Search results for: elderly persons

Authors: Qasem Qananwah, Ahmad Dagamseh, Hiam AlQuran, Khalid Shaker Ibrahim

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Blood pressure helps the physicians greatly to have a deep insight into the cardiovascular system. The determination of individual blood pressure is a standard clinical procedure considered for cardiovascular system problems. The conventional techniques to measure blood pressure (e.g. cuff method) allows a limited number of readings for a certain period (e.g. every 5-10 minutes). Additionally, these systems cause turbulence to blood flow; impeding continuous blood pressure monitoring, especially in emergency cases or critically ill persons. In this paper, the most important statistical features in the photoplethysmogram (PPG) signals were extracted to estimate the blood pressure noninvasively. PPG signals from more than 40 subjects were measured and analyzed and 12 features were extracted. The features were fed to principal component analysis (PCA) to find the most important independent features that have the highest correlation with blood pressure. The results show that the stiffness index means and standard deviation for the beat-to-beat heart rate were the most important features. A model representing both features for Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) was obtained using a statistical regression technique. Surface fitting is used to best fit the series of data and the results show that the error value in estimating the SBP is 4.95% and in estimating the DBP is 3.99%.

Keywords: blood pressure, noninvasive optical system, principal component analysis, PCA, continuous monitoring

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

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

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

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Authors: Mehry Daraei

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The goal of this study was to survey the components and affective factors on organizational commitment of Islamic Azad university Khoramabad Baranch’s faculty members. The research method was correlation by causal modeling and data were gathered by questionnaire. Statistical society consisted of 147 faculty members in Islamic Azad University Khoramabad Branch and sample size was determined as 106 persons by Morgan’s sample table that were selected by class sampling. Correlation test, T-single group test and path analysis test were used for analysis of data. Data were analyzed by Lisrel software. The results showed that organizational corporate was the most effective element on organizational commitment and organizational corporate, experience work and organizational justice were only in direct relation with organizational commitment. Also, job security had direct and indirect effect on OC. Job security had effect on OC by gender. Gender variable had direct and indirect effect on OC. Gender had effect on OC by organizational corporate. Job opportunities out of university also had direct and indirect effect on OC, which means job opportunities had indirect effect on OC by organizational corporate.

Keywords: organization, commitment, job security, Islamic Azad University

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

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

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

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Authors: Liu Jiaxin

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

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

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Authors: Edna Ariste, Richard Standy Coqmar

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

Keywords: acute respiratory infections, pediatrics, cayes, haiti

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Authors: S. Chami, J. Chauvin, T. Demarest, Stan Ng, M. Straus, W. Jahner

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Biometrics tools such as fingerprint and iris are widely used in industry to protect critical assets. However, their vulnerability and lack of robustness raise several worries about the protection of highly critical assets. Biometrics based on Electrocardiographic (ECG) signals is a robust identification tool. However, most of the state-of-the-art techniques have worked on clinical signals, which are of high quality and less noisy, extracted from wearable devices like a smartwatch. In this paper, we are presenting a complete machine learning pipeline that identifies people using ECG extracted from an off-person device. An off-person device is a wearable device that is not used in a medical context such as a smartwatch. In addition, one of the main challenges of ECG biometrics is the variability of the ECG of different persons and different situations. To solve this issue, we proposed two different approaches: per person classifier, and one-for-all classifier. The first approach suggests making binary classifier to distinguish one person from others. The second approach suggests a multi-classifier that distinguishes the selected set of individuals from non-selected individuals (others). The preliminary results, the binary classifier obtained a performance 90% in terms of accuracy within a balanced data. The second approach has reported a log loss of 0.05 as a multi-class score.

Keywords: biometrics, electrocardiographic, machine learning, signals processing

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Authors: Kristof Lukas Heidemann

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The adverse effects of climate change, such as rising sea levels, increased temperatures, and extreme weather events are already posing a significant threat to the lives of people living in extreme weather zones all around the globe and could displace more than a billion people worldwide in the upcoming decades, causing a wave of climate-induced migration. Notwithstanding the urgency of the situation, this situation has so far not been addressed in a specific international treaty. Therefore, this paper analyses whether solutions might be found through existing legal framework. Accordingly, the investigation scrutinizes the possibilities of overcoming the conceptual challenge of combining climate law, refugee law, and human rights law. To this end, the study particularly reflects upon the example of Pacific Islanders by assessing the reasoning within the decisions Ioane Teitota v. New Zealand and Daniel Billy and Others v. Australia. The paper concludes that the differences in objective, scope, and enforcement of the three fields are too fundamental to be surmounted by overlapping concepts, e.g. state responsibility or the non-refoulement principle. Consequently, states are urged to tackle the problem with a separate international treaty in which the advantages of the different traditions are incorporated into a new protection mechanism.

Keywords: climate change, climate treaties, forcibly displaced persons, human rights, improving and creating advanced knowledge of concepts, non-refoulement, state responsibility, refugee law, refugee status

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Authors: Praveenkumar Natarajan

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

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

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Authors: Magdalena Barbara Kaziuk, Ilona Hubner, Jacek Hubner, Slawomir Kroczka

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Background: The motor neuron disease is a progressive neurodegenerative disease causing malfunction. Irrespective of the form of the disease and its onset always leads to the worsening of the quality of life, with patients usually depending on the family. Materials and methods: The study included 20 persons (5 females, 15 males, aged 65,5 ± 20 years) with clinically certain or probable diagnosis of the motor neuron disease. Patients were examined three times in the period of six months. The diagnosis was established based on the criteria of El Escorial. Manual dexterity was assessed using the test of the card Rene Zazzo and the test of shading in with lines Mira Stambak. Results: All patients achieved unsatisfactory results in Rene Zazzo’s test of the card and most of the patients (60%) in Mira Stambak’s test of shading with lines. Significantly higher test results were achieved for Rene Zazzo’s test and lower test results for Mira Stambak’s test in consecutive measurements. Conclusions: Impairment of manual dexterity is present already at the moment of diagnosing the disease and is growing significantly during its course. The quality of life for MND patients undergoes gradual deterioration as a result of the malfunction.

Keywords: manual dexterity, motor neuron disease, quality of life, malfunction

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Authors: Savaş Karpuz, Sami Küçükşen

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The aim of this study is to investigate the effectiveness of neurological rehabilitation in patients with traumatic brain injury. Participants were 45 consecutive adults with traumatic brain injury who were received the neurologic rehabilitation. Sociodemographic characteristics of the patients, the cause of the injury, the duration of the coma and posttraumatic amnesia, the length of stay in the other inpatient clinics before rehabilitation, the time between injury and admission to the rehabilitation clinic, and the length of stay in the rehabilitation clinic were recorded. The differences in functional status between admission and discharge were determined with Disability Rating Scale (DRS), Functional Independence Measure (FIM), and Functional Ambulation Scale (FAS) and levels of cognitive functioning determined with Ranchos Los Amigos Scale (RLAS). According to admission time, there was a significant improvement identified in functional status of patients who had been given the intensive in-hospital cognitive rehabilitation program. At discharge time, the statistically significant differences were obtained in DRS, FIM, FAS and RLAS scores according to admission time. Better improvement in functional status was detected in patients with lower scores in DRS, and higher scores FIM and RLAS scores at the entry time. The neurologic rehabilitation significantly affects the recovery of functional status after traumatic brain injury.

Keywords: traumatic brain injury, rehabilitation, functional status, neurological

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Authors: Elham Ahmadi, Mehrdad Ravanshad, Joyce Fingeroth, Mazyar Ziyaeyan, Rajesh Panigrahi, Jun Xie, Gao Guangping

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B-cell proliferative disorders often occur among persons that are T-cell compromised. These disorders are primarily EBV+ and can first present with a focal lesion. Direct introduction of oncolytic viruses into localized tumors provides theoretical advantages over chemotherapy and immunotherapy by reducing systemic toxicity, to which the immunocompromised host is most vulnerable. Widely studied as a vehicle for gene therapy, AAV has only rarely been applied to treat cancer. As a prelude to development of a therapeutic vehicle, we assessed the ability of 15 distinct recombinant AAV serotypes (rAAV1, rAAV2, rAAV3b, rAAV4, rAAV5, rAAV6, rAAV6.2, rAAV6TM, rAAV7, rAAV8, rAAVrh8, rAAV9, rAAVrh10, rAAV39, rAAV43) bearing eGFP to infect human B-cell tumor lines compared with primary B-cells in vitro. Enhanced infection of tumor lines by AAV 6.2 was demonstrated by flow cytometry. EBV superinfection of EBV negative B-cell tumor lines increased susceptibility to AAV6.2 infection. As proof of concept, AAV6.2 bearing HSV-1 thymidine kinase in place of eGFP eliminated tumor cells upon exposure to ganciclovir.

Keywords: AAV, gene therapy, lymphoma, malignancy, tropism

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Authors: Shokoufeh Roudashti, Shahin Bahari, Fakhri Haghi, Habib Zeighami, Ghazal Naderi, Paniz Shirmast

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Background: Mycobacterium tuberculosis complex (MTBC) causes tuberculosis (TB) in humans and animals. Mycobacterium MTBC is one of the most important species of zoonotic pathogens that can be transmitted from cattle to humans. The disease can transmit to human by direct contact with the infected animals, drinking unpasteurized milk and consumption of uncooked meat. The presence of these opportunistic, pathogenic bacteria in bovine milk has emerged as a public-health concern, especially among individuals who consume raw milk. Tuberculosis MTBC is the predominant infectious cause of morbidity and morality worldwide, It is estimated that one third of the world population (approx. 1.8 billion persons) is infected with M. tuberculosis and each year there are 8 million new cases worldwide. The aim of this study, to detect Mycobacterium MTBC in raw milk samples using polymerase chain reaction (PCR). Materials and Methods: In the present study, 60 raw milk samples were collected from rural areas in Zanjan, Iran. After extraction of DNAs and using special primers for Is6110 gene as a marker, PCR was applied to detect the presence or non-presence of the related gene. Results: According to the findings of this study, 8 (13.5 %) out of 60 milk samples were positive for Mycobacterium spp (P < 0.1). Conclusions: The Outbreak of genus Mycobacteria spp in milk samples were determined to be relatively high in Zanjan, Iran.

Keywords: Mycobacteria spp, raw milk, PCR, Zanjan

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Authors: Marlyn Mathew

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Communication is the key factor in any vocational /job set-up. However many persons with disabilities suffer a deficit in this very area in terms of comprehension, expression and cognitive skills making it difficult for them to get employed appropriately or stay employed. Vocational Rehabilitation is a continuous and coordinated process which involves the provision of vocational related services designed to enable a person with disability to obtain and maintain employment. Therefore the role of the speech language pathologist is crucial in assessing the communication deficits and needs of the individual at the various phases of employment- right from the time of seeking a job and attending interview with suitable employers and also at regular intervals of the employment. This article discusses the various communication deficits and the obstacles faced by individuals with special needs including but not limited to cognitive- linguistic deficits, execution function deficits, speech and language processing difficulties and strategies that can be introduced in the workplace to overcome these obstacles including use of visual cues, checklists, flow charts. The paper also throws light on the importance of educating colleagues and work partners about the communication difficulties faced by the individual. This would help to reduce the communication barriers in the workplace, help colleagues develop an empathetic approach and also reduce misunderstandings that can arise as a result of the communication impairment.

Keywords: vocational rehabilitation, disability, speech language pathologist, cognitive, linguistics

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Authors: James Donald Nyamahono, Kelvin Tinashe Pikirai

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

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

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Authors: Badino Manuel, Farias María Alejandra

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

Keywords: addiction, anxiety, depression, mental health

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

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

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

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

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

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

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Authors: Etienne Sugewe

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Purpose: The establishment of a positive HIV serologic status of an individual could have been an inhibitory factor to prevent risk behaviours in people living with HIV/AIDS. We conducted a cross-sectional study in order to assess the prevalence and predictors of risk behaviors among HIV-positive people in Douala-Cameroon. Methods: We used pre-checked questionnaires to systematically collect data from four HIV treatment centers in Douala. This was done to some of them during the distribution of drugs and to others during their classical rendezvous between the months of May and July 2012. The Chi-Square and Student t-test were used for cross tabulation of variables; multiple regression analysis was performed to identify predictors of risky sexual behaviours. Results: Of the 330 persons interviewed, sixty percent were reported to have had sexual intercourse after the diagnosis of HIV. We obtained 37% HIV-positive partners, and 63% had HIV- negative partners or partners with unknown status. Among our patients, 45% of the subjects with regular partners reported to have had anal or vaginal sex. Those whose score on the knowledge about HIV/AIDS was < 50% and where 90% of them were less susceptible to the condom during intercourse (p: 0.01). About 74% of patients on ARV were less susceptible to the use of condoms during sexual intercourse (p: 0.03). Conclusion: Risk sexual behaviours among people living with HIV/AIDS are common and potentially expose their partners. For HIV-positive partners, these habits pose a real risk of suprainfection by other strains of HIV. The need to increase awareness and education among people living with HIV is therefore highly recommended.

Keywords: HIV/AIDS, behaviours, HIV positive, Douala, 2012

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Authors: Junaid Ahmed, Nandita Shenoy

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Maintaining lifelong knowledge and skills is essential for safe clinical practice. Continuing Professional Development (CPD) is an established method that can facilitate lifelong learning. It focuses on maintaining or developing knowledge, skills and relationships to ensure competent practice.To date, relatively little has been done to comprehensively and systematically synthesize evidence to identify subjects of interest among practising dentist. Hence the aim of our study was to identify areas in clinical practice that would be favourable for continuing professional dental education amongst practicing dentists. Participants of this study consisted of the practicing dental surgeons of Mangalore, a city in Dakshina Kannada, Karnataka. 95% of our practitioners felt that regular updating as a one day program once in 3-6 months is required, to keep them abreast in clinical practice. 60% of subjects feel that CPD programs enrich their theoretical knowledge and helps in patient care. 27% of them felt that CPD programs should be related to general dentistry. Most of them felt that CPD programs should not be charged nominally between one to two thousand rupees. The acronym ‘CPD’ should be seen in a broader view in which professionals continuously enhance not only their knowledge and skills, but also their thinking,understanding and maturity; they grow not only as professionals, but also as persons; their development is not restricted to their work roles, but may also extend to new roles and responsibilities.

Keywords: continuing professional development, competent practice, dental education, practising dentist

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Authors: Michelangelo Liban, Debbie Liquete

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

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

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Authors: Mohd Sarfaraz

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The objective of this study is to investigate the work-life balance and job satisfaction among women employees in a hospital in India. It is believed that balancing a successful career with a family life or personal life can be challenging. WLB impacts on persons' satisfaction in their work and personal life roles. For this purpose, a questionnaire is developed with 22 items. The data collected from women employees who are working in a hospital in Aligarh, India. The constructs considered in this study include WLB and job satisfaction. The demographic and organisational variables considered in the study are genders, age and tenure of the job. Factors of WLB are flexible working conditions, work-life balance programs, and employee intention to change/leave a job, work pressure/stress and long working hours. This paper examines the relationship between work-family conflict, policies, and job and life satisfaction. Appropriate statistical tool using SPSS will be applied to achieve the objective. The anxiety over work-life balance is progressively becoming a common talk, especially for female employees.Increasing demands from the work and family domains represent a high strain for employees which even lead to the health problems among employees. Although it is believed that work-family role strain is more common among women employees. Therefore, the study will focus on these issues of WLB and job satisfaction among female professionals.

Keywords: work-life balance, job satisfaction, work- family conflict, health

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Authors: Aticha Kwaengsopha

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The purpose of this research was to study the behaviour and related factors that tourists utilized for making decisions to choose their accommodations at a tourist destination, Bangkontee district, Samut Songkhran Province, Thailand. The independent variables included gender, age, income, occupation, and region, while the three important dependent variables included selection behaviour, factors related selection process, and satisfaction of the accommodation service. A total of 400 Thai and international tourists were interviewed at tourist destination of Bangkontee. A questionnaire was used as the tool for collecting data. Descriptive statistics in this research included percentage, mean, and standard deviation. The findings revealed that the majority of respondents were single, female, and with the age between 23-30 years old. Most of the international tourists were from Asia and planned to stay in Thailand about 1-6 days. In addition, the majority of tourists preferred to travel in small groups of 3 persons. The majority of respondents used internet and word of mouth as the main tool to search for information. The majority of respondents spent most of their budget on food & drink, accommodation, and travelling. Even though the majority of tourists were satisfied with the quality of accommodation, the price range of accommodation, and the image of accommodation and the facilities of the accommodation, they indicated that they were not likely to re-visit Thailand in the near future.

Keywords: behaviour, decision factors, tourists, media engineering

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Authors: David Chapola Nggada

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Although the concept of terrorism is not a new phenomenon to Nigeria, the protracted terrorist activities experiencing in the north-eastern part of the country since 2009, had left an indelible mark on virtually every aspects of lives whether directly or indirectly, particularly the educational sector. Indeed, since the abduction of over 200 schoolgirls at Chibok in 2014 by the insurgence, education had witnessed a setback as most school remains closed for sometimes. The aftermath of this development on education and its future multiplier effect on national development is a source of concern. Consequently, this paper is designed to examine the consequences of terrorism on educational attainment and national development among the Chibok community of Borno State. The technique employed involves a mixture of both qualitative and quantitative research work on a sample size of 79 secondary school students currently displaced from Chibok, Damboa and Askira-Uba, now residing as internally displaced persons(IDPs) in Biu, Gombe, Maiduguri. A random sample technique is used. Structured and semi-unstructured questionnaire were administered. The result shows that, a significant number of students over these years, lacked access to education and this posed a great danger to national development. Recommendations towards reinvigorating education as a panacea to social, economic cum political vices were articulated. Concerted effort should be made to create confidence in the community.

Keywords: education, effect, terrorism, national, development

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Authors: G. A. Rombach, A. Faron

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Crack formation and growth in reinforced concrete members are, in many cases, the cause of the collapse of technical structures. Such serious failures impair structural behavior and can also damage property and persons. An intensive investigation of the crack propagation is indispensable. Numerical methods are being developed to analyze crack growth in an element and to detect fracture failure at an early stage. For reinforced concrete components, however, further research and action are required in the analysis of shear cracks. This paper presents numerical simulations and continuum mechanical modeling of bending shear crack propagation in a three-dimensional reinforced concrete beam without transverse reinforcement. The analysis will provide a further understanding of crack growth and redistribution of inner forces in concrete members. As a numerical method to map discrete cracks, the extended finite element method (XFEM) is applied. The crack propagation is compared with the smeared crack approach using concrete damage plasticity. For validation, the crack patterns of real experiments are compared with the results of the different finite element models. The evaluation is based on single span beams under bending. With the analysis, it is possible to predict the fracture behavior of concrete members.

Keywords: concrete damage plasticity, crack propagation, extended finite element method, fracture mechanics

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Authors: Wanlapa Kunsongkeit

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When a person gets sick, he or she goes to hospital for the treatment. In the case of severe illness, there might be no hope for some patients to recover. In this state, the patients will face anxiety and fear. These feelings make the patients suffer in mind until the time of death or called bad death. These feeling also directly effect to family members who are loved ones and significant persons of the patients. They can help the dying patients to have good death. From literature reviews, many studies focused on good death in patients and nurses. Little is known about good death in family member. Therefore, the qualitative research based on Heideggerian phenomenology aimed to describe good death as perceived by the critically ill patients’ family members. Five informants who were the critically ill patients’ family members at hospital in Chonburi were purposively selected. Data were collected by in-depth interview, observation and critical reflection during January, 2014 to March, 2014 . Cohen, Kahn and Steeves’s (2000) steps guided data analysis. Trustworthiness was maintained throughout the study following Lincoln and Guba’s guidelines. Four themes were emerged, which were no suffering, acceptance of imminent death, preparing for death, and being with the family. This findings provide deep understanding of good death as perceived by the critically ill patients’ family members. It can be basic information for nurses to provide good death nursing care and further explore for development of knowledge regarding good death nursing care.

Keywords: good death, family member, critically ill patient, phenomenology

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Authors: Chaomeng Liu, Li Li, Xiao Wang, Li Ren, Qinge Zhang

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Late-life depression (LLD) is a prevalent mental disorder among the elderly, frequently accompanied by significant cognitive decline, and has emerged as a worldwide public health concern. Microglia, astrocytes, and peripheral immune cells play pivotal roles in regulating inflammatory responses within the central nervous system (CNS) across diverse cerebral disorders. This review commences with the clinical research findings and accentuates the recent advancements pertaining to microglia and astrocytes in the neuroinflammation process of LLD. The reciprocal communication network between the CNS and immune system is of paramount importance in the pathogenesis of depression and cognitive decline. Stress-induced downregulation of tight and gap junction proteins in the brain results in increased blood-brain barrier permeability and impaired astrocyte function. Concurrently, activated microglia release inflammatory mediators, initiating the kynurenine metabolic pathway and exacerbating the quinolinic acid/kynurenic acid imbalance. Moreover, the balance between Th17 and Treg cells is implicated in the preservation of immune homeostasis within the cerebral milieu of individuals suffering from LLD. The ultimate objective of this review is to present future strategies for the management and treatment of LLD, informed by the most recent advancements in research, with the aim of averting or postponing the onset of AD.

Keywords: neuroinflammation, late-life depression, microglia, astrocytes, central nervous system, blood-brain barrier, Kynurenine pathway

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Authors: Huanhuan Qiang, Sijia Jin

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Population aging has become a global trend, and China has entered an aging society, implementing an active aging system focused on home and community-based care. However, most urban communities where elderly people live face issues such as monotonous planning, unappealing landscapes, and inadequate aging infrastructure, which do not meet the requirements for active aging. Intergenerational friendliness and mutual assistance are key components in China's active aging policy framework. Therefore, residential development should prioritize enhancing intergenerational friendliness. Residential and public spaces are central to community life and well-being, offering new and challenging venues to improve relationships among residents of different ages. They are crucial for developing intergenerational communities with diverse generations and non-blood relationships. This paper takes the Maigaoqiao community in Nanjing, China, as a case study, examining intergenerational interactions in public spaces. Based on Maslow's hierarchy of needs and using time geography analysis, it identifies the spatiotemporal behavior characteristics of intergenerational groups in outdoor activities. Then construct an intergenerational-friendly evaluation system and an IPA quadrant model for public spaces in residential areas. Lastly, it explores optimization strategies for public spaces to promote intergenerational friendly interactions, focusing on five aspects: accessibility, safety, functionality, a sense of belonging, and interactivity.

Keywords: intergenerational friendliness, demand theory, spatiotemporal behavior, IPA analysis, existing residential public space

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Authors: Chamindi Dilkushi Senaratne

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Staff development both formal and informal, structured and unstructured is universally accepted as fundamental to the growth of individuals and institutions. This study is based on feedback summaries collected from 2014 to 2017 from 240 participants of the staff development programme for probationary lecturers at the University of Kelaniya, Sri Lanka. It also contains data from interviews conducted with the resource persons in the programme. The study further includes observations from experts involved in staff training in higher education institutions in Sri Lanka The data reveals that though the programme has many aspects that can be improved, the selected topics in the curriculum and new topics that were incorporated had positive impacts to enhance continuing professional development of staff in Sri Lankan universities. The participants also believe that the programme has an impact on professional development, teaching, and management of classroom and curricula and research skills. Based on the findings, the study recommends the addition of new topics to the curriculum such as continuing professional development, code of conduct in universities, gender awareness and the green concept. The study further recommends programmes for senior academic staff in universities to assist them to reach higher levels in their career by focusing on areas such as teaching, research, and administrative skills.

Keywords: staff development, higher education, curriculum, research

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Authors: Ryuji Yamazaki, Masahiro Kochi, Weiran Zhu, Hiroko Kase

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In care for older adults, behavioral and psychological symptoms of dementia (BPSD) like agitation and aggression are distressing for patients and their caretakers, often resulting in premature institutionalization with increased costs of care. To improve mood and mitigate symptoms, as a non-pharmaceutical approach, emotion-oriented therapy like reminiscence work is adopted in face-to-face communication. Telecommunication support is expected to be provided by robotic media as a bridge for digital divide for those with dementia and facilitate social interaction both verbally and nonverbally. The purpose of this case study is to explore the conditions in which robotic media can effectively attract attention from older adults with dementia and promote their well-being. As a pilot study, we introduced the pillow-phone Hugvie^®, a huggable humanly shaped communication medium to five residents with dementia at a care facility, to investigate how the following conditions work for the elderly when they use the medium; 1) no sound, 2) radio, non-interactive, 3) daily conversation, and 4) reminiscence work. As a result, under condition 4, reminiscence work, the five participants kept concentration in interacting with the medium for a longer duration than other conditions. In condition 4, they also showed larger amount of utterances than under other conditions. These results indicate that providing topics related to personal histories through robotic media could affect communication positively and should, therefore, be further investigated. In addition, the issue of ethical implications by using persuasive technology that affects emotions and behaviors of older adults is also discussed.

Keywords: BPSD, reminiscence, tactile telecommunication, utterances

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