Search results for: atypical axillary involvement

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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Authors: A. Elmajdoub, A. El-Mahmoudy

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The present study was designed to investigate the neurotransmitters that mediate the excitatory response of the circular muscle of final branches of mesenteric artery in bovine calves. Mesentery was dissected and the iliac branches were separated and used. The final mesenteric branches of diameter 400 micrometers and less responded strongly to norepinephrine and moderately to ATP. However, the mesenteric branches of wider diameters were gradually less responsive to norepinephrine and those of diameter 700 micrometers were exclusively nonresponsive. These arteries were strongly responsive to ATP (100 µM). Norepinephrine response was sensitive to phentolamine (3 µM) and prazosin (5 µM) indicating that it is mediated by α1 receptor; while ATP response was sensitive to suramin (200 µM), PPADS (50 µM), but not to cibacron blue (100 µM) indicating that it is mediated via P2X receptor. Further confirmatory experiments were performed including application of α1 and P2X receptor specific agonists which are methoxamine and α,β-methylene ATP. Methoxamine (1 µM) showed effects similar to norepinephrine in final branches and was without effect in wider branches. α,β-methylene ATP (1 µM), exhibited more pronounced effects on both wide and narrow branches but in parallel manner to that of ATP. Agonists for α2 and P2Y receptors as clonidine (10 µM) and 2-meThio ATP (10 µM), respectively, were without effect indicating that involvement of these receptors is unlikely. The neuropeptide-Y (200 nM) did not have any effects on either the narrow or the wide rings. Conclusion: These data may imply that in the most peripheral mesenteric arteries a strong vasopressor power represented by norepinephrine and ATP integration is needed for maintaining peripheral resistance; on the other hand a mild vasopressor power mediated only by ATP is enough to maintain the vascular tone in the relatively central mesenteric branches.

Keywords: ATP, calves, mesenteric artery, norepinephrine

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Authors: Claire Baudry, Jessica Pearson, Laura-Emilie Savage, George Tarbulsy

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Over the last fifty years, maternal sensitivity and child development among vulnerable families have been a priority for researchers. For this reason, attachment-based interventions have been implemented and been shown to be effective in enhancing child development. Most of the time, child outcomes are measured shortly after the intervention. Objectives: The goal of the study was to investigate the effects of an attachment-based intervention on child development shortly after the intervention ended and one-year post-intervention. Methods: Over the seventy-two mother-child dyads referred by Child Protective Services in the province of Québec, Canada, forty-two were included in this study: 24 dyads who received 6 to 8 intervention sessions and 18 dyads who did not. Intervention and none intervention dyads were matched for the following variables: duration of child protective services, the reason for involvement with child protection, age, sex, and family status. Internalizing and externalizing behaviors were measured 3 and 12 months after the end of the intervention when the average age of children were respectively 45 and 54 months old. Findings: Independent-sample t-tests were conducted to compare scores between the two groups and the two data collection times. In general, on differences observed between the two groups three months after the intervention ended, just a few of them were still present nine months later. Conclusions: This first set of analyses suggests that the effects of attachment-based intervention observed three months following the intervention are not lasting for most of them. Those results inform us of the importance of considering the possibility to offer more attachment-based intervention sessions for those highly vulnerable families.

Keywords: attachment-based intervention, child behaviors, child protective services, highly vulnerable families

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Authors: Jane Osei, Kerry Brown, Mehran Nejati

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Numerous studies have established that solar energy is the second most prevalent form of alternative renewable energy globally, particularly in regions with abundant sunlight. The adoption and ongoing sustainability of solar technology are pivotal for the transition to renewable energy sources. However, the literature indicates that some countries, especially in the developing world, may impede this transition. Despite various policy initiatives aimed at supporting the adoption of solar technology, the long-term effectiveness of these policies remains uncertain. This study investigates the current policy drivers influencing the success or failure of solar energy technology adoption and sustainability. It employs a qualitative review approach to compare strategies for implementing the net-metering policy incentive in both developing and developed countries, identifying successful and unsuccessful strategies and drawing conclusions on the lessons learned. The study's findings reveal that the effective implementation of net metering depends on regional variations in solar radiation and differing levels of electricity demand across regions. Further, the study found that the implementation of net metering has faced challenges in some countries due to regulatory barriers and bottlenecks that hinder private sector involvement and business sustainability. Economic stability also significantly impacts net metering implementation. This study concludes that governments should strive to balance benefit-sharing to attract more private-sector investment in solar technology while ensuring the viability of government energy regulatory bodies.

Keywords: solar energy technology, adoption, sustainability, net-metering

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Authors: Chatcai Tangsri, Onjaree Na-Takuatoong

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This paper aims to present the key factors that support the decision to use the technology and to present the knowledge transformation flow of visually impaired students after the use of virtual knowledge system as proposed as a new service innovation to universities in Thailand. Correspondents of 27 visually impaired students are involved in this research. Total of 25 students are selected from the University that mainly conducts non-classroom teaching environment; while another 2 visually impaired students are selected from classroom teaching environment. All of them are fully involved in the study along 8 weeks duration. All correspondents are classified into 5 small groups in various conditions. The research results revealed that the involvement from knowledge facilitator can push out for the behavioral actual use of the virtual knowledge system although there is no any developed intention to use behaviors. Secondly, the situations that the visually impaired students inadequate of the knowledge sources that usually provided by assistants i.e. peers, audio files etc. In this case, they will use the virtual knowledge system for both knowledge access and knowledge transfer request. With this evidence, the need of knowledge would play a stronger role than all technology acceptance factors. Finally, this paper revealed that the knowledge transfer in the normal method that students have a chance to physically meet up is still confirmed as their preference method. In term of other aspects of technology acceptance, it will be discussed together with challenges and recommendations at the end of this paper.

Keywords: knowledge system, visually impaired students, higher education, knowledge management enable technology, synchronous/asynchronous knowledge access, synchronous/asynchronous knowledge transfer

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Authors: Farzad Tofigh, Saeideh Najafi, Reza Heidari, Rashid Jamei

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In order to study the effects of magnetic field on the root system and growth of Phaseolus vulgaris, an experiment was conducted in 2012. The possible involvement of magnetic field (MF) pretreatment in physiological factors of Phaseolus vulgaris was investigated. Seeds were subjected to 10 days with 1.8 mT of magnetic field for 1h per day. MF pretreatment decreased the plant height, fresh and dry weight, length of root and length of shoot, Chlorophyll a, Chlorophyll b and carotenoid in 10 days old seedling. In addition, activity of enzymes such as Catalase and Guaiacol peroxidase was decreased due to MF exposure. Also, the total Protein and DPPH content of the treated by magnetic field was not significantly changed in compare to control groups, while the flavonoid, Phenol and prolin content of the treated of the treated by magnetic field was significantly changed in compare to control groups. Lateral branches of roots and secondary roots increased with MF. The results suggest that pretreatment of this MF plays important roles in changes in crop productivity. In all cases there was observed a slight stimulating effect of the factors examined. The growth dynamics were weakened. The plants were shorter. Moreover, the effect of a magnetic field on the crop of Phaseolus vulgaris and its structure was small.

Keywords: carotenoid, chlorophyll a, chlorophyll b, DPPH, enzymes, flavonoid, germination, growth, phenol, proline, protein, magnetic field

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Authors: Ashlie Latiolais

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Architecture, as a discipline, is on a trajectory of extension beyond the boundaries of buildings and, more increasingly, is coupled with research that connects to alternative and typically disjointed disciplines. A “both/and” approach and (expanded) definition of architecture, as depicted here, expands the margins that contain the profession. Figuratively, architecture is a series of edges, events, and occurrences that establishes a choreography or stage by which humanity exists. The way in which architecture controls and suggests the movement through these spaces, being within a landscape, city, or building, can be viewed as a datum by which the “dance” of everyday life occurs. This submission views the realm of architecture through the lens of movement and dance as a cross-fertilizer of collaboration, tectonic, and spatial geometry investigations. “Designing on digital programs puts architects at a distance from the spaces they imagine. While this has obvious advantages, it also means that they lose the lived, embodied experience of feeling what is needed in space—meaning that some design ideas that work in theory ultimately fail in practice.” By studying the body in motion through real-time performance, a more holistic understanding of architectural space surfaces and new prospects for theoretical teaching pedagogies emerge. The atypical intersection rethinks how architecture is considered, created, and tested, similar to how “dance artists often do this by thinking through the body, opening pathways and possibilities that might not otherwise be accessible” –this is the essence of this poster submission as explained through unFOLDED, a creative performance work. A new languageismaterialized through unFOLDED, a dynamic occupiable installation by which architecture is investigated through dance, movement, and body analysis. The entry unfolds a collaboration of an architect, dance choreographer, musicians, video artist, and lighting designers to re-create one of the first documented avant-garde performing arts collaborations (Matisse, Satie, Massine, Picasso) from the Ballet Russes in 1917, entitled Parade. Architecturally, this interdisciplinary project orients and suggests motion through structure, tectonic, lightness, darkness, and shadow as it questions the navigation of the dark space (stage) surrounding the installation. Artificial light via theatrical lighting and video graphics brought the blank canvas to life – where the sensitive mix of musicality coordinated with the structure’s movement sequencing was certainly a challenge. The upstage light from the video projections created both flickered contextual imagery and shadowed figures. When the dancers were either upstage or downstage of the structure, both silhouetted figures and revealed bodies are experienced as dancer-controlled installation manipulations occurred throughout the performance. The experimental performance, through structure, prompted moving (dancing) bodies in space, where the architecture served as a key component to the choreography itself. The tectonic of the delicate steel structure allowed for the dancers to interact with the installation, which created a variety of spatial conditions – the contained box of three-dimensional space, to a wall, and various abstracted geometries in between. The development of this research unveils the new role of an Architect as a Choreographer of the built environment.

Keywords: dance, architecture, choreography, installation, architect, choreographer, space

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Authors: Ilya Vladimirovich Konevtsev, Elena Anatolievna Rodionova

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This work is devoted to the study of the impact of the methodology of flexible management in IT companies on the level of organizational and professional stress of employees. It is assumed that the level of organizational and professional stress will decrease statistically significantly, provided that the company operates in accordance with the principles of flexible methodology, including Scrum or Kanban frameworks. The professional health of employees of various companies in the modern world is a stable interest for organizational psychology and many other related disciplines. The urgency of the problem is due to the fact that professional health is an extremely important factor that ensures the well-being, involvement, and interest of an employee in the activity, which directly affects his efficiency and work results. The use of modern methodologies for managing projects, teams, and entire companies, as practice shows, largely contributes to improving the efficiency and satisfaction of employees, but it is still not clear what factors contribute to this result. The purpose of this study is largely to clarify the question of how HR management methodologies affect the professional health of company employees. The study involved 44 employees of IT companies, of which 27 are men and 17 women, where Agile management methodology is used, and 41 employees of IT companies (33 men, 8 women) where Agile is not used. As a result, it was found out that the use of Agile methodology is interrelated with low indicators of organizational stress and professional stress; however, regression analysis showed that only the Kanban framework acts as a predictor of reducing professional stress, while the level of organizational stress is statistically significantly reduced when using Scrum and Kanban.

Keywords: professional stress, organizational stress, agile, scrum, Kanban

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Authors: Ana Neves

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The European Union’s multi-level constitutionalism is grounded in an intricate network of vertical and horizontal legal relationships among different levels and types of public authorities. In a very significant way since the 2008 crisis, evolving institutional arrangements and institutional dynamics in the European Union have been progressively impacting Member States and the terms under which national public authorities are organised, interact and exercise their powers. This impact occurs in both macro and micro dimensions. Several examples are relevant here, such as the involvement of national Parliaments in the activities of the European Union, the enhanced integration of public administrations, the side effects of the Council framework decision on the European Arrest Warrant, the European Union Justice Scoreboard, the protection of whistle-blowers regulation, the enhanced cooperation on the establishment of the European Public Prosecutor’s Office, the regime for the protection of the Union budget and the European Rule of Law Mechanism. A common trend or denominator underlies the deepening of institutional interdependence and the increased interactions between the European Union, Member States, and public authorities at different levels. This seems to be conditionality as a general principle. The European multi-level constitutionalism must be considered in the light of this conditionality principle, which does not “imply a relationship of command and obedience”. Nevertheless, it might be more effective or be a very compelling principle. It is as if the extension of the shared rule is being accompanied by a contrapuntal dialogue. The different public authorities at various levels are being called to rethink and readjust themselves within a broader and more plural framework concerning understanding the limitation of power.

Keywords: european union -, multi-level hierarchy, conditionality, separation of powers

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Authors: Basanta Raj Adhikari

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Large and small scale earthquakes are frequent in the Nepal, Himalaya, and many co-seismic landslides are resulted out of it. Recently, Gorkha earthquake-2015 has triggered many co-seismic landslides destroying many lives and properties. People have displaced their original places due to having many cracks and unstable ground. Therefore, Nepal has been adopting a pronged development strategy to address the earthquake issues through reconstruction and rehabilitation policy, plans and budgets. Landslides are major threat for the mountain livelihood, and it is very important to investigate and mitigate to improve human wellbeing factoring in considerations of economic growth, environmental safety, and sustainable development. Community based landslide investigation was carried with the involvement of the local community in the Sindhupalchowk District of Central Nepal. Landslide training and field orientation were the major methodological approach of this study. Combination of indigenous and modern scientific knowledge has created unique working environment which enhanced the local capacity and trained people for replication. Local topography of the landslide was created with the help of Total Station and bill of quantity was derived based on it. River training works, plantation of trees and grasses, support structures, surface and sub-surface drainage management are the recommended mitigative measures. This is a very unique example of how academia and local community can work together for sustainable development by reducing disaster risk at the local level with very low-cost technology.

Keywords: community, earthquake, landslides, Nepal

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Authors: Natalia Selezneva

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The level of crime depends on a number of factors, such as political and economic instability, social inequality and ineffective legislation. A special place in the overall level of crime takes juvenile delinquency. United Nations Standard Minimum developed rules for the administration of juvenile justice (The Beijing Rules), in order to ensure the rights of juvenile offenders under the various legal systems. Most countries support these recommendations, and Russia is no exception. Russia's criminal code establishes the minimum age of criminal liability; types of crimes for which the possible involvement of minors to justice; punishment; sentencing and execution of punishment for minors. However, these provisions cause heated debates in the scientific literature. The high level of juvenile crime indicates the ineffectiveness of legal regulation of criminal liability of minors. In order to ensure compliance with international standards require new and modern approaches to improve national legislation and practice of its application. Achieving this goal will be achieved through the following tasks: 1. Create sub-branches of law regulating the legal status of minors; 2. Improving the types of penalties; 3. The possibility of using alternative measures; 4. The introduction of the procedure of extrajudicial settlement of the conflict. The criminal law of each country depends on the historical, national and cultural characteristics. The development of the Russian legislation taking into account international experience is extremely essential and will be a new stage in the formation of a legal state, especially in the sphere of protection of the rights of juvenile offenders.

Keywords: criminal law, juvenile offender, punishment, the age of criminal responsibility

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Authors: Samson F. Agberotimi, Rachel B. Asagba, Choja Oduaran

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Disturbing rate of use of different substances such as cannabis, alcohol, as well as pharmaceutical drugs among Nigerian youth in recent times has been affirmed in the literature. There is, however, a paucity of literature addressing the pattern of usage of such drugs, especially for clinical relevance and intervention planning. The present study investigated the prevalence and pattern of drug usage among youth in Ogbomoso, Nigeria. A cross-sectional survey involving 92 purposively selected participants comprising of 82 males and 10 females aged between 15 and 24 years was conducted. A measure of drug involvement and demographic characteristics was administered to the participants. Descriptive analysis was done using the SPSS v.21. Cannabis (79.4%), alcohol (77.2%), codeine (70.7%), tobacco (65.2%) and tramadol (47.8%) are the five most frequently used substances. However, the majority of the users of tobacco (68.3%) and alcohol (62.0%) are casual users indicating a mild level of use of the substances among the participants. On the other hand, 49.2% of the codeine users, 27.3% of the tramadol users, and 21.9% of the cannabis users reported harmful/intensive levels of use. Furthermore, the results revealed individuals at the pathological level of use as 28.8% for cannabis, 25.0% for tramadol, and 21.6% for codeine, and thus require clinical/therapeutic intervention. In conclusion, cannabis remains the most frequently used substance among youths. However, there appears to be a shift from the use of conventional psychoactive substances to pharmaceutical/prescription drugs such as codeine and tramadol. The findings of this study raised the need for both preventive and therapeutic interventions addressing the problem of substance use disorder among youth in contemporary society.

Keywords: Ogbomoso, pattern of drug use, prevalence of drug use, youth

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Authors: Hannah Riva, Sarah Mazal, Jessica L. Marquez, Michael Rains

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A 70-year-old female with a Fitzpatrick skin phenotype II presented with a 13-year history of a scaly rash located on the left breast and bilateral pretibial regions. The patient’s past medical history was otherwise unremarkable, with the exception of surgery involving the left breast. Physical examination revealed infiltrative hyperpigmented scaly plaques and nodules located on the left breast and pretibial regions bilaterally. A negative systemic workup excluded organ involvement. A clinical diagnosis of cutaneous sarcoidosis was made. Prior treatments included triamcinolone 0.1% topical cream and clobetasol 0.05% ointment, which failed to show improvement. Full-body narrow-band UVB (NBUVB) treatment was performed on a tri-weekly basis for eight months. NBUVB dosage was slowly titrated from 300 mJ/cm2 to a final dose of 1800 mJ/cm2 to prevent discomfort and burning sensations. Throughout the duration of her treatment, the patient adhered to a regimen of clobetasol 0.05% topical ointment applied twice daily in two-week intervals. Improvement was noticed after two months, with continued improvement up to eight months. The patient is continuing NBUVB phototherapy treatments for maintenance. In our case, NBUVB phototherapy treatment demonstrated promising results with improvement after two months of treatment. Physicians should consider NBUVB phototherapy as an effective option for patients presenting with cutaneous sarcoidosis.

Keywords: dermatology, sarcoidosis, phototherapy, ultraviolet

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Authors: Ratih Andaruni Widhiantari

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The combination of the expanding population of aid agencies and the act of politicization in humanitarian intervention blurred the distinction between what humanitarianism accept as universal human rights in theory and their practices in humanitarian intervention. Humanitarian organizations were now venturing into the formerly taboo territory of politics that place individuals at risk, for examples, cooperating and coordinating with the intervening states, considering moments of destruction as opportunities for political change and even taking on functions that had once been the exclusive preserve of government. Hence, aid agencies were becoming involved in matters of local or even international politics. This study focuses on the comparison between Oxfam and Médecins Sans Frontières (MSF) or Doctor without Borders different attitudes against political influences in humanitarian aid. It aims to untangle the bewilderment whether the contradictory approach to politics will becoming a barrier to performing their principles as humanitarian actors and also the consequences of taking that one particular position. The analysis of quantitative data and qualitative literature analysis are presented. The findings indicated Oxfam is actively engaged with politics. It welcomed government and private sector to shared cooperation to reach its goals to alleviate global inequalities. On the other hand, MSF has always taken a strong position to refuse any politics influence within their aid programmes. With no financial assistance from any government, MSF is free from any direct politics intervention. Hence, it can work efficiently with a clear objective to respond the demand side pressures from the people in needs. It is still publicly against politic involvement in the humanitarian activity, but practically, it has been moving forward to politicization in its own definition.

Keywords: humanitarian agencies, humanitarian intervention, humanitarian principles, politicization of humanitarianism

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Authors: Thilivhali E. Rasimphi, David Tinarwo

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Access to energy is crucial in poverty alleviation, economic growth, education, and agricultural improvement. The best renewable energy source is one which is locally available, affordable, and can easily be used and managed by local communities. The usage of renewable energy technology has the potential to alleviate many of the current problems facing rural areas. To address energy poverty, biogas technology has become an important part of resolving such. This study, therefore, examines the performance of digesters in Gawula village; it also identifies the contributing factors to the adoption and use of the technology. Data was collected using an open-ended questionnaire from biogas users. To evaluate the performance of the digesters, a data envelopment analysis (DEA) non-parametric technique was used, and to identify key factors affecting adoption, a logit model was applied. The reviewed critical barriers to biogas development in the area seem to be a poor institutional framework, poor infrastructure, a lack of technical support, user training on maintenance and operation, and as such, the implemented plants have failed to make the desired impact. Thus most digesters were abandoned. To create awareness amongst rural communities, government involvement is key, and there is a need for national programs. Biogas technology does what few other renewable energy technologies do, which is to integrate waste management and energy. This creates a substantial opportunity for biogas generation and penetration. That is, a promising pathway towards achieving sustainable development through biogas technology.

Keywords: domestic biogas technology, economic, sustainable, social, rural development

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Authors: Lady Salvador Purganan, Jojo M. Villamin, Noel L. Lansang

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Tourism is a multifaceted but interdependent industry. This industry is composed of four major players, the public sector, the private sector, the local community, and the tourists. Each player has a vital role in the success of delivering high-quality tourism products and activities. There are various manifestations of positive economic outcomes that benefit the local community. Pro-poor tourism development approach has a great potential to serve as an avenue for capacity building leading to economic independence since natural attractions and cultural resources are assets that can be capitalized on, especially by the poor, because it is more accessible to them compared to financial resources. In the National Tourism Development Plan 2016-2022, specific mechanisms are not reflected to combat and lower poverty incidence through tourism. The researcher used the multidimensional poverty theory and sustainable tourism theory to formulate indicators in the research instrument and social exchange theory. The expected output of the study is to unlock opportunities, specifically in Brgy. Sta. Lucia, Guimba, Nueva Ecija, by crafting policies taking into utmost consideration local community involvement and participation in the process of tourism development which is essential in attaining inclusive growth and sustainability. This study will apply the sequential explanatory design mixed-method approach.

Keywords: pro-poor tourism, poverty alleviation, livelihood opportunities, tourism development plan

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Authors: Issam Jebreen, Eman Al-Qbelat

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Outsourcing software development projects can be challenging, and there are several common challenges that organizations face. A study was conducted with a sample of 46 papers on outsourcing challenges, and the results show that there are several common challenges faced by organizations when outsourcing software development projects. Poor outsourcing relationship was identified as the most significant challenge, with 35% of the papers referencing it. Lack of quality was the second most significant challenge, with 33% of the papers referencing it. Language and cultural differences were the third most significant challenge, with 24% of the papers referencing it. Non-competitive price was another challenge faced by organizations, with 21% of the papers referencing it. Poor coordination and communication were also identified as a challenge, with 21% of the papers referencing it. Opportunistic behavior, lack of contract negotiation, inadequate user involvement, and constraints due to time zone were also challenges faced by organizations. Other challenges faced by organizations included poor project management, lack of technical capabilities, vendor employee high turnover, poor requirement specification, IPR issues, poor management of budget, schedule, and delay, geopolitical and country instability, the difference in development methodologies, failure to manage end-user expectations, and poor monitoring and control. In conclusion, outsourcing software development projects can be challenging, but organizations can mitigate these challenges by selecting the right outsourcing partner, having a well-defined contract and clear communication, having a clear understanding of the requirements, and implementing effective project management practices.

Keywords: software outsourcing, vendor, outsourcing challenges, quality model, continent, country, global outsourcing, IT workforce outsourcing.

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Authors: Jamie R. Chua, Christina Irene D. Mejia, Regina P. Berba

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Disseminated tuberculosis is an infectious disease caused by Mycobacterium tuberculosis involving two or more non-contiguous sites identified through bacteriologic confirmation or clinical diagnosis. Over the five year period included in the study, the UP-PGH TB DOTS clinic had total of 3,967 referrals, and the prevalence of disseminated tuberculosis is 1% (68/3967). The mean age was 33.9 years (range 19-64 years) with a male: female ratio of 1:1. 67% (52 patients) had no predisposing comorbid illness or immune disorder. The most common presenting symptoms were abdominal pain (19%), back pain (13%), abdominal enlargement (11%) and mass (10.2%). Anemia, leukocytosis, hypoalbuminemia, and high-normal serum calcium were common biochemical and hematologic findings. Around 36% (25) of patients were diagnosed clinically with disseminated tuberculosis despite lacking bacteriologic evidence of multi-organ involvement. The lungs (86%) is still the most commonly involved site, followed by intestinal (22%), vertebral/Pott’s (27%), and pelvic/genital (19%). The mean time from presentation to initiation of therapy was 22 days (SD 32.7). Only 18 patients (29.3%) were properly recorded to have been referred to local TB DOTs facilities. Of the 68 patients, only 16% (11 patients) continued follow-up at PGH, and all had documented treatment completion. Treatment outcomes of the remaining were unknown. Due to the variety of involved sites, a high index of suspicion is required. Knowledge on clinical features, common radiographic findings, and histopathologic characteristics of disseminated TB is important as bacteriologic evidence of infection is not always apparent.

Keywords: disseminated tuberculosis, Mycobacterium tuberculosis, miliary tuberculosis, tuberculosis

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Authors: Akankunda Veronicah Karuhanga

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Dementia is an age mental disorder that makes victims lose normal functionality that needs delicate attention. It has been technically defined as a clinical syndrome that presents a number of difficulties in speech and other cognitive functions that change someone’s behaviors and can also cause impairments in activities of daily living, not forgetting a range of neurological disorders that bring memory loss and cognitive impairment. Family members are the primary healthcare givers and therefore, the way how they handle the situation in its early stages determines future deterioration syndromes like total memory loss. Unfortunately, most family members are ignorant about this condition and in most cases, the patients are brought to our facilities when their condition was already mismanaged by family members and we thus cannot do much. For example, incontinence can be managed at early stages through potty training or toilet scheduling before resorting to 24/7 diapers which are also not good. Professional Elderly care should be understood and practiced as an extension of homes, not a dumping place for people considered “abnormal” on account of ignorance. Immediate relatives should therefore be sensitized concerning the normalcy of dementia in the context of old age so that they can be understanding and supportive of dementia patients rather than discriminating against them as present-day lepers. There is a need to skill home-based caregivers on how to handle dementia in its early stages. Unless this is done, many of our elderly homes shall be filled with patients who should have been treated and supported from their homes. This skilling of home-based caregivers is a vital intervention because until elderly care is appreciated as a human moral obligation, many transactional rehabilitation centers will crop up and this shall be one of the worst moral decadences of our times.

Keywords: dementia, family, Alzheimers, relevancy

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Authors: B. G. Abiona, A. A. Onaseso, T. D. Odetayo, J. Yila, O. E. Fapojuwo, K. G. Adeosun

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This study determines the perceived effects of work-family balance on employees’ job satisfaction among Extension Agents in the Agricultural Development Programme (ADP) in southwest Nigeria. A multistage sampling technique was used to select 256 respondents for the study. Data on personal characteristics, work-family balance domain, and job satisfaction were collected. The collected data were analysed using descriptive statistics, Chi-square, Pearson Product Moment Correlation (PPMC), multiple linear regression, and Student T-test. Results revealed that the mean age of the respondents was 40 years; the majority (59.3%) of the respondents were male, and slightly above half (51.6%) of the respondents had MSc as their highest academic qualification. Findings revealed that turnover intention (x ̅ = 3.20) and work-role conflict (x ̅ = 3.06) were the major perceived work-family balance domain in the studied areas. Further, the result showed that the respondents have a high (79%) level of job satisfaction. Multiple linear regression revealed that job involvement (ß=0.167, p<0.01) and work-role conflict (ß= -0.221, p<0.05) contributed significantly to employees’ level of job satisfaction. The results of the Student T-test revealed a significant difference in the perceived work-family balance domain (t = 0.43, p<0.05) between the two studied areas. The study concluded that work-role conflict among employees causes work-family imbalance and, therefore, negatively affects employees’ job satisfaction. The definition of job design among the respondents that will create a balance between work and family is highly recommended.

Keywords: work-life, conflict, job satisfaction, extension agent

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Authors: Aisling Eves, Andrew Pieri, Ross McLean, Nerys Forester

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Background: The breast unit local guideline recommends that 12 cores should be used in a stereotactic-guided biopsy to diagnose DCIS. Twelve cores are regarded to provide good diagnostic value without removing more breast tissue than necessary. This study aimed to determine compliance with guidelines and investigated how the number of cores impacted upon the re-excision rate and size discrepancies. Methods: This single-centre retrospective cohort study of 72 consecutive breast screened patients with <15mm DCIS on radiological report underwent stereotactic-guided core biopsy and subsequent surgical excision. Clinical, radiological, and histological data were collected over 5 years, and ASCO guidelines for margin involvement of <2mm was used to guide the need for re-excision. Results: Forty-six (63.9%) patients had <12 cores taken, and 26 (36.1%) patients had ≥12 cores taken. Only six (8.3%) patients had 12 cores taken in their stereotactic biopsy. Incomplete surgical excision was seen in 17 patients overall (23.6%), and of these patients, twelve (70.6%) had fewer than 12 cores taken (p=0.55 for the difference between groups). Mammogram and biopsy underestimated the size of the DCIS in this subgroup by a median of 15mm (range: 6-135mm). Re-excision was required in 9 patients (12.5%), and five patients (6.9%) were found to have invasive ductal carcinoma on excision (80% had <12 cores, p=0.43). Discussion: There is poor compliance with the breast unit local guidelines and higher rates of re-excision in patients who did not have ≥12 cores taken. Taking ≥12 cores resulted in fewer missed invasive cancers lower incomplete excision and re-excision rates.

Keywords: stereotactic core biopsy, DCIS, breast screening, Re-excision rates, core biopsy

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Authors: Cheeze Janito, Crisly Dawang

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It is important to determine the personality traits that exist in the workplace and the contribution of these personality traits in the staff’s daily work routines; a sedentary lifestyle is harmful to one’s health. This study reports the personality traits of the University of Southern Mindanao, Kabacan, Philippines, non-teaching staff, the physical activity involvement of the non-teaching staff, and the big five personality traits that shape the relationship of university non-teaching staff in engaging physical activities. A quantitative method approach, which comprised a three-part questionnaire, was used to collect the data. The fifty non-teaching staff complete the survey. The results revealed that among the big five personality traits, the university non-teaching staff scored higher in agreeableness as revealed, that there was a commonality among the respondents’ traits of consideration to the feelings of the co-workers in observance to not being rude and vividly display of respect to co-workers and workplace and scored least in the personality trait of neuroticism. The study also reported that the university non-teaching staff's main physical activity was house chores as a prime physical exercise in which respondents reported a physical activity frequency of once to twice a week; thus, this study reported that the respondents are less engaged in doing physical activities. Further, the relationship of personality traits and the physical activity of the non-teaching staff gained a p-value of .596 that indicates there is no significant relationship between the two variables, the personality trait and physical activities. This study recommends the tight promotion of staff in engaging in physical activity of at least one hundred fifty minutes of moderate-intensity activity each week. Added to this, the use of different platforms containing physical exercise literacy and the benefits of physical exercise for the holistic development of the university community.

Keywords: university staff, physical fitness, personality traits, physical activity

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Authors: Restuning Widiasih, Katherine Nelson, Joan Skinner

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Muslim husbands have significant roles in the family including their roles in women’s health and illness. However, studies that explore Muslim husbands’ participation in women’s health is limited. The objective of this study was to uncover Muslim husbands’ participation in women’ health and illness including cancer prevention and screening. A descriptive exploratory approach was used involving 20 Muslim women from urban and rural areas of West Java Province, Indonesia. Muslim women shared experience related to their husbands support and activities in women’s health and illness. The data from the interviews were analyzed using the Comparative Analysis for Interview (CAI). Women perceived that husbands fully supported their health by providing opportunities for activities, and reminding them about healthy food, their workloads, and family planning. Husbands actively involved when women faced health issues including sharing knowledge and experience, discussing any health problems, advising for medical check-ups, and accompanying them for treatments. The analysis also found that husbands were less active and offered less advice regarding prevention and early detection of cancer. This study highlights the significant involvement of Muslim husbands in women’s health and illness, yet a lack of support from husbands related to screening and cancer prevention. This condition could be a burden for Muslim women to participate in health programs related to cancer prevention and early detection. Health education programs to improve Muslim husbands’ understanding of women’s health is needed.

Keywords: descriptive exploratory study, Muslim husbands, Muslim women, women's health and illness

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Authors: Chibuzo Okoye Daniels, Gillian Glegg, Lynda Rodwell

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Marine debris from fishing nets to medical equipment to food packaging that play major roles in boosting the economy and protecting human health is now more than an environmental problem that can be solved by legislation, law enforcement and technical solutions. It has also been identified as a cultural problem that can only be addressed by identifying instruments that can be used to change human attitudes and behaviors. This may be through management approaches, education and involvement of all sectors/interests, including the public. To contribute to the sustainable development of coastal Nigeria, two case study areas (Ikoyi and Victoria Islands of Lagos State) were used to evaluate the socio-economic impacts of marine debris problem in coastal Nigeria. The following methods were used: (1) semi-structured interviews with key stakeholders and businesses on beaches, waterfronts and waterways within the study areas and (2) observational study of beaches, waterfronts and waterways within the study areas. The results of the study have shown that marine debris is a cultural and multi-sectoral problem that poses great threat not only to the environmental sustainability of the study areas but also to the wellbeing of its citizens and the economy of coastal Nigeria. Current solid waste and marine debris management practices are inefficient due to inadequate knowledge of how to tackle the problem. To ensure environmental sustainability in coastal Nigeria and avoid waste of scarce financial resources, adequate, appropriate and cost effective solutions to the marine debris problem need to be identified and effectively transferred for implementation in the study areas.

Keywords: sustainability, coastal Nigeria, study areas, aquaculture

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Authors: Samedin Mehmeti

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The rationale behind this study is considering combating and preventing the phenomenon of trafficking in human beings from a multidisciplinary perspective that involves many layers of the society. Trafficking in human beings is an abhorrent phenomenon highly affecting negatively the victims and their families in both human and material aspect, sometimes causing irreversible damages. The longer term effects of this phenomenon, in countries with a weak economic development and extremely young and dynamic population, such as Kosovo, without proper measures to prevented and control can cause tremendous damages in the society. Given the fact that a complete eradication of this phenomenon is almost impossible, efforts should be concentrated at least on the prevention and controlling aspects. Treating trafficking in human beings based on traditional police tactics, methods and proceedings cannot bring satisfactory results. There is no doubt that a multi-disciplinary approach is an irreplaceable requirement, in other words, a combination of authentic and functional proactive and reactive methods, techniques and tactics. Obviously, police must exercise its role in preventing and combating trafficking in human beings, a role sanctioned by the law, however, police role and contribution cannot by any means considered complete if all segments of the society are not included in these efforts. Naturally, civil society should have an important share in these collaborative and interactive efforts especially in preventive activities such as: awareness on trafficking risks and damages, proactive engagement in drafting appropriate legislation and strategies, law enforcement monitoring and direct or indirect involvement in protective and supporting activities which benefit the victims of trafficking etc.

Keywords: civil society, cooperation, police, human trafficking

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Authors: Martin Plener

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Developmental and democratization research has a long tradition of focusing on the relationship between democratization and economic development. However, recent studies have shown that economic development is not adequate to measure the actual living conditions of civilian people. In consequence, it is unclear if a democratization process helps to improve people’s quality of life. This work addresses this issue by investigating the influence of democratization on the Human Development Index (HDI) created by the United Nations. The main objective is to study the relationship between democracy and human development and whether democratization positively impacts the living conditions of the population over time. The main mechanism which supports a positive impact is that democratic structures promote participation and political involvement of people from all social classes resulting in a better articulation of interests and thus accountability to the government. To study this issue, a panel regression with Fixed-Effects is conducted. By that, it is examined if democracy has a positive impact on the HDI (Hypothesis 1) and secondly if the same effect weakens in more developed democracies compared to less developed democracies (Hypothesis 2). The results do not reveal a direct positive relationship between the democratization of a country and its development of the HDI, not supporting H1 which denies the first hypothesis. In contrast to the assumption of H2, the effect of democratization on human development seems to be negatively correlated in countries in which democracy is barely developed. Therefore, both hypotheses must be discarded. The results indicate rather a positive correlation between economic development on human development. Therefore, the impact of democracy on the well-being of countries’ citizens needs to be reinvestigated in order to create a better understanding of how improved human development can be achieved.

Keywords: democracy, human development, modernization theory, HDI, TSCS

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Authors: Usman A. Usman

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Undeniably, unlike the Classical side, the Keynesian perspective of the aggregate demand side indeed has a significant position in the policy, growth, and welfare of Nigeria due to government involvement and ineffective demand of the population living with poor per capita income. This study seeks to investigate the effect of Government Final Consumption Expenditure, Financial Deepening on Households, and NPISHs Final consumption expenditure using data on Nigeria from 1981 to 2019. This study employed the ADF stationarity test, Johansen Cointegration test, and Vector Error Correction Model. The results of the study revealed that the coefficient of Government final consumption expenditure has a positive effect on household consumption expenditure in the long run. There is a long-run and short-run relationship between gross fixed capital formation and household consumption expenditure. The coefficients cpsgdp (financial deepening and gross fixed capital formation posit a negative impact on household final consumption expenditure. The coefficients money supply lm2gdp, which is another proxy for financial deepening, and the coefficient FDI have a positive effect on household final consumption expenditure in the long run. Therefore, this study recommends that Gross fixed capital formation stimulates household consumption expenditure; a legal framework to support investment is a panacea to increasing hoodmold income and consumption and reducing poverty in Nigeria. Therefore, this should be a key central component of policy.

Keywords: government final consumption expenditure, household consumption expenditure, vector error correction model, cointegration

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Authors: Sharifah I. N. A. Syed Azmi, Nazarina Mohd Nasir

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The Billing & Customer Relationship Management (BCRM) project is an important enabler towards realizing customer experience transformation. It involves technological shifts for future scalability, revision of multiple business processes and adoption of change by the users and impacted employees. This massive transition, if not managed properly, may result in the decline of business performance due to productivity drop. Organizational change management is an essential element in BCRM project implementation to ensure the system is well understood and embraced by all stakeholders. In order to move impacted employees from unaware state or denial mode to full-acceptance mindset and committing themselves in using the new system, their involvement in the whole change process starting from the initial stage is imperative. Through the BCRM Change Management Plan, a holistic approach was taken whereby the strategy and program for five key components namely executive sponsorship, continuous communication, process change readiness, organizational readiness and individual readiness were all carefully established. Roles of the project sponsor, change agents, change ambassadors and community of practice (CoP) were clearly defined in gaining high commitment and support across the entire organization. Continuous communication and engagement initiatives throughout project implementation have been carried out to reach all stakeholders. The business readiness was constantly monitored and assessed including effectiveness of end-user training, thorough review of process documentation and completion of roles realignment exercise.

Keywords: BCRM, change management, organizational change, transformation project

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Authors: Maariyah Irfan

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Intro: Current cardiovascular (CV) care faces challenges such as low budgets and high hospital admission rates. This review aims to evaluate Big Data in CV healthcare management through the use of wearable devices in atrial fibrillation (AF) detection. AF may present intermittently, thus it is difficult for a healthcare professional to capture and diagnose a symptomatic rhythm. Methods: The iRhythm ZioPatch, AliveCor portable electrocardiogram (ECG), and Apple Watch were chosen for review due to their involvement in controlled clinical trials, and their integration with smartphones. The cost-effectiveness and AF detection of these devices were compared against the 12-lead ambulatory ECG (Holter monitor) that the NHS currently employs for the detection of AF. Results: The Zio patch was found to detect more arrhythmic events than the Holter monitor over a 2-week period. When patients presented to the emergency department with palpitations, AliveCor portable ECGs detected 6-fold more symptomatic events compared to the standard care group over 3-months. Based off preliminary results from the Apple Heart Study, only 0.5% of participants received irregular pulse notifications from the Apple Watch. Discussion: The Zio Patch and AliveCor devices have promising potential to be implemented into the standard duty of care offered by the NHS as they compare well to current routine measures. Nonetheless, companies must address the discrepancy between their target population and current consumers as those that could benefit the most from the innovation may be left out due to cost and access.

Keywords: atrial fibrillation, big data, cardiovascular healthcare management, wearable devices

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Authors: Jhabakhar Aryal, Kesh Bahadur Rana, Durga Prasad Neupane

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This research analyzes the nature and impacts of the 2015 unofficial blockade in Nepal, a significant event that triggered an economic and humanitarian crisis. While official channels denied claims of involvement, Nepal perceived the blockade as orchestrated by India due to concerns about the newly adopted constitution and Madheshi infringements. The study adopts a qualitative approach, utilizing semi-structured interviews, document analysis, and content analysis to gather data from various perspectives. Employing a "colonial hangover lens," it investigates if colonial legacies continue to influence postcolonial nation dynamics, focusing on India's potential attempt to exert influence over Nepal. The findings suggest that the 2015 blockade had profound consequences for Nepal, potentially reflecting lingering colonial power dynamics in the region. Despite India's denials, a significant portion of Nepalis perceived the blockade as an act of external pressure. Examining these perceptions offers valuable insights into postcolonial relations and their impact on regional stability. The 2015 unofficial blockade serves as a critical case study in understanding the complex interplay of internal dynamics, external influences, and historical legacies in shaping the geopolitics of the region. This research contributes to a deeper understanding of these factors and their ongoing implications for Nepal and its relationship with India.

Keywords: blockade, unofficial, constitution, Madhesis, India, Nepal, postcolonial, regional stability, geopolitics

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