Search results for: poor outcome of delayed breast cancer treatment
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 13451

Search results for: poor outcome of delayed breast cancer treatment

6281 The Legality of the Individual Education Plan from the Teachers’ Perspective in Saudi Arabia

Authors: Sohil I. Alqazlan

Abstract:

Introduction and Objectives: The individual educational plans (IEPs) is the cornerstone in education for students with special education need (SEN). The Saudi government supported the students’ right to have an IEP, and their education is one of the primary goals for the Ministry of Education (MoE). However, this support does not reflect the huge government investment. For example, some SEN students do not have an IEP, and poor communication was found between IEP teams and student's families. As a result, this study investigated perspectives and understandings of the IEP from the views of SEN teachers in the Saudi context. Methods: This study design utilised a qualitative approach, where in-depth semi-structured interviews were used with 8 SEN teachers in Riyadh (the capital city of Saudi Arabia) schools. In terms of analysing the interviews’ findings, the researcher used the thematic analyses approach. Results and Conclusion: The legality and the consideration of the legal document in Saudi Arabia are the main areas wherein study participants were questioned. It was observed that the IEP is not considered a legal document in the region of Saudi Arabia. As interpreted from the response of the SEN teachers, the IEP lacks the required legality with respect to its implementation in Saudi Arabia. All teachers were in agreement that the IEP is not considered to be a legal document in the Kingdom of Saudi Arabia. As a result, they did not use it for all their students with SEN. Such findings might have affected the teaching quality, and school outcomes as all SEN students must be supported individually depending on their needs.

Keywords: individual education plan, special education, IEP, teachers

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6280 Chemical Composition and Antibacterial Activity of Ceratonia siliqua L. Growing in Boumerdes, Algeria

Authors: N. Meziou-Chebouti, A. Merabet, Y. Chebouti N. Behidj

Abstract:

This work is a contribution to the knowledge of physicochemical characteristics of mature carob followed by evaluation of the activity, antimicrobial phenolics leaves and green pods of Ceratonia siliqua L. physicochemical study shows that mature carob it has a considerable content of sugar (50.90%), but poor in proteins (7%), fat (8%) and also has a high mineral content. The results obtained from phenolic extracts of leaves and green pods of Ceratonia siliqua L. show a wealth leaf phenolic extract especially flavonoids (0,545 mg EqQ/g) relative to the extract of green pods (0,226 mgEqQ/g). Polyphenols leaves have a slightly inhibitory effect on the growth of strains: Staphylococcus aureus, Escherichia coli, Klebsiella pneumoiae, Streptococcus sp and Sanmonella enteritidis, a strong inhibitory effect on the growth of Pseudomonas strain aerogenosa. Moreover, polyphenols pod have a slightly inhibitory effect on the growth of Streptococcus sp strains, Pseudomonas and aerogenosa Sanmonella enteritidis, a slightly inhibitory effect on the growth of Klebsiella pneumoniae strains, E. coli and Staphylococcus aureus.

Keywords: antimicrobial activity, bacteria, clove, Ceratonia siliqua, polyphenols

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6279 Relationship Between Health Coverage and Emergency Disease Burden

Authors: Karim Hajjar, Luis Lillo, Diego Martinez, Manuel Hermosilla, Nicholas Risko

Abstract:

Objectives: This study examines the relationship between universal health coverage (UCH) and the burden of emergency diseases at a global level. Methods: Data on Disability-Adjusted Life Years (DALYs) from emergency conditions were extracted from the Institute for Health Metrics and Evaluation (IHME) database for the years 2015 and 2019. Data on UHC, measured using two variables, 1) coverage of essential health services and 2) proportion of population spending more than 10% of household income on out-of-pocket health care expenditure, was extracted from the World Bank Database for years preceding our outcome of interest. Linear regression was performed, analyzing the effect of the UHC variables on the DALYs of emergency diseases, controlling for other variables. Results: A total of 133 countries were included. 44.4% of the analyzed countries had coverage of essential health services index of at least 70/100, and 35.3% had at least 10% of their population spend greater than 10% of their household income on healthcare. For every point increase in the coverage of essential health services index, there was a 13-point reduction in DALYs of emergency medical diseases (95% CI -16, -11). Conversely, for every percent decrease in the population with large household expenditure on healthcare, there was a 0.48 increase in DALYs of emergency medical diseases (95% CI -5.6, 4.7). Conclusions: After adjusting for multiple variables, an increase in coverage of essential health services was significantly associated with improvement in DALYs for emergency conditions. There was, however, no association between catastrophic health expenditure and DALYs.

Keywords: emergency medicine, universal healthcare, global health, health economics

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6278 Evaluation of Alpha-Glucosidase Inhibitory Effect of Two Plants from Brazilian Cerrado

Authors: N. A. P. Camaforte, P. M. P. Vareda, L. L. Saldanha, A. L. Dokkedal, J. M. Rezende-Neto, M. R. Senger, F. P. Silva-Jr, J. R. Bosqueiro

Abstract:

Diabetes mellitus is a disease characterized by deficiency of insulin secretion and/or action which results in hyperglycemia. Nowadays, acarbose is a medicine used by diabetic people to inhibit alpha-glucosidases leading to the decreasing of post-feeding glycaemia, but with low effectiveness and many side effects. Medicinal plants have been used for the treatment of many diseases including diabetes and their action occurs through the modulation of insulin-depending processes, pancreas regeneration or inhibiting glucose absorption by the intestine. Previous studies in our laboratory showed that the treatment using two crude extracts of plants from Brazilian cerrado was able to decrease fasting blood glucose and improve glucose tolerance in streptozotocin-diabetic mice. Because of this and the importance of the search for new alternatives to decrease the hyperglycemia, we decided to evaluate the inhibitory action of two plants from Brazilian cerrado - B.H. and Myrcia bella. The enzymatic assay was performed in 50 µL of final volume using pancreatic α-amylase and maltase together with theirs commercial substrates. The inhibition potency (IC50) was determined by the incubation of eight different concentrations of both extracts and the enzymes for 5 minutes at 37ºC. After, the substrate was added to start the reaction. Glucosidases assay was evaluated measuring the quantity of p-nitrophenol in 405 nmin 384 wells automatic reader. The in vitro assay with the extracts of B.H. and M. bella showed an IC50 of 28,04µg/mL and 16,93 µg/mL for α-amilase, and 43,01µg/mL and 17 µg/mL for maltase, respectively. M. bella extract showed a higher inhibitory activity for those enzymes than B.H. extract. The crude extracts tested showed a higher inhibition rate to α-amylase, but were less effective against maltase in comparison to acarbose (IC50 36µg/mL and 9 µg/mL, respectively). In conclusion, the crude extract of B.H. and M. bella showed a potent inhibitory effect against α-amylase and showed promising results to the possible development of new medicines to treat diabetes with less or even without side effects.

Keywords: alfa-glucosidases, diabetes mellitus, glycaemia, medicinal plants

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6277 Effective Practical Proceedings in Breaking the Respiratory Infections Transmission Chain in the Community with the Emphasis on SARS-COV-2 Control

Authors: Fatemeh Aghamohammadzadeh, Mahdi Asghari Ozma

Abstract:

SARS-CoV-2 was transmitted from animals to humans in China and through air transport to almost all world countries, including Iran, creating the first pandemic of the 21st century. The virus was spread through droplets from sneezing, coughing, loud talking, and exhalation of sick and asymptomatic people, even during incubation. It was transmitted from human to human directly by inhalation of viruses in droplets or indirectly through contact with infected surfaces, resulting in the death of a significant number of patients, especially the elderly and those with underlying diseases. The virus is more likely to be transmitted in places with high population densities. The chain of transmission of infection can be broken by observing the following: risk perception, reduced travel, complete quarantine in a particular area, home quarantine, social distancing, use of personal protective equipment (PPE), prevention of gatherings, cleaning and disinfection of public utilities and busy places, identifying, isolating and treating infected people, tracking calls, continuing health education, following health principles by people, especially in poor areas, and washing their hands frequently with soap and water or disinfecting them with 70% ethanol.

Keywords: COVID-19, transmission, population density, home quarantine, social distancing

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6276 Candida antarctica Lipase-B Catalyzed Alkaline-Hydrolysis of Some Aryl-Alkyl Acetate in Non-Aqueous Media

Authors: M. Merabet-Khelassi, Z. Houiene, L. Aribi-Zouioueche, O. Riant

Abstract:

Lipases (EC.3.1.1.3) are efficient biotools widely used for their remarkable chemo-, regio- and enantio-selectivity, especially, in kinetic resolution of racemates. They offer access to a large panel of enantiopure building blocks, such as secondary benzylic alcohols, commonly used as synthetic intermediates in pharmaceutical and agrochemical industries. Due to the stability of lipases in both water and organic solvents poor in water, they are able to catalyze both transesterifications of arylalkylcarbinols and hydrolysis of their corresponding acetates. The use of enzymatic hydrolysis in aqueous media still limited. In this presentation, we expose a practical methodology for the preparation of optically enriched acetates using a Candida antarctica lipase B-catalyzed hydrolysis in non-aqueous media in the presence of alkaline carbonate salts. The influence of several parameters which can intervene on the enzymatic efficiency such as the impact of the introduction of the carbonates salts, its amount and the nature of the alkaline earth metal are discussed. The obtained results show that the use of sodium carbonate with CAL-B enhances drastically both reactivity and selectivity of this immobilized lipase. In all cases, the resulting alcohols and remaining acetates are obtained in high ee values (up to > 99 %), and the selectivities reach (E > 500).

Keywords: alkaline-hydrolysis, enzymatic kinetic resolution, lipases, arylalkylcarbinol, non-aqueous media

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6275 Development of Adsorbents for Removal of Hydrogen Sulfide and Ammonia Using Pyrolytic Carbon Black form Waste Tires

Authors: Yang Gon Seo, Chang-Joon Kim, Dae Hyeok Kim

Abstract:

It is estimated that 1.5 billion tires are produced worldwide each year which will eventually end up as waste tires representing a major potential waste and environmental problem. Pyrolysis has been great interest in alternative treatment processes for waste tires to produce valuable oil, gas and solid products. The oil and gas products may be used directly as a fuel or a chemical feedstock. The solid produced from the pyrolysis of tires ranges typically from 30 to 45 wt% and have high carbon contents of up to 90 wt%. However, most notably the solid have high sulfur contents from 2 to 3 wt% and ash contents from 8 to 15 wt% related to the additive metals. Upgrading tire pyrolysis products to high-value products has concentrated on solid upgrading to higher quality carbon black and to activated carbon. Hydrogen sulfide and ammonia are one of the common malodorous compounds that can be found in emissions from many sewages treatment plants and industrial plants. Therefore, removing these harmful gasses from emissions is of significance in both life and industry because they can cause health problems to human and detrimental effects on the catalysts. In this work, pyrolytic carbon black from waste tires was used to develop adsorbent with good adsorption capacity for removal of hydrogen and ammonia. Pyrolytic carbon blacks were prepared by pyrolysis of waste tire chips ranged from 5 to 20 mm under the nitrogen atmosphere at 600℃ for 1 hour. Pellet-type adsorbents were prepared by a mixture of carbon black, metal oxide and sodium hydroxide or hydrochloric acid, and their adsorption capacities were estimated by using the breakthrough curve of a continuous fixed bed adsorption column at ambient condition. The adsorbent was manufactured with a mixture of carbon black, iron oxide(III), and sodium hydroxide showed the maximum working capacity of hydrogen sulfide. For ammonia, maximum working capacity was obtained by the adsorbent manufactured with a mixture of carbon black, copper oxide(II), and hydrochloric acid.

Keywords: adsorbent, ammonia, pyrolytic carbon black, hydrogen sulfide, metal oxide

Procedia PDF Downloads 254
6274 Deep Learning Approach for Chronic Kidney Disease Complications

Authors: Mario Isaza-Ruget, Claudia C. Colmenares-Mejia, Nancy Yomayusa, Camilo A. González, Andres Cely, Jossie Murcia

Abstract:

Quantification of risks associated with complications development from chronic kidney disease (CKD) through accurate survival models can help with patient management. A retrospective cohort that included patients diagnosed with CKD from a primary care program and followed up between 2013 and 2018 was carried out. Time-dependent and static covariates associated with demographic, clinical, and laboratory factors were included. Deep Learning (DL) survival analyzes were developed for three CKD outcomes: CKD stage progression, >25% decrease in Estimated Glomerular Filtration Rate (eGFR), and Renal Replacement Therapy (RRT). Models were evaluated and compared with Random Survival Forest (RSF) based on concordance index (C-index) metric. 2.143 patients were included. Two models were developed for each outcome, Deep Neural Network (DNN) model reported C-index=0.9867 for CKD stage progression; C-index=0.9905 for reduction in eGFR; C-index=0.9867 for RRT. Regarding the RSF model, C-index=0.6650 was reached for CKD stage progression; decreased eGFR C-index=0.6759; RRT C-index=0.8926. DNN models applied in survival analysis context with considerations of longitudinal covariates at the start of follow-up can predict renal stage progression, a significant decrease in eGFR and RRT. The success of these survival models lies in the appropriate definition of survival times and the analysis of covariates, especially those that vary over time.

Keywords: artificial intelligence, chronic kidney disease, deep neural networks, survival analysis

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6273 The Impact of Deprivation on the Prevalence of Common Mental Health Disorders in Clinical Commissioning Groups across England: A Retrospective, Cross-Sectional Study

Authors: Mohammed-Hareef Asunramu, Sana Hashemi, Raja Ohri, Luc Worthington, Nadia Zaman, Junkai Zhu

Abstract:

Background: The 2012 Health and Social Care Act committed to a ‘parity of esteem between mental and physical health services. Although this investment, aimed to both increase the quality of services and ensure the retention of mental health staff, questions remained regarding its ability to prevent mental health problems. One possible solution is a focus on the social determinants of health which have been shown to impact mental health. Aim: To examine the relationship between the index of multiple deprivations (IMD) and the prevalence of common mental health disorders (CMD) for CCGs in NHS England between 2019 and 2020. Design and setting: Cross-sectional analysis of 189 CCGs in NHS England. Methods: A multivariate linear regression model was utilized with CMD as outcome variable and IMD, age and ethnicity as explanatory variables. Datasets were obtained from Public Health England and the latest UK Census. Results: CCG IMD was found to have a significantly positive relationship with CMD. For every 1-point increase in IMD, CMD increases by 0.25%. Ethnicity had a significantly positive relationship with CMD. For every 1% increase in the population that identifies as BME, there is a 0.03% increase in CMD. Age had a significantly negative relationship with CMD. For every 1% increase in the population aged 60+, there is a 0.11% decrease in CMD. Conclusion: This study demonstrates that addressing mental health issues may require a multi-pronged approach. Beyond budget increases, it is essential to prioritize health equity, with careful considerations towards ethnic minorities and different age brackets.

Keywords: deprivation, health inequality, mental health, social determinants

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6272 Three Memorizing Strategies Reflective of Individual Students' Learning Modalities Applied to Piano Education

Authors: Olga Guseynova

Abstract:

Being an individual activity, the memorizing process is affected to a greater degree by the individual variables; therefore, one of the decisive factors influencing the memorization is students’ individual characteristics. Based on an extensive literature study in the domains of piano education, psychology, and neuroscience, this comprehensive research was designed in order to develop three memorizing strategies that are reflective of individual students’ learning modalities (visual, kinesthetic and auditory) applied to the piano education. The design of the study required an interdisciplinary approach which incorporated the outcome of neuropsychological and pedagogic experiments. The objectives were to determine the interaction between the process of perception and the process of memorizing music; to systematize the methods of memorizing piano sheet music in accordance with the specifics of perception types; to develop Piano Memorization Inventory (PMI) and the Three Memorizing Strategies (TMS). The following research methods were applied: a method of interdisciplinary analysis and synthesis, a method of non-participant observation. As a result of literature analysis, the following conclusions were made: the majority of piano teachers and piano students participated in the surveys, had not used and usually had not known any memorizing strategy regarding learning styles. As a result, they had used drilling as the main strategy of memorizing. The Piano Memorization Inventory and Three Memorizing Strategies developed by the author of the research were based on the observation and findings of the previous researches and considered the experience of pedagogical and neuropsychological studies.

Keywords: interdisciplinary approach, memorizing strategies, perceptual learning styles, piano memorization inventory

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6271 Effect of Implementing a Teaching Module about Diet and Exercises on Clinical Outcomes of Patients with Gout

Authors: Wafaa M. El- Kotb, Soheir Mohamed Weheida, Manal E. Fareed

Abstract:

The aim of this study was to determine the effect of implementing a teaching module about diet and exercises on clinical outcomes of patients with gout. Subjects: A purposive sample of 60 adult gouty patients was selected and randomly and alternatively divided into two equal groups 30 patients in each. Setting: The study was conducted in orthopedic out patient's clinic of Menoufia University. Tools of the study: Three tools were utilized for data collection: Knowledge assessment structured interview questionnaire, Clinical manifestation assessment tools and Nutritional assessment sheet. Results: All patients of both groups (100 %) had poor total knowledge score pre teaching, while 90 % of the study group had good total knowledge score post teaching by three months compared to 3.3 % of the control group. Moreover the recovery outcomes were significantly improved among study group compared to control group post teaching. Conclusion: Teaching study group about diet and exercises significantly improved their clinical outcomes. Recommendation: Patient's education about diet and exercises should be ongoing process for patients with gout.

Keywords: clinical outcomes, diet, exercises, teaching module

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6270 An Inspection of Two Layer Model of Agency: An fMRI Study

Authors: Keyvan Kashkouli Nejad, Motoaki Sugiura, Atsushi Sato, Takayuki Nozawa, Hyeonjeong Jeong, Sugiko Hanawa , Yuka Kotozaki, Ryuta Kawashima

Abstract:

The perception of agency/control is altered with presence of discrepancies in the environment or mismatch of predictions (of possible results) and actual results the sense of agency might become altered. Synofzik et al. proposed a two layer model of agency: In the first layer, the Feeling of Agency (FoA) is not directly available to awareness; a slight mismatch in the environment/outcome might cause alterations in FoA, while the agent still feels in control. If the discrepancy passes a threshold, it becomes available to consciousness and alters Judgment of Agency (JoA), which is directly available in the person’s awareness. Most experiments so far only investigate subjects rather conscious JoA, while FoA has been neglected. In this experiment we target FoA by using subliminal discrepancies that can not be consciously detectable by the subjects. Here, we explore whether we can detect this two level model in the subjects behavior and then try to map this in their brain activity. To do this, in a fMRI study, we incorporated both consciously detectable mismatching between action and result and also subliminal discrepancies in the environment. Also, unlike previous experiments where subjective questions from the participants mainly trigger the rather conscious JoA, we also tried to measure the rather implicit FoA by asking participants to rate their performance. We compared behavioral results and also brain activation when there were conscious discrepancies and when there were subliminal discrepancies against trials with no discrepancies and against each other. In line with our expectations, conditions with consciously detectable incongruencies triggered lower JoA ratings than conditions without. Also, conditions with any type of discrepancies had lower FoA ratings compared to conditions without. Additionally, we found out that TPJ and angular gyrus in particular to have a role in coding of JoA and also FoA.

Keywords: agency, fMRI, TPJ, two layer model

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6269 QSAR, Docking and E-pharmacophore Approach on Novel Series of HDAC Inhibitors with Thiophene Linker as Anticancer Agents

Authors: Harish Rajak, Preeti Patel

Abstract:

HDAC inhibitors can reactivate gene expression and inhibit the growth and survival of cancer cells. The 3D-QSAR and Pharmacophore modeling studies were performed to identify important pharmacophoric features and correlate 3D-chemical structure with biological activity. The pharmacophore hypotheses were developed using e-pharmacophore script and phase module. Pharmacophore hypothesis represents the 3D arrangement of molecular features necessary for activity. A series of 55 compounds with well-assigned HDAC inhibitory activity was used for 3D-QSAR model development. Best 3D-QSAR model, which is a five PLS factor model with good statistics and predictive ability, acquired Q2 (0.7293), R2 (0.9811) and standard deviation (0.0952). Molecular docking were performed using Histone Deacetylase protein (PDB ID: 1t69) and prepared series of hydroxamic acid based HDAC inhibitors. Docking study of compound 43 show significant binding interactions Ser 276 and oxygen atom of dioxine cap region, Gly 151 and amino group and Asp 267 with carboxyl group of CONHOH, which are essential for anticancer activity. On docking, most of the compounds exhibited better glide score values between -8 to -10.5. We have established structure activity correlation using docking, energetic based pharmacophore modelling, pharmacophore and atom based 3D QSAR model. The results of these studies were further used for the design and testing of new HDAC analogs.

Keywords: Docking, e-pharmacophore, HDACIs, QSAR, Suberoylanilidehydroxamic acid.

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6268 Benefits of Collegial Teaming to Improve Knowledge-Worker Productivity

Authors: Prakash Singh, Piet Maphodisa Kgohlo

Abstract:

Knowledge-worker productivity is one of the biggest leadership challenges facing all organizations in the twenty-first century. It cannot be denied that knowledge-worker productivity affects all organizations. The work and the workforce are both undergoing greater changes currently than at any time, since the beginning of the industrial revolution two centuries ago. Employees welcome collegial teaming (CT) as an innovative way to develop their work-integrated learning competencies. Human resource development policies must evoke the symbiotic relationship between CT and work-integrated learning, seeing that employees need to be endowed with the competence to move from one skill to another, as each one becomes obsolete, and to simultaneously develop their cognitive and emotional intelligence. The outcome of this relationship must culminate in the development of highly productive knowledge-workers. While this study focuses on teachers, the conceptual framework and the findings of this research can be beneficial for any organization, public or private sector, business or non-business. Therefore, in this quantitative study, the benefits of CT are considered in developing human resources to sustain knowledge-worker productivity. The ANOVA p-values reveal that the majority of teachers agree that CT can empower them to overcome the challenges of managing curriculum change. CT can equip them with continuous and sustained learning, growth and improvement, necessary for knowledge-worker productivity. This study, therefore, confirms that CT benefits all workers, immaterial of their age, gender or experience. Hence, this exploratory research provides a new perspective of CT in addressing knowledge-worker productivity when organizational change alters the vision of the organization.

Keywords: collegial teaming, human resource development, knowledge-worker productivity, work-integrated learning

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6267 An Academic Theory on a Sustainable Evaluation of Achatina Fulica Within Ethekwini, KwaZulu-Natal

Authors: Sibusiso Trevor Tshabalala, Samuel Lubbe, Vince Vuledzani Ndou

Abstract:

Dependency on chemicals has had many disadvantages in pest management control strategies. Such genetic rodenticide resistance and secondary exposure risk are what is currently being experienced. Emphasis on integrated pest management suggests that to control future pests, early intervention and economic threshold development are key starting points in crop production. The significance of this research project is to help establish a relationship between Giant African Land Snail (Achatina Fulica) solution extract, its shell chemical properties, and farmer’s perceptions of biological control in eThekwini Municipality Agri-hubs. A mixed design approach to collecting data will be explored using a trial layout in the field and through interviews. The experimental area will be explored using a split-plot design that will be replicated and arranged in a randomised complete block design. The split-plot will have 0, 10, 20 and 30 liters of water to one liter of snail solution extract. Plots were 50 m² each with a spacing of 12 m between each plot and a plant spacing of 0.5 m (inter-row) ‘and 0.5 m (intra-row). Trials will be irrigated using sprinkler irrigation, with objective two being added to the mix every 4-5 days. The expected outcome will be improved soil fertility and micro-organisms population proliferation.

Keywords: giant african land snail, integrated pest management, photosynthesis, genetic rodenticide resistance, control future pests, shell chemical properties

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6266 The Effectiveness of Men Who Have Sex with Men (MSM) Sensitivity Training for Nigerian Health Care Providers (HCPs)

Authors: Chiedu C. Ifekandu, Olusegun Sangowawa, Jean E. Njab

Abstract:

Background: Health care providers (HCPs) in Nigeria receive little or no training of the healthcare needs of men who have sex with men (MSM) limiting the quality and effectiveness of comprehensive HIV prevention and treatment services. Consequently, most MSM disguise themselves to access services which limit the quality of care provided partly due to challenges related to stigma and discrimination, and breach of confidentiality. Objective: To assess the knowledge of healthcare providers on effective intervention for MSM. Methods: We trained 122 HIV focal persons drawn from 60 health facilities from twelve Nigerian states. , the participants were requested to complete a pre-training questionnaire to assess their level of working experience with key populations as a baseline. Participants included male and female doctors, nurses and counselors/testers. A test was administered to measure their knowledge on MSM sexual risk practices, HIV prevention and healthcare needs and also to assess their attitudes (including homophobia) and beliefs and how it affects service uptake by key populations particularly MSM prior and immediately after the training to ascertain the impact of the training. Results: The mean age of the HCP was 38 years +/- SD Of the 122 HCPs (45 % female, 55 % male; 85 % counsellor/testers; 15 % doctors and nurses; 92 % working in government facilities) from 42 health facilities were trained, of which 105 attempted the test questions. At the baseline, few HCPs reported any prior sensitivity training on MSM. Most of the HCPs had limited knowledge of MSM sexual health needs. Over 90% of the HCPs believed that homosexuality is a mental illness. 8 % do not consider MSM, FSW and PWID as key populations for HIV infection. 45 % lacked knowledge on MSM anal sexual practices. The post-test showed that homophobic attitudes had decreased significantly by the end of the training; the health care providers have acquired basic knowledge compared to the pre-test. Conclusions: Scaling up MSM sensitivity training for Nigerian HCPs is likely to be a timely and effective means to improve their understanding of MSM-related health issues, reduce homophobic sentiments and enhance their capacity to provide responsive HIV prevention, treatment and care services in a supportive and non-stigmatizing environment.

Keywords: healthcare providers, key population, men who have sex with men, HCT

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6265 Hypolipidemic and Antioxidant Effects of Mycelial Polysaccharides from Calocybe indica in Hyperlipidemic Rats Induced by High-Fat Diet

Authors: Govindan Sudha, Mathumitha Subramaniam, Alamelu Govindasamy, Sasikala Gunasekaran

Abstract:

The aim of this study was to investigate the protective effect of Hypsizygus ulmarius polysaccharides (HUP) on reducing oxidative stress, cognitive impairment and neurotoxicity in D-galactose induced aging mice. Mice were subcutaneously injected with D-galactose (150 mg/kg per day) for 6 weeks and were administered HUP simultaneously. Aged mice receiving vitamin E (100 mg/kg) served as positive control. Chronic administration of D-galactose significantly impaired cognitive performance oxidative defence and mitochondrial enzymes activities as compared to control group. The results showed that HUP (200 and 400 mg/kg) treatment significantly improved the learning and memory ability in Morris water maze test. Biochemical examination revealed that HUP significantly increased the decreased activities of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), glutathione reductase (GR), glutathione-S-transferase (GST), mitochondrial enzymes-NADH dehydrogenase, malate dehydrogenase (MDH), isocitrate dehydrogenase (ICDH), Na+K+, Ca2+, Mg2+ATPase activities, elevated the lowered total anti-oxidation capability (TAOC), glutathione (GSH), vitamin C and decreased the raised acetylcholinesterase (AChE) activities, malondialdehyde (MDA), hydroperoxide (HPO), protein carbonyls (PCO), advanced oxidation protein products (AOPP) levels in brain of aging mice induced by D-gal in a dose-dependent manner. In conclusion, present study highlights the potential role of HUP against D-galactose induced cognitive impairment, biochemical and mitochondrial dysfunction in mice. In vitro studies on the effect of HUP on scavenging DPPH, ABTS, DMPD, OH radicals, reducing power, B-carotene bleaching and lipid peroxidation inhibition confirmed the free radical scavenging and antioxidant activity of HUP. The results suggest that HUP possesses anti-aging efficacy and may have potential in treatment of neurodegenerative diseases.

Keywords: aging, antioxidants, mushroom, neurotoxicity

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6264 Total Longitudinal Displacement (tLoD) of the Common Carotid Artery (CCA) Does Not Differ between Patients with Moderate or High Cardiovascular Risk (CV) and Patients after Acute Myocardial Infarction (AMI)

Authors: P. Serpytis, K. Azukaitis, U. Gargalskaite, R. Navickas, J. Badariene, V. Dzenkeviciute

Abstract:

Purpose: Total longitudinal displacement (tLoD) of the common carotid artery (CCA) wall is a novel ultrasound marker of vascular function that can be evaluated using modified speckle tracking techniques. Decreased CCA tLoD has already been shown to be associated with diabetes and was shown to predict one year cardiovascular outcome in patients with suspected coronary artery disease (CAD) . The aim of our study was to evaluate if CCA tLoD differ between patients with moderate or high cardiovascular (CV) risk and patients after recent acute myocardial infarction (AMI). Methods: 49 patients (54±6 years) with moderate or high CV risk and 42 patients (58±7 years) after recent AMI were included. All patients were non-diabetic. CCA tLoD was evaluated using GE EchoPAC speckle tracking software and expressed as mean of both sides. Data on systolic blood pressure, total and high density lipoprotein (HDL) cholesterol levels, high sensitivity C-reactive protein (hsCRP) level, smoking status and family history of early CV events was evaluated and assessed for association with CCA tLoD. Results: tLoD of CCA did not differ between patients with moderate or high CV risk and patients with very high CV risk after MI (0.265±0.128 mm vs. 0.237±0.103 mm, p>0.05). Lower tLoD was associated with lower HDL cholesterol levels (r=0.211, p=0.04) and male sex (0.228±0.1 vs. 0.297±0.134, p=0.01). Conclusions: tLoD of CCA did not differ between patients with moderate or high CV risk and patients with very high CV risk after AMI. However, lower CCA tLoD was significantly associated with low HDL cholesterol levels and male sex.

Keywords: total longitudinal displacement, carotid artery, cardiovascular risk, acute myocardial infarction

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6263 Using Linear Logistic Regression to Evaluation the Patient and System Delay and Effective Factors in Mortality of Patients with Acute Myocardial Infarction

Authors: Firouz Amani, Adalat Hoseinian, Sajjad Hakimian

Abstract:

Background: The mortality due to Myocardial Infarction (MI) is often occur during the first hours after onset of symptom. So, for taking the necessary treatment and decreasing the mortality rate, timely visited of the hospital could be effective in this regard. The aim of this study was to investigate the impact of effective factors in mortality of MI patients by using Linear Logistic Regression. Materials and Methods: In this case-control study, all patients with Acute MI who referred to the Ardabil city hospital were studied. All of died patients were considered as the case group (n=27) and we select 27 matched patients without Acute MI as a control group. Data collected for all patients in two groups by a same checklist and then analyzed by SPSS version 24 software using statistical methods. We used the linear logistic regression model to determine the effective factors on mortality of MI patients. Results: The mean age of patients in case group was significantly higher than control group (75.1±11.7 vs. 63.1±11.6, p=0.001).The history of non-cardinal diseases in case group with 44.4% significantly higher than control group with 7.4% (p=0.002).The number of performed PCIs in case group with 40.7% significantly lower than control group with 74.1% (P=0.013). The time distance between hospital admission and performed PCI in case group with 110.9 min was significantly upper than control group with 56 min (P=0.001). The mean of delay time from Onset of symptom to hospital admission (patient delay) and the mean of delay time from hospital admissions to receive treatment (system delay) was similar between two groups. By using logistic regression model we revealed that history of non-cardinal diseases (OR=283) and the number of performed PCIs (OR=24.5) had significant impact on mortality of MI patients in compare to other factors. Conclusion: Results of this study showed that of all studied factors, the number of performed PCIs, history of non-cardinal illness and the interval between onset of symptoms and performed PCI have significant relation with morality of MI patients and other factors were not meaningful. So, doing more studies with a large sample and investigated other involved factors such as smoking, weather and etc. is recommended in future.

Keywords: acute MI, mortality, heart failure, arrhythmia

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6262 Modelling Exchange-Rate Pass-Through: A Model of Oil Prices and Asymmetric Exchange Rate Fluctuations in Selected African Countries

Authors: Fajana Sola Isaac

Abstract:

In the last two decades, we have witnessed an increased interest in exchange rate pass-through (ERPT) in developing economies and emerging markets. This is perhaps due to the acknowledged significance of the pattern of exchange rate pass-through as a key instrument in monetary policy design, principally in retort to a shock in exchange rate in literature. This paper analyzed Exchange Rate Pass-Through by A Model of Oil Prices and Asymmetric Exchange Rate Fluctuations in Selected African Countries. The study adopted A Non-Linear Autoregressive Distributed Lag approach using yearly data on Algeria, Burundi, Nigeria and South Africa from 1986 to 2022. The paper found asymmetry in exchange rate pass-through in net oil-importing and net oil-exporting countries in the short run during the period under review. An ERPT exhibited a complete pass-through in the short run in the case of net oil-importing countries but an incomplete pass-through in the case of the net oil-exporting countries that were examined. An extended result revealed a significant impact of oil price shock on exchange rate pass-through to domestic price in the long run only for net oil importing countries. The Wald restriction test also confirms the evidence of asymmetric with the role of oil price acting as an accelerator to exchange rate pass-through to domestic price in the countries examined. The study found the outcome to be very useful for gaining expansive knowledge on the external shock impact on ERPT and could be of critical value for national monetary policy decisions on inflation targeting, especially for countries examined and other developing net oil importers and exporters.

Keywords: pass through, exchange rate, ARDL, monetary policy

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6261 Automatic Classification of Lung Diseases from CT Images

Authors: Abobaker Mohammed Qasem Farhan, Shangming Yang, Mohammed Al-Nehari

Abstract:

Pneumonia is a kind of lung disease that creates congestion in the chest. Such pneumonic conditions lead to loss of life of the severity of high congestion. Pneumonic lung disease is caused by viral pneumonia, bacterial pneumonia, or Covidi-19 induced pneumonia. The early prediction and classification of such lung diseases help to reduce the mortality rate. We propose the automatic Computer-Aided Diagnosis (CAD) system in this paper using the deep learning approach. The proposed CAD system takes input from raw computerized tomography (CT) scans of the patient's chest and automatically predicts disease classification. We designed the Hybrid Deep Learning Algorithm (HDLA) to improve accuracy and reduce processing requirements. The raw CT scans have pre-processed first to enhance their quality for further analysis. We then applied a hybrid model that consists of automatic feature extraction and classification. We propose the robust 2D Convolutional Neural Network (CNN) model to extract the automatic features from the pre-processed CT image. This CNN model assures feature learning with extremely effective 1D feature extraction for each input CT image. The outcome of the 2D CNN model is then normalized using the Min-Max technique. The second step of the proposed hybrid model is related to training and classification using different classifiers. The simulation outcomes using the publically available dataset prove the robustness and efficiency of the proposed model compared to state-of-art algorithms.

Keywords: CT scan, Covid-19, deep learning, image processing, lung disease classification

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6260 An Overview of the Current Status of Lake Jipe and Its Biodiversity Dilemma

Authors: Mercy Chepkirui, Paul Orina, Robin Abell, Leonard Akwany, Tonny Orina, Mercy Matuma, Rasowo Joseph

Abstract:

Lake jipe, a shared water resource between Kenya and Tanzania located at the East African Coast, is under multiple pressures. The lake has receded from 30Km2 to 27.32Km2 due to prolonged dry spells and intensified water abstraction for irrigation and re-route to Mungu ya Nyumba Dam in Tanzania. Agricultural activities have significantly (90%) contributed to the lake levels decline and further affected the lakes’ aquatic biodiversity. Among the most affected are the commercially important endemic fish species of the lake, of which Oreochromis jipe has experienced the greatest decline. Overfishing, use of illegal unreported and unregulated fishing gears, intensified fishing along protected fish breeding areas as well as poor management and uncoordinated conservation efforts have significantly contributed to the decline of fish catches from 348 kg of O. jipe in 2016 to 90 kg daily catches in 2022. Therefore, the lake is on the verge of extinction if no action is taken. This calls for awareness of the significance of the L. Jipe ecosystems and its immediate and long-term benefits. Further, there is a need to revive alternative economic activities, including aquaculture and sustainable agriculture, to offer alternative livelihood to local communities.

Keywords: biodiversity, ecosystem, conservation, fisheries

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6259 Policy Analysis on Family Planning in Pakistan: Providing Options to Improve Service Provision

Authors: M. Moiz

Abstract:

Family planning has been known and accepted as a key tool to decrease fertility, provides birth spacing and plays a vital role to attain better outcomes for maternal and child health. Pakistan initiated various family planning programs to preserve maternal and child health for six decades. However, less contraceptive use leading to high fertility and low birth spacing is ultimately a risk for increasing morbidity and mortality. As an outcome of 2012 London Summit on Family Planning where 20 countries including Pakistan made its commitment to increase contraceptive prevalence rate by 55% and provide a universal access to reproductive health to protect human rights of women and ensure safe, choice informed and affordable contraceptives throughout the country. This paper will assess some of the factors of service delivery, coverage and the role of Ministry of Health and Population Welfare Department in providing Family Planning services and how it can be improved in Pakistan. In view of Pakistan Demographic Health Survey 2017-18, there are total nine million potential users of contraceptives and one third among them never used with unmet need while every fifth pregnancy ends into abortion indicates need for Family Planning services. In order to explain this concern, a comprehensive analysis has been done on role of governance in implementing family planning policy and its limitations are discussed. Moreover, this paper highlights policy options and recommendations for improving service provision through public and private sector in creating demand for Family Planning services in Pakistan.

Keywords: contraceptive prevalence rate, family planning, maternal and child health, policy options

Procedia PDF Downloads 158
6258 A Comprehensive Review of Foam Assisted Water Alternating Gas (FAWAG) Technique: Foam Applications and Mechanisms

Authors: A. Shabib-Asl, M. Abdalla Ayoub Mohammed, A. F. Alta’ee, I. Bin Mohd Saaid, P. Paulo Jose Valentim

Abstract:

In the last few decades, much focus has been placed on enhancing oil recovery from existing fields. This is accomplished by the study and application of various methods. As for recent cases, the study of fluid mobility control and sweep efficiency in gas injection process as well as water alternating gas (WAG) method have demonstrated positive results on oil recovery and thus gained wide interest in petroleum industry. WAG injection application results in an increased oil recovery. Its mechanism consists in reduction of gas oil ratio (GOR). However, there are some problems associated with this which includes poor volumetric sweep efficiency due to its low density and high mobility when compared with oil. This has led to the introduction of foam assisted water alternating gas (FAWAG) technique, which in contrast with WAG injection, acts in improving the sweep efficiency and reducing the gas oil ration therefore maximizing the production rate from the producer wells. This paper presents a comprehensive review of FAWAG process from perspective of Snorre field experience. In addition, some comparative results between FAWAG and the other EOR methods are presented including their setbacks. The main aim is to provide a solid background for future laboratory research and successful field application-extend.

Keywords: GOR, mobility ratio, sweep efficiency, WAG

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6257 Melanoma Antigen Proteins Are Involved in DNA Damage Response

Authors: Olivier de Backer, Alexis Khelfi, Olivier Svensek, Axelle Nolmans, Dominique Desnoeck

Abstract:

The SMC5-SMC6 complex helps replication and repair of DNA double-strand breaks. Nse1, Nse3 and Nse4 are non-SMC components of the complex in which Nse3 stimulates the E3 ubiquitin ligase activity of Nse1 and is required for recruiting the complex on DNA. In most eukaryotes, Nse3 is a single protein, but in eutherians (placental mammals), it belongs to a large family of proteins called MAGE (Melanoma antigen) that share a conserved domain of about 200 aa known as MHD (Mage homology domain). MAGE assembles specific RING and HECT ubiquitin ligases and determines new substrates for ubiquitination. The MHD is required for the interaction with the cognate E3 ligase. Some MAGEs (referred to as Type I) are exclusively expressed in germ cells of the testis but are often expressed ectopically in cancer cells as the result of epigenetic modifications. The 12 MAGE-A genes belong to this category. Serval MAGE-A proteins could promote tumorigenesis by targeting tumor suppressor proteins (including p53) for ubiquitination and degradation. We showed that depletion of MAGE-A proteins in melanoma cells results in impaired DNA damage response and increased double-strand breaks after exposure to camptothecin. Moreover, it was shown that other actors of the DNA Damage Response were impacted when cells were depleted of MAGEA proteins.

Keywords: DNA damage response, melanoma, camptothecin, new role, MAGEA

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6256 Effects of Cold Treatments on Methylation Profiles and Reproduction Mode of Diploid and Tetraploid Plants of Ranunculus kuepferi (Ranunculaceae)

Authors: E. Syngelaki, C. C. F. Schinkel, S. Klatt, E. Hörandl

Abstract:

Environmental influence can alter the conditions for plant development and can trigger changes in epigenetic variation. Thus, the exposure to abiotic environmental stress can lead to different DNA methylation profiles and may have evolutionary consequences for adaptation. Epigenetic control mechanisms may further influence mode of reproduction. The alpine species R. kuepferi has diploid and tetraploid cytotypes, that are mostly sexual and facultative apomicts, respectively. Hence, it is a suitable model system for studying the correlations of mode of reproduction, ploidy, and environmental stress. Diploid and tetraploid individuals were placed in two climate chambers and treated with low (+7°C day/+2°C night, -1°C cold shocks for three nights per week) and warm (control) temperatures (+15°C day/+10°C night). Subsequently, methylation sensitive-Amplified Fragment-Length Polymorphism (AFPL) markers were used to screen genome-wide methylation alterations triggered by stress treatments. The dataset was analyzed for four groups regarding treatment (cold/warm) and ploidy level (diploid/tetraploid), and also separately for full methylated, hemi-methylated and unmethylated sites. Patterns of epigenetic variation suggested that diploids differed significantly in their profiles from tetraploids independent from treatment, while treatments did not differ significantly within cytotypes. Furthermore, diploids are more differentiated than the tetraploids in overall methylation profiles of both treatments. This observation is in accordance with the increased frequency of apomictic seed formation in diploids and maintenance of facultative apomixis in tetraploids during the experiment. Global analysis of molecular variance showed higher epigenetic variation within groups than among them, while locus-by-locus analysis of molecular variance showed a high number (54.7%) of significantly differentiated un-methylated loci. To summarise, epigenetic variation seems to depend on ploidy level, and in diploids may be correlated to changes in mode of reproduction. However, further studies are needed to elucidate the mechanism and possible functional significance of these correlations.

Keywords: apomixis, cold stress, DNA methylation, Ranunculus kuepferi

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6255 Ultrasound Disintegration as a Potential Method for the Pre-Treatment of Virginia Fanpetals (Sida hermaphrodita) Biomass before Methane Fermentation Process

Authors: Marcin Dębowski, Marcin Zieliński, Mirosław Krzemieniewski

Abstract:

As methane fermentation is a complex series of successive biochemical transformations, its subsequent stages are determined, to a various extent, by physical and chemical factors. A specific state of equilibrium is being settled in the functioning fermentation system between environmental conditions and the rate of biochemical reactions and products of successive transformations. In the case of physical factors that influence the effectiveness of methane fermentation transformations, the key significance is ascribed to temperature and intensity of biomass agitation. Among the chemical factors, significant are pH value, type, and availability of the culture medium (to put it simply: the C/N ratio) as well as the presence of toxic substances. One of the important elements which influence the effectiveness of methane fermentation is the pre-treatment of organic substrates and the mode in which the organic matter is made available to anaerobes. Out of all known and described methods for organic substrate pre-treatment before methane fermentation process, the ultrasound disintegration is one of the most interesting technologies. Investigations undertaken on the ultrasound field and the use of installations operating on the existing systems result principally from very wide and universal technological possibilities offered by the sonication process. This physical factor may induce deep physicochemical changes in ultrasonicated substrates that are highly beneficial from the viewpoint of methane fermentation processes. In this case, special role is ascribed to disintegration of biomass that is further subjected to methane fermentation. Once cell walls are damaged, cytoplasm and cellular enzymes are released. The released substances – either in dissolved or colloidal form – are immediately available to anaerobic bacteria for biodegradation. To ensure the maximal release of organic matter from dead biomass cells, disintegration processes are aimed to achieve particle size below 50 μm. It has been demonstrated in many research works and in systems operating in the technical scale that immediately after substrate supersonication the content of organic matter (characterized by COD, BOD5 and TOC indices) was increasing in the dissolved phase of sedimentation water. This phenomenon points to the immediate sonolysis of solid substances contained in the biomass and to the release of cell material, and consequently to the intensification of the hydrolytic phase of fermentation. It results in a significant reduction of fermentation time and increased effectiveness of production of gaseous metabolites of anaerobic bacteria. Because disintegration of Virginia fanpetals biomass via ultrasounds applied in order to intensify its conversion is a novel technique, it is often underestimated by exploiters of agri-biogas works. It has, however, many advantages that have a direct impact on its technological and economical superiority over thus far applied methods of biomass conversion. As for now, ultrasound disintegrators for biomass conversion are not produced on the mass-scale, but by specialized groups in scientific or R&D centers. Therefore, their quality and effectiveness are to a large extent determined by their manufacturers’ knowledge and skills in the fields of acoustics and electronic engineering.

Keywords: ultrasound disintegration, biomass, methane fermentation, biogas, Virginia fanpetals

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6254 Medical Ethics: Knowledge, Attitude and Practices among Young Healthcare Professionals – A Survey from Islamabad, Pakistan

Authors: Asima Mehaboob Khan, Rizwan Taj

Abstract:

Purpose: This study aims to estimate the knowledge, attitude and practices of medical ethics among young healthcare professionals. Method: A qualitative descriptive study was conducted among young healthcare professionals from both public and private sector medical institutions. Using the convenience sampling technique, 272 healthcare professionals participated in this study. A pre-structured modified questionnaire was used to collect the data. Descriptive analyses were executed for each variable. Result: About 76.47% of healthcare professional considers the importance of adequate knowledge of medical ethics, and 82.24% declared lecture, seminars and clinical discussion as the source of their medical knowledge of biomedical ethics. About 42.44% of healthcare professionals exhibited a negative attitude toward medical ethics, 57.72% showed a mildly positive attitude, whereas 1.10% and 0.74% indicated a moderately positive attitude and a highly positive attitude towards medical ethics. Similarly, the level of practice according to medical ethics is also very poor among young healthcare professionals. 34.56% of healthcare professionals deviated from medical ethics during their clinical practices, whereas 0.74% showed a good level of medical practice according to medical ethics. Conclusion: It is concluded in this research study that young healthcare professionals have adequate theoretical knowledge of medical ethics but are not properly trained to perform their clinical practices according to the guidelines of medical ethics. Furthermore, their professional attitude is poorly developed to maintain medical ethics during their clinical practices.

Keywords: knowledge, attitude, practices, medical ethics

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6253 The Impact of the Variation of Sky View Factor on Landscape Degree of Enclosure of Urban Blue and Green Belt

Authors: Yi-Chun Huang, Kuan-Yun Chen, Chuang-Hung Lin

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Urban Green Belt and Blue is a part of the city landscape, it is an important constituent element of the urban environment and appearance. The Hsinchu East Gate Moat is situated in the center of the city, which not only has a wealth of historical and cultural resources, but also combines the Green Belt and the Blue Belt qualities at the same time. The Moat runs more than a thousand meters through the vital Green Belt and the Blue Belt in downtown, and each section is presented in different qualities of moat from south to north. The water area and the green belt of surroundings are presented linear and banded spread. The water body and the rich diverse river banks form an urban green belt of rich layers. The watercourse with green belt design lets users have connections with blue belts in different ways; therefore, the integration of Hsinchu East Gate and moat have become one of the unique urban landscapes in Taiwan. The study is based on the fact-finding case of Hsinchu East Gate Moat where situated in northern Taiwan, to research the impact between the SVF variation of the city and spatial sequence of Urban Green Belt and Blue landscape and visual analysis by constituent cross-section, and then comparing the influence of different leaf area index – the variable ecological factors to the degree of enclosure. We proceed to survey the landscape design of open space, to measure existing structural features of the plant canopy which contain the height of plants and branches, the crown diameter, breast-height diameter through access to diagram of Geographic Information Systems (GIS) and on-the-spot actual measurement. The north and south districts of blue green belt areas are divided 20 meters into a unit from East Gate Roundabout as the epicenter, and to set up a survey points to measure the SVF above the survey points; then we proceed to quantitative analysis from the data to calculate open landscape degree of enclosure. The results can be reference for the composition of future river landscape and the practical operation for dynamic space planning of blue and green belt landscape.

Keywords: sky view factor, degree of enclosure, spatial sequence, leaf area indices

Procedia PDF Downloads 553
6252 Electronic Media and Physical Activity of Primary School Children

Authors: Srna Jenko Miholic, Marta Borovec, Josipa Persun

Abstract:

The constant expansion of technology has further accelerated the development of media and vice versa. Although its promotion includes all kinds of interesting and positive sides, the poor functioning of the media is still being researched and proven. Young people, as well as children from the earliest age, resort to the media the most, so it is necessary to defend the role of adults as it were parents, teachers, and environment against virtual co-educators such as the media. The research aim of this study was to determine the time consumption of using electronic media by primary school children as well as their involvement in certain physical activities. Furthermore, to determine what is happening when parents restrict their children's access to electronic media and encourage them to participate in alternative contents during their leisure time. Result reveals a higher percentage of parents restrict their children's access to electronic media and then encourage children to socialize with family and friends, spend time outdoors, engage in physical activity, read books or learn something unrelated to school content even though it would not be children's favorite activity. The results highlight the importance of parental control when it comes to children's use of electronic media and the positive effects that parental control has in terms of encouraging children to be useful, socially desirable, physically active, and healthy activities.

Keywords: elementary school, digital media, leisure time, parents, physical engagement

Procedia PDF Downloads 144