Search results for: national health insurance program

Authors: Stephanie Remedios, Linda Veronica Rios

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Background. Pediatric obesity is a serious health problem linked to multiple physical diseases and ailments, including diabetes, heart disease, and joint issues. While research has shown pediatric obesity can bring about an array of physical illnesses, it is less known how such a condition can affect children’s cognitive development. With childhood overweight and obesity prevalence rates on the rise, it is essential to understand the scope of their cognitive consequences. The present review of the literature tested the hypothesis that poor physical health, such as childhood obesity or malnutrition, negatively impacts a child’s cognitive development. Methodology. A systematic review was conducted to determine the relationship between poor physical health and lower cognitive functioning in children ages 4-16. Electronic databases were searched for studies dating back to ten years. The following databases were used: Science Direct, FIU Libraries, and Google Scholar. Inclusion criteria consisted of peer-reviewed academic articles written in English from 2012 to 2022 that analyzed the relationship between childhood malnutrition and obesity on cognitive development. A total of 17,000 articles were obtained, of which 16,987 were excluded for not addressing the cognitive implications exclusively. Of the acquired articles, 13 were retained. Results. Research suggested a significant connection between diet and cognitive development. Both diet and physical activity are strongly correlated with higher cognitive functioning. Cognitive domains explored in this work included learning, memory, attention, inhibition, and impulsivity. IQ scores were also considered objective representations of overall cognitive performance. Studies showed physical activity benefits cognitive development, primarily for executive functioning and language development. Additionally, children suffering from pediatric obesity or malnutrition were found to score 3-10 points lower in IQ scores when compared to healthy, same-aged children. Conclusion. This review provides evidence that the presence of physical activity and overall physical health, including appropriate diet and nutritional intake, has beneficial effects on cognitive outcomes. The primary conclusion from this research is that childhood obesity and malnutrition show detrimental effects on cognitive development in children, primarily with learning outcomes. Assuming childhood obesity and malnutrition rates continue their current trade, it is essential to understand the complete physical and psychological implications of obesity and malnutrition in pediatric populations. Given the limitations encountered through our research, further studies are needed to evaluate the areas of cognition affected during childhood.

Keywords: childhood malnutrition, childhood obesity, cognitive development, cognitive functioning

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Authors: Mohammad Aladwan

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Alzheimer’s disease (AD) is a widespread dementing illness with a complex and poorly understood etiology. An important role in improving our understanding of the AD process is the modeling of disease-associated changes in tau protein phosphorylation, a protein known to mediate events essential to the onset and progression of AD. A main feature of AD is the abnormal phosphorylation of tau protein and the presence of neurofibrillary tangles. In order to evaluate the respective roles of the microtubule-binding region (MTBR) and alternatively spliced exons in the N-terminal projection domains in AD, we have constructed SHSY-5Y cell lines that stably overexpress four different species of tau protein (4R2N, 4R0N, N(E-2), N(E+2)). Since the toxicity and spreading of tau lesions in AD depends on the interactions of tau with other proteins, we have performed a proteomic analysis of exosome-fraction interactomes for cell lysates and media samples that were isolated from SHSY-5Y cell lines. Functional analysis of tau interactomes based on gene ontology (GO) terms was performed using the String 10.5 database program. The highest number of exosomes proteomes and tau associated proteins were found with 4R2N isoform (2771 and 159) in cell lysate and they have a high strength of connectivity (78%) between proteins, while N(E-2) isoform in the media proteomes has the highest number of proteins and tau associated protein (1829 and 205). Moreover, known AD markers were significantly enriched in secreted interactomes relative to lysate interactomes in the SHSY-5Y cells of tau isoforms lacking exons 2 and 3 in the N-terminal. The lack of exon 2 (E-2) from tau protein can be mediated by tau secretion and spreading to different cells. Enriched functions in the secreted E-2 interactome include signaling and developmental pathways that have been linked to a) tau misprocessing and lesion development and b) tau secretion and which, therefore, could play novel roles in AD pathogenesis.

Keywords: Alzheimer's disease, dementia, tau protein, neurodegenration disease

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Authors: Samuel Asiedu-Addo, Jonathan Annan, Yarhands Dissou Arthur

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The study aims to explore the relational effect of lecturers’ personal attribute on student’s interest in statistics. In this study personal attributes of lecturers’ such as lecturer’s dynamism, communication strategies and rapport in the classroom as well as applied knowledge during lecture were examined. Here, exploratory research design was used to establish the effect of lecturer’s personal attributes on student’s interest. Data were analyzed by means of confirmatory factor analysis and structural equation modeling (SEM) using the SmartPLS 3 program. The study recruited 376 students from the faculty of technical and vocational education of the University of Education Winneba Kumasi campus, and Ghana Technology University College as well as Kwame Nkrumah University of science and Technology. The results revealed that personal attributes of an effective lecturer were lecturer’s dynamism, rapport, communication and applied knowledge contribute (52.9%) in explaining students interest in statistics. Our regression analysis and structural equation modeling confirm that lecturers personal attribute contribute effectively by predicting student’s interest of 52.9% and 53.7% respectively. The paper concludes that the total effect of a lecturer’s attribute on student’s interest is moderate and significant. While a lecturer’s communication and dynamism were found to contribute positively to students’ interest, they were insignificant in predicting students’ interest. We further showed that a lecturer’s personal attributes such as applied knowledge and rapport have positive and significant effect on tertiary student’s interest in statistic, whilst lecturers’ communication and dynamism do not significantly affect student interest in statistics; though positively related.

Keywords: student interest, effective teacher, personal attributes, regression and SEM

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Authors: Anne Nattembo

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Cervical cancer remains a major public health problem in developing countries, especially in Africa. Effective cervical cancer prevention communication requires identification of behaviors, attitudes and increasing awareness of a given population; thus this study focused on investigating awareness, attitudes, and behavior among female university students towards cervical cancer messages. The study objectives sought to investigate the communication behavior of young adults towards cervical cancer, to understand female students recognition of cervical cancer as a problem, to identify the frames related to cervical cancer and their impact towards audience communication and participation behaviors, to identify the factors that influence behavioral intentions and level of involvement towards cervical cancer services and to make recommendations on how to improve cervical cancer communication towards female university students. The researcher obtained data using semi-structured interviews and focus group discussions targeting 90 respondents. The semi-structured in-depth interviews were carried out through one-on-one discussions basis using a set of prepared questions among 53 respondents. All interviews were audio-tape recorded. Each interview was directly typed into Microsoft Word. 4 focus group discussions were conducted with a total of 37 respondents; 2 female only groups with 10 respondents in one and 9 respondents in another, 1 mixed with 12 participants 5 of whom were male, and 1 male only group with 6 participants. The key findings show that the participants preferred to receive and access cervical cancer information from doctors although they were mainly receiving information from the radio. In regards to the type of public the respondents represent, majority of the respondents were non-publics in the sense that they did not have knowledge about cervical cancer, had low levels of involvement and had high constraint recognition their cervical cancer knowledge levels. The researcher identified the most salient audience frames among female university students towards cervical cancer and these included; death, loss, and fear. These frames did not necessarily make cervical cancer an issue of concern among the female university students but rather an issue they distanced themselves from as they did not perceive it as a risk. The study also identified the constraints respondents face in responding to cervical cancer campaign calls-to-action which included; stigma, lack of knowledge and access to services as well as lack of recommendation from doctors. In regards to sex differences, females had more knowledge about cervical cancer than the males. In conclusion the study highlights the importance of interpersonal communication in risk or health communication with a focus on health providers proactively sharing cervical cancer prevention information with their patients. Health provider’s involvement in cervical cancer is very important in influencing behavior and compliance of cervical cancer calls-to-action. The study also provides recommendations for designing effective cervical cancer campaigns that will positively impact on the audience such as packaging cervical cancer messages that also target the males as a way of increasing their involvement and more campaigns to increase awareness of cervical cancer as well as designing positive framed messages to counter the negative audience frames towards cervical cancer.

Keywords: cervical cancer communication, health communication, university students, risk communication

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Authors: Thais Cavalheri Santos, Pedro Jose Gabriel Ferreira, Alexandre Daliberto Frugoli, Lucio Leonardo, Pedro Americo Frugoli

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This paper presents a low cost education proposal to be used in engineering courses. The engineering education in universities of a developing country that is in need of an increasing number of engineers carried out with quality and affordably, pose a difficult problem to solve. In Brazil, the political and economic scenario requires academic managers able to reduce costs without compromising the quality of education. Within this context, the elaboration of a physics principles teaching method with the construction of an electronic balance is proposed. First, a method to develop and construct a load cell through which the students can understand the physical principle of strain gauges and bridge circuit will be proposed. The load cell structure was made with aluminum 6351T6, in dimensions of 80 mm x 13 mm x 13 mm and for its instrumentation, a complete Wheatstone Bridge was assembled with strain gauges of 350 ohms. Additionally, the process involves the use of a software tool to document the prototypes (design circuits), the conditioning of the signal, a microcontroller, C language programming as well as the development of the prototype. The project also intends to use an open-source I/O board (Arduino Microcontroller). To design the circuit, the Fritizing software will be used and, to program the controller, an open-source software named IDE®. A load cell was chosen because strain gauges have accuracy and their use has several applications in the industry. A prototype was developed for this study, and it confirmed the affordability of this educational idea. Furthermore, the goal of this proposal is to motivate the students to understand the several possible applications in high technology of the use of load cells and microcontroller.

Keywords: Arduino, load cell, low-cost education, strain gauge

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Authors: Behrooz Daneshmand

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Software Defined Networking (SDN) is designed to meet the future needs of 5G mobile networks. The SDN architecture offers a new solution that involves separating the control plane from the data plane, which is usually paired together. Network functions traditionally performed on specific hardware can now be abstracted and virtualized on any device, and a centralized software-based administration approach is based on a central controller, facilitating the development of modern applications and services. These plan standards clear the way for a more adaptable, speedier, and more energetic network beneath computer program control compared with a conventional network. We accept SDN gives modern inquire about openings to security, and it can significantly affect network security research in numerous diverse ways. Subsequently, the SDN architecture engages systems to effectively screen activity and analyze threats to facilitate security approach modification and security benefit insertion. The segregation of the data planes and control and, be that as it may, opens security challenges, such as man-in-the-middle attacks (MIMA), denial of service (DoS) attacks, and immersion attacks. In this paper, we analyze security threats to each layer of SDN - application layer - southbound interfaces/northbound interfaces - controller layer and data layer. From a security point of see, the components that make up the SDN architecture have a few vulnerabilities, which may be abused by aggressors to perform noxious activities and hence influence the network and its administrations. Software-defined network assaults are shockingly a reality these days. In a nutshell, this paper highlights architectural weaknesses and develops attack vectors at each layer, which leads to conclusions about further progress in identifying the consequences of attacks and proposing mitigation strategies.

Keywords: software-defined networking, security, SDN, 5G/IMT-2020

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Authors: Mohammed Sherzad

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The Sahara desert covers third of the total surface of Africa with a quarter of this area within the national boundaries of Algeria. Sand drift and deposition is considered one of the major factors of the desertification process in the area. It is estimated that a third of the world's hot arid lands are covered by aeolian sand deposits, forming extensive sand bedforms. The Gourrara region in the Grand Erg Occidental (west of Algerian Sahara) and the region of Souf in the Grand Erg Oriental (east of Algerian Sahara) have been chosen as case studies. These were significant cultural and trading centers for many centuries despite their remote location and their harsh desert environment particularly solar radiation and sand drift and deposition. The architecture of the sustained vernacular settlements in each of the two regions has unique design features for this environment. So do the irrigation systems used - palm groves and the foggara system for capturing and distributing groundwater. However, the ecological balance which enabled the Saharans to live with the desert has been upset. New buildings often use technology based on models imported or imposed from areas that climatically have little in common. These make the inhabitants live ‘in the desert’ rather than ‘with the desert’. This paper will describe the qualities of the vernacular architecture and demonstrate its effectiveness and adaptability to the region’s harsh desert environment in comparison with contemporary buildings. Developing design guides and approaches based on lessons from the traditional architecture is important to ensure sustained livelihoods of the inhabitants in these areas.

Keywords: vernacular architecture, desert architecture, hot climate, aeolian sand deposition

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Authors: Santosh B. Phad, Priyanka V. Janbandhu, Dhananjay W. Bansod

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Population Ageing is a growing concern for the social scientists. There is a higher level of aged male participation compared to elderly females. Now, the critical question is whether participation in work improves the quality of life among the elderly and the impact of working status on the mental well-being of the elderly. While examining these research questions, the present paper focuses on the workforce participation of the elderly and the reasons behind it, additionally, determines the association between employment status and the mental well-being of the elderly. The present study has a base of two data sources. First one is Census of India data, 2001 and 2011, and another one is – the Study on Global Ageing and Adult Health (SAGE), a survey conducted in 2007. To capture the trend of workforce participation elderly Census data is significant and to obtain other information associated with this issue the SAGE data is studied. The research piece consists of univariate and bivariate analysis along with some statistical methods like principal component analysis (PCA) and regression modeling – to investigate the association between workforce participation of elderly and subjective well-being (SWB). The results show that the percentage of elderly participating in the labor market is gradually reducing, but the share of working elderly has increased within the group of overall workers. i.e., the ratio of aged workers to non-aged workers is rising. The findings from survey data specify that there is a considerable share of the elderly in the labor market; three-fourths of the employed elderly enrolled the workforce unwillingly. They are in need of some earnings mainly to afford the medical expenses on their health or the health of their spouse, also to support their family members who are economically inactive. Apart from need, duration of working is another vital aspect for the elderly, whereas more than 80 percent of the elderly are working for six hours or more, and most of them engaged in self-employment. However, more than one-third of the working elderly falls into a negative cluster of the subjective well-being (SWB) index, and it is consistent with the result of the discriminant analysis. Here, the SWB index calculated from the 12 items and the reliability score of these items is 0.89.

Keywords: ageing, workforce, census of India, SAGE

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Authors: Bushra

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This paper explores the historical significance, ecological benefits, and contemporary applications of natural dyes in textile dyeing, aiming to provide a comprehensive overview of their potential to contribute to a sustainable fashion industry while minimizing ecological footprints. This research explores the potential of natural dyes as a sustainable alternative to synthetic dyes in the textile industry, examining their historical context, sources, and environmental benefits. Natural dyes come from plants, animals, and minerals, including roots, leaves, bark, fruits, flowers, insects, and metal salts, used as mordants to fix dyes to fabrics. Natural dyeing involves extraction, mordanting, and dyeing techniques. Optimizing these processes can enhance the performance of natural dyes, making them viable for contemporary textile applications based on experimental research. Natural dyes offer eco-friendly benefits like biodegradability, non-toxicity, and resource renewables, reducing pollution, promoting biodiversity, and reducing reliance on petrochemicals. Natural dyes offer benefits but face challenges in color consistency, scalability, and performance, requiring industrial production to meet modern consumer standards for durability and colorfastness. Contemporary initiatives in the textile industry include fashion brands like Eileen Fisher and Patagonia incorporating natural dyes, artisans like India Flint's Botanical Alchemy promoting traditional dyeing techniques, and research projects like the European Union's Horizon 2020 program. Natural dyes offer a sustainable textile industry solution, reducing environmental impact and promoting harmony with nature. Research and innovation are paving the way for widespread adoption, transforming textile dyeing.

Keywords: historical significance, textile industry, natural dyes, sustainability

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Authors: Sujeet Kumar

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Education has greater importance particularly in terms of increasing human capital and economic competitiveness. It plays a crucial role in terms of cognitive and skill development. Its plays a vital role in process of socialization, fostering social justice, and enhancing social cohesion. Policy related to education has been always a priority for developed countries, which is later adopted by developing countries also. The government of India has also brought change in education polices in line with recognizing change at national and supranational level. However, quality education is still not become an open door for every child in India and several reports are produced year to year about level of school education in India. This paper is concerned with schooling in India. Particularly, it focuses on two government and two private schools in Bihar, but reference has made to schools in Delhi especially around slum communities. The paper presents brief historical context and an overview of current school systems in India. Later, it focuses on analysis of current development in policy in reference with field observation, which is anchored around choice, diversity, market – orientation and gap between different groups of pupils. There is greater degree of difference observed at private and government school levels in terms of quality of teachers, method of teaching and overall environment of learning. The paper concludes that the recent policy development in education particularly Sarva Siksha Abhiyaan (SAA) and Right to Education Act (2009) has required renovating new approach to bridge the gap through broader consultation at grassroots and participatory approach with different stakeholders.

Keywords: education, public policy, participatory approach

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Authors: Paweł Strzępek, Małgorzata Zasadzińska, Szymon Kordaszewski, Wojciech Ściężor

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The constant tendency toward the materials properties improvement nowadays creates opportunities for the scientists, and furthermore the manufacturers all over the world to design, form and produce new alloys almost every day. Considering the fact that companies all over the world look for alloys with the highest values of mechanical properties coexisting with a reasonable electrical conductivity made it necessary to develop new materials based on copper, such as copper magnesium alloys with over 2 wt. % of Mg. Though, before such new material may be mass produced it must undergo a series of tests in order to determine the production technology and its parameters. The presented study is based on the numerical simulations calculated with the use of finite element method analysis, where the geometry of the cooling system, the material used to produce the cooling system and the surface quality of the graphite crystallizer at the place of contact with the cooling system and its influence on the temperatures throughout the continuous casting process is being investigated. The calculated simulations made it possible to propose the optimal set of equipment necessary for the continuous casting process to be carried out in laboratory conditions with various casting parameters and to determine basic materials properties of the obtained alloys such as hardness, electrical conductivity and homogeneity of the chemical composition. The authors are grateful for the financial support provided by The National Centre for Research and Development – Research Project No. LIDER/33/0121/L-11/19/NCBR/2020.

Keywords: CuMg alloys, continuous casting, temperature analysis, finite element method

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Authors: B. B. van Schalkwyk, C. B. Schoeman, E. J. Cilliers

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High levels of urbanisation and the lingering effects of Apartheid have caused South African municipalities to experience difficulties in planning for sustainability and, more specifically, sustainable community development. Sustainable community development is needed in order to achieve more integrated and sustainable towns and cities with an improved living environment and a higher quality of life. Due to this, sustainable community development is of particular relevance to South Africa. Although policies and legislation exist at international, national and local level, there is a lack of suitable planning instruments to guide sustainable community development. Tlokwe Local Municipality is researched in this paper as study area to test and develop planning instruments for sustainable community development. A comparative assessment matrix of sustainability indicators is linked to Multi-Criteria Analysis (MCA) and applied to identify the themes and sub-themes applicable to sustainability in which intervention is required to improve the sustainability rating of the municipality. The result of the comparative sustainability assessment is that the Tlokwe Local Municipality is considered to be relatively sustainable, performing overall better than the three spheres of government against which it was measured. It is recommended that municipalities use the comparative assessment matrix method to determine its level of sustainability when developing respective sectorial plans (SDFs, ITPs, EMFs and IDPs). Areas in which there is a lack of sustainability are highlighted and can consequently be addressed through intervention strategies. The comparative assessment matrix method is a valuable planning instrument with which to achieve sustainable community development.

Keywords: sustainable community development, sustainability indicators, comparative sustainability, urbanisation, development planning, urban management

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Authors: Marie Taylor, Catriona Murphy

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The aim of this paper is to identify the factors of success in community based heritage tourism initiatives. Heritage and community are central to many tourism initiatives with heritage tourism having the potential to act as a catalyst for community development. This paper presents the findings of research that examined the relationship between heritage tourism and community development. The findings recognised that heritage tourism had economic, social and cultural benefits for a community as well as a role in strengthening concepts such as sense of identity, place, and authenticity. In addition, this paper proposes an assessment framework for sustainable community based heritage tourism to identify factors and contextual influences involved in their success or failure. In evaluating the sustainability of such initiatives, a number of issues are investigated including the continued role of stakeholders, the role of funding, the influence of collaboration and the changing role of rural development and its impact on community engagement. The research is descriptive, evaluative and explanatory research, exploring and analysing issues such as the development of community structures in community based heritage tourism. Thus, it will contribute to the development of potential tourism and community development policies and strategies at a local, national and international level. An interpretative and inductive approach is utilised, and a mixed method approach followed as it encapsulates the best of quantitative and qualitative research methods. The case studies focus on social enterprises in relation to tourism and community based tourism cooperatives as there are limited study and knowledge of these. Consequently, this research will contribute to the discourse on community based heritage tourism as an aspect of community development.

Keywords: collaboration, community-based heritage tourism, stakeholders, sustainable tourism

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Authors: Tugba Sevinc Gamsiz, Emine Koroglu, Ozcan Keskin

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Aim: Nonalcoholic fatty liver disease (NAFLD) is considered the most common chronic liver disease in the general population. The higher mortality and morbidity among NAFLD patients and lack of symptoms makes early detection and management important. In our study, we aimed to evaluate the relationship between noninvasive imaging and biochemical markers in diabetic and nondiabetic patients diagnosed with NAFLD. Materials and Methods: The study was conducted from (September 2017) to (December 2017) on adults admitted to Internal Medicine and Gastroenterology outpatient clinics with hepatic steatosis reported on ultrasound or transient elastography within the last six months that exclude patients with other liver diseases or alcohol abuse. The data were collected and analyzed retrospectively. Number cruncher statistical system (NCSS) 2007 program was used for statistical analysis. Results: 116 patients were included in this study. Diabetic patients compared to nondiabetics had significantly higher Controlled Attenuation Parameter (CAP), Liver Stiffness Measurement (LSM) and fibrosis values. Also, hypertension, hepatomegaly, high BMI, hypertriglyceridemia, hyperglycemia, high A1c, and hyperuricemia were found to be risk factors for NAFLD progression to fibrosis. Advanced fibrosis (F3, F4) was present in 18,6 % of all our patients; 35,8 % of diabetic and 5,7 % of nondiabetic patients diagnosed with hepatic steatosis. Conclusion: Transient elastography is now used in daily clinical practice as an accurate noninvasive tool during follow-up of patients with fatty liver. Early diagnosis of the stage of liver fibrosis improves the monitoring and management of patients, especially in those with metabolic syndrome criteria.

Keywords: diabetes, elastography, fatty liver, fibrosis, metabolic syndrome

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Authors: Mamidi Ramakrishna Rao

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Doubly-fed induction generator (DFIG) is currently the choice for many wind turbines. These generators, when connected to the grid through a converter, is subjected to varied power system conditions like voltage variation, frequency variation, short circuit fault conditions, etc. Further, many countries like Canada, Germany, UK, Scotland, etc. have distinct grid codes relating to wind turbines. Accordingly, following the network faults, wind turbines have to supply a definite reactive current. To satisfy the requirements including reactive current capability, an optimum electrical design becomes a mandate for DFIG to function. This paper intends to optimize the equivalent circuit parameters of an electrical design for satisfactory DFIG performance. Direct search method has been used for optimization of the parameters. The variables selected include electromagnetic core dimensions (diameters and stack length), slot dimensions, radial air gap between stator and rotor and winding copper cross section area. Optimization for 2 MW DFIG has been executed separately for three objective functions - maximum reactive power capability (Case I), maximum efficiency (Case II) and minimum weight (Case III). In the optimization analysis program, voltage variations (10%), power factor- leading and lagging (0.95), speeds for corresponding to slips (-0.3 to +0.3) have been considered. The optimum designs obtained for objective functions were compared. It can be concluded that direct search method of optimization helps in determining an optimum electrical design for each objective function like efficiency or reactive power capability or weight minimization.

Keywords: direct search, DFIG, equivalent circuit parameters, optimization

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Authors: Paolo Pilloni, Fabrizio Mulas, Salvatore Carta

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Nowadays, several research studies point up that an active lifestyle is essential for physical and mental health benefits. Mobile phones have greatly influenced people’s habits and attitudes also in the way they exercise. Our research work is mainly focused on investigating how to exploit mobile technologies to favour people’s exertion experience. To this end, we developed an exertion framework users can exploit through a real world mobile application, called BLINDED, designed to act as a virtual personal trainer to support runners during their trainings. In this work, inspired by both previous findings in the field of interaction design for people with visual impairments, feedback gathered from real users of our framework, and positive results obtained from two experimentations, we present some new interaction facilities we designed to enhance the interaction experience during a training. The positive obtained results helped us to derive some interaction design recommendations we believe will be a valid support for designers of future mobile systems conceived to be used in circumstances where there are limited possibilities of interaction.

Keywords: human computer interaction, interaction design guidelines, persuasive mobile technologies for sport and health

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Authors: Asaiel Mubark Al Hadi

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Background: A frequent anorectal condition known as hemorrhoids, sometimes known as piles, is characterized by a weakening of the anal cushion and the supporting tissue as well as spasms of the internal sphincter. Hemorrhoids are most frequently identified by painless bright red bleeding, prolapse, annoying grape-like tissue prolapse, itching, or a combination of symptoms. digital rectal examination (DRE) and anoscope are used to diagnose it. Constipation, a low-fiber diet, a high body- mass index (BMI), pregnancy, and a reduced physical activity are among the factors that are typically thought to increase the risk of hemorrhoids. Golighers is the most commonly used hemorrhoid classification scheme It is 4 degrees, which determines the degree of the event. The purpose of this study is to assess knowledge and awareness level of the causes and stages of Hemorrhoids in the public of Saudi Arabia. Method: This cross-sectional study was conducted in the Saudi Arabia between Oct 2022- Dec 2022. The study group included at least 384 aged above 18 years. The outcomes of this study were analyzed using the SPSS program using a pre-tested questionnaire. Results: The study included 1410 participants, 69.9% of them were females and 30.1% were males. 53.7% of participants aged 20- 30 years old. 17% of participants had hemorrhoids and 42% had a relative who had hemorrhoids. 42.8% of participants could identify stage 1 of hemorrhoids correctly, 44.7% identified stage 2 correctly, 46.7% identified stage 3 correctly and 58.1% identified stage 4 correctly. Only 28.9% of participants had high level of knowledge about hemorrhoids, 62.7% had moderate knowledge and 8.4% had low knowledge. Conclusion: In conclusion, Saudi general population has poor knowledge of hemorrhoids, their causes and their management approach. There was a significant association between knowledge scores of hemorrhoids with age, gender, residence area and employment.

Keywords: hemorrhoids, external hemorrhoid, internal hemorrhoid, anal fissure, hemorrhoid stages, prolapse, rectal bleeding

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Authors: Silas Webb, Joseph Hartland

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Background: Long-term retention of patients on ART has become a major health challenge in Sub-Saharan Africa (SSA). In 2010 a systematic review of 39 papers found that 30% of patients were no longer taking their ARTs two years after starting treatment. In the same review, it was noted that there was a paucity of data as to why patients become lost to follow-up (LTFU) in SSA. This project was performed in Mulanje Mission Hospital in Malawi as part of Swindon Academy’s Global Health eSSC. The HIV prevalence for Malawi is 10.3%, one of the highest rates in the world, however prevalence soars to 18% in the Mulanje. Therefore it is essential that patients at risk of being LTFU are identified early and managed appropriately to help them continue to participate in the service. Methodology: All patients on adult antiretroviral formulations at MMH, who were classified as ‘defaulters’ (patients missing a scheduled follow up visit by more than two months) over the last 12 months were included in the study. Demographic varibales were collected from Mastercards for data analysis. A comparison group of patients currently not lost to follow up was created by using all of the patients who attended the HIV clinic between 18th-22nd July 2016 who had never defaulted from ART. Data was analysed using the chi squared (χ²) test, as data collected was categorical, with alpha levels set at 0.05. Results: Overall, 136 patients had defaulted from ART over the past 12 months at MMH. Of these, 43 patients had missing Mastercards, so 93 defaulter datasets were analysed. In the comparison group 93 datasets were also analysed and statistical analysis done using Chi-Squared testing. A higher proportion of men in the defaulting group was noted (χ²=0.034) and defaulters tended to be younger (χ²=0.052). 94.6% of patients who defaulted were taking Tenofovir, Lamivudine and Efavirenz, the standard first line ART therapy in Malawi. The mean length of time on ART was 39.0 months (RR: -22.4-100.4) in the defaulters group and 47.3 months (RR: -19.71-114.23) in the control group, with a mean difference of 8.3 less months in the defaulters group (χ ²=0.056). Discussion: The findings in this study echo the literature, however this review expands on that and shows the demographic for the patient at most risk of defaulting and being LTFU would be: a young male who has missed more than 4 doses of ART and is within his first year of treatment. For the hospital, this data is important at it identifies significant areas for public health focus. For instance, fear of disclosure and stigma may be disproportionately affecting younger men, so interventions can be aimed specifically at them to improve their health outcomes. The mean length of time on medication was 8.3 months less in the defaulters group, with a p-value of 0.056, emphasising the need for more intensive follow-up in the early stages of treatment, when patients are at the highest risk of defaulting.

Keywords: anti-retroviral therapy, ART, HIV, lost to follow up, Malawi

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Authors: Vorapoj Promasatayaprot, Sumattana Glangkarn

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Background: Early childhood, the first five years of life, is a time of rapid cognitive, linguistic, social, emotional and motor development. This study was descriptive research which the main purpose of this research was to study early childhood development in Child Center of Local Government in order to emphasize the public citizen and communities participate in the Child Development Center. Method: The study designed was Action Research and divided into four steps consisted of (1) Planning (2) Acting (3) Observing and (4) Reflecting. This study was employed the areas and the subjects consisted of 10 committees of the Child Center in Thakhonyang municipality, Kantharawichai District, Maha Sarakham Province, Thailand and 50 representative parents by using the purposive sampling technique. The instrument used in this study were questionnaires. The data were analyzed using descriptive statistic; percentage, mean, standard deviation, maximum value, minimum, median. Qualitative data was collected using the observation and interview and was analysed by content analysis. Results: The results of this research were as follows: The promoting of early childhood development in child center at Thakhonyang Municipality, Kantharawichai District, Maha Sarakham Province, Thailand were 6 procedures ; (1) workshop participation (2) workshop in action plan (3) performing in action plan (4) following supervision (5) self – assessment (6) knowledge sharing seminar. The service model of the Local Fund Health Security in Thailand was passed the qualifications of local fund health security by 6 procedures to be the high potential local fund health security. Conclusion: The key success is that the commission will have to respond the performance at all process of plan to address the issue in the future. Factor of success is to community participate with transparent procedure. Coordination committee should manipulate the child center benefits among stake holders.

Keywords: child center, develop, early childhood development, local government, promote

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Authors: Mike Omilusi

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Since the Buhari administration came to power, it has gained the people’s confidence with its anti-corruption efforts. Making culprits account for their past unlawful deeds, in a very determined and aggressive manner ever witnessed in the nation’s political history, generates different reactions among Nigerians. However, some questions remain pertinent to this study: Are Nigerians really advocating persecution or prosecution in respect of the graft suspects? Do they want conviction without being convinced? Is their outburst propelled by emotions and revengeful anticipation of having suspected looters of the nation’s commonwealth behind bars? Can the war be successfully fought without resorting to impunity? Relying extensively on secondary sources with the aid of descriptive and narrative tools, this study seeks to interrogate the claim of fundamental human rights in the face of wanton looting of the nation’s resources. If, as opined by President Buhari, corruption is a crime against humanity, then it is argued that those who commit such crime should be subjected to penalties prescribed by law. Such crime -as corruption in this study- deprives the citizens of welfare, social amenities and good things of life. In this instance, it also poses threats to national security, having misappropriated funds meant for the war against the Boko Haram terrorism as revealed by the anti-corruption agency in the country. A theoretically-driven investigation, this essay raises some expectations within the context of good governance-propelled anti-corruption crusade, making modest recommendations as to how corruption should be prevented and combated within the confine of rule of law.

Keywords: corruption, rule of law, human rights, prosecution, commonwealth

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Authors: Sadra Abbasi

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The complex connection between psychological stress and the onset of different diseases has been an ongoing issue in the mental health field for a long time. Multiple studies have demonstrated that long-term stress can greatly heighten the likelihood of developing health issues like heart disease, cancer, arthritis, and severe depression. Recent research in cognitive science has provided insight into the intricate processes involved in posttraumatic stress disorder (PTSD), suggesting that distinct memory systems are accountable for both vivid reliving and normal autobiographical memories of traumatic incidents, as proposed by dual representation theory. This theory has important consequences for our comprehension of the neural mechanisms involved in fear and behavior related to threats, highlighting the amygdala-hippocampus-medial prefrontal cortex circuit as a crucial component in this process. This particular circuit, extensively researched in behavioral neuroscience, is essential for regulating the body's reactions to stress and trauma. This review will examine how incorporating a modern neuroscience viewpoint into an integrative case formulation offers a current way to comprehend the intricate connections among psychological stress, trauma, and disease.

Keywords: social, cognitive, stress, neuroscience, behavior, PTSD

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Authors: Daphne Alroy-Thiberge

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Trauma-impacted individuals present unique treatment challenges that include high reactivity, hyper-and hypo-arousal, poor adherence to therapy, as well as powerful transference and counter-transference experiences in therapy. This work provides an overview of the clinical tenets most often encountered in trauma-impacted individuals. Further, it provides readily applicable clinical techniques to optimize therapeutic rapport and facilitate accelerated positive mental health outcomes. Finally, integrated neuroscience and clinical evidence-based data are discussed to shed new light on crisis states in trauma-impacted individuals. This knowledge is utilized to provide effective and concrete interventions towards rapid and successful de-escalation of the impacted individual. A highly interactive, adult-learning-principles-based modality is utilized to provide an organic learning experience for participants. The information and techniques learned aim to increase clinical effectiveness, reduce staff injuries and burnout, and significantly enhance positive mental health outcomes and self-determination for the trauma-impacted individuals treated.

Keywords: clinical competencies, crisis interventions, psychotherapy techniques, trauma informed care

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Authors: A. D'Alessandro, F. Ubertini, A. L. Materazzi

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In the field of civil engineering, Structural Health Monitoring is a topic of growing interest. Effective monitoring instruments permit the control of the working conditions of structures and infrastructures, through the identification of behavioral anomalies due to incipient damages, especially in areas of high environmental hazards as earthquakes. While traditional sensors can be applied only in a limited number of points, providing a partial information for a structural diagnosis, novel transducers may allow a diffuse sensing. Thanks to the new tools and materials provided by nanotechnology, new types of multifunctional sensors are developing in the scientific panorama. In particular, cement-matrix composite materials capable of diagnosing their own state of strain and tension, could be originated by the addition of specific conductive nanofillers. Because of the nature of the material they are made of, these new cementitious nano-modified transducers can be inserted within the concrete elements, transforming the same structures in sets of widespread sensors. This paper is aimed at presenting the results of a research about a new self-sensing nanocomposite and about the implementation of smart sensors for Structural Health Monitoring. The developed nanocomposite has been obtained by inserting multi walled carbon nanotubes within a cementitious matrix. The insertion of such conductive carbon nanofillers provides the base material with piezoresistive characteristics and peculiar sensitivity to mechanical modifications. The self-sensing ability is achieved by correlating the variation of the external stress or strain with the variation of some electrical properties, such as the electrical resistance or conductivity. Through the measurement of such electrical characteristics, the performance and the working conditions of an element or a structure can be monitored. Among conductive carbon nanofillers, carbon nanotubes seem to be particularly promising for the realization of self-sensing cement-matrix materials. Some issues related to the nanofiller dispersion or to the influence of the nano-inclusions amount in the cement matrix need to be carefully investigated: the strain sensitivity of the resulting sensors is influenced by such factors. This work analyzes the dispersion of the carbon nanofillers, the physical properties of the fresh dough, the electrical properties of the hardened composites and the sensing properties of the realized sensors. The experimental campaign focuses specifically on their dynamic characterization and their applicability to the monitoring of full-scale elements. The results of the electromechanical tests with both slow varying and dynamic loads show that the developed nanocomposite sensors can be effectively used for the health monitoring of structures.

Keywords: carbon nanotubes, self-sensing nanocomposites, smart cement-matrix sensors, structural health monitoring

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Authors: Riyas Peringattuthodiyil, Mark Taylor, Ian Wallace, Ailish Nugent, Mike Mitchell, Judith Thompson, Allison McKee, Philip C. Johnston

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Aim of Study: The purpose of the study was to screen for diabetes through HbA1c in patients with chronic pancreatitis (CP) within the Belfast Trust. Background: Patients with chronic pancreatitis are at risk of developing diabetes, earlier diagnosis with subsequent multi-disciplinary input has the potential to improve clinical outcomes. Methods: Clinical and laboratory data of patients with chronic pancreatitis were obtained through the Northern Ireland Electronic Healthcare Record (NIECR), specialist hepatobiliary, and gastrointestinal clinics. Patients were invited to have a blood test for HbA1c. Newly diagnosed patients with diabetes were then invited to attend a dedicated Belfast City Hospital (BCH) specialist chronic pancreatitis and diabetes clinic for follow up. Results: A total of 89 chronic pancreatitis patients were identified; Male54; Female:35, mean age 52 years, range 12-90 years. Aetiology of CP included alcohol 52/89 (58%), gallstones 18/89 (20%), idiopathic 10/89 11%, 2 were genetic, 1: post ECRP, 1: IgG autoimmune, 1: medication induced, 1: lipoprotein lipase deficiency 1: mumps, 1: IVDU and 1: pancreatic divisum. No patients had pancreatic carcinoma. Mean duration of CP was nine years, range 3-30 years. 15/89 (16%) of patients underwent previous pancreatic surgery/resections. Recent mean BMI was 25.1 range 14-40 kg/m². 62/89 (70%) patients had HbA1c performed. Mean HbA1c was 42 mmol/mol, range 27-97mmol/mol, 42/62 (68%) had normal HbA1c (< 42 mmol/mol) 13/62 (21%) had pre-diabetes (42-47mmol/mol) and 7/62 (11%) had diabetes (≥ 48 mmol/mol). Conclusions: Of those that participated in the screening program around one-third of patients with CP had glycaemic control in the pre and diabetic range. Potential opportunities for improving screening rates for diabetes in this cohort could include regular yearly testing at gastrointestinal and hepatobiliary clinics.

Keywords: pancreatogenic diabetes, screening, chronic pancreatitis, trust experience

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Authors: Ali Arazeem Abdullahi, Mariam Seedat-Khan, Bamidele S. Akanni

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Background: Like the rest of the world, cancer of the breast is a life-threatening disease to Nigerian women. The utilization of mammography is however very poor among the general population. Whereas, there strong indications that women who engage in the regular screening of breast cancer using mammography are more likely to have a lower risk of developing and dying from advanced breast cancer compared to unscreened women. This study examined knowledge of breast cancer and utilization of mammography among undergraduate female students at the University of Ilorin, Nigeria. Health Belief Model (HBM) was deployed to guide the conduct of the study. Method: Self-administered questionnaire was used to collect data from 292 undergraduate female students from the faculties of Social and Management Sciences of the University. A simple random sampling technique was used to select the respondents. Data was analyzed using both descriptive and inferential statistics. Results: The study found that apart from high knowledge of breast cancer and mammography, perceived threat, perceived susceptibility and perceived seriousness of breast cancer were equally high. However, the uptake of mammography was very poor largely due to perceived barriers including being single and young and poor history of breast cancer in families (cues to action). The test of hypotheses showed that there is a weak relationship of about 6.8% between knowledge of breast cancer and utilization of mammography (p-value= 0.244) at 0.05 level of significance. However, 64.4% of the respondents were willing to utilize mammography in the future if the opportunity arises. While the study found a significant statistical relationship between the perceived benefits of mammography and its utilization among the respondents, no significant statistical association was found between the socio-demographic characteristics of the respondents and the uptake of mammography. Recommendations: Findings highlight the need for health education interventions to promote breast cancer screening and the utilization mammography, while addressing barriers to the uptake of mammography among female undergraduate students of the University of Ilorin and Nigeria in general.

Keywords: cancer of the breast, mammography, female undergraduate students, health belief model, University of Ilorin

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Authors: R. M. K. S. Chandana, A. P. D. G. Pathirana, N. Priyankarage, W. A. D. Nayananjalie, S. S. P. Silva

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Full fat soybean meal (FFSBM) has been used in many parts of the world together with solvent-extracted soybean meal (SBM) in livestock feeds. Although some local FFSBM is available, their use has not been assessed experimentally. This study was carried out to evaluate the use of local extruded FFSBM in broiler rations. Four treatment diets were formulated by incorporating locally produced FFSBM (0, 10, 20, and 30%) as a replacement for soybean meal (SBM) in a two-phase (starter and finisher) feeding program. Two hundred Hubbard F 15 day old broiler chicks were randomly assigned into four treatments with five replicates per each. Bodyweight gain (BWG), feed intakes (FI), and feed conversion ratio (FCR) were calculated for a period of 42 days. Nutrient utilization in the form of dry matter (DM), energy, nitrogen, and fat retention were estimated by the total collection method in three weeks old broilers. At the end of the experiment, carcass weight was measured, and the dressing percentage was calculated. Data were analyzed using one way analysis of variance (ANOVA) in SAS. There was no significant effect of FFSBM on feed intakes of chicks fed different diets (p > 0.05). Birds fed the control diet, and FF10 (10% FFSBM diet) gained significantly more than that of birds fed FF20 or FF30 diets (p > 0.05). In the finisher period, control birds gained more than all the other treatment birds. FCR was poorer in bird fed higher levels of FFSBM compared to the control or FF10 birds during their early life, but that was not evident in the latter part of the experiment. Treatments did not alter (p > 0.05) the retention of DM and nitrogen, but energy utilization was lowest (p < 0.05) in birds fed with 0% FFSBM, and the highest fat digestibility was observed in birds fed with 30% FFSBM diets. Thus, it can be concluded that FFSBM can be used as a substitute for SBM in broiler rations and could be incorporated up to 10% of the diet safely with no adverse effects on broiler performances.

Keywords: body weight, broiler, digestibility, full fat soybean meal, soybean meal

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Authors: Said Abdirasak Abidrahman, Ibrahim Mohamed

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Background: Urinary Tract Infections (UTIs) are the commonest infections described among diabetes mellitus patients. More often, empirical antimicrobial therapy is initiated before the laboratory results are made available with minimal treatment success. The knowledge of the etiology and antibiotic susceptibility patterns of the organisms causing urinary tract infections among diabetes mellitus patients remains scarce, despite its vitality. This study sought to determine the prevalence, bacteria species, and drug susceptibility patterns of common causes of urinary tract infections among diabetes mellitus patients attending Bosaso health centers. Materials and methods: We conducted a cross-sectional study involving adult diabetic patients at Bosaso health centers between the months of May and July 2020. Laboratory assay of mid-stream urine samples was done to isolate bacteria causes of UTIs. These were biochemically identified using Gram stain, Kligler iron agar (KIA), Indole test, citrate, urea, coagulase, catalase, motility agar, and lysine iron agar. Their antibiotic susceptibility pattern for the isolated organisms was made for Ampicillin 10μg, Ciprofloxacin 5μg, Cotrimoxazole 25μg, Gentamycin 10μg, Ceftriaxone 10μg, and determined using the Kirby Bauer Disc Diffusion method. Results: Of 177 participants, 69 (39.0%) were males and 108 (61.0%) were females. Their mean age was 33.1 years (range; 18-67 years). Of these, 14.7% (26/177) of the samples revealed significant growth (>= 105 CFU/mL) giving a prevalence of 14.9 % (95% CI: 10.6 to 16.3). The organisms isolated were Escherichia coli -50% (N=13), Klebsiella pneumonia 30.8% (N=8), Staphylococcus aureus 15.4% (N=4), and unidentified organism 3.8% (N=1), and these were associated with such socio-demographic factors like history of catheterization and sexual activity. Antibiotic susceptibility to the commonly used agents for treating UTIs indicated higher sensitivity to Gentamicin and Ceftriaxone.

Keywords: antimicrobials, bacteria, urinary tract infections, diabetes

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Authors: Monique Palma, Isabel Amaral

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This paper aims at mapping medical places in Oporto in the twentieth century in order to bring the urban history of medicine and healthcare in Portugal to a large audience, using Oporto as a case study. This analysis is consistent with the SDS's 2030 goals for policy guidance for heritage and development actors. As a result, it is critical to begin this research in order to place on the political agenda the preservation of Portuguese culture's history, memory, and heritage, particularly the medical culture, which is one of the most important drivers of civilizational development. To understand the evolution of medical care in urban history, we will conduct archive research (manuals, treatises, reports, periodic journals, newspapers, etc.) and interviews with key actors from medical institutions and medical museums. The findings of this study will be used to develop medical itineraries for inclusion in touristic agendas in Portugal and abroad, to include Portuguese medicine in global roadmaps, and to promote the preservation of the most iconic places of health care and medical heritage, as well as tools to promote social cohesion, dialogue among people, and "sense of place" globally.

Keywords: medical itineraries, history of medicine, urban history, Oporto

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Authors: Joyce Fernandez

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This study examined the effects of critical incident stress debriefing and other related interventions on the psychological recovery of earthquake survivors. It is a mixed experimental and qualitative study using post-test only control group design and focus group discussion. After the conduct of critical incident stress debriefing activities and other related interventions in the form of counseling and psychiatric treatment to the survivors of a 6.9 magnitude earthquake, a post-test measuring the level of psychological recovery was given to randomized participants categorized as intervention and control groups. Using the traumatic assessment and belief scale as instrument for the quantitative aspect in order to gauge recovery in the psychological need areas of safety, trust, esteem, intimacy and control, the findings are the following: Intervention group participants have relatively better adjustment along the five psychological need areas compared to the control group participants; there is no significant difference in the psychological recovery among female and male participants of the invention and control groups and; there are significant differences between intervention and control groups in the psychological need areas of self-safety, self-trust, other-trust, self-esteem, and self-intimacy. Using a guided interview for the qualitative data, the themes derived are the following. Safety: The world is an unsafe place to live because of the calamities. Trust: Trust and dependence are anchored on the family. Esteem: Participants are having confused self-worth. Intimacy: Participants are thriving on attachment with their family. Control: Participants have unaltered desire to help but feeling restricted because of personal and logistical concerns.As an outcome of the study a Psychosocial Care Program for Individuals, Families and Communities Affected by Disaster and Trauma was proposed.

Keywords: critical incident stress debriefing, earthquake survivors, psychological recovery, related interventions

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Authors: Stephens Oluyemi Adetunji, Nel Norma Margaret, Krogs Sozein

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There has been a shift in the role of sports from being a form of entertainment and relaxation to becoming a huge business concern and high money spinning venture. This shift has placed a greater demand on sport coaches as regards expectations for high performance from investors as well as other stake holders. The responsibility of sports coaches in ensuring high performance of sports men and women has become increasingly more demanding from both spectators and sports organisers. Coaches are leaders who should possess soft skills such as emotional intelligence aside from employing skills and drills to ensure high performance of athletes. This study is, therefore, designed to determine the emotional intelligence of sports coaches in South Africa. An assessment of the emotional intelligence of sports coaches would enable the researchers to identify those who have low emotional intelligence and to design an intervention program that could improve their emotional intelligence. This study will adopt the pragmatic world view of research using the mixed methods research design of the quantitative and qualitative approach. The non-probability sampling technique will be used to select fifty sports coaches for the quantitative study while fifteen sports coaches will be purposively selected for the qualitative study. One research question which seeks to ascertain the level of emotional intelligence of sports coaches will be raised to guide this study. In addition, two research hypotheses stating that there will be no significant difference in the level of emotional intelligence of sports coaches on the basis of gender and type of sports will be formulated and statistically analysed at 0.05 level of significance. For the quantitative study, an emotional intelligence test will be used to measure the emotional intelligence of sport coaches. Focus group interviews and open ended questions will be used to obtain the qualitative data. Quantitative data obtained will be statistically analysed using the SPSS version 22.0 while the qualitative data will be analysed using atlas ti. Based on the findings of this study, recommendations will be made.

Keywords: emotional intelligence, high performance, sports coaches, South Africa

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