Eastern area, where the burden of disease and disability is heavy, and access to care is constrained. This study aims to fill this gap by exploring the roles, challenges and support needs of caregivers, care home management, funding and administration in challenged communities in North Eastern Nigeria. The study will also provide a comprehensive understanding of the current situation and identify opportunities for improving the quality of care and support for caregivers and care recipients in these communities. Methods: A mixed-methods design, including both quantitative and qualitative data collection methods, will be used, and it will be guided by the stress process model of caregiving. The qualitative stage approach will comprise a survey, In-depth interviews, observations, and focus group discussion and the quantitative analysis will be used in order to comprehend the variations between caregiver's roles and care home management. A review of relevant documents, such as care home policies and funding reports, would be used to gather quantitative data on the administrative and financial aspects of care. The data collected will be analyzed using both descriptive statistics and thematic analysis. A sample size of around 200-300 participants, including caregivers, care recipients, care home managers and administrators, policymakers and health care providers, would be recruited. Findings: The study revealed that caregivers in challenged communities in North Eastern Nigeria face significant challenges, including lack of training and support, limited access to funding and resources, and high levels of burnout. Care home management and administration were also found to be inadequate, with a lack of clear policies and procedures and limited oversight and accountability. Conclusion: There is a need for increased investment in training and support for caregivers, as well as a need for improved care home management and administration in challenged communities in North Eastern Nigeria. It also highlights the importance of involving community members in decision-making and planning processes related to care homes and services. The study would contribute to the existing body of knowledge by providing a detailed understanding of the challenges faced by caregivers, care home managers and administrators.

Keywords: caregivers, care home management, funding, administration, challenge communities, North Eastern Nigeria

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Authors: Ergham Al Bachir

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This study adopts strategic leadership (Upper Echelons) as the core theory and contextual leadership theory as the research lens. This research asks how the external context impacts strategic leadership effectiveness to achieve the outcomes in pluralistic organizations (PO). The study explores how the context influences the selection of CEOs, top management teams (TMT), and their leadership effectiveness. POs are characterized by the multiple objectives of their top management teams, divergent objectives, multiple strategies, and multiple governing authorities. The research question is explored by means of a qualitative multiple-case study focusing on healthcare, real estate, and financial services organizations. The data sources are semi-structured interviews, documents, and direct observations. The data analysis strategy is inductive and deploys thematic analysis and cross-case synthesis. The findings differentiate between national and international CEOs' delegation of authority and relationship with the Board of Directors. The findings identify the elements of the dynamic context that influence TMT and PO outcomes. The emergent hybrid strategic and contextual leadership framework shows how the different contextual factors influence strategic direction, PO context, selection of CEOs and TMT, and the outcomes in four pluralistic organizations. The study offers seven theoretical contributions to Upper Echelons, strategic leadership, and contextual leadership research. (1) The integration of two theories revealed how CEO’s impact on the organization is complementary to the contextual impact. (2) Conducting this study in the Middle East contributes to strategic leadership and contextual leadership research. (3) The demonstration of the significant contextual effects on the selection of CEOs. (4 and 5) Two contributions revealed new links between the context, the Board role, internal versus external CEOs, and national versus international CEOs. (6 and 7) This study offered two definitions: what accounts for CEO leadership effectiveness and organizational outcomes. Two methodological contributions were also identified: (1) Previous strategic leadership and Upper Echelons research are mainly quantitative, while this study adopts qualitative multiple-case research with face-to-face interviews. (2) The extrication of the CEO from the TMT advanced the data analysis in strategic leadership research. Four contributions are offered to practice: (1) The CEO's leadership effectiveness inside and outside the organization. (2) Rapid turnover of predecessor CEOs signifies the need for a strategic and contextual approach to CEOs' succession. (3) TMT composition and education impact on TMT-CEO and TMT-TMT interface. (4) Multilevel strategic contextual leadership development framework.

Keywords: strategic leadership, contextual leadership, upper echelons, pluralistic organizations, cross-cultural leadership

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Authors: Rachel Shukrun, Szilvia Baron, Victoria Fidel, Anna Shusterman, Osnat Sher, Netanya Kollender, Dror Levin, Yair Peled, Yair Gortzak, Yoav Ben-Shahar, Revital Caspi, Sagi Gordon, Michal Manisterski, Ronit Elhasid

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Ewing sarcoma (EWS) is a highly aggressive cancer with a survival rate of 70–80% for patients with localized disease and under 30% for those with metastatic disease. Tumor-infiltrating neutrophils (TIN) can generate extracellular net-like DNA structures known as neutrophil extracellular traps (NETs). However, little is known about the presence and prognostic significance of tumor-infiltrating NETs in EWS. Herein, we investigated 46 patients diagnosed with EWS and treated in the Tel Aviv Medical Center between 2010 and 2021. TINs and NETs were identified in diagnostic biopsies of EWS by immunofluorescent. In addition, NETs were investigated in neutrophils isolated from peripheral blood samples of EWS patients at diagnosis and following neoadjuvant chemotherapy. The relationships between the presence of TINs and NETs, pathological and clinical features, and outcomes were analyzed. Our results demonstrate that TIN and NETs at diagnosis were higher in EWS patients with metastatic disease compared to those with local disease. High NETs formation at diagnosis predicted poor response to neo-adjuvant chemotherapy, relapse, and death from disease (P < .05). NETs formation in peripheral blood samples at diagnosis was significantly elevated among patients with EWS compared to pediatric controls and decreased significantly following neoadjuvant chemotherapy. In conclusion, NETs formation seems to have a role in the EWS immune microenvironment. Their presence can refine risk stratification, predict chemotherapy resistance and survival, and serve as a therapeutic target in patients with EWS.

Keywords: Ewing sarcoma, tumor microenvironment, neutrophil, neutrophil extracellular traps (NETs), prognosis

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Authors: Maram Shahad Dana Anfal

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This research paper presents the design of a surveillance drone with computer-aided durability and model analyses that provides a cost-effective and efficient solution for various applications. The quadcopter's design is based on a lightweight and strong structure made of materials such as aluminum and titanium, which provide a durable structure for the quadcopter. The structure of this product and the computer-aided durability system are both designed to ensure frequent repairs or replacements, which will save time and money in the long run. Moreover, the study discusses the drone's ability to track, investigate, and deliver objects more quickly than traditional methods, makes it a highly efficient and cost-effective technology. In this paper, a comprehensive analysis of the quadcopter's operation dynamics and limitations is presented. In both simulation and experimental data, the computer-aided durability system and the drone's design demonstrate their effectiveness, highlighting the potential for a variety of applications, such as search and rescue missions, infrastructure monitoring, and agricultural operations. Also, the findings provide insights into possible areas for improvement in the design and operation of the drone. Ultimately, this paper presents a reliable and cost-effective solution for surveillance applications by designing a drone with computer-aided durability and modeling. With its potential to save time and money, increase reliability, and enhance safety, it is a promising technology for the future of surveillance drones. operation dynamic equations have been evaluated successfully for different flight conditions of a quadcopter. Also, CAE modeling techniques have been applied for the modal risk assessment at operating conditions.Stress analysis have been performed under the loadings of the worst-case combined motion flight conditions.

Keywords: drone, material, solidwork, hypermesh

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Authors: Mariateresa Torchia, Helene Cristini, Hannele Kauppinen

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Leadership plays a vital role in organizations. Leaders provide directions and facilitate the processes that enable organizations to achieve their goals and objectives. However, while productivity and financial objectives are often given the greatest emphasis, leaders also have the responsibility for instituting standards of ethical conduct and moral values that guide the behavior of employees. Leaders’ behaviors such as support, empowerment and a high-quality relationship with their employees might not only prevent stress, but also improve employees’ stress coping meanwhile contributing to their affective well-being. Stemming from Girard’s Mimetic Theory, this study aims at understanding how leaders can foster well-being in organizations. To do so, we explore which is the role leaders play in conflict management, resentment management and negative emotions dissipation. Furthermore, we examine whether and to what extent religiosity impacts the way in which leaders operate in relation to employees’ well-being. Indeed, given that organizational values are crucial to ethical behavior and firms’ values may be steeled by a deep sense of spirituality and religious identification, there is a need to take a closer look at the role religion and spirituality play in influencing the way leaders impact employees’ well-being. Thus, religion might work as an overarching logic that provides a set of principles guiding leaders’ everyday practices and relations with employees. We answer our research questions using a qualitative approach. We interviewed 27 Christian leaders (members of the Christian Entrepreneurs and Leaders Association – EDC, a non-profit organization created in 1926 including 3,000 French Christian Leaders & Entrepreneurs). Our results show that well-being can have a different meaning in relation to the type of companies, size, culture, country of analysis. Moreover the values and believes of leaders influence the way they see and foster well-being among employees. Furthermore, leaders can have both a positive or negative impact on well-being. Indeed on the one side, they could increase well-being in the company while on the other hand, they could be the source of resentment and conflicts among employees. Finally, we observed that Christian leaders possess characteristics that are sometimes missing in leaders (humility, inability to compare with others, attempt to be coherent with their values and beliefs, interest in the common good instead of the personal interest, having tougher dilemmas, collectively undertaking the firm). Moreover the Christian leader believes that the common good should come before personal interest. In other words, to them, not only short –termed profit shouldn’t guide strategical decisions but also leaders should feel responsible for their employees’ well-being. Last but not least, the study is not an apologia of Christian, yet it discusses the implications of these values through the light of Girard’s mimetic theory for both theory and practice.

Keywords: Christian leaders, employees well-being, leadership, mimetic theory

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Authors: Eric Lai, Sarah Lorger, David Eisinger, Richard Waugh

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Introduction: Percutaneous embolization of varicoceles has shown similar outcomes to surgery. However, there are advantages of radiological intervention as patients are not exposed to general anaesthesia, experience a quicker recovery and face a lower risk of major complications. Radiological interventions are also preferable after a failed surgical approach. We evaluate clinical outcomes of percutaneous embolization at a tertiary hospital in Sydney, Australia. Methods: Retrospective case series without a control group from a single site (Royal Prince Alfred Hospital, Sydney, Australia). A data search was performed on the interventional radiology database with the word “varicocele” between February 2017 and March 2022. 62 patients were identified. Each patient file was reviewed and included in the study if they met the inclusion criteria. Results: A total of 56 patients were included. 6 patients were excluded as they did not receive intervention after the initial diagnostic venography. Technical success was 100%. Complications were seen in 3 patients (5.3%). The complications included post-procedural pain and fever, venous perforation with no clinical adverse outcome, and a mild allergic reaction to contrast. Recurrence occurred in 3 patients (5.6%), all of whom received a successful second procedure. DISCUSSION: This study demonstrates comparable rates of technical success, complication rate and recurrence to other studies in the literature. When compared to surgical outcomes, the results were also similar. The main limitation is multiple patients lack long-term follow-up beyond 1 year, resulting in potential underestimation of the recurrence rate. Conclusion: Percutaneous embolization of varicocele is a safe alternative to surgical intervention.

Keywords: varicocele, interventional radiology, urology, radiology

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

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

Keywords: pasurgrel, PCI, NICE, STEMI

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Authors: Shraddha Srivastava, N. K. Painuly, S. P. Mishra, Navin Singh, Muhsin Punchankandy, Kirti Srivastava, M. L. B. Bhatt

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Various optimization methods used in interstitial brachytherapy are based on dwell positions and dwell weights alteration to produce dose distribution based on the implant geometry. Since these optimization schemes are not anatomy based, they could lead to deviations from the desired plan. This study was henceforth carried out to compare anatomy-based Inverse Planning Simulated Annealing (IPSA) optimization technique with graphical and geometrical optimization methods in interstitial high dose rate brachytherapy planning of cervical carcinoma. Six patients with 12 CT data sets of MUPIT implants in HDR brachytherapy of cervical cancer were prospectively studied. HR-CTV and organs at risk (OARs) were contoured in Oncentra treatment planning system (TPS) using GYN GEC-ESTRO guidelines on cervical carcinoma. Three sets of plans were generated for each fraction using IPSA, graphical optimization (GrOPT) and geometrical optimization (GOPT) methods. All patients were treated to a dose of 20 Gy in 2 fractions. The main objective was to cover at least 95% of HR-CTV with 100% of the prescribed dose (V100 ≥ 95% of HR-CTV). IPSA, GrOPT, and GOPT based plans were compared in terms of target coverage, OAR doses, homogeneity index (HI) and conformity index (COIN) using dose-volume histogram (DVH). Target volume coverage (mean V100) was found to be 93.980.87%, 91.341.02% and 85.052.84% for IPSA, GrOPT and GOPT plans respectively. Mean D90 (minimum dose received by 90% of HR-CTV) values for IPSA, GrOPT and GOPT plans were 10.19 ± 1.07 Gy, 10.17 ± 0.12 Gy and 7.99 ± 1.0 Gy respectively, while D100 (minimum dose received by 100% volume of HR-CTV) for IPSA, GrOPT and GOPT plans was 6.55 ± 0.85 Gy, 6.55 ± 0.65 Gy, 4.73 ± 0.14 Gy respectively. IPSA plans resulted in lower doses to the bladder (D₂

Keywords: cervical cancer, HDR brachytherapy, IPSA, MUPIT

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Authors: Linda Boussaid, Farid Brahim Belaribi

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The physico-chemical properties of liquid materials in the industrial field, in general, and in that of the chemical industries, in particular, constitutes a prerequisite for the design of equipment, for the resolution of specific problems (related to the techniques of purification and separation, at risk in the transport of certain materials, etc.) and, therefore, at the production stage. Chloroalkanes, ethers constitute three chemical families having an industrial, theoretical and environmental interest. For example, these compounds are used in various applications in the chemical and pharmaceutical industries. In addition, they contribute to the particular thermodynamic behavior (deviation from ideality, association, etc.) of certain mixtures which constitute a severe test for predictive theoretical models. Finally, due to the degradation of the environment in the world, a renewed interest is observed for ethers, because some of their physicochemical properties could contribute to lower pollution (ethers would be used as additives in aqueous fuels.). This work is a thermodynamic, experimental and theoretical study of the volumetric properties of liquid binary systems formed from compounds belonging to the chemical families of chloroalkanes, ethers, having an industrial, theoretical and environmental interest. Experimental determination of the densities and excess volumes of the systems studied, at different temperatures in the interval [278.15-333.15] K and at atmospheric pressure, using an AntonPaar vibrating tube densitometer of the DMA5000 type. This contribution of experimental data, on the volumetric properties of the binary liquid mixtures of 1,2-dichloroethane with an ether, supplemented by an application of the theoretical model of Prigogine-Flory-Patterson PFP, will probably contribute to the enrichment of the thermodynamic database and the further development of the theory of Flory in its Prigogine-Flory-Patterson (PFP) version, for a better understanding of the thermodynamic behavior of these liquid binary mixtures

Keywords: prigogine-flory-patterson (pfp), propriétés volumétrique , volume d’excés, ethers

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Authors: Nadeem Munawar, Tariq Mahmood

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Habitat manipulation is an important technique that can be used for controlling rodent damage in agricultural ecosystems. It involves intentionally manipulation of vegetation cover in adjacent habitats around the active burrows of rodents to reduce shelter, food availability and to increase predation pressure. The current study was conducted in the Pothwar Plateau during the respective non-crop period of wheat-groundnut (post-harvested and un-ploughed/non-crop fallow lands) with the aim to assess the impact of the reduction in vegetation height of adjacent habitats (field borders) on rodent’s richness and abundance. The study area was divided into two sites viz. treated and non-treated. At the treated sites, habitat manipulation was carried out by removing crop cache, and non-crop vegetation’s over 10 cm in height to a distance of approximately 20 m from the fields. The trapping sessions carried out at both treated and non-treated sites adjacent to wheat-groundnut fields were significantly different (F 2, 6 = 13.2, P = 0.001) from each other, which revealed that a maximum number of rodents were captured from non-treated sites. There was a significant difference in the overall abundance of rodents (P < 0.05) between crop stages and between treatments in both crops. The manipulation effect was significantly observed on damage to crops, and yield production resulted in the reduction of damage within the associated croplands (P < 0.05). The outcomes of this study indicated a significant reduction of rodent population at treated sites due to changes in vegetation height and cover which affect important components, i.e., food, shelter, movements and increased risk sensitivity in their feeding behavior; therefore, they were unable to reach levels where they cause significant crop damage. This method is recommended for being a cost-effective and easy application.

Keywords: agricultural ecosystems, crop damage, habitat manipulation, rodents, trapping

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Authors: Tess Hartland, Moitree Banerjee, Sue Churchill, Antonina Pereira, Ian Tyndall, Ruth Lowry

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Background: Sexual health services and policies for middle-aged and older adults are underdeveloped, while global sexually transmitted infections in this age group are on the rise. The Interreg cross-Europe Sexual Health In Over 45s (SHIFT) project aims to increase participation in sexual health services and improve sexual health and wellbeing in people aged over 45, with an additional focus on disadvantaged groups. Methods: A two-pronged mixed-methodology is being used to develop a model for good service provision in sexual health for over 45s. (1) Following PRISMA-ScR guidelines, a scoping review is being conducted, using the databases PsychINFO, Web of Science, ERIC and PubMed. A key search strategy using terms around sexual health, good practice, over 45s and disadvantaged groups. The initial search for literature yielded 7914 results. (2) Surveys (n=1000) based on the Theory of Planned Behaviour are being administered across the UK, Belgium and Netherlands to explore current sexual health knowledge, awareness and attitudes. Expected results: It is expected that sexual health needs and potential gaps in service provision will be identified in order to inform good practice for sexual health services for the target population. Results of the scoping review are being analysed, while focus group and survey data is being gathered. Preliminary analysis of the survey data highlights barriers to access such as limited risk awareness and stigma. All data analysis will be completed by the time of the conference. Discussion: Findings will inform the development of a model to improve sexual health and wellbeing for among over 45s, a population which is often missed in sexual health policy improvement.

Keywords: adult health, disease prevention, health promotion, over 45s, sexual health

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Authors: Thel Phyu Phyu Soe

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Myanmar started its new political movement in 2011, opening up to trade, encouraging foreign investment, deepening its financial sectors. The tourism is one of the key sectors to make reform process from the perspective of green economy and green growth. The Inle Lake, second largest lake, famous for broad diversity of cultural and natural assets, become one of the country’s main tourism destination. In the study area, local livelihoods are based on a combination of farming (mainly floating garden) wage labor, tourism, and small business. But the Inle lake water body or water surface area decreased by 96.44 km² within 20 years, from 67.98 km² in 1990 to 56.63 km² in 2010. Floating garden cultivation (hydro phonic farm) is a distinguished characteristic of Inle Lake. Two adjacent villages (A and B) were selected to compare the relationship between tourism access and agricultural production. Ground truthing, focus group discussion, and in-depth questionnaires with floating gardeners were carried out. In A village, 57% of the respondents relied tourism as their major income sources, while almost all the households in B village relied floating gardens as major livelihood. Both satellite image interpretation and community studies highlighted that around 80% of the floating garden become fallow after severe drought in 2010 and easy income access to tourism related activities. The villagers can get 20-30 US$ for round trip guiding to major tourist attraction places.Even though tourism is the major livelihood options for the A village, the poorest households (less than 1500 US$ per year) are those who didn’t own transportation property for tourism related activities. In B village, more than 70% of the households relied floating gardens as their major income sources and less participated in tourism related activities because they don’t have motorboat stand connected to the major tourist attraction areas. Access to tourism related activities (having boat stand where they can guide tourists by boat and sell local products and souvenirs) have much impacted on changes in local people livelihood options. However, tourism may have impacts that are beneficial for one group of a society, but which are negative for another. Income inequality and negative impacts can only be managed effectively if they have been identified, measured and evaluated. The severe drought in 2010, instability of lake water level, high expenses for agriculture assisted the local people to participate in easy access tourism related activities.

Keywords: diminishing, floating garden, livelihood, tourism-related income

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Authors: Farida Habib, Haya Alfozan, Eman Miligi, Najla Alotaibi

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Background: Women’s satisfaction with maternity services, especially care during labor and birth, has become highly significant to healthcare providers, administrators, and policymakers. Purpose: The aims of this study were to assess maternal satisfaction regarding the quality of care during labor and to compare the level of maternal satisfaction between women who delivered by physicians and those delivered by midwives. Methodology: A descriptive, cross-sectional, correlational design was used. A convenient sample of 180 low-risk cases of immediate postpartum women who delivered at King Abdul-Aziz medical city was recruited. Women whose babies were diagnosed with serious health problems were excluded from the study. Data were collected using a self-administered questionnaire. The validity and reliability of the questionnaire were ensured. The questionnaire included three parts, namely: demographics data, medical history, and obstetrical history, and the last part is the satisfaction assessment tool. Ethical confederations were ensured. Maternal satisfaction during labor was classified in terms of health care, health workers' communication, and the environment. Results: Regarding health care, women were highly satisfied with care received from nurse (M = 4.21 + 0.88), medical care received (M = 4.17 + 0.79), and comfort techniques (M = 4.04 + 0.91). Regarding health workers' communication, women were highly satisfied with the provider to treat with dignity and respect (M = 4.03 + 0.91) and orientation to the toilet, bathroom, washing area (M = 4.00 + 0.93). Regarding the environment, women were highly satisfied with the experience of their baby's birth (M = 4.18 + 0.98) and supplies with drugs and supplies (M = 4.09 + 0.97). There was no statistically significant difference in maternal satisfaction between women who delivered by physicians and those delivered by midwives. Conclusion: Women were generally satisfied with their labor and delivery experience. There was no difference in maternal satisfaction on the labor process between women who delivered by physicians and those delivered by midwives.

Keywords: maternity, satisfaction, labor, delivery

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Authors: Bushra Alghamdi, Alla Alsharif, Hamzah Aljohani, Saba Kassim

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Introduction: Collaborative work has always been acknowledged as a fundamental concept in delivering oral health care. Aim: This study aimed to assess the perception and attitude of pharmacists in oral health promotion and to determine the confident levels of pharmacists in delivering advice on oral health problems. Methods: An observational cross-sectional survey, using self-administered anonymous questionnaires, was conducted between March and April 2017. The study recruited a convenience sample of registered community pharmacists who were working in local private pharmaceutical stores in the urban area of Madinah, Kingdom of Saudi Arabia (KSA). A preliminary descriptive analysis was performed. Results: Thirty-five pharmacists have completed the surveys. All participants were males, with a mean age of 35.5 ( ± 6.92) years. Eighty-six percent of the participants reported that pharmacists should have a role in oral health promotion. Eighty percent have reported adequate level of confident when giving advice on most of the common oral health problems that include; oral health related risk behaviors such as tobacco cessation (46%), bleeding gums (63%) and sensitive teeth (60%). However, higher percentages of pharmacists have reported low confident levels when giving advice in relation to specific domain of dentistry, such as lost dental fillings (57%), loose crowns (60%), trauma to teeth (40%), denture-related problems (51%) and oral cancer (6.9%). Conclusion: Community pharmacists recognized their potential role in promoting oral health in KSA. Community pharmacists had varying levels of ability and confidence to offer support for oral health. The study highlighted that inner professional collaboration between pharmacists and dental care healthcare should be enhanced.

Keywords: community, oral health, promotion, pharmacist

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Authors: Mehak Nagpal, T. S. Sathyanarayan Rao

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Background: Sexual functioning is a neglected aspect of health in women with diabetes, though it contributes greatly towards quality of life and feeling of wellbeing. Also women with DM are at higher risk than men of developing sexual dysfunction and depression. Materials and Methods: Cross-sectional comparison study. Sample size: 100 previously diagnosed type 2DM patients attending Outpatient Diabetic Clinic at Medicine department JSS Hospital Mysore; aged 20-65 years and 60 normal healthy female subjects for Control group. Data was collected with ethical approval over a period of 2 years. Tools Used: 1) Hamilton Depression Rating Scale (HAMD – 17 item) 2) Female Sexual Functioning Index (FSFI) 3) Arizona Sexual Experience Scale (ASEX-F) for female-for screening. 4) The Appraisal of Diabetes Scale (ADS). Results: Statistically significant differences were observed in prevalence rate and severity of depression between diabetic group (45% vs 11% syndromal depression) and controls. Depression scores correlated significantly with glycaemic control, adherence to treatment, BMI and the cognitive appraisal of diabetes. There was significantly greater impairment in the sexual functioning of women with type 2 diabetes mellitus as compared to controls; both prevalence (62% vs 38.3%) and severity (p value < 0.01). Arousal (74.2% vs 53.3%), Desire (76.3% vs 50%) and Satisfaction (76.7% vs 63.7%) were most affected and 64.5% were affected in 2 or more domains. A negative illness appraisal on ADS correlated significantly with poor glycaemic control, higher rates of depression and also more severe female sexual dysfunction (p value < 0.05). Conclusion: Diabetes specific factors that correlated significantly with FSD in this study included the psychological appraisal of diabetes, duration of diabetes, presence of complications and BMI.

Keywords: depression, female sexual dysfunction, India, type 2 diabetes mellitus

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Authors: Jong Yeop Kim, In Kyong Yi, Hyun Jeong Kwak, Sook Young Lee, Sung Yong Park

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Background: Several video laryngoscopes (VLs) were used to facilitate tracheal intubation in the normal and potentially difficult airway, especially by novice personnel. The aim of this study was to compare tracheal intubation performance regarding the time to intubation, glottic view, difficulty, and dental click, by a novice using McGrath VL, Pentax Airway Scope (AWS) and Macintosh laryngoscope in normal and cervical immobilized manikin models. Methods: Thirty-five anesthesia nurses without previous intubation experience were recruited. The participants performed endotracheal intubation in a manikin model at two simulated neck positions (normal and fixed neck via cervical immobilization), using three different devices (McGrath VL, Pentax AWS, and Macintosh direct laryngoscope) at three times each. Performance parameters included intubation time, success rate of intubation, Cormack Lehane laryngoscope grading, dental click, and subjective difficulty score. Results: Intubation time and success rate at the first attempt were not significantly different between the 3 groups in normal airway manikin. In the cervical immobilized manikin, the intubation time was shorter (p = 0.012) and the success rate with the first attempt was significantly higher (p < 0.001) when using McGrath VL and Pentax AWS compared with Macintosh laryngoscope. Both VLs showed less difficulty score (p < 0.001) and more Cormack Lehane grade I (p < 0.001). The incidence of dental clicks was higher with McGrath VL than Macintosh laryngoscope in the normal and cervical immobilized airway (p = 0.005, p < 0.001, respectively). Conclusion: McGrath VL and Pentax AWS resulted in shorter intubation time, higher first attempt success rate, compared with Macintosh laryngoscope by a novice intubator in a cervical immobilized manikin model. McGrath VL could be reduced the risk of dental injury compared with Macintosh laryngoscope in this scenario.

Keywords: intubation, manikin, novice, videolaryngoscope

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