Search results for: symptom cluster

Authors: S. M. C. Kelly, M. Goulden

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Introduction: Chronic Pancreatitis is an increasing problem worldwide. Pain is the main symptom and the main reason for hospital readmission following diagnosis, despite the use of strong analgesics including opioids. Ketamine infusions reduce pain in complex regional pain syndrome and other neuropathic pain conditions. Our centre has trialed the use of ketamine infusions in patients with chronic pancreatitis. We have evaluated this service to assess whether ketamine reduces emergency department admissions and analgesia requirements. Methods: This study collected retrospective data from 2010 in all patients who received a ketamine infusion for chronic pain secondary to a diagnosis of chronic pancreatitis. The day-case ketamine infusions were initiated in theatre by an anaesthetist, with standard monitoring and the assistance of an anaesthetic practitioner. A bolus dose of 0.5milligrams/kilogram was given in theatre. The infusion of 0.5 milligrams/kilogram per hour was then administered over a 6 hour period in the theatre recovery area. A study proforma detailed the medical history, analgesic use and admissions to hospital. Patients received a telephone follow up consultation. Results: Over the last eight years, a total of 30 patients have received intravenous ketamine infusions, with a total of 92 ketamine infusions being administered. 53% of the patients were male with the average age of 47. A total of 27 patients participated with the telephone consultation. A third of patients reported a reduction in hospital admissions with pain following the ketamine infusion. Analgesia requirements were reduced by an average of 48.3% (range 0-100%) for an average duration of 69.6 days (range 0-180 days.) Discussion: This service evaluation illustrates that ketamine infusions can reduce analgesic requirements and the number of hospital admissions in patients with chronic pancreatitis. In the light of increasing pressures on Emergency departments and the increasing evidence of the dangers of long-term opioid use, this is clearly a useful finding. We are now performing a prospective study to assess the long-term effectiveness of ketamine infusions in reducing analgesia requirements and improving patient’s quality of life.

Keywords: acute-on-chronic pain, intravenous analgesia infusion, ketamine, pancreatitis

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Authors: Muhammad Kamran Hanif Khan, Fahad Mushtaq

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Background: In both developed and underdeveloped countries, coronary artery disease (CAD) is a serious cause of death and disability. Cardiovascular disease (CVD) is becoming more prevalent in emerging countries like Pakistan due to the spread and acceptance of Western lifestyles. Material and Methods: An observational cross-sectional investigation was conducted, and data collection relied on a random cluster sampling method. The sample size for this cross-sectional study was calculated using the following factors: estimated true proportion of 17.5%, desired precision of 2%, and confidence interval of 95%. The data for this study was collected from a sample of 1387 adults. Results: The average age of those living in rural areas is 55.24 years, compared to 52.60 years for those living in urban areas. The mean fasting blood glucose of the urban participants is 105.28 mg/dL, which is higher than the mean fasting blood glucose of the rural participants, which is 102.06 mg/dL. The mean total cholesterol of the urban participants is 192.20 mg/dL, which is slightly higher than the mean total cholesterol of the rural participants, which is 191.97 mg/dL. CAD prevalence is greater in urban areas than in rural areas. ECG abnormalities prevalence is 16.1% in females compared to 12.5% in men. Conclusion: The prevalence of CAD is more common in urban areas than in rural ones for all of the measures of CAD used in the study.

Keywords: CVD prevalence, CVD risk factors, rural area, urban area

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Authors: Ching-Yuan Chen, Lung-Kwang Pan

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Objective: Back pain is a major health problem costing billions of health budgets annually in Taiwan. Thousands of back pain surgeries are performed annually with up to 40% of patients complaining of back pain at time of post-surgery causing failed back surgery syndrome (FBSS), although diagnosis in these patients may be complex. The aim of study is to assess the feasibility of using bone SPECT-CT imaging to localize the active lesions causing persistent, recurrent or new backache after spine surgery. Materials and Methods: Bone SPECT-CT imaging was performed after the intravenous injection of 20 mCi of 99mTc-MDP for all the patients with diagnosis of FBSS. Patients were evaluated using status of subjectively pain relief, functional improvement and degree of satisfaction by reviewing the medical records and questionnaires in a 2 more years’ follow-up. Results: We enrolled a total of 16 patients were surveyed in our hospital from Jan. 2015 to Dec. 2016. Four people on SPEC/CT imaging ensured significant lesions were undergone a revised surgery (surgical treatment group). The mean visual analogue scale (VAS) decreased 5.3 points and mean Oswestry disability index (ODI) improved 38 points in the surgical group. The remaining 12 on SPECT/CT imaging were diagnosed as no significant lesions then received drug treatment (medical treatment group). The mean VAS only decreased 2 .1 point and mean ODI improved 12.6 points in the medical treatment group. In the posttherapeutic evaluation, the pain of the surgical treatment group showed a satisfactory improvement. In the medical treatment group, 10 of the 12 were also satisfied with the symptom relief while the other 2 did not improve significantly. Conclusions: Findings on SPECT-CT imaging appears to be easily explained the patients' pain. We recommended that SPECT/CT imaging was a feasible and useful clinical tool to improve diagnostic confidence or specificity when evaluating patients with FBSS.

Keywords: failed back surgery syndrome, oswestry disability index, SPECT-CT imaging, 99mTc-MDP, visual analogue scale

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Authors: Jamileh Vasheghani Farahani

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The main purpose of this research is to show the current active faults and active tectonic of the area by three seismic networks in Tehran region: 1-Tehran Disaster Mitigation and Management Organization (TDMMO), 2-Broadband Iranian National Seismic Network Center (BIN), 3-Iranian Seismological Center (IRSC). In this study, we analyzed microearthquakes happened in Tehran city and its surroundings using the Tehran networks from 1996 to 2015. We found some active faults and trends in the region. There is a 200-year history of historical earthquakes in Tehran. Historical and instrumental seismicity show that the east of Tehran is more active than the west. The Mosha fault in the North of Tehran is one of the active faults of the central Alborz. Moreover, other major faults in the region are Kahrizak, Eyvanakey, Parchin and North Tehran faults. An important seismicity region is an intersection of the Mosha and North Tehran fault systems (Kalan village in Lavasan). This region shows a cluster of microearthquakes. According to the historical and microseismic events analyzed in this research, there is a seismic gap in SE of Tehran. The empirical relationship is used to assess the Mmax based on the rupture length. There is a probability of occurrence of a strong motion of 7.0 to 7.5 magnitudes in the region (based on the assessed capability of the major faults such as Parchin and Eyvanekey faults and historical earthquakes).

Keywords: Iran, major faults, microseismicity, Tehran

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Authors: Shanza Akram, Samir Salah, Imran Saleem, Ashraf Alzaabi, Jassim Abdou

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Introduction: 300 million people worldwide are affected by asthma .In UAE, prevalence is around 10% (900,000 people).Patients with persistent symptoms despite using high dose ICS plus a second controller +/- OCS are considered to have severe asthma. Omalizumab (Xolaire) an IgE monoclonal antibody is approved as add on therapy for severe allergic asthma. Objective: To determine the efficacy of omalizumab based on clinical outcomes in our cohort of patient pre and post 52 weeks of treatment to assess safety and tolerability of treatment. Methods: Medical records of patients receiving omalizumab therapy for asthma at ZMH ,Abu Dhabi were retrospectively analyzed.Patients fulfilling the criteria of severe allergic asthma as per GINA guidelines were included. Asthma control over 12 months prior to and 12 months after commencement of omalizumab therapy was analysed by taking into account the number of exacerbations and hospitalizations in addition to maintenance of medication dosages, need for rescue reliever therapy and pulmonary function testing. Results: Total cohort of 21 patient (5 females), average age 41 years and av length of therapy 22 months were included. Seven patients (total 11/52%) managed to stop steroids on treatment while four were able to decrease the dosage. Mean exacerbation rate decreased from five/ year pre treatment to 1.36 while on treatment. Number of hospitalizations decreased from mean of two per year to 0.9 per year. Rescue reliever inhaler usage decreased from mean of 40 puffs to 15 puffs per week. 2 patients discontinued therapy, 1 due to lack of benefit (2 doses) and 2nd due to severe persistent side effects including local irritation, severe limb and joint pains after 6 months. Conclusion: Treatment with omalizumab showed effect in terms of reduced number of exacerbations, maintenance therapy and reliever medications. However, no improvement was seen in PFTs.There is room for improved documentation in terms of symptom recording and use of rescue medicationas as well as for better patient education and counselling in order to improve compliance.

Keywords: asthma, omalizumab, severe allergic asthma, UAE

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Authors: Laura Piedra-Munoz, Angeles Godoy-Duran, Emilio Galdeano-Gomez, Juan C. Perez-Mesa

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Spain is very sensitive to water management issues due to its climatic characteristics and the deficit of this resource in many areas of its territory. This study examines the characteristics of the family farms that are more efficient in the use of water, focusing on a semi-arid area located in Almeria, southeast of Spain. In the case of irrigated agriculture, water usage efficiency usually indicates water productivity in terms of yield (kg/m³), or in economic terms (euros/m³). These two water usage indicators were considered to analyse water usage efficiency according to other studies on water efficiency in the horticultural area under analysis. This work also takes into account other water usage characteristics such as water supplied, innovative irrigation practices, water-efficient technology, and water-saving practices. The results show that the most water efficient farms have technical advisors and use irrigation on demand, that measures the water needs of the crops and are considered the most technological irrigation system. These farms are more technological and less labor intensive. They are also aware of water scarcity and the need to conserve the environment. This approach allow managers to identify the principal factors and best practices related to water efficiency in order to promote and implement them in inefficient farms and promote sustainability.

Keywords: cluster analysis, family farms, Spain, sustainability, water-use efficiency

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Authors: J. Barilla, M. Lokajíček, H. Pisaková, P. Simr

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The final biological effect of ionizing particles may be influenced strongly by some chemical substances present in cells mainly in the case of low-LET radiation. The influence of oxygen may be particularly important because oxygen is always present in living cells. The corresponding processes are then running mainly in the chemical stage of radio biological mechanism. The radical clusters formed by densely ionizing ends of primary or secondary charged particles are mainly responsible for final biological effect. The damage effect depends then on radical concentration at a time when the cluster meets a DNA molecule. It may be strongly influenced by oxygen present in a cell as oxygen may act in different directions: at small concentration of it the interaction with hydrogen radicals prevails while at higher concentrations additional efficient oxygen radicals may be formed. The basic radical concentration in individual clusters diminishes, which is influenced by two parallel processes: chemical reactions and diffusion of corresponding clusters. The given simultaneous evolution may be modeled and analyzed well with the help of Continuous Petri nets. The influence of other substances present in cells during irradiation may be studied, too. Some results concerning the impact of oxygen content will be presented.

Keywords: radiobiological mechanism, chemical phase, DSB formation, Petri nets

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Authors: Vahid Rashedi, Banafsheh Ebrahimi, Mahtab Sharif Mohseni, Mohammadali Hosseini

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Introduction: One of the metrics used to evaluate health status is life expectancy. This index alters as people age as a result of several events, illnesses, stress, and anxiety. One of the issues that might develop into a lethal phobia is death anxiety. This study looked at older persons in Tehran, Iran, to see if there was any correlation between life expectancy and fear of dying. Methods: Cluster random sampling was used to select 208 older persons (age 60) who had been sent to adult daycare facilities in Tehran for this correlational descriptive study. A demographic questionnaire, Temper's death anxiety scale, and Snyder's life expectancy scale were used to gather the data. Statistical Package for the Social Sciences softwear version 22 was used to conduct the data analysis. Results: The average age of the senior citizens was 66.60 (6.58) years. With a mean life expectancy of 24.94, it was discovered that the average death anxiety was 12.21. Additionally, Pearson's correlation coefficient demonstrated a bad correlation between fear of dying and life expectancy. Age, residential status, and death fear were the three primary predictors of a decline in life expectancy, according to multiple regression analysis. Conclusion: The findings suggest that there is a link between death fear and a lower life expectancy, which calls for the use of appropriate strategies to increase older individuals' life expectancies as well as the teaching of anxiety coping mechanisms.

Keywords: aged, frailty, death, anxiety, life

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Authors: Samrawit Tamrat Gebretsadik

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Recurrent wheezing is a common respiratory symptom among children, often indicative of underlying airway inflammation and hyperreactivity. Understanding the prevalence and associated factors of recurrent wheezing in specific age groups is crucial for targeted interventions and improved respiratory health outcomes. This study aimed to investigate the prevalence and associated factors of recurrent wheezing among 6-year-old children attending Adama Comprehensive Specialized Hospital Medical College in Ethiopia. A cross-sectional study design was employed, involving structured interviews with parents/guardians, medical records review, and clinical examination of children. Data on demographic characteristics, environmental exposures, family history of respiratory diseases, and socioeconomic status were collected. Logistic regression analysis was used to identify factors associated with recurrent wheezing. The study included X 6-year-old children, with a prevalence of recurrent wheezing found to be Y%. Environmental exposures, including tobacco smoke exposure (OR = Z, 95% CI: X-Y), indoor air pollution (OR = Z, 95% CI: X-Y), and presence of pets at home (OR = Z, 95% CI: X-Y), were identified as significant risk factors for recurrent wheezing. Additionally, a family history of asthma or allergies (OR = Z, 95% CI: X-Y) and low socioeconomic status (OR = Z, 95% CI: X-Y) were associated with an increased likelihood of recurrent wheezing. The impact of recurrent wheezing on the quality of life of affected children and their families was also assessed. Children with recurrent wheezing experienced a higher frequency of respiratory symptoms, increased healthcare utilization, and decreased physical activity compared to their non-wheezing counterparts. In conclusion, recurrent wheezing among 6-year-old children attending Adama Comprehensive Specialized Hospital Medical College is associated with various environmental, genetic, and socioeconomic factors. These findings underscore the importance of targeted interventions aimed at reducing exposure to known triggers and improving respiratory health outcomes in this population. Future research should focus on longitudinal studies to further elucidate the causal relationships between risk factors and recurrent wheezing and evaluate the effectiveness of preventive strategies.

Keywords: wheezing, inflammation, respiratory, crucial

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Authors: Raees Khan, Sheikh Z. Ul Abidin, Abdul S. Mumtaz, Jie Liu

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The present study is intended to assess gymnosperms pollen flora of Pakistan using Light Microscope (LM) and Scanning Electron Microscopy (SEM) for its taxonomic significance in identification of gymnosperms. Pollens of 35 gymnosperm species (12 genera and five families) were collected from its various distributional sites of gymnosperms in Pakistan. LM and SEM were used to investigate different palyno-morphological characteristics. Five pollen types (i.e., Inaperturate, Monolete, Monoporate, Vesiculate-bisaccate, and Polyplicate) were observed. In equatorial view seven types of pollens were observed, in which ten species were sub-angular, nine species were triangular, six species were perprolate, three species were rhomboidal, three species were semi-angular, two species were rectangular and two species were prolate. While five types of pollen were observed in polar view, in which ten species were spheroidal, nine species were angular, eight were interlobate, six species were circular, and two species were elliptic. Eighteen species have rugulate and 17 species has faveolate ornamentation. Eighteen species have verrucate and 17 have gemmate type sculpturing. The data was analysed through cluster analysis. The study showed that these palyno-morphological features have significance value in classification and identification of gymnosperms. Based on these different palyno-morphological features, a taxonomic key was proposed for the accurate and fast identifications of gymnosperms from Pakistan.

Keywords: gymnosperms, palynology, Pakistan, taxonomy

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Authors: Swati Sharma, R. P. Sharma

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We intend to study the nonlinear evolution of the parallel propagating finite frequency Alfvén wave (also called Dispersive Alfvén wave/Hall MHD wave) propagating in the solar wind regime of the solar region when a perpendicularly propagating magnetosonic wave is present in the background. The finite frequency Alfvén wave behaves differently from the usual non-dispersive behavior of the Alfvén wave. To study the nonlinear processes (such as filamentation) taking place in the solar regions such as solar wind, the dynamical equation of both the waves are derived. Numerical simulation involving finite difference method for the time domain and pseudo spectral method for the spatial domain is then performed to analyze the transient evolution of these waves. The power spectra of the Dispersive Alfvén wave is also investigated. The power spectra shows the distribution of the magnetic field intensity of the Dispersive Alfvén wave over different wave numbers. For DAW the spectra shows a steepening for scales larger than the proton inertial length. This means that the wave energy gets transferred to the solar wind particles as the wave reaches higher wave numbers. This steepening of the power spectra can be explained on account of the finite frequency of the Alfvén wave. The obtained results are consistent with the observations made by CLUSTER spacecraft.

Keywords: solar wind, turbulence, dispersive alfven wave

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Authors: Elaosi Vhurumuku

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During the past twenty years, there has been an increased interest by science educators in researching and developing teachers’ pedagogical content knowledge for teaching the nature of science (PCKNOS). While there has been this surge in interest in the idea of PCKNOS, there has not been a common understanding among NOS researchers as to how exactly the PCKNOS concept should be construed. In this paper, we analyse and evaluate published accredited journal articles on PCKNOS research. We also draw from our teaching experiences. The major points of foci are the researchers’ presentations of SMKNOS and their centres of attention regarding the elements of PCKNOS. Our content, cluster analysis, and evaluation of the studies on PCKNOS reveal that most researchers have presented SMKNOS in the form of a heuristic or a set of heuristics (targeted NOS ideas) to be mastered by teachers or learners. Furthermore, we found that most of the researchers’ attention has been on developing and recommending teacher pedagogical practices for teaching NOS. From this, we synthesize and propose a subject knowledge content structure and a pedagogical approach that we believe is relevant and appropriate for secondary school and science teacher education if the goal of science education for scientific literacy is to be achieved. The justification of our arguments is rooted in tracing and unpacking the origins and meaning of pedagogical content knowledge (PCK). From our analysis, synthesis, and evaluation, as well as teaching experiences, we distil and construct a meaning for the PCKNOS construct.

Keywords: pedagogical content knowledge, teaching, nature of science, construct, subject matter knowledge

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Authors: Jane E. Souyave, Judith Bower

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This study is an ongoing collaborative project between the University of Central Lancashire and the Alzheimer’s Society to design and test the idea of using interactive tools for a person living with dementia and their carers. It is hoped that the tools will fulfill the possible needs of engagement and interaction as dementia progresses, therefore enhancing wellbeing and improving quality of life for the person with dementia and their carers. The project was informed by Kitwood’s five psychological needs for producing wellbeing and explored evidence that fidgeting is often seen as a form of agitation and a negative symptom of dementia. Although therapy for agitation may be well established, there is a lack of appropriate items aimed at people in the later stage of dementia, that are not childlike or medical in their aesthetic. Individuals may fidget in a particular way and the tools in the Fidget Widget Toolkit have been designed to encourage repetitive movements of the hand, specifically to address the abilities of people with relatively advanced dementia. As an intervention, these tools provided a new approach that had not been tested in dementia care. Prototypes were created through an iterative design process and tested with a number of people with dementia and their carers, using quantitative and qualitative methods. Dementia Care Mapping was used to evaluate the impact of the intervention in group settings. Cohen Mansfield’s Agitation Inventory was used to record the daily use and interest of the intervention for people in their usual place of residence. The results informed the design of a new set of devices to promote safe, stigma free fidgeting as a positive experience, meaningful activity and enhance wellbeing for people in the later stage of dementia. The outcomes addressed the needs of individuals by reducing agitation and restlessness through helping them to connect, engage and act independently, providing the means of doing something for themselves that they were able to do. The next stage will be to explore the commercial feasibility of the Fidget Widget Toolkit so that it can be introduced as good practice and innovation in dementia care. It could be used by care homes, with carers and their families to support wellbeing and lead the way in providing some positive experiences and person-centred approaches that are lacking in the later stage of dementia.

Keywords: dementia, design, fidgeting, healthcare, positive moments, quality of life, wellbeing

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Authors: Sanaa Mekdad, Leenah Alsayed

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Pharmacists play an important role in the CDTM in the care of patients with heart failure (HF). CDTM allows specialized, dedicated clinical pharmacists in a formal agreement in collaborative practice with physicians. Thus, the aim of this study is to investigate the role of cardiology clinical pharmacists in CDTM in decreasing hospitalization and cost. We studied patients with left ventricular systolic dysfunction in a cluster-randomized selection in a tertiary care center. We allocated 296 patients to pharmacist intervention from 1480 patients. Results: With an acceptance rate of 86%, we documented 696 interventions carried out by clinical pharmacists in cardiology. The average intervention was 2.4 patients, and the admission after interventions decreased from 0.79 to. 0.24 (p value = 0.001). Conclusions: In HF CDTM, clinical pharmacists play a crucial role in enhancing medication management, patient education, and lifestyle modification of patients with chronic heart failure. These efforts improve patients' outcomes and lower costs by reducing hospitalization and other associated expenses.

Keywords: cardiology, medication management, heart failure, outpatient therapy, pharmacist-based services, chronic heart failure, heart failure recommendations, CDTM, Middle East, pharmacist-based services, quality of life, pharmacist

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Authors: Franklin Nantui Mabe, Robert Osei

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Activities and operations of artisanal small scale mining (ASM) have recently appealed to the attention of policymakers, researchers, and the general public in Ghana. This stems from the negative impacts of ASM operations on the environment and livelihoods of local inhabitants, as well as the disregard for available ASM mining policies. This study, therefore, investigates whether or not artisanal small-scale miners have enough knowledge of the mining policies and their implementations. The study adopted the Knowledge, Attitudes, and Practices (KAP) framework approach to design the research, collect and analyze primary data. The most aware ASM policy provision is the one that mandates the government to reserve demarcated ASM areas for Ghanaians, whilst the least aware provision is the one that admonishes the government to promote co-operative saving among ASM. The awareness index is lower than the attitude index towards the policy provisions. In terms of practices, miners continued to use bad practices with the associated negative impacts on the environment and rural livelihoods. It is therefore important for the government through mineral commission, district, municipal and metropolitan assemblies to intensify the education on the ASM policies. These could be done with the help of ASM associations. The current systems where a cluster of districts have a single Mineral Commission Office should be restructured to make sure that each mining district has an office.

Keywords: mining policies, KAP, awareness, artisanal small-scale mining

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Authors: Gaoyuan Wang, Tian Chen

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China’s emission peak and carbon neutrality strategies lead to the transformation of development patterns and call for new green urban design thinking. This paper begins by revealing the evolution of green urban design thinking during the periods of carbon enlightenment, carbon dependency, and carbon decoupling from the perspective of the energy transition. Combined with the current energy situation, national strengths, and technological trends, the emergence of green urban design towards carbon neutrality becomes inevitable. Based on the preliminary analysis of its connotation, the characteristics of the new type of green urban design are generalized as low-carbon orientation, carbon-related objects, carbon-reduction means, and carbon-control patterns. Its theory is briefly clarified in terms of the human-earth synergism, quality-energy interconnection, and form-flow interpromotion. Then, its mechanism is analyzed combined with the core tasks of carbon neutrality, and the scope of design issues is defined, including carbon flow mapping, carbon source regulation, carbon sink construction, and carbon emission management. Finally, a multi-scale spatial response system is proposed across the region, city, cluster, and neighborhood level. The discussion aims to provide support for the innovation of green urban design theories and methods in the context of peak neutrality.

Keywords: carbon neutrality, green urban design, energy transition, theoretical exploration

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Authors: Liberata Borralho, Saúl N. de Jesus, Adelinda Candeias, Victória Fernández-Puig

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In the last decades, we have witnessed a deterioration in the health of teachers worldwide, reflecting the constant social, political and economic changes. The quality of teaching and the success of students depends on the health status of the teachers, which justifies the importance of periodically evaluating their health. With this purpose, the Teacher’s Health Questionnaire was applied to 15.394 teachers teaching in Portugal and Spain (6.208 Spanish and 9.186 Portuguese) of primary and secondary education (3.482 men, 11.911 women). This questionnaire is specific and includes both the main risks of the teaching profession and the manifestations of teacher well-being, according to the definition recommended by the World Health Organization. A descriptive analysis of the results was carried out, including a study of the dimensions and the differences according to some sociodemographic and professional variables, from an analysis of variance ANOVA, applying the Bonferroni correction. Cluster analysis (K-means) allowed us to obtain cutoff scores to assess health status. The results allow concluding that Portuguese teachers perceive a poor well-being in the performance of their professional activity and that more than half present manifestations in the various dimensions of health deterioration, highlighting the exhaustion and cognitive disorders. In turn, Spanish teachers demonstrate a high level of well-being, being the musculoskeletal dimensions and cognitive disorders the main manifestations of deterioration of health.

Keywords: job prevention, occupational health, teacher’s health, teachers work risks, teacher’s well-being

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Authors: Sérgio J. Teixeira, João J. Ferreira

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Tourism frequently gets identified as one of the sectors with the greatest potential for expansion on a global scale and hence conveying the importance of attempting to better understand the regional factors of competitiveness prevailing in this sector. This study’s objective essentially strives to provide a mapping of the scientific publications and the intellectual knowledge therein contained while conveying past research trends and identifying potential future lines of research in the fields of regional competitiveness and tourism innovation. This correspondingly deploys a systematic review of the literature in keeping with the bibliometric approach based upon VOSviewer software, with a particular focus on drafting maps for visualising the underlying intellectual structure. This type of analysis encapsulates the number of articles published and their annual number of citations for the period between 1900 and 2016 as registered by the Web of Science database. The results demonstrate how the intellectual structure on regional competitiveness divides essentially into three major categories: regional competitiveness, tourism innovation, and tourism clusters. Thus, the main contribution of this study arises out of identifying the main research trends in this field and the respective shortcomings and specific needs for future scientific research in the field of regional competitiveness and innovation in tourism.

Keywords: regional competitiveness, tourism cluster, bibliometric studies, tourism innovation, systematic review

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Authors: Glenda Wrenn, Juliet Muzere, Meldra Hall, Allyson Belton, Kisha Holden, Chanita Hughes-Halbert, Martha Kent, Bekh Bradley

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Understanding the help seeking decision making process and experiences of health disparity populations with posttraumatic stress disorder (PTSD) is central to development of trauma-informed, culturally centered, and patient focused services. Yet, little is known about the decision making process among adult Black women who are non-treatment seekers as they are, by definition, not engaged in services. Methods: Audiotaped interviews were conducted with 30 African American adult women with clinically significant PTSD symptoms who were engaged in primary care, but not in treatment for PTSD despite symptom burden. A qualitative interview guide was used to elucidate key themes. Independent coding of themes mapped to theory and identification of emergent themes were conducted using qualitative methods. An existing quantitative dataset was analyzed to contextualize responses and provide a descriptive summary of the sample. Results: Emergent themes revealed that active mental avoidance, the intermittent nature of distress, ambivalence, and self-identified resilience as undermining to help seeking decisions. Participants were stuck within the help-seeking phase of ‘recognition’ of illness and retained a sense of “it is my decision” despite endorsing significant social and environmental negative influencers. Participants distinguished ‘help acceptance’ from ‘help seeking’ with greater willingness to accept help and importance placed on being of help to others. Conclusions: Elucidation of the decision-making process from the perspective of non-treatment seekers has implications for outreach and treatment within models of integrated and specialty systems care. The salience of responses to trauma symptoms and stagnation in the help seeking recognition phase are findings relevant to integrated care service design and community engagement.

Keywords: culture, help-seeking, integrated care, PTSD

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Authors: Strahinja Z. Kovačević, Lidija R. Jevrić, Sanja O. Podunavac Kuzmanović

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The relationship between antibacterial activity of eighteen different substituted benzimidazole derivatives and their molecular characteristics was studied using chemometric QSAR (Quantitative Structure–Activity Relationships) approach. QSAR analysis has been carried out on inhibitory activity towards Staphylococcus aureus, by using molecular descriptors, as well as minimal inhibitory activity (MIC). Molecular descriptors were calculated from the optimized structures. Principal component analysis (PCA) followed by hierarchical cluster analysis (HCA) and multiple linear regression (MLR) was performed in order to select molecular descriptors that best describe the antibacterial behavior of the compounds investigated, and to determine the similarities between molecules. The HCA grouped the molecules in separated clusters which have the similar inhibitory activity. PCA showed very similar classification of molecules as the HCA, and displayed which descriptors contribute to that classification. MLR equations, that represent MIC as a function of the in silico molecular descriptors were established. The statistical significance of the estimated models was confirmed by standard statistical measures and cross-validation parameters (SD = 0.0816, F = 46.27, R = 0.9791, R2CV = 0.8266, R2adj = 0.9379, PRESS = 0.1116). These parameters indicate the possibility of application of the established chemometric models in prediction of the antibacterial behaviour of studied derivatives and structurally very similar compounds.

Keywords: antibacterial, benzimidazole, molecular descriptors, QSAR

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Authors: Fernanda M. Assef, Maria Teresinha A. Steiner, David Gabriel F. Barros

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Review researches are useful in terms of analysis of research problems. Between the types of review documents, we commonly find bibliometric studies. This type of application often helps the global visualization of a research problem and helps academics worldwide to understand the context of a research area better. In this document, a bibliometric view surrounding clustering techniques and sustainability problems is presented. The authors aimed at which issues mostly use clustering techniques, and, even which sustainability issue would be more impactful on today’s moment of research. During the bibliometric analysis, we found ten different groups of research in clustering applications for sustainability issues: Energy; Environmental; Non-urban planning; Sustainable Development; Sustainable Supply Chain; Transport; Urban Planning; Water; Waste Disposal; and, Others. And, by analyzing the citations of each group, we discovered that the Environmental group could be classified as the most impactful research cluster in the area mentioned. Now, after the content analysis of each paper classified in the environmental group, we found that the k-means technique is preferred for solving sustainability problems with clustering methods since it appeared the most amongst the documents. The authors finally conclude that a bibliometric assessment could help indicate a gap of researches on waste disposal – which was the group with the least amount of publications – and the most impactful research on environmental problems.

Keywords: bibliometric assessment, clustering, sustainability, territorial partitioning

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Authors: Manoj K. Sharma, Neha Grover

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Dynamical cluster decay model (DCM) is applied to study the decay mechanism of 118Xe* nucleus in reference to recent data on 28Si + 90Zr → 118Xe* reaction, as an extension of our previous work on the dynamics of 112Xe* nucleus. It is relevant to mention here that DCM is based on collective clusterization approach, where emission probability of different decay paths such as evaporation residue (ER), intermediate mass fragments (IMF) and fission etc. is worked out on parallel scale. Calculations have been done over a wide range of center of mass energies with Ec.m. = 65 - 92 MeV. The evaporation residue (ER) cross-sections of 118Xe* compound nucleus are fitted in reference to available data, using spherical and quadrupole (β2) deformed choice of decaying fragments within the optimum orientations approach. It may be noted that our calculated cross-sections find decent agreement with experimental data and hence provide an opportunity to analyze the exclusive role of deformations in view of fragmentation behavior of 118Xe* nucleus. The possible contribution of IMF fragments is worked out and an extensive effort is being made to analyze the role of excitation energy, angular momentum, diffuseness parameter and level density parameter to have better understanding of the decay patterns governed in the dynamics of 28Si + 90Zr → 118Xe* reaction.

Keywords: cross-sections, deformations, fragmentation, angular momentum

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Authors: Sresha Yadav, Ishwar Kumar

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Second language learning is an important area of research in the language and linguistic domains. Literature suggests that several factors impact second language learning, including age, motivation, objectives, teacher, instructional material, classroom interaction, intelligence and previous background, previous linguistic experience, other student characteristics. Previous researchers have also highlighted that classroom atmospherics has a significant impact on learning as well as on the performance of students. However, the impact of classroom atmospherics on second language learning is still not known in the existing literature. Therefore, the purpose of the present study is to explore whether classroom atmospherics has an impact on second language learning or not? And if it does, it would be worthwhile to explore the nature of such relationship. The present study aims to explore the impact of classroom atmospherics on second language learning by dwelling into the existing literature to explore factors which impact second language learning, classroom atmospherics which impact language learning and the metrics through which such learning impacts could be measured. Based on the findings of literature review, the researchers have adopted a clustering approach for categorization and positioning of various measures of second language learning. Based on the clustering approach, the researchers have approach for measuring the impact of classroom atmospherics on second language learning by drawing a student sample consisting of 80 respondents. The results of the study uncover various basic premises of second language learning, especially with regard to classroom atmospherics. The present study is important not only from the point of view of language learning but implications could be drawn with regard to the design of classroom atmospherics, environmental psychology, anthropometrics, etc as well.

Keywords: classroom atmospherics, cluster analysis, linguistics, second language learning

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Authors: Igbozuruike Chigozie Jude, Agwu Agwu Ejem

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This research examines the comparative influence of social media and TV campaigns on youth participation in the 2023 general elections in Nigeria. It interrogates the roles played by these two media in influencing youth participation, especially youths in Nigeria, while revealing the factors that influenced their exposure to the media and their participation. The study employed a survey design of quantitative research method to gather the data for this study. Data was collected through a questionnaire from 300 youths in Lagos. The sample size was selected using a multi-stage cluster sampling technique. Social media was the most media that was rated to have had the most impact on youth participation during the election period with its political campaigns. The elaborate likelihood model was used to underpin the study. The study concluded that social media campaigns played a major role in political participation among the youth during the 2023 general election. It revealed how social media contributed to the youths' participation and influenced them to engage in common forms of political participation. The main recommendation of this study is that since the majority of the youths are between the ages of 18 to 35, the media should work on coming up with more content around the year to sensitize them about their political rights and enlighten them socio-politically so that they grow up to become responsible citizens in the country both politically and socially.

Keywords: social media, general election, Nigeria, political apathy, youth

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Authors: Erna Judith Roach, Nalini Bhaskaranand

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Background & Significance: Asthma is the most common chronic disease among children. Education is the cornerstone of management of asthma to help the affected children. In India there are about 1.5- 3.0 million asthmatic children in the age group of 5-11 years. Many parents face management dilemmas in administration of medications to their children. Mothers being primary caregivers of children are often responsible for administering medications to them. The purpose of the study was to develop an educational package on techniques of drug administration for mothers of asthmatic children and determine its effectiveness in terms of improvement in skill in drug administration. Methodology: A quasi- experimental time series pre-test post -test control group design was used. Mothers of asthmatic children attending paediatric outpatient departments of selected hospitals along with their children between 5 and 12 years were included. Sample size consisted of 40 mothers in the experimental and 40 mothers in the control groups. Block randomization was used to assign samples to both the groups. The data collection instruments used were Baseline Proforma, Clinical Proforma, Daily asthma drug intake and symptoms diary and Observation Rating Scales on technique of using a metered dose inhaler with spacer; metered dose inhaler with facemask; metered dose inhaler alone and dry powder inhaler. The educational package consisted of a video and booklet on techniques of drug administration. Data were collected at baseline, 1, 3 and 6 months. Findings: The mean post-test scores in techniques of drug administration were higher than the mean pre-test scores in the experimental group in all techniques. The Friedman test (p < 0.01), Wilcoxon Signed Rank test (p < 0.008) and Mann Whitney U (p < 0.01) showed statistically significant difference in the experimental group than the control group. There was significant decrease in the average number of symptom days (11 Vs. 4 days/ month) and hospital visits (5 to 1 per month) in the experimental group when compared to the control group. Conclusion: The educational package was found to be effective in improving the skill of mothers in drug administration in all the techniques, especially with using the metered dose inhaler with spacer.

Keywords: childhood asthma, drug administration, mothers of children, inhaler

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Authors: Goldie Lynn Diaz, Ma. Teresa Tricia G. Bautista, Elisabeth Engeljakob, Mary Glaze Rosal

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Introduction: Residents are expected to convey unfavorable news, discuss prognoses, and relieve suffering, and address do-not-resuscitate orders, yet some report a lack of competence in providing this type of care. Recognizing this need, Family Medicine residency programs are incorporating end-of-life care from symptom and pain control, counseling, and humanistic qualities as core proficiencies in training. Objective: This study determined the competency of Family Medicine Residents from various institutions in Metro Manila on rendering care for the dying. Materials and Methods: Trainees completed a Palliative Care Evaluation tool to assess their degree of confidence in patient and family interactions, patient management, and attitudes towards hospice care. Results: Remarkably, only a small fraction of participants were confident in performing independent management of terminal delirium and dyspnea. Fewer than 30% of residents can do the following without supervision: discuss medication effects and patient wishes after death, coping with pain, vomiting and constipation, and reacting to limited patient decision-making capacity. Half of the respondents had confidence in supporting the patient or family member when they become upset. Majority expressed confidence in many end-of-life care skills if supervision, coaching and consultation will be provided. Most trainees believed that pain medication should be given as needed to terminally ill patients. There was also uncertainty as to the most appropriate person to make end-of-life decisions. These attitudes may be influenced by personal beliefs rooted in cultural upbringing as well as by personal experiences with death in the family, which may also affect their participation and confidence in caring for the dying. Conclusion: Enhancing the quality and quantity of end-of-life care experiences during residency with sufficient supervision and role modeling may lead to knowledge and skill improvement to ensure quality of care. Fostering bedside learning opportunities during residency is an appropriate venue for teaching interventions in end-of-life care education.

Keywords: end of life care, geriatrics, palliative care, residency training skill

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Authors: Acheampong Addo, Emmanuel Odartei Armah, Seth Koranteng Agyakwah, Ruby Asmah, Emmanuel Tetteh-Doku Mensah, Rhoda Lims Diyie, Sena Amewu, Catherine Ragasa, Edward Kofi Abban, Mike Yaw Osei-Atweneboana

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The study investigated genetic variation and relationships among populations of Nile tilapia cultured in small-scale fish farms in selected regions of Ghana. A total of 700 samples were collected. All samples were screened with five microsatellite markers and results were analyzed using (Genetic Analysis in Excel), (Molecular and Evolutionary Genetic Analysis software, and Genpop on the web for Heterozygosity and Shannon diversity, (Analysis of Molecular Variance), and (Principal Coordinate Analysis). Fish from the 16 populations (made up of 14 farms and 2 selectively bred populations) clustered into three groups: 7 populations clustered with the GIFT-derived strain, 4 populations clustered with the Akosombo strain, and three populations were in a separate cluster. The clustering pattern indicated groups of different strains of Nile tilapia cultured. Mantel correlation test also showed low genetic variations among the 16 populations hence the need to boost seed quality in order to accelerate aquaculture production in Ghana.

Keywords: microsatellites, small- scale, Nile tilapia, akosombo strain, GIFT strain

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Authors: Ricky Munyaradzi Mukonza

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E-government literature continues to grow as scholars and practitioners endeavour to understand this phenomenon. There are many facets of e-government that have been written about including its definition, adoption, and implementation and so on. However, more still needs to be known particularly in relation to how e-government is being adopted in different contexts. There could be many context specific factors that have a bearing on e-government adoption and in this paper focus is on attitudes and perceptions. Association between usage of e-government services and various perceptions such as ease of use, transparency, security, ease of understanding, communication, reliability, relevancy, perceived usefulness and perceived trust is examined. Within the Zimbabwean context and in particular the country’s local government sphere, such a study has not been done. The main aim of the paper is therefore to establish perceptions and attitudes towards e-government services among residents in Zimbabwe’s two local authorities. In terms of research methodology the paper is based on a Mixed Methods Approach (MMA) to collect and analyse data giving the researcher a holistic picture of the phenomenon being investigated. A sample of 785 residents from the two local authorities was used and these were selected using a combination of cluster and purposive sampling methods. A key finding in this paper is that a majority of respondents who have had the opportunity to use e-government services perceive the services to be easy to use, transparent, secure, easy to understand, reliable, relevant, useful and trustworthy. The paper, therefore, makes an important contribution on the relationship between residents’ perceptions and attitudes and e-government usage within the chosen cases.

Keywords: adoption, attitudes, e-government, perceptions

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Authors: Kyi Pyar Zaw, Zin Mar Kyu

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Character recognition is the process of converting a text image file into editable and searchable text file. Feature Extraction is the heart of any character recognition system. The character recognition rate may be low or high depending on the extracted features. In the proposed paper, 25 features for one character are used in character recognition. Basically, there are three steps of character recognition such as character segmentation, feature extraction and classification. In segmentation step, horizontal cropping method is used for line segmentation and vertical cropping method is used for character segmentation. In the Feature extraction step, features are extracted in two ways. The first way is that the 8 features are extracted from the entire input character using eight direction chain code frequency extraction. The second way is that the input character is divided into 16 blocks. For each block, although 8 feature values are obtained through eight-direction chain code frequency extraction method, we define the sum of these 8 feature values as a feature for one block. Therefore, 16 features are extracted from that 16 blocks in the second way. We use the number of holes feature to cluster the similar characters. We can recognize the almost Myanmar common characters with various font sizes by using these features. All these 25 features are used in both training part and testing part. In the classification step, the characters are classified by matching the all features of input character with already trained features of characters.

Keywords: chain code frequency, character recognition, feature extraction, features matching, segmentation

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Authors: Nancy Ayman Kamal Mohamed Mehrz

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Like the economies of other countries in the Mediterranean region, the tourism sector in our country has excellent economic prospects. Tourism companies are building tourism, a sector that faces various challenges in its activities. These problems have made business activities and competition between companies difficult. In this study, which was conducted to identify the problems of the tourism sector in the Central Anatolia region, most of the problems faced by the tourism sector and consumer information on consumer rights were used. The aim is to contribute to the awareness of workers and managers working in the tourism sector and to attract the attention of companies and legislators working in the tourism sector. E-tourism is one of the newest issues in the field of tourism. Infrastructure and Information Technology (or ICT) and partner government and tourism organizations are required to achieve this type of tourism. This study measures the views of managers and tourism managers in Leman City regarding e-tourism; In addition, the effect of the literacy level of the tourism management system on tourist attractions was also examined. This research has been carried out. One of the suburbs of Isfahan province. This research is a documentary research and source material that includes literature and surveys. The results obtained show that if managers use ICT, it can help the development of e-tourism in the region, and increasing managers' views about e-tourism and improving their literacy levels can affect the development of tourism.

Keywords: financial problems, the problems of tourism businesses, tourism businesses, internet, marketing, tourism, tourism management economic competitiveness, enhancing competitiveness

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