Search results for: middle adult

Authors: Jeena R. S., Sukesh Kumar A.

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Stroke is one of the major reasons of adult disability and morbidity in many of the developing countries like India. Early diagnosis of stroke is essential for timely prevention and cure. Various conventional statistical methods and computational intelligent models have been developed for predicting the risk and outcome of stroke. This research work focuses on a multilevel approach for predicting the occurrence of stroke based on various risk factors and invasive techniques like retinal imaging. This risk prediction model can aid in clinical decision making and help patients to have an improved and reliable risk prediction.

Keywords: prediction, retinal imaging, risk factors, stroke

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Authors: Narae Yang, Hyun Kyung Sung, Seon Mi Shin, Hee Jung, Yong Ji Kim, Tae-Yong Park, Ho Yeon Go

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The aim of this study was to build base-line data for the Korean Medicine Doctors` Visiting School Program (KMDVSP) by analyzing a student health survey filled out by the students. Korean medicine doctors assigned to 20 middle and high schools in Seong-nam visited these schools eight times in five months. During each visit, the assigned doctors performed health consultations and Korean medicine treatment, and taught health education classes. 12115 students answered self-reported questionnaires about their own physical condition at the beginning of the program. In a question about pain, 7080(58%) reported having a headache, while 4048(33%) said they had a backache, nuchal pain/shoulder pain was reported by 5993(49%), dyspepsia was present in 2736(23%), rhinitis/sinusitis was reported by 4176(34%), coughing/dyspnea by 7102(59%), itching/skin rash by 2840(23%), and constipation was reported by 1091(9%), while 2264(18%) said they had diarrhea. Increased urinary frequency/feeling of residual urine was reported by 569 students (5%), and 3324(27%) said they had insomnia/fitful sleep/morning fatigue. When asked about menstruation, 4450(83%) of the female students reported irregular menstruation or said they experienced menstrual pain. Understanding the health condition of adolescent students is the starting point to determining national health policy to prevent various diseases in the future. We have developed the pilot project of KMDVSP and collected research about students’ health. Based on this data, further studies should be performed in order to develop a cooperative program between schools and the Korean medical center.

Keywords: korean medicine doctors` visiting school program(kmdvsp), student`s health condition, questionnaires, cohort study

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Authors: Naeemeh Silvari

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The tourism industry is important for different nations in two ways. Apart from economic benefits, it provides a basis for getting acquainted with the culture of different regions of the world. Depending on the capacities and contexts of their geography, countries try to attract more people to their country in different ways. Health tourism has been an important branch of the tourism industry in recent years, and many countries around the world are trying to make progress in this field and attract many tourists from around the world. Iran, like many developing countries in the Middle East and East Asia, is trying to improve and develop tourist attractions in the field of health. Due to the cheapness of providing medical services to tourists, many people have traveled to Iran for medical and health care. However, there is a long way to go before recognizing and reaching the desired position in this field. Due to the direct relationship between tourism and culture, the negative attitude towards the context of Iran has caused foreign travelers not to choose this country as their tourist destination. In this article, we tried to study the change in their attitude towards Iran by using semi-structured interviews of foreign travelers who traveled to Iran for treatment and medical services. The text of the interviews was coded and analyzed by MAX QDA software. Many of the people in the sample were from Middle Eastern and Arabic-speaking countries. Influenced by the media, they felt rejected by the Iranians before the trip. During their stay in Iran and in connection with the health care staff, in the first stage, they pointed out that many of their anxieties about the kind of treatment of Iranians have been allayed. In addition to the satisfaction with the medical services provided, they considered the atmosphere of Iranians' interaction with foreign travelers to be relatively appropriate, and some stated that Iran would be the destination of their leisure trip in the future. At the end of the research, policymakers were suggested that in order to resolve cultural contradictions rooted in values, they should first be recognized and seek to use other opportunities to resolve contradictions and form interactions with other cultures.

Keywords: cultural conflict, health tourism, cultural prejudice, advertising and media

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Authors: Robi Lou Logarta, Meliz Ann Marilag, Kristyl Lee Nisnisan, Felipe Lula Jr.

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Nowadays, alcohol is consumed widely around the globe for plenty of reasons. College years are the time that the students really decide if whether they will or will not engage into alcohol, although alcohol drinking begins before students arrive at college. The reasons on why college students consume alcohol vary in many categories. The norms on alcohol drinking are addiction, emotional pain reliever, popularity purposes, socialization, and a medium of euphoria for most students; college students in particular are most likely to feel this need. After tons of requirements to be complied and courses to be reviewed, they felt a need for celebration and relaxation which ends up in drinking with college mates and a few old friends. A lot of reasons consist the consumption of alcohol and this research determined the reasons behind the students’ onset for alcohol consumption; the main reason for such action and the experiences they encountered after in-take, furthermore, the correlation of alcohol drinking to the average allowance of the involved participants; Mindanao State University-Iligan Institute of Technology Students whether it affects their spending towards alcohol or not. This study assumes that alcohol drinking for MSU-IIT students’ is done to relieve emotional pain caused by flunking in particular subjects as well as dealing with romance, as part of the student body, these acts are noticeable enough which made this hypothesis be formulated. Selected MSU-IIT students were asked about their opinions regarding reasons of alcohol consumption. There were 100 respondents consisting of first year to fifth-year students aging 17-23 years old. Choices were given to the students to mark their most favorable reason for drinking that is adult influence, curiosity, family/personal problems, peer pressure, stress. Using the bar and pie chart illustrations, the collected data was then analyzed and among the given choices, the result has invalidated the hypothesis. The outcome shows that curiosity is the topmost reason why students start to drink and not due to emotional pain. With this, another hypothesis is formulated stating that millennial is a curious generation; this generation has changed the norm of drinking. One of the characteristics of the Y generation is being adventurous which correlates to how they get curious about things and the same goes for alcohol consumption, compared to the latter, this generation can be considered early drinkers in this manner. Therefore, it is concluded that MSU-IIT students which are part of the generation Y are adventurous enough to try unfamiliar beverages to satisfy their curious minds.

Keywords: adult influence, curiosity, family/personal problems, peer pressure, stress

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Authors: Tamara Vagg, Cathy Shortt, Claire Hickey, Joseph A. Eustace, Barry J. Plant, Sabin Tabirca

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Introduction: Paper-based patient passports have been used advantageously for older patients, patients with diabetes, and patients with learning difficulties. However, these passports can experience issues with data security, patients forgetting to bring the passport, patients being over encumbered, and uncertainty with who is responsible for entering and managing data in this passport. These issues could be resolved by transferring the paper-based system to a convenient platform such as a smartphone application (app). Background: Life expectancy for some Cystic Fibrosis (CF) patients are rising and as such new complications and procedures are predicted. Subsequently, there is a need for education and management interventions that can benefit CF adults. This research proposes a CF patient passport to record basic medical information through a smartphone app which will allow CF adults access to their basic medical information. Aim: To provide CF patients with their basic medical information via mobile multimedia so that they can receive care when traveling abroad or between CF centres. Moreover, by recording their basic medical information, CF patients may become more aware of their own condition and more active in their health care. Methods: This app is designed by a CF multidisciplinary team to be a lightweight reflection of a hospital patient file. The passport app is created using PhoneGap so that it can be deployed for both Android and iOS devices. Data entered into the app is encrypted and stored locally only. The app is password protected and includes the ability to set reminders and a graph to visualise weight and lung function over time. The app is introduced to seven participants as part of a stress test. The participants are asked to test the performance and usability of the app and report any issues identified. Results: Feedback and suggestions received via this testing include the ability to reorder the list of clinical appointments via date, an open format of recording dates (in the event specifics are unknown), and a drop down menu for data which is difficult to enter (such as bugs found in mucus). The app is found to be usable and accessible and is now being prepared for a pilot study with adult CF patients. Conclusions: It is anticipated that such an app will be beneficial to CF adult patients when travelling abroad and between CF centres.

Keywords: Cystic Fibrosis, digital patient passport, mHealth, self management

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Authors: Ashwini Tiwari

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Introduction: Inclusive education for all is a multifaceted approach that requires system thinking and the promotion of a "Culture of Inclusion." Such can only be achieved through the collaboration of multiple stakeholders at the community, regional, state, national, and international levels. Researchers have found effective practices used in inclusive general classrooms are beneficial to all students, including students with disabilities, those who experience challenges academically and socially, and students without disabilities as well. However, to date, no statistically significant effects on the academic performance of students without disabilities in the presence of students with disabilities have been revealed. Therefore, proponents against inclusive education practices, based solely on their beliefs regarding the detrimental effects of students without disabilities, appears to have unfounded perceptions. This qualitative case study examines students' perspectives and beliefs about inclusive education in a middle school in South Texas. More specifically, this study examined students understanding of how inclusive education practices intersect with the classroom community. The data was collected from the students attending fully inclusive classrooms through interviews and focus groups. The findings suggest that peer integration and friendships built during classes are an essential part of schooling for both disabled and non-disabled students. Research Methodology: This qualitative case study used observations and focus group interviews with 12 middle school students attending an inclusive classroom at a public school located in South Texas. The participant of this study includes eight females and five males. All the study participants attend a fully inclusive middle school with special needs peers. Five of the students had disabilities. The focus groups and interviews were conducted during for entire academic year, with an average of one focus group and observation each month. The data were analyzed using the constant comparative method. The data from the focus group and observation were continuously compared for emerging codes during the data collection process. Codes were further refined and merged. Themes emerged as a result of the interpretation at the end of the data analysis process. Findings and discussion: This study was conducted to examine disabled and non-disabled students' perspectives on the inclusion of disabled students. The study revealed that non-disabled students generally have positive attitudes toward their disabled peers. The students in the study did not perceive inclusion as a special provision; rather, they perceived inclusion as a way of instructional practice. Most of the participants in the study spoke about the multiple benefits of inclusion. They emphasized that peer integration and friendships built during classes are an essential part of their schooling. Students believed that it was part of their responsibility to assist their peers in the ways possible. This finding is in line with the literature that the personality of children with disabilities is not determined by their disability but rather by their social environment and its interaction with the child. Interactions with peers are one of the most important socio-cultural conditions for the development of children with disabilities.

Keywords: inclusion, special education, k-12 education, student voices

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Authors: Khushboo Shah

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Categorical bans on the death penalty and life-without-parole sentences for juvenile offenders in a growing number of countries have established a new era in juvenile jurisprudence. This has been brought about by integration of the growing knowledge in cognitive neuroscience and appreciation of the inherent differences between adults and adolescents over the last ten years. This evolving understanding of being a child in the criminal system can be aptly reflected through policies that incorporate the mitigating traits of youth. First, the presentation will delineate the structures in cognitive neuroscience and in particular, focus on the prefrontal cortex, the amygdala, and the basal ganglia. These key anatomical structures in the brain are linked to three mitigating adolescent traits—an underdeveloped sense of responsibility, an increased vulnerability to negative influences, and transitory personality traits—that establish why juveniles have a lessened culpability. The discussion will delve into the details depicting how an underdeveloped prefrontal cortex results in the heightened emotional angst, high-energy and risky behavior characteristic of the adolescent time period or how the amygdala, the emotional center of the brain, governs different emotional expression resulting in why teens are susceptible to negative influences. Based on this greater understanding, it is incumbent that policies adequately reflect the adolescent physiology and psychology in the criminal system. However, it is important to ensure that these views are appropriately weighted while considering the jurisprudence for the treatment of children in the law. To ensure this balance is appropriately stricken, policies must incorporate the distinctive traits of youth in sentencing and legal considerations and yet refrain from the potential fallacies of absolving a juvenile offender of guilt and culpability. Accordingly, three policies will demonstrate how these results can be achieved: (1) eliminate housing of juvenile offenders in the adult prison system, (2) mandate fitness hearings for all transfers of juveniles to adult criminal court, and (3) use the post-disposition review as a type of rehabilitation method for juvenile offenders. Ultimately, this interdisciplinary approach of science and law allows for a better understanding of adolescent psychological and social functioning and can effectuate better legal outcomes for juveniles tried as adults.

Keywords: criminal law, Juvenile Justice, interdisciplinary, neuroscience

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Authors: Husnain Yousaf, Rudy Swennen, Hannes Claes, Muhammad Amjad

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In recent years, the Lower Triassic Main Buntsandstein sandstones in the southern Netherlands Basins have become a point of interest for their deep geothermal potential. To identify the most suitable reservoir for geothermal exploration, the diagenesis and factors affecting reservoir quality, such as porosity and permeability, are assessed. This is done by combining point-counted petrographic data with conventional core analysis. The depositional environments play a significant role in determining the distribution of lithofacies, cement, clays, and grain sizes. The position in the basin and proximity to the source areas determine the lateral variability of depositional environments. The stratigraphic distribution of depositional environments is linked to both local topography and climate, where high humidity leads to fluvial deposition and high aridity periods lead to aeolian deposition. The Middle Buntsandstein Sandstones in the southern part of the Netherlands shows high porosity and permeability in most sandstone intervals. There are various controls on reservoir quality in the examined sandstone samples. Grain sizes and total quartz content are the primary factors affecting reservoir quality. Conversely, carbonate and anhydrite cement, clay clasts, and intergranular clay represent a local control and cannot be applied on a regional scale. Similarly, enhanced secondary porosity due to feldspar dissolution is locally restricted and minor. The analysis of textural, mineralogical, and petrophysical data indicates that the aeolian and fluvial sandstones represent a heterogeneous reservoir system. The ephemeral fluvial deposits have an average porosity and permeability of <10% and <1mD, respectively, while the aeolian sandstones exhibit values of >18% and >100mD.

Keywords: reservoir quality, diagenesis, porosity, permeability, depositional environments, Buntsandstein, Netherlands

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Authors: Toufic Sarieddine

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As the belt and road Initiative (henceforth, BRI) enters its 9th year, Iran and China are forging stronger ties on economic and military fronts, a development which has not only caused alarm in Washington but also risks staining China’s relationships with the oil-rich Gulf monarchies. World-systems theory has been used to examine the impact of the BRI on the current world order, with scholarship split on the capacity of China to emerge as a hegemon contending with the US or even usurping it. This paper argues the emergence of a new China-centered world-system comprised of states/areas and processes participating in the BRI and overlapping with the global world-system under (shaky) US hegemony. This world-system centers around China as core and hegemon via economic domination, capable new institutions (Shanghai Cooperation Council), legal modi operandi, the common goal of infrastructure development to rally support among developing states, and other indicators of hegemony outlined in world-systems theory. In this regard, while states like Pakistan could become peripheries to China in the BRI-bound world-system via large-scale projects such as the China-Pakistan Economic Corridor, Iran has greater capacities and influence in the Middle East, making it superior to a periphery. This paper thus argues that the increasing proximity between Iran and China sees the former becoming a semi-periphery with respect to China within the BRI-bound world-system, having economic dependence on its new core and hegemon while simultaneously wielding political and military influence on weaker states such as Iraq, Lebanon, Yemen, and Syria. The indicators for peripheralization as well as the characteristics of a semi-periphery outlined in world-systems theory are used to examine the current economic, political, and militaristic dimensions of Iran and China’s growing relationship, as well as the trajectory of these dimensions as part of the BRI-bound world-system.

Keywords: belt and road initiative, China, China-Middle East relations, Iran, world-systems analysis

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Authors: Juan Facetti, Rocky McBride, Karina Loup

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The Chaco Region of Paraguay is a key biodiverse area for the conservation of jaguars (Panthera onca), the largest feline of the Americas. It comprises five eco-regions, which holds important but decreasing populations of this species. The last decades, the expansion of soybean over the Atlantic Forest, forced the translocation of cattle-ranches towards the Chaco. Few studies of Jaguar's population densities in the American hemisphere were done until now. In the region, the specie is listed as vulnerable or threatened and more information is needed to implement any conservation policy. Among the factors that threaten the populations are land-use change, habitat fragmentation, prey depletion and illegal hunting. Two largest eco-regions were studied: the Wet Chaco and the Dry Chaco. From 2002 more than 20 jaguars were captured and fitted with GPS-collar. Data collected from 11 GPS-collars were processed, transformed numerically and finally converted into maps for analyzing. 8.092 locations were determined for four adult females (AF) and one adult male (AM) in the Wet Chaco, and one AF, one juvenile male (JM) and four AM in the Dry Chaco, during 1,867 days. GIS and kernel methodology were used to calculate daily distance of movement, home range-HR (95% isopleth), and core area (considered as 50% isopleth). In the Wet Chaco HR were 56 Km2 and 238 km2 for females and males respectively; while in the Dry Chaco HR were 685 Km2 and 844.5 km2 for females and males respectively, and 172 Km2 for a juvenile. Core areas of individual activity for each jaguar, were on average 11.5 Km2 and 33.55 km2 for AF and AM respectively in the Wet Chaco, while in the Dry Chaco were larger: 115 km2 for five AM and 225 Km2 for an AF and 32.4 Km2 for a JM. In both ecoregions, only one relevant overlap of HR of adults was reported. During the reproduction season, the HR (95% K) of one AM overlapped 49.83% with that of one AF. At the Wet Chaco, the maximum daily distance moved by an AF was 14.5 Km and 11.6 Km for the AM, while the Maximum Mean Daily Moved (MMDM) distance was 5.6 km for an AF and 3.1 km for an AM. At the Dry Chaco, the maximum daily distance for an AF was 61.7Km., 50.9Km for the AM and 6.6 Km for the JM, while the MMDM distance was 13.2 km for an AM and 8.4 km for an AF. This study confirmed that, as the invasion to jaguar habitat increased, it resulted in fragmented landscapes that influence spacing patterns of jaguars. Males used largest HR that of the smaller females and males covers largest distances that of the females. There appeared to be important spatial segregation between not only females but also males. It is likely that the larger areas used by males are partly caused by the sexual dimorphism in body size that entails differences in prey requirements. These could explain the larger distances travelled daily by males.

Keywords: Chaco ecoregions, Jaguar, home range, Panthera onca, Paraguay

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Authors: Siddharth Jain, Abhenil Mittal, Surendra Kumar Sharma

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Background: With its recent emergence and re-emergence, dengue has become a major international public health concern, imposing significant financial burden especially in developing countries. Despite aggressive control measures in place, India experienced one of its largest outbreaks in 2015 with Delhi being most severely affected. There is a lack of reliable predictors of disease severity and mortality in dengue. The present study was carried out to identify these predictors during the 2015 outbreak. Methods: This prospective observational study conducted at an apex tertiary care center in Delhi, India included confirmed adult dengue patients admitted between August-November 2015. Patient demographics, clinical details, and laboratory findings were recorded in a predesigned proforma. Appropriate statistical tests were used to summarize and compare the clinical and laboratory characteristics and derive predictors of mortality and severe disease, while developing a clinical risk score for mortality. Serotype analysis was also done for 75 representative samples to identify the dominant serotypes. Results: Data of 369 patients were analyzed (mean age 30.9 years; 67% males). Of these, 198 (54%) patients had dengue fever, 125 (34%) had dengue hemorrhagic fever (DHF Grade 1,2)and 46 (12%) developed dengue shock syndrome (DSS). Twenty two (6%) patients died. Late presentation to the hospital (≥5 days after onset) and dyspnoea at rest were identified as independent predictors of severe disease. Age ≥ 24 years, dyspnoea at rest and altered sensorium were identified as independent predictors of mortality. A clinical risk score was developed (12*age + 14*sensorium + 10*dyspnoea) which, if ≥ 22, predicted mortality with a high sensitivity (81.8%) and specificity (79.2%). The predominant serotypes in Delhi (2015) were DENV-2 and DENV-4. Conclusion: Age ≥ 24 years, dyspnoea at rest and altered sensorium were identified as independent predictors of mortality. Platelet counts did not determine the outcome in dengue patients. Timely referral/access to health care is important. Development and use of validated predictors of disease severity and simple clinical risk scores, which can be applied in all healthcare settings, can help minimize mortality and morbidity, especially in resource limited settings.

Keywords: dengue, mortality, predictors, severity

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Authors: Robert H. Bradley

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Many minority adolescents in the United States live in adverse circumstances that pose long-term threats to their well-being. A strong sense of personal control and self-efficacy can help youth mitigate some of those risks and may help protect youth from influences connected with deviant peer groups. Accordingly, it is important to identify conditions that help foster feelings of efficacy in areas that seem critical for the accomplishment of developmental tasks during adolescence. The purpose of this study is to examine two aspects of the home environment (modeling and encouragement of maturity, family companionship and investment) and their relation to three components of self efficacy (self efficacy in enlisting social resources, self efficacy for engaging in independent learning, and self-efficacy for self-regulatory behavior) in three groups of minority adolescents (Native American, African American, Latino). The sample for this study included 54 Native American, 131 African American, and 159 Latino families, each with a child between 16 and 20 years old. The families were recruited from four states: Arizona, Arkansas, California, and Oklahoma. Each family was administered the Late Adolescence version of the Home Observation for Measurement of the Environment (HOME) Inventory and each adolescent completed a 30-item measure of perceived self-efficacy. Three areas of self-efficacy beliefs were examined for this study: enlisting social resources, independent learning, and self-regulation. Each of the three areas of self-efficacy was regressed on the two aspects of the home environment plus overall household risk. For Native Americans, modeling and encouragement were significant for self-efficacy pertaining to enlisting social resources and independent learning. For African Americans, companionship and investment was significant in all three models. For Latinos, modeling and encouragement was significant for self-efficacy pertaining to enlisting social resources and companionship and investment were significant for the other two areas of self-efficacy. The findings show that even as minority adolescents are becoming more individuated from their parents, the quality of experiences at home continues to be associated with their feelings of self-efficacy in areas important for adaptive functioning in adult life. Specifically, individuals can develop a sense that they are efficacious in performing key tasks relevant to work, social relationships, and management of their own behavior if they are guided in how to deal with key challenges and they have been exposed and supported by others who are competent in dealing with such challenges. The findings presented in this study would seem useful given that there is so little current research on home environmental factors connected to self-efficacy beliefs among adolescents in the three groups examined. It would seem worthwhile that personnel from health, human service and juvenile justice agencies give attention to supporting parents in communicating with adolescents, offering expectations to adolescents in mutually supportive ways, and in engaging with adolescents in productive activities. In comparison to programs for parents of young children, there are few specifically designed for parents of children in middle childhood and adolescence.

Keywords: family companionship, home environment, household income, modeling, self-efficacy

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Authors: Adel Khorramrouz, Monireh Ahmadi Bani, Ehsan Norouzi

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Background:-Due to the essential role of the foot in movement, foot disorders (FDs) have significant impacts on activity and quality of life. Many studies confirmed the association between FDs and demographic characteristics. On the other hand, recent advances in data collection and statistical analysis led to an increase in the volume of databases. Analysis of patient’s data through the decision tree can be used to explore the relationship between demographic characteristics and FDs. Significance of the study: This study aimed to investigate the relationship between demographic characteristics with common FDs. The second purpose is to better inform foot intervention, we classify FDs based on demographic variables. Methodologies: We analyzed 2323 subjects with pes-planus (PP), pes-cavus (PC), hallux-valgus (HV) and plantar-fasciitis (PF) who were referred to a foot therapy clinic between 2015 and 2021. Subjects had to fulfill the following inclusion criteria: (1) weight between 14 to 150 kilogram, (2) height between 30 to 220, (3) age between 3 to 100 years old, and (4) BMI between 12 to 35. Medical archives of 2323 subjects were recorded retrospectively and all the subjects examined by an experienced physician. Age and BMI were classified into five and four groups, respectively. 80% of the data were randomly selected as training data and 20% tested. We build a decision tree model to classify FDs using demographic characteristics. Findings: Results demonstrated 981 subjects from 2323 (41.9%) of people who were referred to the clinic with FDs were diagnosed as PP, 657 (28.2%) PC, 628 (27%) HV and 213 (9%) identified with PF. The results revealed that the prevalence of PP decreased in people over 18 years of age and in children over 7 years. In adults, the prevalence depends first on BMI and then on gender. About 10% of adults and 81% of children with low BMI have PP. There is no relationship between gender and PP. PC is more dependent on age and gender. In children under 7 years, the prevalence was twice in girls (10%) than boys (5%) and in adults over 18 years slightly higher in men (62% vs 57%). HV increased with age in women and decreased in men. Aging and obesity have increased the prevalence of PF. We conclude that the accuracy of our approach is sufficient for most research applications in FDs. Conclusion:-The increased prevalence of PP in children is probably due to the formation of the arch of the foot at this age. Increasing BMI by applying high pressure on the foot can increase the prevalence of this disorder in the foot. In PC, the Increasing prevalence of PC from women to men with age may be due to genetics and innate susceptibility of men to this disorder. HV is more common in adult women, which may be due to environmental reasons such as shoes, and the prevalence of PF in obese adult women may also be due to higher foot pressure and housekeeping activities.

Keywords: decision tree, demographic characteristics, foot disorders, machine learning

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Authors: M. M. Shahidul Hassan, Omiya Hassan

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Bangladesh has set its goal to reach upper middle-income country status by 2024. To attain this status, the country must satisfy the World Bank requirement of achieving minimum Gross National Income (GNI). Number of youth job seekers in the country is increasing. University graduates are looking for decent jobs. So, the vital issue of this country is to understand how the GNI and jobs can be increased. The objective of this paper is to address these issues and find ways to create more job opportunities for youths at home and abroad which will increase the country’s GNI. The paper studies proportion of different goods Bangladesh exported, and also the percentage of employment in different sectors. The data used here for the purpose of analysis have been collected from the available literature. These data are then plotted and analyzed. Through these studies, it is concluded that growth in sectors like agricultural, ready-made garments (RMG), jute industries and fisheries are declining and the business community is not interested in setting up capital-intensive industries. Under this situation, the country needs to explore other business opportunities for a higher economic growth rate. Knowledge can substitute the physical resource. Since the country consists of the large youth population, higher education will play a key role in economic development. It now needs graduates with higher-order skills with innovative quality. Such dispositions demand changes in a university’s curriculum, teaching and assessment method which will function young generations as active learners and creators. By bringing these changes in higher education, a knowledge-based society can be created. The application of such knowledge and creativity will then become the commodity of Bangladesh which will help to reach its goal as an upper middle-income country.

Keywords: Bangladesh, economic sectors, economic growth, higher education, knowledge-based economy, massifcation of higher education, teaching and learning, universities’ role in society

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Authors: Mende Mensa Sorato, Majid Davari, Abbas Kebriaeezadeh, Nizal Sarrafzadegan, Tamiru Shibru, Behzad Fatemi

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Markov model, like cardiovascular disease (CVD) policy model based simulation, is being used for evaluating the cost-effectiveness of hypertension treatment. Stroke, angina, myocardial infarction (MI), cardiac arrest, and all-cause mortality were included in this model. Hypertension is a risk factor for a number of vascular and cardiac complications and CVD outcomes. Objective: This systematic review was conducted to evaluate the comprehensiveness of this model across different regions globally. Methods: We searched articles written in the English language from PubMed/Medline, Ovid/Medline, Embase, Scopus, Web of Science, and Google scholar with a systematic search query. Results: Thirteen cohort studies involving a total of 2,165,770 (1,666,554 hypertensive adult population and 499,226 adults with treatment-resistant hypertension) were included in this scoping review. Hypertension is clearly associated with coronary heart disease (CHD) and stroke mortality, unstable angina, stable angina, MI, heart failure (HF), sudden cardiac death, transient ischemic attack, ischemic stroke, subarachnoid hemorrhage, intracranial hemorrhage, peripheral arterial disease (PAD), and abdominal aortic aneurism (AAA). Association between HF and hypertension is variable across regions. Treatment resistant hypertension is associated with a higher relative risk of developing major cardiovascular events and all-cause mortality when compared with non-resistant hypertension. However, it is not included in the previous CVD policy model. Conclusion: The CVD policy model used can be used in most regions for the evaluation of the cost-effectiveness of hypertension treatment. However, hypertension is highly associated with HF in Latin America, the Caribbean, Eastern Europe, and Sub-Saharan Africa. Therefore, it is important to consider HF in the CVD policy model for evaluating the cost-effectiveness of hypertension treatment in these regions. We do not suggest the inclusion of PAD and AAA in the CVD policy model for evaluating the cost-effectiveness of hypertension treatment due to a lack of sufficient evidence. Researchers should consider the effect of treatment-resistant hypertension either by including it in the basic model or during setting the model assumptions.

Keywords: cardiovascular disease policy model, cost-effectiveness analysis, hypertension, systematic review, twelve major cardiovascular events

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Authors: Reza Hedayati, Meysam Jahanbakhshi

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The typical airplane stabilizer structures consist of two main similar segments (outer and inner parts), one of them a little larger than the other. In this study, bird impact on four different spots of the stabilizer structure: (a) between two ribs of smaller segment, (b) between two ribs of larger segment, (c) on the rib connecting the two segments, and (d) on a middle rib of the smaller segment, is investigated and their results are compared by means of energy absorption, displacement, and bird’s mass diagrams as well as visible damage induced on the stabilizer structure.

Keywords: airplane, bird strike, LS-DYNA, stabilizer

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Authors: Casta Guillaume, Robert Jagers, Deborah Rivas-Drake

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Civically engaged youth are critical to maintaining and/or improving the functioning of local, national and global communities and their institutions. The present study investigated how school climate and academic beliefs (academic self-efficacy and school belonging) may inform emergent civic behaviors (emergent citizenship) among self-identified middle school youth of color (African American, Multiracial or Mixed, Latino, Asian American or Pacific Islander, Native American, and other). Study aims: 1) Understand whether and how school climate is associated with civic engagement behaviors, directly and indirectly, by fostering a positive sense of connection to the school and/or engendering feelings of self-efficacy in the academic domain. Accordingly, we examined 2) The association of youths’ sense of school connection and academic self-efficacy with their personally responsible and participatory civic behaviors in school and community contexts—both concurrently and longitudinally. Data from two subsamples of a larger study of social/emotional development among middle school students were used for longitudinal and cross sectional analysis. The cross-sectional sample included 324 6th-8th grade students, of which 43% identified as African American, 20% identified as Multiracial or Mixed, 18% identified as Latino, 12% identified as Asian American or Pacific Islander, 6% identified as Other, and 1% identified as Native American. The age of the sample ranged from 11 – 15 (M = 12.33, SD = .97). For the longitudinal test of our mediation model, we drew on data from the 6th and 7th grade cohorts only (n =232); the ethnic and racial diversity of this longitudinal subsample was virtually identical to that of the cross-sectional sample. For both the cross-sectional and longitudinal analyses, full information maximum likelihood was used to deal with missing data. Fit indices were inspected to determine if they met the recommended thresholds of RMSEA below .05 and CFI and TLI values of at least .90. To determine if particular mediation pathways were significant, the bias-corrected bootstrap confidence intervals for each indirect pathway were inspected. Fit indices for the latent variable mediation model using the cross-sectional data suggest that the hypothesized model fit the observed data well (CFI = .93; TLI =. 92; RMSEA = .05, 90% CI = [.04, .06]). In the model, students’ perceptions of school climate were significantly and positively associated with greater feelings of school connectedness, which were in turn significantly and positively associated with civic engagement. In addition, school climate was significantly and positively associated with greater academic self-efficacy, but academic self-efficacy was not significantly associated with civic engagement. Tests of mediation indicated there was one significant indirect pathway between school climate and civic engagement behavior. There was an indirect association between school climate and civic engagement via its association with sense of school connectedness, indirect association estimate = .17 [95% CI: .08, .32]. The aforementioned indirect association via school connectedness accounted for 50% (.17/.34) of the total effect. Partial support was found for the prediction that students’ perceptions of a positive school climate are linked to civic engagement in part through their role in students’ sense of connection to school.

Keywords: civic engagement, early adolescence, school climate, school belonging, developmental niche

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Authors: Sumohon Matilal, Neveen Abdelrehim

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The purpose of this study is to examine the way households manage the risks of civil war, using the calculative practices of accounting as a lens. As is the case with other social phenomena, accounting serves as a conduit for attributing values and rationales to crisis and in the process makes it visible and calculable. Our focus, in particular, is on the dialogue facilitated by the numerical logic of accounting between the householder and a crisis scenario, such as civil war. In other words, we seek to study how the risk of war is rationalized through household budgets, income and expenditure statements etc. and how such accounting constructs in turn shape attitudes toward earnings and spending in a wartime economy. The existing literature on war and accounting demonstrates how an accounting logic can have potentially destabilising consequences and how it is used to legitimise war. However, very few scholars have looked at the way accounting constructs are used to internalise the effects of war in an average household and the behavioural consequences that arise from such accounting. Relatedly, scholars studying household accounting have mostly focussed on the links between gender and hierarchy in relation to managing the financial affairs. Few have focused on the role of household accounts in a crisis scenario. This study intends to fill this gap. We draw upon Egypt, a country in the middle of civil war since 2011 for our purpose. We intend to carry out 15-20 semi-structured interviews with middle income households in Cairo that maintain some form of accounts to study the following issues: 1. How do people internalise the risks of civil war? What kind of accounting constructs do they use (this may take the form of simple budgets, income-expenditure notes/statements on a periodic basis, spreadsheets etc.) 2. How has civil war affected household expenditure? Are people spending more/less than before? 3. How has civil war affected household income? Are people finding it difficult/easy to survive on the pre-war income? 4. How is such accounting affecting household behaviour towards earnings and expenditure? Are families prioritising expenditure on necessities alone? Are they refraining from indulging in luxuries? Are family members doing two or three jobs to cope with difficult times? Are families increasingly turning toward borrowing? Is credit available? From whom?

Keywords: risk, accounting, war, crisis

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Authors: Samia Elfekih, Wee Tek Tay, Karl Gordon, Paul De Barro

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Invasive species represent an increasing threat to food biosecurity, causing significant economic losses in agricultural systems. An example is the sweet potato whitefly, Bemisia tabaci, which is a complex of morphologically indistinguishable species causing average annual global damage estimated at US$2.4 billion. The Bemisia complex represents an interesting model for evolutionary studies because of their extensive distribution and potential for invasiveness and population expansion. Within this complex, two species, Middle East-Asia Minor 1 (MEAM1) and Mediterranean (MED) have invaded well beyond their home ranges whereas others, such as Indian Ocean (IO) and Australia (AUS), have not. In order to understand why some Bemisia species have become invasive, genome-wide sequence scans were used to estimate population dynamics over time and relate these to climate. The Bayesian Skyline Plot (BSP) method as implemented in BEAST was used to infer the historical effective population size. In order to overcome sampling bias, the populations were combined based on geographical origin. The datasets used for this particular analysis are genome-wide SNPs (single nucleotide polymorphisms) called separately in each of the following groups: Sub-Saharan Africa (Burkina Faso), Europe (Spain, France, Greece and Croatia), USA (Arizona), Mediterranean-Middle East (Israel, Italy), Middle East-Central Asia (Turkmenistan, Iran) and Reunion Island. The non-invasive ‘AUS’ species endemic to Australia was used as an outgroup. The main findings of this study show that the BSP for the Sub-Saharan African MED population is different from that observed in MED populations from the Mediterranean Basin, suggesting evolution under a different set of environmental conditions. For MED, the effective size of the African (Burkina Faso) population showed a rapid expansion ≈250,000-310,000 years ago (YA), preceded by a period of slower growth. The European MED populations (i.e., Spain, France, Croatia, and Greece) showed a single burst of expansion at ≈160,000-200,000 YA. The MEAM1 populations from Israel and Italy and the ones from Iran and Turkmenistan are similar as they both show the earlier expansion at ≈250,000-300,000 YA. The single IO population lacked the latter expansion but had the earlier one. This pattern is shared with the Sub-Saharan African (Burkina Faso) MED, suggesting IO also faced a similar history of environmental change, which seems plausible given their relatively close geographical distributions. In conclusion, populations within the invasive species MED and MEAM1 exhibited signatures of population expansion lacking in non-invasive species (IO and AUS) during the Pleistocene, a geological epoch marked by repeated climatic oscillations with cycles of glacial and interglacial periods. These expansions strongly suggested the potential of some Bemisia species’ genomes to affect their adaptability and invasiveness.

Keywords: whitefly, RADseq, invasive species, SNP, climate change

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Authors: Chiu-Wen Chang, I-Yun Chang, Wei-Ting Chen, Hui-Ping Ho, Chao-Ying Pan, Joh-Jong Huang

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Dengue is a ‘community disease’ or ‘environmental disease’, as long as the environment exist suitable container (including natural and artificial) for mosquito breeding, once the virus invade will lead to the dengue epidemic. Surveillance of vector density is critical to effective infectious disease control and play an important role in monitoring the dynamics of mosquitoes in community, such as mosquito species, density, distribution area. The objective of this study was to examine the relationship in vector density survey (Breteau index, Adult index, House index, Container index, and Larvae index) form 2014 to 2016 in Kaohsiung City and evaluate the effects of introducing the Breeding Elimination and Appraisal Team (hereinafter referred to as BEAT) as an intervention measure on eliminating dengue vector breeding site started from May 2016. BEAT were performed on people who were suspected of contracting dengue fever, a surrounding area measuring 50 meters by 50 meters was demarcated as the emergency prevention and treatment zone. BEAT would perform weekly vector mosquito inspections and vector mosquito inspections in regions with a high Gravitrap index and assign a risk assessment index to each region. These indices as well as the prevention and treatment results were immediately reported to epidemic prevention-related units every week. The results indicated that, vector indices from 2014 to 2016 showed no statistically significant differences in the Breteau index, adult index, and house index (p > 0.05) but statistically significant differences in the container index and larvae index (p <0.05). After executing the integrated elimination work, container index and larvae index are statistically significant different from 2014 to 2016 in the (p < 0.05). A post hoc test indicated that the container index of 2014 (M = 12.793) was significantly higher than that of 2016 (M = 7.631), and that the larvae index of 2015 (M = 34.065) was significantly lower than that of 2014 (M = 66.867). The results revealed that effective vector density surveillance could highlight the focus breeding site and then implement the immediate control action (BEAT), which successfully decreased the vector density and the risk of dengue epidemic.

Keywords: Breteau index, dengue control, monitoring method, vector density

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Authors: Yui Okuno, Mariko Era, Takayoshi Kawahara, Takahide Kanyama, Hiroshi Morita

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Introduction: Fungus and mite are known as allergens that cause an allergic disease for example asthma bronchiale and allergic rhinitis. Cladosporium cladosporioides is one of the most often detected fungi in the indoor environment and causes pollution and deterioration. Dermatophagoides farinae is major mite allergens indoors. Therefore, the creation of antifungal agents with high safety and the antifungal effect is required. Fatty acid salts are known that have antibacterial activities. This report describes the effects of fatty acid salts against Cladosporium cladosporioides NBRC 30314 and Dermatophagoides farinae. Methods: Potassium salts of 9 fatty acids (C4:0, C6:0, C8:0, C10:0, C12:0, C14:0, C18:1, C18:2, C18:3) were prepared by mixing the fatty acid with the appropriate amount of KOH solution to a concentration of 175 mM and pH 10.5. The antifungal method, the spore suspension (3.0×104 spores/mL) was mixed with a sample of fatty acid potassium (final concentration of 175 mM). Samples were counted at 0, 10, 60, 180 min by plating (100 µL) on PDA. Fungal colonies were counted after incubation for 3 days at 30 °C. The MIC (minimum inhibitory concentration) against the fungi was determined by the two-fold dilution method. Each fatty acid salts were inoculated separately with 400 µL of C. cladosporioides at 3.0 × 104 spores/mL. The mixtures were incubated at the respective temperature for each organism for 10 min. The tubes were then contacted with the fungi incubated at 30 °C for 7 days and examined for growth of spores on PDA. The acaricidal method, twenty D. farinae adult females were used and each adult was covered completely with 2 µL fatty acid potassium for 1 min. The adults were then dried with filter paper. The filter paper was folded and fixed by two clips and kept at 25 °C and 64 % RH. Mortalities were determained 48 h after treatment under the microscope. D. farina was considered to be dead if appendages did not move when prodded with a pin. Results and Conclusions: The results show that C8K, C10K, C12K, C14K was effective to decrease survival rate (4 log unit) of the fatty acids potassium incubated time for 10 min against C. cladosporioides. C18:3K was effective to decrease 4 log unit of the fatty acids potassium incubated time for 60 min. Especially, C12K was the highest antifungal activity and the MIC of C12K was 0.7 mM. On the other hand, the fatty acids potassium showed no acaricidal effects against D. farinae. The activity of D. farinae was not adversely affected after 48 hours. These results indicate that C12K has high antifungal activity against C. cladosporioides and suggest the fatty acid potassium will be used as an antifungal agent.

Keywords: fatty acid salts, antifungal effects, acaricidal effects, Cladosporium cladosporioides, Dermatophagoides farinae

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Authors: F. Saleh, F. Lyall, A. Abdulsid, L. Marks

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Background: Labour in human is a complex biological process that involves interactions of neurological, hormonal and inflammatory pathways, with the placenta being a key regulator of these pathways. It is known that uterine contractions and labour pain cause physiological changes in gene expression in maternal and fetal blood, and in placenta during labour. Oxidative and inflammatory stress pathways are implicated in labour and they may cause alteration of placental gene expression. Additionally, in placental tissues, labour increases the expression of genes involved in placental oxidative stress, inflammatory cytokines, angiogenic regulators and apoptosis. Recently, Hydrogen Sulphide (H2S) has been considered as an endogenous gaseous mediator which promotes vasodilation and exhibits cytoprotective anti-inflammatory properties. The endogenous H2S is synthesised predominantly by two enzymes: cystathionine β-synthase (CBS) and cystathionine γ-lyase (CSE). As the H2S pathway has anti-oxidative and anti-inflammatory characteristics thus, we hypothesised that the expression of CBS and CSE in placental tissues would alter during labour. Methods: CBS and CSE expressions were examined in placentas using western blotting and RT-PCR in inner, middle and outer placental zones in placentas obtained from healthy non labouring women who delivered by caesarian section. These were compared with the equivalent zone of placentas obtained from women who had uncomplicated labour and delivered vaginally. Results: No differences in CBS and CSE mRNA or protein levels were found between the different sites within placentas in either the labour or non-labour group. There were no significant differences in either CBS or CSE expression between the two groups at the inner site and middle site. However, at the outer site there was a highly significant decrease in CBS protein expression in the labour group when compared to the non-labour group (p = 0.002). Conclusion: To the best of author’s knowledge, this is the first report to suggest that, CBS is expressed in a spatial manner within the human placenta. Further work is needed to clarify the precise function and mechanism of this spatial regulation although it is likely that inflammatory pathways regulation is a complex process in which this plays a role.

Keywords: anti-inflammatory, hydrogen sulphide, labour, oxidative stress

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Authors: Gregor Moncrieff, Ursula Bahlmann

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A number of incident reports were filed from the intensive care unit with regards to adult patients admitted following operations who had a central venous catheter inserted of the incorrect length for the relevant anatomical site and catheters not compatible with pressurised injection inserted whilst in theatre. Incorrect catheter length can lead to a variety of complications and pressurised injection is a requirement for contrast enhanced computerised tomography scans. This led to several patients having a repeat procedure to insert a catheter of the correct length and also compatible with pressurised injection. This project aimed to identify the types of central venous catheters used in theatres and ensure the correct equipment would be stocked and used in future cases in accordance the existing Association of Anaesthetics of Great Britain and Northern Ireland guidelines. A questionnaire was sent out to all of the anaesthetic department in our hospital aiming to determine what types of central venous catheters were preferably used by anaesthetists and why these had been chosen. We also explored any concerns regarding introduction of standardised, pressure injectable central venous catheters to the theatre department which were already in use in other parts of the hospital and in keeping with national guidance. A total of 56 responses were collected. 64% of respondents routinely used a central venous catheter which was significantly shorter than the national recommended guidance with a further 4 different types of central venous catheters used which were different to other areas of the hospital and not pressure injectable. 75% of respondents were in agreement to standardised introduction of the pressure injectable catheters of the recommended length in accordance with national guidance. Reasons why 25% respondents were opposed to introduction of these catheters were explored and discussed. We were successfully able to introduce the standardised central catheters to the theatre department following presentation at the local anaesthetic quality and safety meeting. Reasons against introduction of the catheters were discussed and a compromise was reached that the existing catheters would continue to be stocked but would only be available on request, with a focus on encouraging use of the standardised catheters. Additional changes achieved included removing redundant catheters from the theatre stock. Ongoing data is being collected to analyse positive and negative feedback from use of the introduced catheters.

Keywords: central venous catheter, medical equipment, medical safety, quality improvement

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Authors: Payal Maheshwari, Maheaswari Brindavan

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The present study aimed at studying the level of perceived self-efficacy of children with learning disability and their mother’s perception about the efficacy of the child and the relationship between the two. The study further aimed at finding out the relationship between the level of perceived self-efficacy of children with learning disability and their academic achievement and their mother’s perception about the Efficacy of the child and child’s Academic Achievement. The sample comprised of 80 respondents (40 children with learning disability and their mothers). Children with learning disability as their primary condition, belonging to middle or upper middle class, living with both the parents, residing in Mumbai and their mothers were selected. Purposive or judgmental and snowball sampling technique was used to select the sample for the present study. Proformas in the form of questionnaires were used to obtain the background information of the children with learning disability and their mother’s. A self-constructed Mother’s Perceived Efficacy of their Child Assessment Scale was used to measure mothers perceived level of efficacy of their child with learning disability. Self-constructed Child’s Perceived Self-Efficacy Assessment Scale was used to measure the level of child’s perceived self-efficacy. Academic scores of the child were collected from the child’s parents or teachers and were converted into percentage. The data were analyzed quantitatively using frequencies, mean and standard deviation. Correlations were computed to ascertain the relationships between the different variables. The findings revealed that majority of the mother’s perceived efficacy about their child with learning disability was above average as well as majority of the children with learning disability also perceived themselves as having above average level of self-efficacy. Further in the domains of self-regulated learning and emotional self-efficacy majority of the mothers perceived their child as having average or below average efficacy, 50% of the children also perceived their self-efficacy in the two domains at average or below average level. A significant (r=.322, p < .05) weak correlation (Spearman’s rho) was found between mother’s perceived efficacy about their child, and child’s perceived self-efficacy and a significant (r=.377, p < .01) weak correlation (Pearson Correlation) was also found between mother’s perceived efficacy about their child and child’s academic achievement. Significant weak positive correlation was found between child’s perceived self-efficacy and academic achievement (r=.332, p < .05). Based on the findings, the study discussed the need for intervention program for children in non-academic skills like self-regulation and emotional competence.

Keywords: learning disability, perceived self efficacy, academic achievement, mothers, children

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Authors: Sara Nosari

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In the research field on adult education, the learning development project followed different itineraries: recently it has promoted adult transformation by practices focused on the reflexive oriented interaction. This perspective, that connects life stories and life-based methods, characterizes a transformative space between formal and informal education. Within this framework, in the Nursing Degree Courses of Turin University, it has been discussed and realized a formal reflexive path on the care work professional identity through group practices. This path compared the future care professionals with possible experiences staged by texts used with the function of a pre-tests: these texts, setting up real or believable professional situations, had the task to start a reflection on the different 'elements' of care work professional life (relationship, educational character of relationship, relationship between different care roles; or even human identity, aims and ultimate aim of care, …). The learning transformative aspect of this kind of experience-test is that it is impossible to anticipate the process or the conclusion of reflexion because they depend on two main conditions: the personal sensitivity and the specific situation. The narrated experience is not a device, it does not include any tricks to understand the answering advance; the text is not aimed at deepening the knowledge, but at being an active and creative force which takes the group to compare with problematic figures. In fact, the experience-text does not have the purpose to explain but to problematize: it creates a space of suspension to live for questioning, for discussing, for researching, for deciding. It creates a space 'open' and 'in connection' where each one, in comparing with others, has the possibility to build his/her position. In this space, everyone has to possibility to expose his/her own argumentations and to be aware of the others emerged points of view, aiming to research and find the own personal position. However, to define his/her position, it is necessary to learn to exercise character skills (conscientiousness, motivation, creativity, critical thinking, …): if these not-cognitive skills have an undisputed evidence, less evident is how to value them. The paper will reflect on the epistemological limits and possibility to 'measure' character skills, suggesting some evaluation criteria.

Keywords: transformative learning, educational role, formal/informal education, character-skills

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Authors: Fouzia Qamar, Shahida Hasnain

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The present study is primarily concerned with the alteration in haemocyte profile of adult male Periplaneta americana with emphasis on the effect of bacterial inoculations on the haemogram i.e., total haemocyte count (THC) and differential haemocyte count (DHC) of different haemocyte types of the target insect. Haemolymph cellular profile showed considerable alterations under the effect of nine strains of Agrobacterium tumefaciens after 8, 16 and 24 hrs of treatment thereby signifying the potential role of Agrobacterium tumefaciens as a possible biocontrol agent against the house hold pests.

Keywords: Agrobacterium tumefaciens, Periplaneta americana, Haemolymph, cellular parametes

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Authors: Fouzia Qamar, Shahida Hasnain

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The objective of the present study was to evaluate the possible role of Agrobacterium tumefaciens as a possible insect biocontrol agent. Pests selected for the present challenge were adult males of Periplaneta americana and last instar larvae of Pieris brassicae and Spodoptera litura. Different ranges of bacterial doses were selected and tested to score the mortalities of the insects after 24 hours, for the lethal dose estimation studies. Mode of application for the inoculation of the bacteria, was the microinjection technique. The evaluation of the possible entomopathogenic carrying attribute of bacterial Ti plasmid, led to the conclusion that the loss of plasmid was associated with the loss of virulence against target insects.

Keywords: agrobacterium tumefaciens, toxicity assessment, biopesticidal attribute, entomopathogenic agent

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Authors: Miguel Limbert Ramos, Joseph Amado Galvez

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Background: The nasal septal cartilage is an autologous graft that is widely used in different otolaryngologic procedures of the different subspecialties, such as in septorhinoplasty and ear rehabilitation procedures. The cartilage can be easily accessed and harvested to be utilized for such procedures. However, the dimension of the nasal septal cartilage differs, corresponding to race, gender, and age. Measurements can be done via direct measurement of harvested septal cartilage in cadavers or utilizing radiographic imaging studies giving baseline measurement of the nasal septal cartilage distinct to every race. A preliminary baseline measurement of the dimensions of Filipino nasal septal cartilage was previously established by measuring harvested nasal septal cartilage in Filipino Malay cadavers. This study intends to reinforce this baseline measurement by utilizing computed tomography (CT) scans of adult Filipinos in a tertiary government hospital in the City of Manila, Philippines, which will cover a larger sampling population. Methods: The unit of observation and analysis will be the computed tomography (CT) scans of patients ≥ 18years old who underwent cranial, facial, orbital, paranasal sinus, and temporal bone studies for the year 2019. The measurements will be done in a generated best midsagittal image (155 subjects) which is a view through the midline of the cerebrum that is simultaneously viewed with its coronal and axial views for proper orientation. The view should reveal important structures that will be used to plot the anatomic boundaries, which will be measured by a DICOM image viewing software (RadiAnt). The measured area of nasal septal cartilage will be compared by gender and age. Results: The total area of the nasal septal cartilage is larger in males compared to females, with a mean value of 6.52 cm² and 5.71 cm², respectively. The harvestable nasal septal cartilage area is also larger in males with a mean value of 3.57 cm² compared to females with only a measured mean value of 3.13 cm². The total and harvestable area of the nasal septal cartilage is largest in the 18-30 year-old age group with a mean value of 6.47 cm² and 3.60 cm² respectively and tends to decrease with the advancement of age, which can be attributed to continuous ossification changes. Conclusion: The best time to perform septorhinoplasty and other otolaryngologic procedures which utilize the nasal septal cartilage as graft material is during post-pubertal age, hence surgeries should be avoided or delayed to allow growth and maturation of the cartilage. A computed tomography scan is a cost-effective and non-invasive tool that can provide information on septal cartilage areas prior to these procedures.

Keywords: autologous graft, computed tomography, nasal septal cartilage, septorhinoplasty

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Authors: Ronit Even Zahav

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Objectives: Mother-daughter relationships are often portrayed as one of the most constitutive ties that shape women's identities throughout their lives. Yet, to the best of author’s knowledge, only few studies examine mother-daughter relationships in adulthood in the context of cross-cultural transition. Most of them focus on the mother-daughter relationship among one origin group. Hence, the existing knowledge about these relationships in adulthood, in the context of intercultural transition and encounters between different cultures, remain limited. Based on a critical feminist approach critical and cultural perspectives the current study focuses on a cross-cultural comparison of adult mother-daughter relationships among three groups of origin: Ethiopia, Russia, and Israel. The study aimed to: Explore the voices of women participating in a mother-daughter discourse in the context of gender and ethnicity; examine the differences in the mother-daughter relationship through number of factors (e.g. expectations of similarity and difference, perceptions of gender roles, gender identity, emotional closeness, sharing and stress) and finally, to develop a gender informed tool for understanding the gender dialectic in mother-daughter relationship in the context of cross cultural transitions. Method: 37 dyads of mothers and adult daughters participated in a qualitative study. A semi-structured interview was conducted that included questions about socio-demographic characteristics, language proficiency, social distance, closeness, emotional stress, and expectations of similarity and difference in mother-daughter relationships. Results: Analysis of the findings yielded three relationship patterns of gender dialectic and expectations of similarity and difference that characterize the groups of origin. Ethiopian mothers reported more sharing their daughters, fewer expectations of similarity, and felt more stress in the relationship compered to women from the two other origin groups. Conclusions: The study highlighted the impact of intercultural transition and social exclusion on mother-daughter relationships in adulthood in the context of the gender dialectic and women’s status in society. The presentation will explore the findings that were brought up by participants. The discussion will focus on the practices related to gender dialectic and intersecting inequalities regarding diverse groups and discuss gender development reducing inequalities and promoting empowerment to transform oppressive conditions.

Keywords: gender informed perspectives, gender dialectic, mother-daughter relationships, multiculturalism

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Authors: Julie Mariam Abraham, G. J. Melendez-Torres

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Background. Maternal mortality is disproportionately higher in low- and middle- income countries (LMICs) compared to other parts of the world. At the current pace of progress, the Sustainable Development Goals for maternal mortality rate will not be achieved by 2030. A variety of factors influence the increased risk of maternal complications in LMICs. These are exacerbated by socio-economic and political factors, including poverty, illiteracy, and gender inequality. This paper aims to use realist synthesis to identify the contexts, mechanisms, and outcomes (CMOs) of maternal health interventions conducted in LMICs to inform evidence-based practice for future maternal health interventions. Methods. In May 2022, we searched four electronic databases for systematic reviews of maternal health interventions in LMICs published in the last five years. We used open and axial coding of CMOs to develop an explanatory framework for intervention effectiveness. Results. After eligibility screening and full-text analysis, 44 papers were included. The intervention strategies and measured outcomes varied within reviews. Healthcare system level contextual factors were the most frequently reported, and infrastructural capacity was the most reported context. The most prevalent mechanism was increased knowledge and awareness. Discussion. Health system infrastructure must be considered in interventions to ensure effective implementation and sustainability. Healthcare-seeking behaviours are embedded within social and cultural norms, environmental conditions, family influences, and provider attitudes. Therefore, effective engagement with communities and families is important to create new norms surrounding pregnancy and delivery. Future research should explore community mobilisation and involvement to enable tailored interventions with optimal contextual fit.

Keywords: maternal mortality, service delivery and organisation, realist synthesis, sustainable development goals, overview of reviews

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