Search results for: Malaysian elderly
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 896

Search results for: Malaysian elderly

236 A Preliminary Investigation on Factors That Influence Road Users' Speeding Behaviour on Selected Roads in Peninsular Malaysia

Authors: Farah Fazlinda Binti Mohamad, Ahmad Saifizul Abdullah, Mohamed Rehan Karim , Jamilah Mohamad, Siti Hikmah Musthar

Abstract:

Road safety is an important issue in Malaysia. It become important as it is discussed widely throughout printed and electronic media. Most of the news portrays on road accident and fatalities have increased the concern of everyone. This issue affects everyone's life as everyone shares the roads. The most vulnerable victims are the road user who uses the roads every day. It is appalling when World Health Organization (WHO) reported that in every 100,000 of population in Malaysia, 23 fatalities recorded due to road accident alone. This figure is quite alarming and requires serious attention. Furthermore, research by Malaysian Institute of Road Safety Research concluded that that speeding has contributed to 60% of all road accident in the country. Therefore, this study aims to elucidate the factors that influence road users’ speeding behaviour on selected roads in Peninsular Malaysia. To achieve this, set of questionnaires has distributed to 500 respondents on selected roads in Peninsular Malaysia. The respondents came from various demographic backgrounds in order to have a fair opinion on the issue. Using descriptive analysis, the results have indicated that psychological factors such as emotion and attitude of road user are the prominent factors that influence the road user’s speeding behaviour. Furthermore, the results have shown that male road users were dominant in speeding compared to female, which led to increased vulnerability to road injuries and fatalities. These findings are very useful in order for us to understand road users’ driving behaviour. Relevant authorities should also revise the existing countermeasures and find ways to reduce road accident. Engineers and road experts could cooperate in designing new road specifications for the road user. Nevertheless, it is important to comprehend this speeding issue and factors associated with it. Each road user should take this matter seriously and responsibly as road safety is a responsibility of all.

Keywords: countermeasures, psychological, road safety, speeding

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235 Analysing Tertiary Lecturers’ Teaching Practices and Their English Major Students’ Learning Practices with Information and Communication Technology (ICT) Utilization in Promoting Higher-Order Thinking Skills (HOTs)

Authors: Malini Ganapathy, Sarjit Kaur

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Maximising learning with higher-order thinking skills with Information and Communications Technology (ICT) has been deep-rooted and emphasised in various developed countries such as the United Kingdom, the United States of America and Singapore. The transformation of the education curriculum in the Malaysia Education Development Plan (PPPM) 2013-2025 focuses on the concept of Higher Order Thinking (HOT) skills which aim to produce knowledgeable students who are critical and creative in their thinking and can compete at the international level. HOT skills encourage students to apply, analyse, evaluate and think creatively in and outside the classroom. In this regard, the National Education Blueprint (2013-2025) is grounded based on high-performing systems which promote a transformation of the Malaysian education system in line with the vision of Malaysia’s National Philosophy in achieving educational outcomes which are of world class status. This study was designed to investigate ESL students’ learning practices on the emphasis of promoting HOTs while using ICT in their curricula. Data were collected using a stratified random sampling where 100 participants were selected to take part in the study. These respondents were a group of undergraduate students who undertook ESL courses in a public university in Malaysia. A three-part questionnaire consisting of demographic information, students’ learning experience and ICT utilization practices was administered in the data collection process. Findings from this study provide several important insights on students’ learning experiences and ICT utilization in developing HOT skills.

Keywords: English as a second language students, critical and creative thinking, learning, information and communication technology and higher order thinking skills

Procedia PDF Downloads 480
234 Mathematical Description of Functional Motion and Application as a Feeding Mode for General Purpose Assistive Robots

Authors: Martin Leroux, Sylvain Brisebois

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Eating a meal is among the Activities of Daily Living, but it takes a lot of time and effort for people with physical or functional limitations. Dedicated technologies are cumbersome and not portable, while general-purpose assistive robots such as wheelchair-based manipulators are too hard to control for elaborate continuous motion like eating. Eating with such devices has not previously been automated, since there existed no description of a feeding motion for uncontrolled environments. In this paper, we introduce a feeding mode for assistive manipulators, including a mathematical description of trajectories for motions that are difficult to perform manually such as gathering and scooping food at a defined/desired pace. We implement these trajectories in a sequence of movements for a semi-automated feeding mode which can be controlled with a very simple 3-button interface, allowing the user to have control over the feeding pace. Finally, we demonstrate the feeding mode with a JACO robotic arm and compare the eating speed, measured in bites per minute of three eating methods: a healthy person eating unaided, a person with upper limb limitations or disability using JACO with manual control, and a person with limitations using JACO with the feeding mode. We found that the feeding mode allows eating about 5 bites per minute, which should be sufficient to eat a meal under 30min.

Keywords: assistive robotics, automated feeding, elderly care, trajectory design, human-robot interaction

Procedia PDF Downloads 158
233 To Investigate Quality of Life in Elderly Persons with Dementia Residing in Assisting Living Facility

Authors: Ya-Chuan Hsu, Wen-Chen Ouyang, Wei-Siang Huang

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Problem/Background: With constantly increasing aged populations, quality of life (QOL) in persons with dementia has become a significant research concern. The Alzheimer’s Related Quality of Life (ADRQL) is a high-validated, theory-derived, and multidimensional instrument. It has widely utilized in many countries, except in Taiwan. However, diverse results of quality of life from different countries by using the same measurement can provide the potential to help understand the impact of cultural contributor on QOL. Objective: To investigate the extent to which quality of life on older adults with dementia in Taiwan. Methods: Cross-sectional, descriptive study conducted in an assisting living facility affiliated with a daycare center in southern Taiwan. A purposeful sample of 34 participants was recruited. Inclusion criteria included those who were at least 65 years old, able to communicate, and diagnosed with mild to moderate dementia. The QOL was measured by Chinese version ADRQL. This observational instrument consists of 30 items that is divided into five subscales with the full range of each subscale scores from 0 to 100.0. Higher scores indicate better QOL. Results: The means for subscale of the Social Interaction, Awareness of Self, Feelings and Mood, Enjoyment of Activities, and Response to Surroundings were 87.9, 74.7, 91.3, 64.5, and 90.3, respectively. The overall mean for the ADQOL was 0.83. Conclusion: Findings suggest that the level of Enjoyment of Activities is the lowest and may convey information about a need of evaluation on arrangement of facility’s activities.

Keywords: dementia, quality of life, elders, Alzheimer’s related quality of life

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232 Nanoparticles in Drug Delivery and Therapy of Alzeheimer's Disease

Authors: Nirupama Dixit, Anyaa Mittal, Neeru Sood

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Alzheimer’s disease (AD) is a progressive form of dementia, contributing to up to 70% of cases, mostly observed in elderly but is not restricted to old age. The pathophysiology of the disease is characterized by specific pathological changes in brain. The changes (i.e. accumulation of metal ions in brain, formation of extracellular β-amyloid (Aβ) peptide aggregates and tangle of hyper phosphorylated Tau protein inside neurons) damage the neuronal connections irreversibly. The current issues in improvement of life quality of Alzheimer's patient lies in the fact that the diagnosis is made at a late stage of the disease and the medications do not treat the basic causes of Alzheimer's. The targeted delivery of drug through the blood brain barrier (BBB) poses several limitations via traditional approaches for treatment. To overcome these drug delivery limitation, nanoparticles provide a promising solution. This review focuses on current strategies for efficient targeted drug delivery using nanoparticles and improving the quality of therapy provided to the patient. Nanoparticles can be used to encapsulate drug (which is generally hydrophobic) to ensure its passage to brain; they can be conjugated to metal ion chelators to reduce the metal load in neural tissue thus lowering the harmful effects of oxidative damage; can be conjugated with drug and monoclonal antibodies against BBB endogenous receptors. Finally this review covers how the nanoparticles can play a role in diagnosing the disease.

Keywords: Alzheimer's disease, β-amyloid plaques, blood brain barrier, metal chelators, nanoparticles

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231 To Assess the Awareness and Health Seeking Practices Related to Vitamin-A Deficiency Diseases in Urban Slums of Delhi, India

Authors: Dr.Vasundhra Misra, Prof. Praveen Vashist

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Purpose: Vitamin A deficiency prevention programmes are at varying stages of development and implementation in all countries. Vitamin A deficiency has been recognized as a public health issue in developing countries like India. Despite achieving a lot of success a load of blindness due to Vitamin A deficiencies is still high. In this regard, a study was conducted to assess the awareness and health-seeking practices about Vitamin A deficiency diseases among the urban slum population of Delhi, India. Methods: A descriptive cross-sectional study was conducted in the 5 slum clusters from the urban population of South Delhi. A specially designed pre-tested questionnaire schedule was administered. The study sample was comprised of 1552 inhabitants. Results: The mean age of the respondents was 34 ± 12.1 years. A total of 1003 (64.6%) participants out of 1552, had heard of night blindness. Awareness of night blindness was more in the elderly age group and also found significant (p < 0.001). Only 31 (3.1%) knew that night blindness is caused due to deficiency of vitamin A. The awareness of vitamin A prophylaxis programme was significantly higher among elder age (p < 0.05) and females (p < 0.05). Conclusion: The findings highlighted that even though many of the respondents have heard of night blindness but the awareness about causes and treatment was found low in the community. There is a need for efforts directed to enhance community-level counseling and educational programmes.

Keywords: awareness, health-seeking practices, night blindness, vitamin-A deficiency diseases

Procedia PDF Downloads 152
230 Legal Feminism, Modernity and Their Impact on Some African Countries

Authors: Umulisa Linda, Andy Cons Matata

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The origin of legal feminism can be attributed to an attempt to provide a safe space for women such as voting, parental, and inheritance rights, among others. It was also a rebellion against male supremacy. However, with the development of technology and especially in the era of the internet, it appears that both legal feminism and the modernism are losing their luster. While these movements had their origin either in the United States of America or western Europe, their impacts have been felt as far as Africa, Asia, and Latin America. In Africa, different countries have different levels of penetration of these movements. This study, therefore, had its focus on how legal feminism and modernism have influenced legal developments in Kenya and Rwanda. The study adopted a qualitative approach with the respondents being asked about their feelings and perceptions on how the two movements had affected legal developments in their countries. In order to gauge the opinion of different categories of people such as the youth, middle-aged and the elderly people as well as being gender-sensitive, the study adopted a purpose method of sampling. The questionnaires and the focus group discussions were employed as the main tools for data gathering. From the questionnaires, the focus group discussions, and the data analysis that followed, the study concluded that both legal feminism and modernity had penetrated the legal systems of both Kenya and Rwanda so deeply. The study further found that the proponents of the two movements were mostly urban based and educated women. The men were generally opposed to the movements.

Keywords: legal development, legal feminsim, modernism, voting, parental and inheritance rights

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229 The Importance of Training in Supply Chain Management on Personnel Differentiation and Business Performance

Authors: Arawati Agus, Rahmah Ismail

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An effective training has been increasingly recognized as critical factors in enhancing the skills and knowledge of employee or personnel in the organization. More and more manufacturing companies in Malaysia are increasingly incorporating training as an important element in supply chain management (SCM) to improve their employee skills and knowledge and ultimately organizational performances. In order to understand the connection of training in SCM and the performance of an organization, this paper considers of many arguments from various research papers. This paper presents the findings of a research which examines the relationship between training in SCM, personnel differentiation and business performance of manufacturing companies in Malaysia. The study measures perception of senior management regarding the incorporation of training in SCM and the level of personnel differentiation and business performance measurements in their companies. The associations between training in SCM, personnel differentiation and business performance dimensions are analyzed through methods such as Pearson’s correlations and Smart partial least squares (smart PLS) using 126 respondents’ data. The correlation results demonstrate that training in SCM has significant correlations with personnel differentiation determinants (comprises of variables namely employee differentiation and service differentiation). The findings also suggest that training in SCM has significant correlations with business performance determinants (comprises of indicators, namely market share, profitability, ROA and ROS). Specifically, both personnel differentiation and business performance have high correlations with training in SCM, namely ‘Employee training on production skills’, ‘On the job production employee training’ and ‘Management training on supply chain effectiveness’ and ‘Employee training on supply chain technologies’. The smart PLS result also reveals that training in SCM exhibits significant impact on both personnel differentiation (directly) and business performance (indirectly mediated by personnel differentiation). The findings of the study provide a demonstration of the importance of training in SCM in enhancing competitive performances in Malaysian manufacturing companies.

Keywords: training in SCM, personnel differentiation, business performance, Pearson’s correlation, Smart PLS

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228 Reliability and Construct Validity of the Early Dementia Questionnaire (EDQ)

Authors: A. Zurraini, Syed Alwi Sar, H. Helmy, H. Nazeefah

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Early Dementia Questionnaire (EDQ) was developed as a screening tool to detect patients with early dementia in primary care. It was developed based on 20 symptoms of dementia. From a preliminary study, EDQ had been shown to be a promising alternative for screening of early dementia. This study was done to further test on EDQ’s reliability and validity. Using a systematic random sampling, 200 elderly patients attending primary health care centers in Kuching, Sarawak had consented to participate in the study and were administered the EDQ. Geriatric Depression Scale (GDS) was used to exclude patients with depression. Those who scored >21 MMSE, were retested using the EDQ. Reliability was determined by Cronbach’s alpha for internal consistency and construct validity was assessed using confirmatory factor analysis (principle component with varimax rotation). The result showed that the overall Cronbach’s alpha coefficient was good which was 0.874. Confirmatory factor analysis on 4 factors indicated that the Cronbach’s alpha for each domain were acceptable with memory (0.741), concentration (0.764), emotional and physical symptoms (0.754) and lastly sleep and environment (0.720). Pearson correlation coefficient between the first EDQ score and the retest EDQ score among those with MMSE of >21 showed a very strong, positive correlation between the two variables, r = 0.992, N=160, P <0.001. The results of the validation study showed that Early Dementia Questionnaire (EDQ) is a valid and reliable tool to be used as a screening tool to detect early dementia in primary care.

Keywords: Early Dementia Questionnaire (EDQ), screening, primary care, construct validity

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227 Dietary Intake, Serum Vitamin D Status, and Sun Exposure of Malaysian Women of Different Ethnicity

Authors: H. Z. M. Chong, M. E. Y. Leong, G. L. Khor, S. C. Loke

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Vitamin D insufficiency is reported to be prevalent among women living in different altitudes including the equator where sunshine is available throughout the year. Multiple factors for vitamin D insufficiency include poor intake of vitamin D rich food and inadequate sun exposure, especially among women working indoor with a sedentary lifestyle. Furthermore, Muslim women in Malaysia whose attire covers the entire body are likely to receive poor sun exposure. This research determined serum vitamin D status, vitamin D intake and sun exposure of women aged 20-45 years of different ethnicity in Kuala Lumpur, Malaysia. Blood samples were collected from 106 women for determination of serum 25(OH)D levels. Information about vitamin D intake and sun exposure were obtained by interviewing the subjects using pre-tested questionnaires. The overall mean serum 25(OH)D was found to be 29.9 ± 14 nmol/L. Vitamin D deficiency and insufficiency was prevalent and highest among the Malay women. Less than ten percent of the subjects in this study met the sufficient vitamin D level recommendation of ≥50 nmol/L. Intake of vitamin D rich food such as oily fishes was poor across the different ethnicity. Other dietary sources of vitamin D in the diet were fortified bread and skim milk. On the other hand, the median sunlight exposure of the subjects was 3.9 hours per week. The Malay women reported to have the highest duration being exposed to the sun. Nevertheless, due to cultural clothing practices, these women had the least body surface area exposed to sunlight, resulting in the lowest calculated sun index score compared to the Chinese and the Indians. Low intake of vitamin D rich foods and sun exposure were negatively correlated with serum 25(OH)D level. In conclusion, intake of food sources rich in vitamin D and adequate body surface area exposed to the sun are essential to ensure healthy vitamin D level. Supplementation of vitamin D may be recommended to women whom unable to meet these recommendations.

Keywords: serum 25-OH, sun exposure, vitamin D food frequency, vitamin D deficiency

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226 Psychological Aspects of Depression among the Romanian Adults

Authors: Zoltan Abram

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Background: In the last time it was hardly increased the prevalence of psychical diseases and disorders which reduce work capacity, life quality and life expectancy. Objectives: The aim of our research is to study the psychical health state of the Romanian adults living in the middle part of the country and the role of some economical, psychological and social factors, especially in relationship with depression. Methods: The study is based on a complex anonymous questionnaire, including Beck depressive scale, which was completed by a representative sample among adult population. The applied method was a combination between stratification and more-steps sampling. Results: After our results depression is the most common psychical illness with 9,1% diagnosis, but the tendency to depression, the existence of depressive symptoms is much higher than the treated illness. The percentage of suicide attempt among the studied population was 2,9%. It is analysed how gender, age, professional and social status, living and working conditions and different social factors are influencing the health state. According to Beck score, it was established a significant difference in the favour of female, elderly people, lower educational level, urban population. Conclusions: In our study it is underlined the importance of health promotion and education. It is concluded that improving living standards, modifying in a proper way the lifestyle of the population, we can positively influence the physical and mental health state of the Romanian adult population.

Keywords: Beck scale, depression, psychological aspects, suicide attempt

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225 Diversity and Taxonomy: Malaysian Marine Algae Genus Halimeda (Halimedaceae, Chlorophyta)

Authors: Nur Farah Ain Zainee, Ahmad Ismail, Nazlina Ibrahim, Asmida Ismail

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The study of genus Halimeda in Malaysia is in the early stage due to less specific study on its taxonomy. Most of the previous research tend to choose other genus such as Caulerpa and Gracilaria because of the potential of being utilized. The identification of Halimeda is complex by the high morphological variation within individual species due to different types of habitat and the changes in composition of seawater. The study was completed to study the diversity and distribution of Halimeda in Malaysia and to identify the morphological and anatomical differences between Halimeda species. The methods which have been used for this study are collection of Halimeda and seawater, preservation of specimen, identification of the specimen including the preparation of the temporary slide and decalcification of the calcium layer by using diluted hydrochloric acid. The specimen were processed in laboratory and kept as herbarium specimen in Algae Herbarium, Universiti Kebangsaan Malaysia. Environmental parameters were tested by using YSI multiparameter probe and the recorded data were temperature, salinity, pH and dissolved oxygen. The nutrient content of seawater such as nitrate and phosphate were analysed by using Hach kit model DR 2000. In the present study, out of 330 herbarium specimen, ten species were identified as Halimeda cuneata, H. discoidea, H. macroloba, H. macrophysa, H. opuntia, H. simulans, H. stuposa, H. taenicola, H. tuna and H. velasquezii. Of these, five species were new record to Malaysia. They are Halimeda cuneata, H. macrophysa, H. stuposa, H. taenicola and H. velasquezii. H. opuntia was found as the most abundance species with wide distribution in Malaysia coastal area. Meanwhile, from the study of their distribution, two localities in which Pulau Balak Balak, Kudat and Pulau Langkawi, Kedah, were noted having high number of Halimeda species. As a conclusion, this study has successfully identified ten species of Halimeda of Malaysia with full description of morphological characteristics that may assist further researcher to differentiate and identify Halimeda.

Keywords: Distribution, diversity, Halimeda, morphological, taxonomy

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224 A Prospective Study on the Evaluation of Statins Usage on HbA1c Control among Type 2 Diabetes Mellitus in an Outpatients Setting

Authors: Mohamed A. Hammad, Dzul Azri Mohamed Noor, Syed Azhar Syed Sulaiman, Abeer Kharshid, Nor Azizah Aziz, Tarek M. Elsayed

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Medication safety is always an issue. In 2015, the National Pharmaceutical Control Bureau released a statement requesting all statins manufacturers in Malaysia to include the risk of diabetes information in the drug information leaflet in response to United States Food and Drug Administration (U.S. FDA) report. However, the data regarding this warning label in Malaysia is limited, so there is still some uncertainty whether such risk can also be observed in the Malaysian population or not. The study aims to determine the effect of statins on HbA1c% in type 2 diabetic outpatients in endocrine clinics at Hospital Pulau Pinang between June 2015 and May 2016 in Malaysia. In a prospective cohort study, records of 400 type 2 diabetic patients (control group 104 patients not using statin and treatment group 296 patients using statin) were reviewed to identify demographic criteria and lab tests. The prevalence of glycemic control (Glycated hemoglobin, HbA1C ≤ 7% for patient < 65 years, and < 8% for patient ≥ 65 years) was estimated, according to American Diabetes Association guidelines 2015. The results were presented as descriptive statistics. From 296 patients with Type 2 diabetes using statins cohort with a mean age of 57.52 ± 12.2 years, only 81 (27.4%) cases had controlled glycemia, and 215 (72.6%) had uncontrolled glycemia, CI: 95% (6.3–11.1). While the control group 104 diabetic patients had a mean age 46.1 ± 18 years and distributed among 59 (56.7%) patients with controlled diabetes and 45 (43.3%) cases, had uncontrolled glycemia, CI: 95% (5.2–10.3). The relative risk (RR) of uncontrolled glycemia in diabetic patients used statins was 1.68, and the excessive relative risk (ERR) was 68%. The absolute risk (AR) was 29.3%, and the number needed to harm (NNH) was 4. Diabetic patients using statins have more risk of uncontrolled glycemia than the patients with Type 2 diabetes non-using statins.

Keywords: diabetes mellitus, HbA1c, Malaysia, outpatients, statin, type 2, uncontrolled glycemia

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223 Analysis of Brain Activities due to Differences in Running Shoe Properties

Authors: Kei Okubo, Yosuke Kurihara, Takashi Kaburagi, Kajiro Watanabe

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Many of the ever-growing elderly population require exercise, such as running, for health management. One important element of a runner’s training is the choice of shoes for exercise; shoes are important because they provide the interface between the feet and road. When we purchase shoes, we may instinctively choose a pair after trying on many different pairs of shoes. Selecting the shoes instinctively may work, but it does not guarantee a suitable fit for running activities. Therefore, if we could select suitable shoes for each runner from the viewpoint of brain activities, it would be helpful for validating shoe selection. In this paper, we describe how brain activities show different characteristics during particular task, corresponding to different properties of shoes. Using five subjects, we performed a verification experiment, applying weight, softness, and flexibility as shoe properties. In order to affect the shoe property’s differences to the brain, subjects run for ten min. Before and after running, subjects conducted a paced auditory serial addition task (PASAT) as the particular task; and the subjects’ brain activities during the PASAT are evaluated based on oxyhemoglobin and deoxyhemoglobin relative concentration changes, measured by near-infrared spectroscopy (NIRS). When the brain works actively, oxihemoglobin and deoxyhemoglobin concentration drastically changes; therefore, we calculate the maximum values of concentration changes. In order to normalize relative concentration changes after running, the maximum value are divided by before running maximum value as evaluation parameters. The classification of the groups of shoes is expressed on a self-organizing map (SOM). As a result, deoxyhemoglobin can make clusters for two of the three types of shoes.

Keywords: brain activities, NIRS, PASAT, running shoes

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222 Utilization of Acupuncture in Palliative Care for Cancer Patients

Authors: Jui-Hung Hung, Ching-Liang Hsieh, Yi-Wen Lin

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Modern medicine highly emphasizes the importance of palliative treatment. The inception of palliative and hospice care recently developed into the concept of caring for the patients’ and families’ physical, psychological and spiritual problems. There are several benefits related to palliative care such as reducing medical expenses, decreasing patients’ suffer, and supporting patient go through the finale of the life. Nowadays, in Taiwan, over 60-70% terminal cancer patients were covered in hospice care, and the coverage rate increased annually. Acupuncture is a well-known therapy used more than thousand years to relieve symptoms of cancer patient. Many reports showed that, even in the Western society, many reputable medical centers can provide Acupuncture therapy for patients. Accordingly, using Acupuncture for cancer patient care is a global trend. There are increased evidences indicate that Acupuncture can relieve the symptoms for cancer patients including pain, reduce the dosage of anesthetic, improve the cancer-related fatigue, relieve the chemotherapy-related nausea and vomiting, ease anxiety mood and even improving the quality of life. Furthermore, some trials show that Acupuncture may help relieve xerostomia, hot flash, sleep disorders, and some GI discomfort and so on. Acupuncture therapy has many advantages for clinical use with effective, low-cost, minimal side effect, suitable for cancer patients and even for elderly population. Especially in nowadays, there are more diversified challenges in modern medicine, all of them will make the higher medical budget. We suggest that Acupuncture will be one of methods for palliative care for cancer patients.

Keywords: Acupuncture, cancer, integrative medicine, palliative care

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221 Evaluation of the Pain of Patients with Chronic Renal Disease in Hemodialysis

Authors: Fabiana Souza Orlandi, Izabel Cristina Chavez Gomes, Barbara Isabela De Paula Morais, Ana Carolina Ottaviani

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Chronic Kidney Disease (CKD) is considered a public health problem. Patients who present CKD in their more advanced stages usually present several biopsychosocial changes, which may include pain. Pain can be considered subjective and personal, and its perception is characterized as a multidimensional experience. The objective of this study was to evaluate the level and descriptors of pain of adults and elderly patients with chronic kidney disease, through the Multidimensional Pain Evaluation Scale (EMADOR). This is a descriptive cross-sectional study with a quantitative approach. The sample consisted of 100 subjects with CKD in hemodialysis treatment at a Renal Replacement Therapy Service in the interior of the state of São Paulo. Data were collected through an individual interview, using a Sociodemographic Characterization and Multidimensional Pain Evaluation Scale (EMADOR). All ethical precepts were respected. The majority of the respondents were men (61.0%), white (56.0%) and with a high school education (34.0%). Regarding the pain of the individuals, 89 patients reported pain, with Chronic Pain predominating (50.0%, n = 50), followed by Acute Pain (39.0%, n = 39). Of the subjects who presented acute pain most of the 89.0% described the pain felt as unbearable, and of those who presented chronic pain, 35.0% described the pain felt as painful, unbearable and uncomfortable. It was concluded that there was a significant presence of pain, being the chronic pain dominant in the studied population. Faced with such factors, the present study motivates researches in this population, in order to establish interventions with the objective of improving the quality of life of these individuals.

Keywords: pain, chronic kidney disease, dialysis, evaluation

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220 Implementation Status of Industrial Training for Production Engineering Technology Diploma Inuniversity Kuala Lumpur Malaysia Spanish Institute (Unikl Msi)

Authors: M. Sazali Said, Rahim Jamian, Shahrizan Yusoff, Shahruzaman Sulaiman, Jum'Azulhisham Abdul Shukor

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This case study focuses on the role of Universiti Kuala Lumpur Malaysian Spanish Institute (UniKL MSI) to produce technologist in order to reduce the shortage of skilled workers especially in the automotive industry. The purpose of the study therefore seeks to examine the effectiveness of Technical Education and Vocational Training (TEVT) curriculum of UniKL MSI to produce graduates that could immediately be productively employed by the automotive industry. The approach used in this study is through performance evaluation of students attending the Industrial Training Attachment (INTRA). The sample of study comprises of 37 students, 16 university supervisors and 26 industrial supervisors. The research methodology involves the use of quantitative and qualitative methods of data collections through the triangulation approach. The quantitative data was gathered from the students, university supervisors and industrial supervisors through the use of questionnaire. Meanwhile, the qualitative data was obtained from the students and university supervisors through the use of interview and observation. Both types of data have been processed and analyzed in order to summarize the results in terms of frequency and percentage by using a computerized spread sheet. The result shows that industrial supervisors were satisfied with the students’ performance. Meanwhile, university supervisors rated moderate effectiveness of the UniKL MSI curriculum in producing graduates with appropriate skills and in meeting the industrial needs. During the period of study, several weaknesses in the curriculum have been identified for further continuous improvements. Recommendations and suggestions for curriculum improvement also include the enhancement of technical skills and competences of students towards fulfilling the needs and demand of the automotive industries.

Keywords: technical education and vocational training (TEVT), industrial training attachment (INTRA), curriculum improvement, automotive industry

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219 A Conceptual Model of Social Entrepreneurial Intention Based on the Social Cognitive Career Theory

Authors: Anh T. P. Tran, Harald Von Korflesch

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Entrepreneurial intention play a major role in entrepreneurship academia and practice. The spectrum ranges from the first model of the so-called Entrepreneurial Event, then the Theory of Planned Behavior, the Theory of Planned Behavior Entrepreneurial Model, and the Social Cognitive Career Theory to some typical empirical studies with more or less diverse results. However, little is known so far about the intentions of entrepreneurs in the social areas of venture creation. It is surprising that, since social entrepreneurship is an emerging field with growing importance. Currently, all around the world, there is a big challenge with a lot of urgent soaring social and environmental problems such as poor households, people with disabilities, HIV/AIDS infected people, the lonely elderly, or neglected children, some of them even actual in the Western countries. In addition, the already existing literature on entrepreneurial intentions demonstrates a high level of theoretical diversity in general, especially the missing link to the social dimension of entrepreneurship. Seeking to fill the mentioned gaps in the social entrepreneurial intentions literature, this paper proposes a conceptual model of social entrepreneurial intentions based on the Social Cognitive Career Theory with two main factors influencing entrepreneurial intentions namely self-efficacy and outcome expectation. Moreover, motives, goals and plans do not arise from empty nothingness, but are shaped by interacting with the environment. Hence, personalities (i.e., agreeableness, conscientiousness, extraversion, neuroticism, openness) as well as contextual factors (e.g., role models, education, and perceived support) are also considered as the antecedents of social entrepreneurship intentions.

Keywords: entrepreneurial intention, social cognitive career theory, social entrepreneurial intention, social entrepreneurship

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218 Intrathecal Sufentanil or Fentanyl as Adjuvants to Low Dose Bupivacaine in Endoscopic Urological Procedures

Authors: Shikha Gupta, Suneet Kathuria, Supriya Sampley, Sunil Katyal

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Opioids are being increasingly used these days as adjuvants to local anesthetics in spinal anesthesia. The aim of this prospective, randomized, double‑blind study is to compare the effects of adding sufentanil or fentanyl to low dose bupivacaine in spinal anesthesia for endoscopic urological procedures. A total of 90 elective endoscopic urological surgery patients, 40‑80 years old, received spinal anesthesia with 7.5 mg hyperbaric bupivacaine 0.5% (Group A) or by adding sufentanil 10 μg (Group B) or fentanyl 25 μg (Group C) to 5 mg hyperbaric bupivacaine 0.5%. These groups were compared in terms of the quality of spinal anesthesia as well as analgesia. Analysis of variance and Chi‑square test were used for Statistical analysis. The onset of sensory and motor blockade was significantly rapid in Group A as compared with Groups B and C. The maximum upper level of sensory block was higher in Group A patients than Groups B and C patients. Quality of analgesia was significantly better and prolonged in sufentanil group as compared with other two groups. Motor block was more intense and prolonged in Group A as compared with Groups B and C patients. Request for post‑operative analgesic was significantly delayed in Group B patients. Hence in conclusions, spinal anesthesia for endoscopic urological procedures in elderly patients using low dose bupivacaine (5 mg) combined with 10 μg sufentanil is associated with a lower incidence of hemodynamic instability, better quality and prolonged duration as compared to that by adding 25 μg fentanyl.

Keywords: adjuvants, bupivacaine, fentanyl, intrathecal, low dose spinal, sufentanil

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217 The Inhibitory Effect of Riceberry Rice Extract on Acetylcholinesterase Activity

Authors: Yaiprae Chatree, Tawan Chaiwon, Rodjana Chunhabundit, Kritsana Piriyawatcharakon, Waralai Ratwiset, Sasiwimol Chaiya

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The world is facing a serious situation of aging society. Elderly may have many physical health problems due to degenerative diseases including Alzheimer’s disease. Riceberry rice relatively contain high levels of carbohydrate, vitamin E, -oryzanol, and also abundant of bioactive compound of anthocyanin. This study aimed to determine the inhibitory effect of Riceberry rice crude extract on acetylcholinesterase activity. The active compound was extracted by using 70% ethanol (v/v). The inhibitory effect of Riceberry rice on acetylcholinesterase was evaluated by using slightly modified method of Ellman’s method. The 120 seconds time interval of kinetics measurement showed that Riceberry rice extract at concentrations of 2.5-12.5 mg/ml presented the acetylcholinesterase inhibitory activity at the statistically significant difference at p  0.05 compared to control group over 60 -120 seconds. At the concentrations of 10 and 12.5 mg/ml of Riceberry rice extract expressed the high percentage of inhibitory activity of 50.86 and 71.22%, respectively. The half maximal inhibitory concentration (IC50) of acetylcholinesterase inhibitory activity of Riceberry rice extract; considered to the end point, was found at concentration of 9.34 mg/ml. The physostigmine (positive control); however, showed a higher inhibitory capacity than that of Riceberry rice extract. The inhibitory activity of the positive control group was around at 80.40 – 90.41%. In conclusion, the results of this study indicated that Riceberry rice extract possessed the inhibitory capacity of acetylcholinesterase activity. Moreover, at the concentrations of 12.5 mg/ml it showed the identical inhibitory effect with physostigmine group. The Riceberry rice extract might be able to alleviate the clinical manifestations of Alzheimer’s disease.

Keywords: acetylcholine, acetylcholinesterase, Alzheimer's disease, riceberry rice

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216 Livonian Werewolves, 1500-1700s: A Sociological Assessment of Their Historical Significance and Origins through the Case of Old Thiess

Authors: Liu Jiaxin

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This paper seeks to do an in-depth investigation on the phenomenon of Early Modern era (1500-1700s) Livonian werewolves. Noting their uniqueness in comparison to contemporaneous werewolves hailing from other geographic areas, the paper suggests that the Livonian werewolf is a metaphor for Livonian society at that time, one which was characterized by social turmoil and strict class hierarchy. This metaphor was utilized by different classes to establish their own interests in society, and thus the paper concludes that the werewolf is a mutable artifact whose value is contingent on its social context. This is demonstrated by the particular case of Old Thiess—a poor, elderly Livonian peasant who gave an unorthodox and anomalous testimony when accused of being a werewolf. In his court statement, it is shown how Thiess was, in fact, alluding to social tensions by lambasting the rich German elite and establishing the righteousness of the peasantry, of which he was a member. A close reading method was utilized on the trial transcript of Old Thiess with heavy reference to Carlo Ginzburg and Bruce Lincoln’s collaborative work Old Thiess, a Livonian werewolf: a classic case in comparative perspective. Through a contextual reading of Livonia’s social atmosphere, the paper draws connections between the content of the trial to wider societal disturbances happening at the time. The thesis—that the werewolf is a flexible metaphor for the social milieu—is further buttressed by numerous contemporaneous sources that had similar messages as Thiess’ transcript, which are discussed as well.

Keywords: early-modern baltic, Livonia, Old Thiess, social history, werewolves

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215 Measurement and Monitoring of Graduate Attributes via iCGPA Implementation and ACADEMIA Programming: UNIMAS Case Study

Authors: Shanti Faridah Salleh, Azzahrah Anuar, Hamimah Ujir, Rohana Sapawi, Wan Hashim Wan Ibrahim, Noraziah Abdul Wahab, Majina Sulaiman, Raudhah Ahmadi, Al-Khalid Othman, Johari Abdullah

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Integrated Cumulative Grade Point Average or iCGPA is an evaluation and reporting system that represents a comprehensive development of students’ achievement in their academic programs. Universiti Malaysia Sarawak, UNIMAS has started its implementation of iCGPA in 2016. iCGPA is driven by the Outcome-Based Education (OBE) system that has been long integrated into the higher education in Malaysia. iCGPA is not only a tool to enhance the OBE concept through constructive alignment but it is also an integrated mechanism to assist various stakeholders in making decisions or planning for program improvement. The outcome of this integrated system is the reporting of students’ academic performance in terms of cognitive (knowledge), psychomotor (skills), and affective (attitude) of which the students acquire throughout the duration of their study. The iCGPA reporting illustrates the attainment of student’s attribute in the eight domains of learning outcomes listed in the Malaysian Qualifications Framework (MQF). This paper discusses on the implementation of iCGPA in UNIMAS on the policy and strategy to direct the whole university to implement the iCGPA. The steps and challenges in integrating the exsting Outcome-Based Education and utilising iCGPA as a tool to quantify the students’ achievement are also highlighted in this paper. Finally, the ACADEMIA system, which is a dedicated centralised program ensure the implementation of iCGPA is a success has been developed. This paper discusses the structure and the analysis of ACADEMIA program and concludes the analysis made on the improvement made on the implementation of constructive alignment in all 40 programs involves in iCGPA implementation.

Keywords: constructive alignment, holistic graduates, mapping of assessment, programme outcome

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214 Epidemiological Profile of Acute Respiratory Infections Hospitalized in Infants and Children Under 15 Years of Age, Hospital Immaculée, Cayes, Haiti, 2019-2021

Authors: Edna Ariste, Richard Standy Coqmar

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Background: Acute respiratory infections are a major public health problem in the world, mainly in vulnerable populations such as newborns, children under five years of age, and the elderly. The objective of this study was to Characterize the cases of acute respiratory infections in infants and under 15 years old hospitalized at the Immaculée Conception Hospital in Cayes from January 1, 2019, to December 31, 2021. Methods: A retrospective descriptive study was conducted on the epidemiology profile of acute respiratory infections hospitalized in the pediatric ward at Immaculée Conception Hospital in Les Cayes from January 2019 to December 2021. The study population consisted of all newborns, infants, and children under 15 years of age diagnosed with respiratory infections at the pediatric service. Data were collected from the hospitalization registers and patient records of this unit. A database was created and used for data collection. Excel and Epi info 7.2 were used for data analysis. Results: A total of 588 cases were identified during the 2019-2021 year. 43.5% (256) were female, and 56.5% (332) were male. The average age was 4, 3. The most affected age group was 1-4 years. The male/female sex ratio was 1.2. The most frequent respiratory infections were respectively pneumonia 44.9%, bronchitis 16.5%, and respiratory distress 10.5%. The mortality rate recorded during this period was 4.4%. Conclusion: Acute respiratory infections are more frequent in young children. It is, therefore, necessary to practice hand hygiene. Reinforce the surveillance of severe acute respiratory infections.

Keywords: acute respiratory infections, pediatrics, cayes, haiti

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213 COVID-19: The Cause or the Confounder

Authors: Praveenkumar Natarajan

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A 59-year-old male with no known co-morbidities was admitted to a private hospital for complaints of fever and cough and was diagnosed to haveCOVID-19. CT of the thorax revealed the involvement of 50% of the lungs. Screening ECG and ECHO were normal. The patient was treated with oxygen therapy and drugs and was discharged after 12 days of admission. Post-discharge, the patient remained symptom-free and continued his work. After one month, the patient developed a fever for three days, for which he took antipyretics. Subsequently, the patient developed sudden onset breathlessness, which rapidly progressed to grade 4 NYHA, and developed a cough as well. Suspecting COVID-19 reinfection, the patient visited a nearby hospital, where COVID–19 rt-PCR swabs turned out to be positive, and was referred to our hospital. On receiving, the patient had diffuse lung crepitations and a diastolic murmur in the neo-aortic area. CT thorax revealed pulmonary edema with areas of consolidation. ECHO revealed vegetation on the aortic valve with severe aortic regurgitation. Blood cultures were taken, which revealed the growth of Enterococcus faecalis. The diagnosis of infective endocarditis was made, and the patient was started on appropriate treatment. COVID–19 has effects on various systems, including the cardiovascular system. Even though infective endocarditis is common in the elderly with valvular heart disease, this patient had developed infective endocarditis in an apparently normal aortic valve. Infective endocarditis and COVID–19 can have similar presentations leading to diagnostic difficulties. COVID–19, affecting the heart valves causing valvulitis and predisposing them to the development of infective endocarditis, is also an area to be explored.

Keywords: aortic regurgitation, COVID-19, infective endocarditis, valvulitis

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212 Crossing the Interdisciplinary Border: A Multidimensional Linguistics Analysis of a Legislative Discourse

Authors: Manvender Kaur Sarjit Singh

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There is a crucial mismatch between classroom written language tasks and real world written language requirements. Realizing the importance of reducing the gap between the professional needs of the legal practitioners and the higher learning institutions that offer the legislative education in Malaysia, it is deemed necessary to develop a framework that integrates real-life written communication with the teaching of content-based legislative discourse to future legal practitioners. By highlighting the actual needs of the legal practitioners in the country, the present teaching practices will be enhanced and aligned with the actual needs of the learners thus realizing the vision and aspirations of the Malaysian Education Blueprint 2013-2025 and Legal Profession Qualifying Board. The need to focus future education according to the actual needs of the learners can be realized by developing a teaching framework which is designed within the prospective requirements of its real-life context. This paper presents the steps taken to develop a specific teaching framework that fulfills the fundamental real-life context of the prospective legal practitioners. The teaching framework was developed based on real-life written communication from the legal profession in Malaysia, using the specific genre analysis approach which integrates a corpus-based approach and a structural linguistics analysis. This approach was adopted due to its fundamental nature of intensive exploration of the real-life written communication according to the established strategies used. The findings showed the use of specific moves and parts-of-speech by the legal practitioners, in order to prepare the selected genre. The teaching framework is hoped to enhance the teachings of content-based law courses offered at present in the higher learning institutions in Malaysia.

Keywords: linguistics analysis, corpus analysis, genre analysis, legislative discourse

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211 Impacts of COVID-19 on Communal Based Natural Resources Management in Newtown, Bekezela Village, Eastern Cape, South Africa

Authors: James Donald Nyamahono, Kelvin Tinashe Pikirai

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Communal based natural resource management (CBNRM) is regarded as one of the most significant methods for sustainable natural resource conservation. This is due to the fact that it entails the engagement of local communities as well as the use of indigenous knowledge and customary conservation. The emergence of COVID-19 had a devastating impact on this sector since it has resulted in the disbandment of all collective activities, such as group gatherings, including those with a good cause. This is supported by research, which demonstrates that throughout the era of full lockdowns, the coordination of diverse activities and the sustainability of various working groups were severely harmed. This study was undertaken in the CBNRM niche to examine how COVID-19 affected this sector. Data were gathered through focus group discussions with youths, women, and the elderly active in CBNRM in Newtown, Bekezela Village, Eastern Cape. The study concluded that the sustainability of indigenous knowledge in natural resource management was endangered due to the restricted movements and community participation in developmental initiatives. The study also revealed a 'environment-community divide,' since COVID-19 hindered local communities from holding their regular conservation meetings. The research, on the other hand, discovered that there were 'secret' gatherings in which local communities attempted to adopt Afrocentric ways in which the available natural resources would provide a remedy for COVID-19.

Keywords: CBNRM, COVID-19, indigenous knowledge, South Africa

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210 Prevalence of Anxiety and Depression: A Descriptive Cross-Sectional Study among Individuals with Substance-Related Disorders in Argentina

Authors: Badino Manuel, Farias María Alejandra

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Anxiety and depression are considered the main mental health issues found in people with substance-related disorders. Furthermore, substance-related disorders, anxiety-related and depressive disorders are among the leading causes of disability and are associated with increased mortality. The co-occurrence of substance-related disorders and these mental health conditions affect the accuracy in diagnosis, treatment plan, and recovery process. The aim is to describe the prevalence of anxiety and depression in patients with substance-related disorders in a mental health service in Córdoba, Argentina. A descriptive cross-sectional study was conducted among patients with substance-related disorders (N=305). Anxiety and depression were assessed using the Patient Health Questionnaire-4 (PHQ-4) during the period from December 2021 to March 2022. For a total of 305 participants, 71,8% were male, 25,6% female and 2,6% non-binary. As regards marital status, 51,5% were single, 21,6% as a couple, 5,9% married, 15,4% separated and 5,6% divorced. In relation to education status, 26,2% finished university, 56,1% high school, 16,4% only primary school and 1,3% no formal schooling. Regarding age, 10,8% were young, 84,3% were adults, and 4,9% were elderly. In-person treatment represented 64,6% of service users, and 35,4% were conducted through teleconsultation. 15,7% of service users scored 3 or higher for anxiety, and 32,1% scored 3 or higher for depression in the PHQ-4. 13,1% obtained a score of 3 or higher for both anxiety and depression. It is recommended to identify anxiety and depression among patients with substance-related disorders to improve the quality of diagnosis, treatment, and recovery. It is suggested to apply PHQ-4, PHQ-9 within the protocol of care for these patients.

Keywords: addiction, anxiety, depression, mental health

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209 Challenges for the Implementation of Community Led Total Sanitation in Rural Malawi

Authors: Save Kumwenda, Khumbo Kalulu, Kondwani Chidziwisano, Limbani Kalumbi, Vincent Doyle, Bagrey Ngwira

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Introduction: The Malawi Government in partnership with Non-Governmental Organizations adopted Community Led Total Sanitation (CLTS) in 2008 as an approach in sanitation and hygiene promotion with an aim of declaring Malawi Open Defeacation Free (ODF) by 2015. While there is a significant body of research into CLTS available in public domain, there is little research done on challenges faced in implementing CLTS in Malawi. Methods: A cross-sectional qualitative study was carried out in three districts of Ntcheu, Balaka, and Phalombe. Data was collected using Focus Group Discussions (FGDs) and Key informant interviews (KII) and analysed manually. Results: In total, 96 people took part in FGDs and 9 people in KII. It was shown that choice of leaders after triggering was commonly done by chiefs, facilitators, and VHC without following CLTS principles as opposed to identifying individuals who showed leadership skills. Despite capacity building initiatives involving District Coordinating Teams, lack of resources to undertake follow-ups contributed to failure to sustain ODF in the community. It was also found that while most respondents appreciating the need for no subsidies, the elderly and those with disabilities felt the need for external support because do not have money for buying strong logs, slabs for durable toilet floor and also to hire people to build latrines for them. Conclusion: Effective implementation of CLTS requires comprehensive consideration of various issues that may affect its success.

Keywords: open defecation, community-led, sanitation, faecal matter, hygiene, Malawi

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208 The Role of Cognitive Impairment in Asthma Self-Management Behaviors and Outcomes in Older Adults

Authors: Gali Moritz, Jacqueline H. Becker, Jyoti V. Ankam, Kimberly Arcoleo, Matthew Wysocki, Roee Holtzer, Juan Wisnivesky, Paula J. Busse, Alex D. Federman, Sunit P. Jariwala, Jonathan M. Feldman

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Objective: Cognitive impairment (CI), whose incidence is greater among ethnic/racial minorities, is a significant barrier to asthma self-management (SM) behaviors and outcomes in older adults. The aim of this study was to examine the relationships between CI, assessed using the Montreal Cognitive Assessment (MoCA), and asthma SM behaviors and outcomes in a sample of predominantly Black and Hispanic participants. Additionally, we evaluated whether using two different MoCA cutoff scores influenced the association between CI and study outcomes. Methods: Baseline cross-sectional data were extracted from a longitudinal study of older adults with asthma (N=165) age≥ 60 years and used for analysis. Cognition was assessed using the MoCA. Asthma control, asthma-related quality of life (QOL), inhaled corticosteroid (ICS) dosing, and ICS adherence were assessed using self-report. The inhaler technique was observed and rated. Results: Using established MoCA cutoff scores of 23 and 26 yielded 45% and 74% CI rates, respectively. CI, defined using the 23 cutoff score, was significantly associated with worse asthma control (p=.04) and worse ICS adherence (p=.01). With a cutoff score of 26, only asthma-related QOL was significantly associated with CI (p=.03). Race/ethnicity and education did not moderate the relationships between CI and asthma SM behaviors and outcomes. Conclusions: CI in older adults with asthma is associated with important clinical outcomes, but this relationship is influenced by the cutoff score used to define CI.

Keywords: cognition, respiratory, elderly, testing, adherence, validity

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207 Pontine and Lobar Hemorrhage from Venous Infarction secondary to Cerebral Venous Thrombosis in a 70-year old Filipina with Protein S Deficiency: A Case Report

Authors: Michelangelo Liban, Debbie Liquete

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A 70-year-old right-handed Filipina was seen by the Neurology service due to a new onset headache, bi-occipital in location, dull squeezing in character with a pain score of 8/10 with associated nausea and one episode of non-projectile, which provided no relief. Due to the alarming features of the headache despite the absence of risk factors and an essentially normal neurologic examination, a cranial CTA+CTV was done, which revealed a small left frontal and small right pontine hyper density with minimal perilesional edema. Findings also revealed filling defects in the straight and right transverse sinus and a consideration of hypoplastic left transverse sinus with no definite evidence of aneurysm nor A-V malformation. She had normal levels of D-Dimer, Protein C, ANA and Anti-DS DNA but had a low Protein S of 56% (N.V is 70-120%). Antithrombin, homocysteine and Factor V Leiden were not done due to unavailability of the tests. She was then treated as a case of Cerebral Venous Thrombosis with multiple hemorrhage from venous infraction and was given anticoagulants which provided relief of the headache. She did not manifest with any further cortical, bulbar or sensorimotor deficits hence was discharged improved after 15 hospital days. To our knowledge, there are no case reports of patients with CVT from Protein S deficiency and venous anomaly that presented with multiple hemorrhage from venous infarction, more so affecting the brainstem. In this paper, a rare location of CVT in a newly diagnosed Protein S deficient patient is presented together with an uneventful course and favorable outcome.

Keywords: protein S deficiency, cerebral venous thrombosis, pontine hemorrhage from venous infarction, elderly

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