Search results for: socio-cultural background of Nepalese students

Authors: Minwuyelet Maru, Solomon Habtemariam, Endalamaw Gadissa, Abraham Aseffa

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Background: Tuberculosis is a major public health problem in Ethiopia. The burden of TB is aggravated by emergence and expansion of drug resistant tuberculosis and different lineages of Mycobacterium tuberculosis (M. tuberculosis) have been reported in many parts of the country. Describing strains of Mycobacterial isolates and drug susceptibility pattern is necessary. Method: Sputum samples were collected from smear positive pulmonary TB patients age >= 7 years between October 1, 2012 to September 30, 2013 and Mycobacterial strains isolated on Loweensten Jensen (LJ) media. Each strain was characterized by deletion typing and Spoligotyping. Drug sensitivity testing was determined with the indirect proportion method using Middle brook 7H10 media and association to determine possible risk factors to drug resistance was done. Result: A total of 144 smear positive pulmonary tuberculosis patients were enrolled. The age of participants ranged from 7 to 78 with mean age of 29.22 (±10.77) years. In this study 82.2% (n=97) of the isolates were sensitive to the four first line anti-tuberculosis drugs and resistance to any of the four drugs tested was 17.8% (n=21). A high frequency of any resistance was observed in isoniazid, 13.6%, (n=16) followed by streptomycin, 11.8% (n=14). No significant association of isoniazid resistance with HIV, sex and history of previous TB treatment was observed but there was significant association with age, high between 31-35 years of age (p=0.01). Majority, 89.9% (n=128) of participants were new cases and only 11.1% (n=16) had history of previous TB treatment. No MDR-TB from new cases and 2 MDRTB (13.3%) was isolated from re-treatment cases which was significantly associated with previous TB treatment (p<0.01). Thirty two different types of spoligotype patterns were identified and 74.1% were grouped in to 13 clusters. The dominant strains were SIT 25, 18.1% (n=21), SIT 53, 17.2% (n=20) and SIT 149, 8.6% (n=10). Lineage 4 is the predominant lineage followed by lineage 3 and lineage 7 comprising 65.5% (n=76), 28.4% (n=33) and 6% (n=7) respectively. Majority of strains from lineage 3 and 4 were SIT 25 (63.6%) and SIT 53 (26.3%) whereas SIT 343 was the dominant strain from lineage 7 (71.4%). Conclusion: Wide spread of lineage 3 and lineage 4 of the modern lineage and high number of strain cluster indicates high ongoing transmission. The high proportion resistance to any of the first line anti-tuberculosis drugs may be a potential source in the emergence of MDR-TB. Wide spread of SIT 25 and SIT 53 having a tendency of ease transmission and presence of higher resistance of isoniazid in working and mobile age group, 31-35 years of age may increase risk of drug resistant strains transmission.

Keywords: tuberculosis, drug susceptibility, strain diversity, lineage, Ethiopia, spoligotyping

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Authors: Bibiana Hlebova

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The Slovak Republic is a democratic and plural society consisting of people differing in language and culture, and its citizens should already be well prepared for the coexistence of multiple nations, nationalities or ethnic groups. Reflection on culture, art and literature of the Roma minority has taken on a new dimension in Slovakia in the past two decades when it comes to social, cultural and arts integration of this ethnic group with the plural society. Non-Roma view Roma as a specific ethnic group with their own culture, language, customs and traditions, social norms and coexistence that has retained archetypal qualities of Roma identity (romipen) in their real lives as well as in the literary world. Roma characters in works of art are specific and distinguishable from other literary characters simply by being Roma, that is, of a different origin and social status, they represent a different way of life, a distinctive hierarchy of values. The portrayal of Roma and the life of Roma ethnic group in the most dominant genre of Roma literature for children and youth, a Roma fairy tale (paramisi), can work as a suitable means to learn about, accept and tolerate the otherness of Roma in the conditions of school inclusion of students coming from the Roma ethnic group, and to support their identification with their own ethnic group and its cultural traditions. The paper aims to point out not only the specific nature of Roma identity (romipen) through the selected Roma fairy tale (paramisa) – Children of the Sun, but also the diversity of its uses in the educational process within primary education of pupils at elementary schools, advocating the philosophy of inclusive education. Through the suggestions of multi-cultural, emotional, and language and communication education of pupils through the work with the selected Roma fairy tale (paramisa), the author is exploring ways to overcome the issues stemming from the coexistence of Roma and Non-Roma pupils, which are burdened with prejudice, intolerance, aggression and racism on both sides, in the education process.

Keywords: inclusive education, otherness, Roma, Roma fairy tale, Roma identity

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Authors: Choon Seong Ng, P. Petrick, C. L. Lau

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Background: Carbapenem-resistant isolates have been increasingly reported recently. Carbapenem stewardship is designed to optimize its usage particularly among medical wards with high prevalence of carbapenem prescriptions to combat such emerging resistance. Carbapenem stewardship programmes (CSP) can reduce antibiotic use but clinical outcome of such measures needs further evaluation. We examined this in a prospective manner using feedback mechanism. Methods: Our single-center prospective cohort study involved all carbapenem prescriptions across the medical wards (including medical patients admitted to intensive care unit) in a tertiary university hospital setting. The impact of such stewardship was analysed according to the accepted and the rejected groups. The primary endpoint was safety. Safety measure applied in this study was the death at 1 month. Secondary endpoints included length of hospitalisation and readmission. Results: Over the 19 months’ period, input from 144 carbapenem prescriptions was analysed on the basis of acceptance of our CSP recommendations on the use of carbapenems. Recommendations made were as follows : de-escalation of carbapenem; stopping the carbapenem; use for a short duration of 5-7 days; required prolonged duration in the case of carbapenem-sensitive Extended Spectrum Beta-Lactamases bacteremia; dose adjustment; and surgical intervention for removal of septic foci. De-escalation, shorten duration of carbapenem and carbapenem cessation comprised 79% of the recommendations. Acceptance rate was 57%. Those who accepted CSP recommendations had no increase in mortality (p = 0.92), had a shorter length of hospital stay (LOS) and had cost-saving. Infection-related deaths were found to be higher among those in the rejected group. Moreover, three rejected cases (6%) among all non-indicated cases (n = 50) were found to have developed carbapenem-resistant isolates. Lastly, Pitt’s bacteremia score appeared to be a key element affecting the carbapenem prescription’s behaviour in this trial. Conclusions: Carbapenem stewardship program in the medical wards not only saves money, but most importantly it is safe and does not harm the patients with added benefits of reducing the length of hospital stay. However, more time is needed to engage the primary clinical teams by formal clinical presentation and immediate personal feedback by senior Infectious Disease (ID) personnel to increase its acceptance.

Keywords: audit and feedback, carbapenem stewardship, medical wards, university hospital

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Authors: Pei-Chen Wu

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Both preexisting cross-sectional and longitudinal studies of personality-depression relationship have suffered from one main limitation: they ignored the stability of the construct of interest (e.g., personality and depression) can be expected to influence the estimate of the association between personality and depression. To address this limitation, the Trait-State-Occasion (TSO) modeling was adopted to analyze the sources of variance of the focused constructs. A TSO modeling was operated by partitioning a state variance into time-invariant (trait) and time-variant (occasion) components. Within a TSO framework, it is possible to predict change on the part of construct that really changes (i.e., time-variant variance), when controlling the trait variances. 750 high school students were followed for 4 waves over six-month intervals. The baseline data (T1) were collected from the senior high schools (aged 14 to 15 years). Participants were given Beck Depression Inventory and Big Five Inventory at each assessment. TSO modeling revealed that 70~78% of the variance in personality (five constructs) was stable over follow-up period; however, 57~61% of the variance in depression was stable. For personality construct, there were 7.6% to 8.4% of the total variance from the autoregressive occasion factors; for depression construct there were 15.2% to 18.1% of the total variance from the autoregressive occasion factors. Additionally, results showed that when controlling initial symptom severity, the time-invariant components of all five dimensions of personality were predictive of change in depression (Extraversion: B= .32, Openness: B = -.21, Agreeableness: B = -.27, Conscientious: B = -.36, Neuroticism: B = .39). Because five dimensions of personality shared some variance, the models in which all five dimensions of personality were simultaneous to predict change in depression were investigated. The time-invariant components of five dimensions were still significant predictors for change in depression (Extraversion: B = .30, Openness: B = -.24, Agreeableness: B = -.28, Conscientious: B = -.35, Neuroticism: B = .42). In sum, the majority of the variability of personality was stable over 2 years. Individuals with the greater tendency of Extraversion and Neuroticism have higher degrees of depression; individuals with the greater tendency of Openness, Agreeableness and Conscientious have lower degrees of depression.

Keywords: assessment, depression, personality, trait-state-occasion model

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Authors: Man Wai Lei, Charles Mark Zaroff

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Objective: A majority of studies suggest that people with Autism Spectrum Disorder (ASD) have multisensory integration deficits. However, normal and even supranormal multisensory integration abilities have also been reported. Additionally, little of this work has been undertaken utilizing a dimensional conceptualization of ASD; i.e., a broader autism phenotype. Utilizing methodology that controls for common potential confounds, the current study aimed to examine if deficits in multisensory integration are associated with ASD traits in a non-clinical population. The contribution of affective versus non-affective components of sensory hypersensitivity to multisensory integration was also examined. Methods: Participants were 147 undergraduate university students in Macau, a Special Administrative Region of China, of Chinese ethnicity, aged 16 to 21 (Mean age = 19.13; SD = 1.07). Participants completed the Autism-Spectrum Quotient, the Sensory Perception Quotient, and the Adolescent/Adult Sensory Profile, in order to measure ASD traits, non-affective, and affective aspects of sensory/perceptual hypersensitivity, respectively. In order to explore multisensory integration across visual and haptic domains, participants were asked to judge which one of two equally weighted, but different sized cylinders was heavier, as a means of detecting the presence of the size-weight illusion (SWI). Results: ASD trait level was significantly and negatively correlated with susceptibility to the SWI (p < 0.05); this correlation was not associated with either accuracy in weight discrimination or gender. Examining the top decile of the non-normally distributed SWI scores revealed a significant negative association with sensation avoiding, but not other aspects of effective or non-effective sensory hypersensitivity. Conclusion and Implications: Within the normal population, a greater degree of ASD traits is associated with a lower likelihood of multisensory integration; echoing was often found in individuals with a clinical diagnosis of ASD, and providing further evidence for the dimensional nature of this disorder. This tendency appears to be associated with dysphoric emotional reactions to sensory input.

Keywords: Autism Spectrum Disorder, dimensional, multisensory integration, size-weight illusion

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Authors: Pranee Suecharoen, Ratchadaporn Soontornpas, Jaturat Kanpittaya

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Background: Contrast media has an important role for disease diagnosis through detection of pathologies. Contrast media can, however, cause adverse reactions after administration of its agents. Although non-ionic contrast media are commonly used, the incidence of adverse events is relatively low. The most common reactions found (10.5%) were mild and manageable and/or preventable. Pharmacists can play an important role in evaluating adverse reactions, including awareness of the specific preparation and the type of adverse reaction. As most common types of adverse reactions are idiosyncratic or pseudo-allergic reactions, common standards need to be established to prevent and control adverse reactions promptly and effectively. Objective: To measure the effect of using tools for symptom evaluation in order to reduce the severity, or prevent the occurrence, of adverse reactions from contrast media. Methods: Retrospective review descriptive research with data collected on adverse reactions assessment and Naranjo’s algorithm between June 2015 and May 2016. Results: 158 patients (10.53%) had adverse reactions. Of the 1,500 participants with an adverse event evaluation, 137 (9.13%) had a mild adverse reaction, including hives, nausea, vomiting, dizziness, and headache. These types of symptoms can be treated (i.e., with antihistamines, anti-emetics) and the patient recovers completely within one day. The group with moderate adverse reactions, numbering 18 cases (1.2%), had hypertension or hypotension, and shortness of breath. Severe adverse reactions numbered 3 cases (0.2%) and included swelling of the larynx, cardiac arrest, and loss of consciousness, requiring immediate treatment. No other complications under close medical supervision were recorded (i.e., corticosteroids use, epinephrine, dopamine, atropine, or life-saving devices). Using the guideline, therapies are divided into general and specific and are performed according to the severity, risk factors and ingestion of contrast media agents. Patients who have high-risk factors were screened and treated (i.e., prophylactic premedication) for prevention of severe adverse reactions, especially those with renal failure. Thus, awareness for the need for prescreening of different risk factors is necessary for early recognition and prompt treatment. Conclusion: Studying adverse reactions can be used to develop a model for reducing the level of severity and setting a guideline for a standardized, multidisciplinary approach to adverse reactions.

Keywords: role of pharmacist, management of adverse reactions, guideline for contrast media, non-ionic contrast media

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Authors: Miguel Limbert Ramos, Joseph Amado Galvez

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

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

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Authors: Wafa Al Jabri

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Background: In Middle Eastern Islamic Countries (MEICs), there is a high prevalence of genetic blood disorders (GBDs), particularly sickle cell disease and thalassemia. The GBDs are considered a major public health concern, especially with the increase in affected populations along with the associated psychological, social, and financial cost of management. Despite the availability of premarital screening services (PSS) that aim to identify the asymptomatic carriers of GBDs and provide genetic counseling to couples in order toreduce the prevalence of these diseases; yet, the success rate of PSS is very low due to religious and socio-cultural concerns. Purpose: This paper aims to highlight the factors that affect the success of PSS in MEICs. Methods: A literature review of articles located in CINAHL, PubMed, SCOPUS, and MedLinewas carried out using the following terms: “premarital screening,” “success,” “effectiveness,” and “ genetic blood disorders.” Second, a hand search of the reference lists and Google searches were conducted to find studies that did not exist in the primary database searches. Only studies which are conducted in MEICs countries and published in the last five years were included. Studies that were not published in English were excluded. Results: Fourteen articles were included in the review. The results showed that PSS in most of the MEICs was successful in achieving its objective of identifying high-risk marriages; however, the service failed to meetitsultimate goal of reducing the prevalence of GBDs. Various factors seem to hinder the success of PSS, including poor public awareness, late timing of the screening, culture and social stigma, religious beliefs, availability of prenatal diagnosis and therapeutic abortion, emotional factors, and availability of genetic counseling services. However, poor public awareness, late timing of the screening, and unavailability of adequate counseling services were the most common barriers identified. Conclusion: Overcoming the identified barriers by providing effective health education programs, offering the screening test to young adults at an earlier stage, and tailoring the genetic counseling would be crucial steps to provide a framework for an effective PSS in MEICs.

Keywords: premarital screening, success, effectiveness, and genetic blood disorders

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Authors: Karen Boaz, C. R. Charan

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Background: The infiltration of tumour stroma by eosinophils, Tumor-Associated Tissue Eosinophilia (TATE), is known to modulate the progression of Oral Squamous Cell Carcinoma (OSCC). Eosinophils have direct tumoricidal activity by release of cytotoxic proteins and indirectly they enhance permeability into tumor cells enabling penetration of tumoricidal cytokines. Also, eosinophils may promote tumor angiogenesis by production of several angiogenic factors. Identification of eosinophils in the inflammatory stroma has been proven to be an important prognosticator in cancers of mouth, oesophagus, larynx, pharynx, breast, lung, and intestine. Therefore, the study aimed to correlate TATE with clinical and histopathological variables, and blood eosinophil count to assess the role of TATE as a prognosticator in Oral Squamous Cell Carcinoma (OSCC). Methods: Seventy two biopsy-proven cases of OSCC formed the study cohort. Blood eosinophil counts and TNM stage were obtained from the medical records. Tissue sections (5µm thick) were stained with Haematoxylin and Eosin. The eosinophils were quantified at invasive tumour front (ITF) in 10HPF (40x magnification) with an ocular grid. Bryne’s grading of ITF was also performed. A subset of thirty cases was also assessed for association of TATE with recurrence, involvement of lymph nodes and surgical margins. Results: 1) No statistically significant correlation was found between TATE and TNM stage, blood eosinophil counts and most parameters of Bryne’s grading system. 2) Statistically significant relation of intense degree of TATE was associated with the absence of distant metastasis, increased lympho-plasmacytic response and increased survival (diseasefree and overall) of OSCC patients. 3) In the subset of 30 cases, tissue eosinophil counts were higher in cases with lymph node involvement, decreased survival, without margin involvement and in cases that did not recur. Conclusion: While the role of eosinophils in mediating immune responses seems ambiguous as eosinophils support cell-mediated tumour immunity in early stages while inhibiting the same in advanced stages, TATE may be used as a surrogate marker for determination of prognosis in oral squamous cell carcinoma.

Keywords: tumour-associated tissue eosinophilia, oral squamous cell carcinoma, prognosticator, tumoral immunity

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Authors: Navid P Roodaki, Rochelle Abila, Daisy Evangeline Garcia

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Background and Objective: Respiratory Distress Syndrome (RDS) among premature infants is a major causes of neonatal death. The use of Continuous Positive Airway Pressure (CPAP) has become a standard of care for preterm newborns with RDS hence cost-effective innovations are needed. This study compared a novel low-cost Bubble CPAP (bCPAP) device to ventilator driven CPAP in the treatment of RDS. Methods: This is a single-blind, randomized controlled trial done on May 2022 to October 2022 in a Level III Neonatal Intensive Care Unit in the Philippines. Preterm newborns (<36 weeks) with RDS were randomized to receive Vayu bCPAP device or Ventilator-derived CPAP. Arterial Blood Gases, Oxygen Saturation, administration of surfactant, and CPAP failure rates were measured. Results: Seventy preterm newborns were included. No differences were observed between the Ventilator driven CPAP and Vayu bCPAP on the PaO2 (97.51mmHg vs 97.37mmHg), So2 (97.08% vs 95.60%) levels, amount of surfactant administered between groups. There were no observed differences in CPAP failure rates between Vayu bPCAP (x̄ 3.23 days) and ventilator-driven CPAP (x̄ 2.98 days). However, a significant difference was noted on the CO2 level (40.32mmHg vs 50.70mmHg), which was higher among those hooked to Ventilator-driven CPAP (p 0.004). Conclusion: This study has shown that the novel low-cost bubble CPAP (Vayu bCPAP) can be used as an efficacious alternate non invasive oxygen therapy among preterm neonates with RDS, although the CO2 levels were higher among those hooked to ventilator driven CPAP, other outcome parameters measured showed that both devices are comparable. Recommendation: A multi-center or national study to account for geographic region, which may alter the outcomes of patients connected to different ventilatory support. Cost comparison between devices is also suggested. A mixed-method research assessing the experiences of health care professionals in assembling and utilizing the gadget is a second consideration.

Keywords: bubble CPAP, ventilator-derived CPAP; infant, premature, respiratory distress syndrome

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Authors: Getenet Dessie, Jinhu Li, Son Nghiem, Tinh Doan

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Background: Concerns regarding malnutrition have evolved from focusing solely on single forms to addressing the simultaneous occurrence of multiple types, commonly referred to as the double or triple burden of malnutrition. Nevertheless, data concerning the concurrent occurrence of various types of malnutrition are scarce. Therefore, this systematic review and meta-analysis aims to assess the pooled prevalence of the double burden of malnutrition among children under five in Sub-Saharan Africa and other least-developed countries (LDCs). Methods: Electronic, web-based searches were conducted from January 15 to June 28, 2023, across several databases, including PubMed, Embase, Google Scholar, and the World Health Organization's Hinari portal, as well as other search engines, to identify primary studies published up to June 28, 2023. Laboratory-based cross-sectional studies on children under the age of five were included. Two independent authors assessed the risk of bias and the quality of the identified articles. The primary outcomes of this study were micronutrient deficiencies and the comorbidity of stunting and anemia, as well as wasting and anemia. The random-effects model was utilized for analysis. The association of identified variables with the various forms of malnutrition was also assessed using adjusted odds ratios (AOR) with a 95% confidence interval (CI). This review was registered in PROSPERO with the reference number CRD42023409483. Findings: The electronic search generated 6,087 articles, 93 of which matched the inclusion criteria for the final meta-analysis. Micronutrient deficiencies were prevalent among children under five in Sub-Saharan Africa and other LDCs, with rates ranging from 16.63% among 25,169 participants for vitamin A deficiency to 50.90% among 3,936 participants for iodine deficiency. Iron deficiency anemia affected 20.56% of the 63,121 participants. The combined prevalence of wasting anemia and stunting anemia was 5.41% among 64,709 participants and 19.98% among 66,016 participants, respectively. Both stunting and vitamin A supplementation were associated with vitamin A and iron deficiencies, with adjusted odds ratios (AOR) of 1.54 (95% CI: 1.01, 2.37) and 1.37 (95% CI: 1.21, 1.55), respectively. Interpretation: The prevalence of the double burden of malnutrition among children under the age of five was notably high in Sub-Saharan Africa and other LDCs. These findings indicate a need for increased attention and a focus on understanding the factors influencing this double burden of malnutrition.

Keywords: children, Sub-Saharan Africa, least developed countries, double burden of malnutrition, systematic review, meta-analysis

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Authors: Divya Kanchibhotla

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Of all the major health threats to emerge, none has challenged the very foundation of public health so profoundly as the rise of non-communicable diseases (NCD). Encouraging a holistic health approach encompasses the community’s well-being. Competent public health grounded with holistic health approach can lay a better foundation in the modern world. Yoga has been increasingly explored as an adjunct therapy to major disorders. This study explores the efficacy of Yoga as a tool for public health. A survey was administered to 5500 adults, and 300 teens were selected from 25 states of India. The study explored the differences in health, happiness, and sustainable living between Yoga-practitioners and Non-yoga practitioners. The study also explored the practice and habits of yoga practitioners (frequency, place, reasons to practice) and Health, Happiness, and Sustainable Living. The subjects were grouped based on age, education, experience in yoga (years of practice), and occupational background. The study population comprised of 54% males and 46% females. Majority of the respondents (59%) were from 18 to 30 years age group. The study indicated that 96.4% of the total respondents have heard of Yoga. However, only 46.8% of the total study population practice yoga (YP) and the rest 53.2% were non-practitioners (NP). From a perspective of how Yoga and health, 72.7% yoga practitioners asserted a peaceful and happy life, 71.9% yoga practitioners felt satisfaction in life, and 70.2 % yoga practitioners had satisfactory health. 61.9% of yoga practitioners report being vegetarian, not eating junk food, and not drinking alcohol than 38.1% Non-Practitioners population. 47% of yoga practitioners found themselves to be more sensitive to the environment compared to only 40% of non-practitioners. India has been witnessing an unprecedented rise in the NCDs, accounting for 61% deaths. The importance of yoga as an adjunct therapy for various disorders and diseases is gaining momentum across the globe. There are various studies on yoga that have indicated benefits of yoga as a unique holistic approach towards lifestyle and a consistent, complementary solution that could be adopted for long-term viability for a well being. The comprehensive study is the first of its kind that takes a holistic look at the prevalence of Yoga for public health in India. Our study is unique and stands out as it is detailed in its outlook with extensive coverage of almost the whole country (surveying 25 out of 29 states) and contemplates on the benefits to an individual at the grass-root level – physical, mental and social outlook. The insights from the study will enable the health care systems and grassroots organizations to make the holistic practice of Yoga accessible to spread sustainable living for a healthy community.

Keywords: non-communicable disease (NCD), sustainable development goal (SDG 3), public health, healthy living

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Authors: Tarek K. Jalouta, Jolietta R. Holliman, Kathryn R. Burke, Kathleen M. Bewley-Thomas

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Background: Chronic hepatitis C virus (HCV) infection is one of the leading causes of liver cirrhosis and hepatocellular carcinoma. In the United States, HCV screening awareness, treatment, and linkage to care are under continues ascending progress. However, still millions of people are asymptomatically infected and undiagnosed yet. Through this community mission, we sought to identify the best and the newest strategies to identify those infected people to educate them, link them to care and cure them. Methods: We have identified patients that did not have a prior HCV screening in our Electronic medical record (EMR) including all our different hospital locations (South Suburban Chicago, Northern, Western and Central Indiana). Providing education to all Primary care/Gastroenterology/Infectious diseases providers and staff in the clinic to increase awareness of the HCV screening. Health-related quality of life, chronic clinical complications, and demographics data were collected for each patient. All outcomes of HCV antibody-reactive and HCV RNA–positive results were identified and statistically analyzed. Results: From July 2016 to July 2018 we screened 35,720 individuals of birth cohort in our different Franciscan’s health medical centers. Of the screened population, 986 (2.7%) individuals were HCV AB-reactive. Of those, 319 (1%) patients were HCV RNA-positive, and 264 patients were counseled and linked to providers. 34 patients initiated anti-HCV therapy with successful treatment. Conclusions: Our HCV screening augmentation project considered the largest screening program in the Midwest. Augmenting the HCV screening process through creating a Best Practice Alert (BPA) in the EMR (Epic Sys.) and point of care testing could be helpful. Although continued work is required, our team is working on increase screening through adding HCV test to CBC-Panels in Emergency Department settings, phone calls to all birth cohort individuals through Robo-Calling System aimed to reach 75,000 individuals by 2019. However, a better linkage to care and referral monitoring system to all HCV RNA positive patients is still needed, and access to therapy, especially for uninsured patients, is challenging.

Keywords: chronic hepatitis C, chronic hepatitis C treatment, chronic hepatitis C screening, chronic hepatitis C prevention, liver cancer

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Authors: Amina El-Warari, Agata Vitale, Laura Caulfield, Jennifer Kinloch

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Background: Unemployment levels among refugees in the UK are much higher than voluntary migrants and UK-born citizens. The lack of employment and/or of suitable employment has detrimental consequences on refugees’ ability to integrate and become active citizens in the host country. Research indicates that, when individuals are forced to migrate, one of the most significant aspects to building their identity is their previous profession; this particularly applies to qualified refugees. Despite this, there is little support available to them. The current study is set in this context and aims to explore highly qualified refugees’ employment-related experiences in the UK as well as their suggestions on how to develop specific interventions that can support them in finding suitable employment. Methods: A qualitative study design was employed. Qualitative methods are in fact well suited to research with refugees, as they allow them to give their direct opinion, rather than this being filtered by stakeholders. Listening to ‘the refugee’s voice’ means developing ‘a refugee centered perspective’ where the diverse narratives told by participants are organized to tell their direct collective story. A total of 12 refugees, attending a non-profit refugee organization in the south-west of England, took part in the study. The selection criteria were being over 18, having a level of English that allows them to sustain a conversation, and having a University degree and/or professional qualification. All participants were interviewed individually; the data were transcribed and analyzed thematically. Findings: Participants had very little support in finding suitable employment; this often only consisted of a few sessions in their local job centers and English tutorials. They indicated that being unemployed/underemployed negatively affected their sense of identity, their acculturative stress, and their in-group/ out-group relations. They suggested that specific employment interventions for qualified refugees should be delivered to them individually in order to address their specific needs. Furthermore, most participants suggested that these interventions should support them in volunteering in organizations that match their skills/ qualifications. They also indicated that the employment interventions should support them in having their qualifications recognized in the UK as well as building links with universities/ centers where they can receive adequate training on how to understand and adapt to the employments needs in the UK. Conclusions: These findings will provide the basis for the second stage of the research where specific employment interventions will be designed and tested with highly qualified refugees. In addition, these findings shed light refugee integration policy.

Keywords: employment interventions, identity, integration, qualified refugees

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Authors: Jakub Marek, Marie Vagnerova, Ladislav Csemy

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Background: The length of time spent on the street influences the degree of adjustment to homelessness. Over the years spent sleeping rough, homeless people gradually lose the ability to control their lives and their return to mainstream society becomes less and less likely. Goals: The aim of the study was to discover whether and how men who have been sleeping rough for more than ten years differ from those who have been homeless for four years or less. Methods: The research was based on a narrative analysis of in-depth interviews focused on the respondent’s entire life story, i.e. their childhood, adolescence, and the period of adulthood preceding homelessness. It also asked the respondents about how they envisaged the future. The group under examination comprised 51 homeless men aged 37 – 54. The first subgroup contained 29 men who have been sleeping rough for 10 – 21 years, the second group contained 22 men who have been homeless for four years or less. Results: Men who have been sleeping rough for more than ten years had problems adapting as children. They grew up in a problematic family or in an institution and acquired only a rudimentary education. From the start they had problems at work, found it difficult to apply themselves, and found it difficult to hold down a job. They tend to have high-risk personality traits and often a personality disorder. Early in life they had problems with alcohol or drugs and their relationships were unsuccessful. If they have children, they do not look after them. They are reckless even in respect of the law and often commit crime. They usually ended up on the street in their thirties. Most of this subgroup of homeless people lack motivation and the will to make any fundamental change to their lives. They identify with the homeless community and have no other contacts. Men who have been sleeping rough for four years or less form two subgroups. There are those who had a normal childhood, attended school and found work. They started a family but began to drink, and as a consequence lost their family and their job. Such men end up on the street between the ages of 35 and 40. And then there are men who become homeless after the age of 40 because of an inability to cope with a difficult situation, e.g. divorce or indebtedness. They are not substance abusers and do not have a criminal record. Such people can be offered effective assistance to return to mainstream society by the social services because they have not yet fully self-identified with the homeless community and most of them have retained the necessary abilities and skills. Conclusion: The length of time a person has been homeless is an important factor in respect of social prevention. It is clear that the longer a person is homeless, the worse are their chances of being reintegrated into mainstream society.

Keywords: risk factors, homelessness, chronicity, narrative analysis

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Authors: Stella Laletas, Andrea Reupert, Melinda Goodyear, Bradley Morgan

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Background: Many people with a mental illness have young children. Research has shown that early childhood is a particularly vulnerable time for children whose parents have a mental illness. Moreover, repeated research has demonstrated the effectiveness of a multiagency approach to family focused practice for improving parental functioning and preventing adverse outcomes in children whose parents have a mental illness, particularly in the early years of a child’s life. However, there is a paucity of professional development resources for professionals who work with families where a parent has a mental illness and has young children. Significance of the study: This study will make a contribution to addressing knowledge gaps around resource development and workforce needs for early childhood and mental health professionals working with young children where a parent has a mental illness. Objective: This presentation describes a newly developed resource, 'Pathways of Care', specifically designed for early childhood educators and mental health workers, alongside pilot evaluation data regarding its effectiveness. ‘Pathways of Care’ aims to promote collaborative practice and present early identification and referral processes for workers in this sector. The resource was developed by the Children of Parents with a Mental Illness (COPMI) National Initiative which is funded by the Australian Government. Method: Using a mixed method design, the effectiveness of the training resource is also presented. Fifteen workers completed the Family Focus Mental Health Practice Questionnaire pre and post using the resource, to measure confidence and practice change; semi-structured interviews were also conducted with eight of these same workers to further explore the utility of the resource. Findings: The findings indicated the resource was effective in increasing knowledge and confidence, particularly for new and/or inexperienced staff. Examples of how the resource was used in practice by various professions emerged from the interview data. Conclusions: Collaborative practice, early identification and intervention in early childhood can potentially play a key role in altering the life trajectory of children who are at risk. This information has important implications for workforce development and staff training in both the early childhood and mental health sectors. Implications for policy and future research are discussed.

Keywords: parents with mental ilnesses, early intervention, evaluation, preschool children

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Authors: Christine Demaecker

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Many researchers have underlined the importance of metaphors in specialised language. Their use of specific domains helps us understand the conceptualisations used to communicate new ideas or difficult topics. Within the wide area of specialised discourse, wine tasting is a very specific example because it is almost exclusively metaphoric. Wine tasting metaphors express various conceptualisations. They are not linguistic but rather conceptual, as defined by Lakoff & Johnson. They correspond to the linguistic expression of a mental projection from a well-known or more concrete source domain onto the target domain, which is the taste of wine. But unlike most specialised terminologies, the vocabulary is never clearly defined. When metaphorical terms are listed in dictionaries, their definitions remain vague, unclear, and circular. They cannot be replaced by literal linguistic expressions. This makes it impossible to transfer them into another language with the traditional linguistic translation methods. Qualitative research investigates whether wine tasting metaphors could rather be translated with the cognitive translation process, as well described by Nili Mandelblit (1995). The research is based on a corpus compiled from two high-profile wine guides; the Parker’s Wine Buyer’s Guide and its translation into French and the Guide Hachette des Vins and its translation into English. In this small corpus with a total of 68,826 words, 170 metaphoric expressions have been identified in the original English text and 180 in the original French text. They have been selected with the MIPVU Metaphor Identification Procedure developed at the Vrije Universiteit Amsterdam. The selection demonstrates that both languages use the same set of conceptualisations, which are often combined in wine tasting notes, creating conceptual integrations or blends. The comparison of expressions in the source and target texts also demonstrates the use of the cognitive translation approach. In accordance with the principle of relevance, the translation always uses target language conceptualisations, but compared to the original, the highlighting of the projection is often different. Also, when original metaphors are complex with a combination of conceptualisations, at least one element of the original metaphor underlies the target expression. This approach perfectly integrates into Lederer’s interpretative model of translation (2006). In this triangular model, the transfer of conceptualisation could be included at the level of ‘deverbalisation/reverbalisation’, the crucial stage of the model, where the extraction of meaning combines with the encyclopedic background to generate the target text.

Keywords: cognitive translation, conceptual integration, conceptual metaphor, interpretative model of translation, wine tasting metaphor

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Authors: Nick Woodier, Paul Sampson, Iain Moppett

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Background: For years, healthcare across the world has recognised that patients are coming to harm from the very processes meant to help them. In response, healthcare tells itself that it needs to ‘be more like aviation.’ Aviation safety is highly regarded by those in healthcare and is seen as an exemplar. Specifically, healthcare is keen to learn from how aviation uses near misses to make their industry safer. Healthcare is rife with near misses; however, there has been little progress addressing them, with most research having focused on reporting. Addressing the factors that contribute to near misses will potentially help reduce the number of significant, harm patientsafety incidents. While the healthcare literature states the need to learn from aviation’s use of near misses, there is nothing that describes how best to do this. The authors, as part of a larger study of near-miss management in healthcare, sought to learn from aviation to develop principles for how healthcare can identify, report, and learn from near misses to improve patient safety. Methods: A Grounded Theory (GT) methodology, augmented by a scoping review, was used. Data collection included interviews, field notes, and the literature. The review protocol is accessible online. The GT aimed to develop theories about how aviation, amongst other safety-critical industries, manages near misses. Results: Twelve aviation interviews contributed to the GT across passenger airlines, air traffic control, and bodies involved in policy, regulation, and investigation. The scoping review identified 83 articles across a range of safety-critical industries, but only seven focused on aviation. The GT identified that aviation interprets the term ‘near miss’ in different ways, commonly using it to specifically refer to near-miss air collisions, also known as Airproxes. Other types of near misses exist, such as health and safety, but the reporting of these and the safety climate associated with them is not as mature. Safety culture in aviation was regularly discussed, with evidence that culture varies depending on which part of the industry is being considered (e.g., civil vs. business aviation). Near misses are seen as just one part of an extensive safety management system, but processes to support their reporting and their analysis are not consistent. Their value alone is also questionable, with the challenge to long-held beliefs originating from the ‘common cause hypothesis.’ Conclusions: There is learning that healthcare can take from how parts of aviation manage and learn from near misses. For example, healthcare would benefit from a formal safety management system that currently does not exist. However, it may not be as simple as ‘healthcare should learn from aviation’ due to variation in safety maturity across the industry. Healthcare needs to clarify how to incorporate near misses into learning and whether allocating resources to them is of value; it was heard that catastrophes have led to greater improvements in safety in aviation.

Keywords: aviation safety, patient safety, near miss, safety management systems

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Authors: Bashair Al Riyami

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Background: Acylation stimulating protein (ASP) is a small basic protein that was isolated based on its function as a potent lipogenic factor. The role of ASP in lipid metabolism has been described in numerous studies. Several association studies suggest that ASP may play a prominent role in female fat metabolism and distribution. Progesterone is established as a female lipogenic hormone, however the mechanisms by which progesterone exert its effects are not fully understood. AIM: Since ASP is an established potent lipogenic factor with a known mechanism of action, in this study we aim to investigate acute effects of different hormone treatments on ASP levels in vivo after a fat load. Methods: This is a longitudinal study including 24 female wister rats that were randomly divided into 4 groups including controls (n=6). The rats were ovariectomized, and fourteen days later the fasting rats were injected subcutaneously with a single dose of different hormone treatments (progesterone, estrogen and testosterone). An hour later, olive was administered by oral gavage, and plasma blood samples were collected at several time points after oil administration for ASP and triglyceride measurements. Area under the curve (TG-AUC) was calculated to represent TG clearance Results: RM-ANCOVA and post-analysis showed that only the progesterone treated group had a significant postprandial ASP increase at two hours compared to basal levels and to the controls (439.8± 62.4 vs 253.45± 59.03 ug/ml), P= 0.04. Interestingly, increased postprandial ASP levels coordinated negatively with corresponding TG levels and TG-AUC across the postprandial period most apparent in the progesterone and testosterone treated groups that behaved in an opposite manner. ASP levels were 3-fold higher in the progesterone compared to the testosterone treated group, whereas TG-AUC was significantly lower in the progesterone treated group compared to the testosterone treated group. Conclusion: These findings suggest that progesterone treatment enhances ASP production and TG clearance in a simultaneous manner. The strong association of postprandial ASP levels and TG clearance in the progesterone treated group support the notion of a stimulatory role for progesterone on ASP mediated TG clearance. This is the first functional study to demonstrate a cause-effect relationship between hormone treatment and ASP levels in vivo. These findings are promising and may contribute to further understanding the mechanism of progesterone function as a female lipogenic hormone through enhancing ASP production and plasma levels.

Keywords: ASP, lipids, sex hormones, wister rats

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Authors: Mimoza Canga, Irene Malagnino, Vergjini Mulo, Alketa Qafmolla, Vito Antonio Malagnino

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Background: Dental caries is the most common dental disease and pregnancy represents a special process of physical, hormonal and metabolic changes in pregnant women, which is accompanied by an imbalance in the oral cavity. Objective: The objective of this study is to evaluate caries reduction after dental visits, the scaling of teeth, fluoridated water, brushing of the teeth and using fluoride toothpaste before and during pregnancy. Materials and methods: This study was conducted in the time period March 2018- September 2021, the age range of the participants was: 18-41 years old. The sample taken under observation was composed of 84 pregnant women. The questionnaire included the demographic characteristics of the sample, such as age, women's education level was primary, secondary, and higher education. Based on women's education level, our analysis found that 25.9% of pregnant women had completed primary education, 35.2% of them had secondary education and 38.9% of pregnant women had higher education. The descriptive and analytical research analysis is formulated as a longitudinal study. Statistical analysis was performed using IBM SPSS Statistics 23.0. The significance level (α) was set at 0.05, whereas P-value and analysis of variance (ANOVA) were used to analyze the data. Results: In the present study, it was observed that there is a strong relationship between dental visits and the scaling of the teeth with the value of P˂ .0001. While the number of teeth with caries before pregnancy and fluoridated water have a P-value=0.002. If we compare the same factor with the number of teeth with dental caries during pregnancy, the correlation is P-value = 0.0001. The number of teeth with caries before pregnancy and carbohydrates consumption has a strong relation with P-value=0.05. According to the present research, the number of teeth with dental caries before pregnancy in relation to brushing the teeth has a P-value ˂ 0.05. Furthermore, in the actual research, it was established that using fluoride toothpaste doesn’t affect the number of teeth with caries before pregnancy with a P-value= .314. Conclusion: According to the results of the present study performed in Albania, it was found out that the periodical dental visits, scaling of the teeth, fluoridated water, brushing of the teeth influenced caries reduction before and during pregnancy. In comparison, the usage of fluoride toothpaste did not have any effect on dental caries reduction in the same time period. The recommendations are as follows: maintaining oral hygiene, using fluoridated water and brushing the teeth regularly. Healthcare providers should inform pregnant women about the importance of oral health and the implementation of measures to manage dental caries.

Keywords: brushing of the teeth, dental visits, dental scaling, fluoridated water, pregnancy

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Authors: Poonsook Thatchaopas, Nik Kamariah Nikmat, Nattakarn Eakuru

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Since 2003, the Thai Government has implemented several initiatives to encourage and incubate entrepreneurial skills and motivation among her citizens. One of the initiatives is the “One College One Product” business model or well known as ‘OCOP’, launched by the Vocational Education Commission to encourage partnership between college students to choose at least one product for business venture. In line with this mission, several business enterprises were established such as food products, restaurants, spa, Thai massage, minimart, computer maintenance, karaoke centre, internet café, mini theater etc. Currently, these business incubator projects can be observed at 404 vocational colleges and 21 incubation centres to encourage entrepreneurial small and medium enterprise (SME) development. However, the number of successful OCOP projects is still minimal. Out of the 404 individual OCOP projects at Vocational Colleges around Thailand, very few became successful. The objective of this paper is to identify the critical success factors needed to be a successful OCOP business entrepreneur. This study uses qualitative method by interviewing business partners of an OCOP business called Crispy Roti Krua Acheeva Brand (CRKAB). It is a snack food company that is developed at Pattani Vocational College in South Thailand. This project was initiated by three female entrepreneurs who were alumni student cum owners of the CRKAB. The finding shows that the main critical success factors are self-confidence, creativity or innovativeness, knowledge, skills and perseverance. Additionally, they reiterated that the keys to business success are product quality, perceived price, promotion, branding, new packaging to increase sales and continuous developments. The results implies for a student business SME to be successful, the company should have credible partners and effective marketing plan.

Keywords: student entrepreneurship, business incubator, food industry, qualitative, Thailand

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Authors: Anita Ghai

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The present paper explores the imperative to establish disability studies as an independent area of academic inquiry in India through the establishment of specific programmes in disability studies. The case study of the efforts made by the Ambedkar University, Delhi, to develop such programs and courses shall be used to substantiate this imperative as well as to explore some of the challenges entailed. The paper shall explore the certain extent aspects of relevant scholarship in the area of disability studies in India today and critically reflect on the perspectives of disability in this scholarship. The study of disability in India has hitherto been the prerogative of special education, rehabilitation psychology, and social work departments. While instances of these departments adopting critical approaches to disability can be identified, their empirical focus has perpetuated the production of disability as the site of suffering and oppression. The complex cultural, phenomenological, historical and economic discourses within which disability is embedded can be better captured within distinctive programmes that have disability sui generis as their focus. Such programs would foreground disability as an epistemology, which universalizes the study of disability from disabled people alone to an analysis of various other groups who have been historically marginalized. It will also play an important role in recuperating disability from a state of alterity. The interdisciplinary nature of disability studies offers an opportunity to integrate perspectives from the humanities and the social sciences in the proposed programs. Some of the challenges or rather aspects of reflection that emerge in the course of developing these programs are the criteria for determining the suitability of faculty to teach these programs and the challenges in identifying faculty and in addressing any apprehensions about career prospects that prospective students might have. The manner in which these concerns are being addressed through the collaboration of expertise as well as through the interdisciplinary and flexible nature of the program shall be addressed in the course of the paper. In conclusion, the paper shall foreground the need for disability studies programs in India, the re-appropriation of existing scholarship in the process of formulation these programs, emerging concerns and the manner in which these concerns will be addressed.

Keywords: academia, disability studies, epistemology, India

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Authors: Nopparet Thammasaranyakun

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This research objects are: 1: To study the biodiversity of medicinal plants used for food and medicinal tourism economies along the Phu Sing district Sisaket province. 2: To study the use of medicinal plants used for food and medicinal tourism economies along the Phu Sing district Sisaket province. 3: To provide a database of information on biodiversity for food and medicinal plants and medicinal tourism economies along the Phu Sing district Sisaket province. 4: Learn to create a biodiversity of medicinal plants used as food and treatment by Journeys economic Phu Sing district Sisaket province Boundaries used in this study was the Phu Sing district. Population and Agricultural Development Center, rayong Mun due to the initiative for youth Local, Government Health officials, community leaders, teachers, students, schools, the local people and tourists. Sage wisdom to know the herbs and women's groups, OTOP Phu Sing district in SiisaKet province. By selecting the specific data that way. The process of participatory action research (PAR) is a community-based research. The method of collecting qualitative data. (Qualitative) tool is used from context, Community areas, interview and Taped recordings. Observation and focus group data was statistically analyzed using descriptive statistics (Descriptive Statistics). The results findings: 1- A study of the biodiversity of plants used for food and medicinal tourism economies along the Phu Sing district Sisaket province. Were used in the dry season and the rainy season find the medicinal plants of 251 species 41 types of drugs. 2- The study utilized medicinal plants used as food and the treatment of indigenous Phu Sing Sisaket province. Found 251 species have medicinal properties that are used for food and medicinal purposes 41 types of drugs. 3- Of the database technology of biodiversity for food and medicinal plants used by local treatment Phu Sing district Sisaket province. A data base of 251 medicinal species 41 types of drugs is used for food and medicinal properties Sisaket province. 4- learning the biodiversity of medicinal plants used for food and medicinal tourism economies along the Phu Sing district Sisaket province.

Keywords: utilization of biodiversity, peaces herbals, used as Food, Sing district, sisaket

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Authors: Asrat Agalu Abejew

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Background: Antimicrobial resistance (AMR) is a silent tsunami and one of the top global threats to health care and public health. It is one of the common agendas globally and in Ethiopia. Emerging AMR will be a double burden to Ethiopia, which is facing a series of problems from infectious disease morbidity and mortality. In Ethiopia, although there are attempts to document AMR in healthcare institutions, comprehensive and all-inclusive analysis is still lacking. Thus, this study is aimed to determine trends in AMR from 2016-2021. Methods: A retrospective analysis of secondary data recorded in the Amhara Public Health Institute (APHI) from 2016 to 2021 G.C was conducted. Blood, Urine, Stool, Swabs, Discharge, body effusions, and other Microbiological specimens were collected from each study participants, and Bacteria identification and Resistance tests were done using the standard microbiologic procedure. Data was extracted from excel in August 2022, Trends in AMR were analyzed, and the results were described. In addition, the chi-square (X2) test and binary logistic regression were used, and a P. value < 0.05 was used to determine a significant association. Results: During 6 years period, there were 25143 culture and susceptibility tests. Overall, 265 (46.2%) bacteria were resistant to 2-4 antibiotics, 253 (44.2%) to 5-7 antibiotics, and 56 (9.7%) to >=8 antibiotics. The gram-negative bacteria were 166 (43.9%), 155 (41.5%), and 55 (14.6%) resistant to 2-4, 5-7, and ≥8 antibiotics, respectively, whereas 99(50.8%), 96(49.2% and 1 (0.5%) of gram-positive bacteria were resistant to 2-4, 5-7 and ≥8 antibiotics respectively. K. pneumonia 3783 (15.67%) and E. coli 3199 (13.25%) were the most commonly isolated bacteria, and the overall prevalence of AMR was 2605 (59.9%), where K. pneumonia 743 (80.24%), E. cloacae 196 (74.81%), A. baumannii 213 (66.56%) being the most common resistant bacteria for antibiotics tested. Except for a slight decline during 2020 (6469 (25.4%)), the overall trend of AMR is rising from year to year, with a peak in 2019 (8480 (33.7%)) and in 2021 (7508 (29.9%). If left un-intervened, the trend in AMR will increase by 78% of variation from the study period, as explained by the differences in years (R2=0.7799). Ampicillin, Augmentin, ciprofloxacin, cotrimoxazole, tetracycline, and Tobramycin were almost resistant to common bacteria they were tested. Conclusion: AMR is linearly increasing during the last 6 years. If left as it is without appropriate intervention after 15 years (2030 E.C), AMR will increase by 338.7%. A growing number of multi-drug resistant bacteria is an alarm to awake policymakers and those who do have the concern to intervene before it is too late. This calls for a periodic, integrated, and continuous system to determine the prevalence of AMR in commonly used antibiotics.

Keywords: AMR, trend, pattern, MDR

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Authors: Hansraj Riteesh Bookun, Cassandra Monique Hidajat

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This pilot study investigated the efficacy of a newly designed shoe which will act as an intermittent pneumatic compression device to augment venous flow in the lower limb. The aim was to assess the degree with which a wearable intermittent compression device can increase the venous flow in the popliteal vein. Background: Deep venous thrombosis and chronic venous insufficiency are relatively common problems with significant morbidity and mortality. While mechanical and chemical thromboprophylaxis measures are in place in hospital environments (in the form of TED stockings, intermittent pneumatic compression devices, analgesia, antiplatelet and anticoagulant agents), there are limited options in a community setting. Additionally, many individuals are poorly tolerant of graduated compression stockings due to the difficulty in putting them on, their constant tightness and increased associated discomfort in warm weather. These factors may hinder the management of their chronic venous insufficiency. Method: The device is lightweight, easy to wear and comfortable, with a self-contained power source. It features a Bluetooth transmitter and can be controlled with a smartphone. It is externally almost indistinguishable from a normal shoe. During activation, two bladders are inflated -one overlying the metatarsal heads and the second at the pedal arch. The resulting cyclical increase in pressure squeezes blood into the deep venous system. This will decrease periods of stasis and potentially reduce the risk of deep venous thrombosis. The shoe was fitted to 2 healthy participants and the peak systolic velocity of flow in the popliteal vein was measured during and prior to intermittent compression phases. Assessments of total flow volume were also performed. All haemodynamic assessments were performed with ultrasound by a licensed sonographer. Results: Mean peak systolic velocity of 3.5 cm/s with standard deviation of 1.3 cm/s were obtained. There was a three fold increase in mean peak systolic velocity and five fold increase in total flow volume. Conclusion: The device augments venous flow in the leg significantly. This may contribute to lowered thromboembolic risk during periods of prolonged travel or immobility. This device may also serve as an adjunct in the treatment of chronic venous insufficiency. The study will be replicated on a larger scale in a multi—centre trial.

Keywords: venous, intermittent compression, shoe, wearable device

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Authors: Beaudoin Marie-Joelle, Poirier Nathalie

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Introduction: Children with autism spectrum disorder (ASD) tend to lack socio-emotional skills (e.g., emotional regulation and theory of mind). Eisenberg’s theoretical model on emotion-related socialization behaviors suggests that mothers of children with ASD could play a central role in fostering the acquisition of socio-emotional skills by engaging in frequent educational conversations about emotions. Although, mothers’ perceptions of their own emotional skills and their child’s personality traits and social deficits could mitigate the benefit of their educative role. Objective: Our study aims to explore the association between mother-child conversations about emotions and the socio-emotional skills of their children when accounting for the moderating role of the mothers’ perceptions. Forty-nine mothers completed five questionnaires about emotionally related conversations, self-openness to emotions, and perceptions of personality and socio-emotional skills of their children with ASD. Results: Regression analyses showed that frequent mother-child conversations about emotions predicted better emotional regulation and theory of mind skills in children with ASD (p < 0.01). The children’s theory of mind was moderated by mothers’ perceptions of their own emotional openness (p < 0.05) and their perceptions of their children’s openness to experience (p < 0.01) and conscientiousness (p < 0.05). Conclusion: Mothers likely play an important role in the socio-emotional education of children with ASD. Further, mothers may be most helpful when they perceive that their interventions improve their child’s behaviors. Our findings corroborate those of the Eisenberg model, which claims that mother-child conversations about emotions predict socio-emotional development skills in children with ASD. Our results also help clarify the moderating role of mothers’ perceptions, which could mitigate their willingness to engage in educational conversations about emotions with their children. Therefore, in special needs' children education, school professionals could collaborate with mothers to increase the frequency of emotion-related conversations in ASD's students with emotion dysregulation or theory of mind problems.

Keywords: autism, parental socialization of emotion, emotional regulation, theory of mind

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Authors: Ayelet Gur

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Background: In recent years we are witnessing a welcome trend in which more children/persons with disabilities are living at home with their families and within their communities. This trend is related to various policy innovations as the UN Convention on the Rights of People with Disabilities that reflect a shift from the medical-institutional model to a human rights approach. We also witness the emergence of family centered approaches that perceive the family and not just the individual with the disability as a worthy target of policy planning, implementation and evaluation efforts. The current investigation aims to explore economic, psychological and social factors among households of families of children or adults with intellectual disabilities in Israel and to present policy recommendation. Methods: A national sample of 301 households was recruited through the education and employment settings of persons with intellectual disability. The main caregiver of the person with the disability (a parent) was interviewed. Measurements included the income and expense surveys; assets and debts questionnaire; the questionnaire on resources and stress; the social involvement questionnaire and Personal Wellbeing Index. Results: Findings indicate significant gaps in financial circumstances between households of families of children with intellectual disabilities and households of the general Israeli society. Households of families of children with intellectual disabilities report lower income and higher expenditures and loans than the general society. They experience difficulties in saving and coping with unexpected expenses. Caregivers (the parents) experience high stress, low social participation, low financial support from family, friend and non-governmental organizations and decreased well-being. They are highly dependent on social security allowances which constituted 40% of the household's income. Conclusions: Households' dependency on social security allowances may seem contradictory to the encouragement of persons with intellectual disabilities to favor independent living in light of the human rights approach to disability. New policy should aim at reducing caregivers' stress and enhance their social participation and support, with special emphasis on families of lower socio-economic status. Finally, there is a need to continue monitoring the economic and psycho-social needs of households of families of children with intellectual disabilities and other developmental disabilities.

Keywords: disability policy, family policy, intellectual and developmental disabilities, Israel, households study, parents of children with disabilities

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Authors: Clara Luwe, Oliver Harness, Helena Meally, Kim Martin, Alexandra Harrington

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Background: The role of ‘Renal Specialist Podiatrist’ originated in 2022 due to prevailing evidence of patients with diabetes and end-stage renal disease (ESRD) on haemodialysis (HD) and active ulcerations that were at higher risk of rapid deterioration, foot-related hospital admissions, and lower limb amputations. This role started in April 2022 with the aim of screening all patients on haemodialysis and instigating preventative measures to reduce serious foot related complications. Methods: A comprehensive neurovascular foot assessment was completed to establish baseline vascular status and identify those with peripheral arterial disease (PAD) for all patients on HD. Individual’s foot risk was stratified, advice and education tailored and issued. Identifying all diabetes patients on HD as high-risk for diabetic foot complications. Major Findings: All patients screened revealed over half of the caseload had diabetes, and more than half had a clinical presentation of PAD. All those presenting with ulcerations had a diagnosis of diabetes. Of the presenting ulcerations, the majority of these ulcers predated the renal specialist post and were classified as severe >3 SINBAD Score. Since April’22, complications have been identified quicker, reducing the severity (SINBAD<3 or below), and have improved healing times, in line with the national average. During the eight months of the role being in place, we have seen a reduction in minor amputations and no major amputations. Conclusion: By screening all patients on haemodialysis and focusing on education, early recognition of complications, appropriate treatment, and timely onward referral, we can reduce the risk of foot Diabetic foot ulcerations and lower limb amputations. Having regular podiatry input to stratify and facilitate high-risk, active wound patients across different services has helped to keep these patients stable, prevent amputations, and reduce foot-related hospital admissions and mortality from foot-related disease. By improving the accessibility to a specialist podiatrist, patients felt able to raise concerns sooner. This has helped to implement treatment at the earliest possible opportunity, enabling the identification and healing of ulcers at an earlier and less complex stage (SINBAD <3), thus, preventing potential limb-threatening complications.

Keywords: renal, podiatry, haemodialysis, prevention, early detection

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Authors: Laurie U. deBettencourt

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During pre-service field experiences teacher candidates are often asked to reflect as part of their training and in this investigation candidates’ reflective journal entries were reviewed, coded and analyzed with results suggesting teacher candidates need more direct instruction on how to describe, analyze, and make judgements on their instructional practices so that their practices improve over time. Teacher education programs often incorporate reflective-based activities during field experiences. The purpose of this investigation was to determine if special education teacher candidate’s reflective practices changed as they completed their two supervised field experiences and to determine what topics the candidates focused on in their reflections. The six females graduate students were completing two field experiences in special education classrooms within one academic year as part of their coursework leading to a master’s degree and special education teacher state certification. Each candidate wrote 15 reflection journal entries (approximately 200 words each) per field experience. Each of the journal entries were reviewed sentence by sentence to determine a reflective practice score and to determine the topics discussed. The reflective practice score was calculated using four dimensions of reflection (describe, analyze, judge, and apply) in order to create a continuous variable representing their reflective practice across four points of time. A One-way Repeated Measures Analysis of Variance (ANOVA) suggested that special education teacher candidates did not change their reflective practices over time (i.e., at time-point one the practitioner’s mean score was 56.0 out of 100 (SD = 7.6), 53.8 (SD = 4.3) at time-point two, 51.2 (SD = 4.5) at time-point three, and 57.7 (SD = 8.2) at time-point four). Qualitative findings suggest candidates focused mostly on themselves in their reflections. Conclusions suggest the need for teacher preparation programs to provide more direct instruction on how a teacher should reflect. Specific implications are provided for teacher training and future research.

Keywords: field experiences, reflective practices, special educators, teacher preparation

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Authors: K. Shyamnath, K. Suresh Kutty

Abstract:

The purpose of the study was to find out the effect of three resistance training methods on performance-related variables of powerlifters. A total of forty male students (N=40) who had participated in Kannur University powerlifting championship were selected as subjects. The age group of the subjects ranged from 18 years old to 25 years old. The selected subjects were equally divided into four groups (n=10) of three experimental groups and a control group. The experimental Group I underwent traditional resistance training (TRTG), Group II underwent combined traditional resistance training and plyometrics (TRTPG), and Group III underwent combined traditional resistance training and resistance training with high rhythm (TRTHRG). Group IV acted as the control group (CG) receiving no training during the experimental period. The duration of the experimental period was sixteen weeks, five days per week. Powerlifting performance was assessed by the 1RM test in the squat, bench press and deadlift. Performance-related variables assessed were chest girth, arm girth, forearm girth, thigh girth, and calf girth. Pre-test and post-test were conducted a day before and two days after the experimental period on all groups. Analysis of covariance (ANCOVA) was applied to analyze the significant difference. The 0.05 level of confidence was fixed as the level of significance to test the F ratio obtained by the analysis of covariance. The result indicates that there is a significant effect of all the selected resistance training methods on the performance and selected performance-related variables of powerlifters. Combined traditional resistance training and plyometrics and combined traditional resistance training and resistance training with high rhythm proved better than the traditional resistance training in improving performance and selected performance-related variables of powerlifters. There was no significant difference between combined traditional resistance training and plyometrics and combined traditional resistance training and resistance training with high rhythm in improving performance and selected performance-related variables of powerlifters.

Keywords: girth, plyometrics, powerlifting, resistance training

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