Search results for: amblyopia prevalence

Authors: Madhuresh Dwivedi, Navneet Singh Deora, H. N. Mishra

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In the context of bakery products, the gluten component of wheat has a crucial role in stabilizing the gas-cell and crumb structures, appearance, mouth feel and maintaining the rheological properties, thus the acceptability of these products. However, because of coeliac disease, some individuals cannot tolerate the protein gliadin present in the gluten fraction of wheat flour. Also termed as gluten-sensitive enteropathy, it is a common chronicle disorder in populations throughout the world with average prevalence of 0.37%. The safest way for celiac sufferers is to stay away from gluten-containing foods such as wheat, rye, barley as well as durum wheat, spelt wheat, and triticale. Thus, in view of the current increasing incidence of gluten intolerant sufferers (due to improved diagnostic procedures), the development of gluten-free cereal-based bakery products suitable for celiac patients represents a challenging and serious task, but also very demanding call for food technologists as well as for the bakers. The use of alternative cereal starches (like rice, soy, maize, potato and so on), gums, hydrocolloids, dietary fibres, alternative protein sources, prebiotics and combinations of them represent the most widespread approach used as replacement to mimic gluten in the manufacture of industrial processable gluten-free bakery products due to their structure-building and water binding properties.

Keywords: gluten-free, coeliac disease, alternative flour, hydrocolloid, crumb structure

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Authors: Talal Alshammari, Nasser Alshammari, Mohamed Sedky, Chris Howard

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With the widespread adoption of the Internet-connected devices, and with the prevalence of the Internet of Things (IoT) applications, there is an increased interest in machine learning techniques that can provide useful and interesting services in the smart home domain. The areas that machine learning techniques can help advance are varied and ever-evolving. Classifying smart home inhabitants’ Activities of Daily Living (ADLs), is one prominent example. The ability of machine learning technique to find meaningful spatio-temporal relations of high-dimensional data is an important requirement as well. This paper presents a comparative evaluation of state-of-the-art machine learning techniques to classify ADLs in the smart home domain. Forty-two synthetic datasets and two real-world datasets with multiple inhabitants are used to evaluate and compare the performance of the identified machine learning techniques. Our results show significant performance differences between the evaluated techniques. Such as AdaBoost, Cortical Learning Algorithm (CLA), Decision Trees, Hidden Markov Model (HMM), Multi-layer Perceptron (MLP), Structured Perceptron and Support Vector Machines (SVM). Overall, neural network based techniques have shown superiority over the other tested techniques.

Keywords: activities of daily living, classification, internet of things, machine learning, prediction, smart home

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Authors: Herawati Tri Siswati, Nurhidayat Ana Sıdık Fatimah

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The Indonesia Basic Health Research, 2013 showed that prevalence of stunting of 6–12 children years old was 35,6%, wasting was 12,2% and obesiy was 9,2%. The Indonesian Goverment have School Health Program, held in coordination, plans, directing and responsible, developing and implement health student. However, it's implementation still under expected, while Indonesian Ministry of Health has initiated the School Health Program acceleration. This aimed is to know the influencing of training to knowledge and skill of elementary school teacher about measurement and assesment nutrirional status children. The research is quasy experimental with pre-post design, in Sleman disctrict, Yogyakarta province, Indonesia, 2015. Subject was all of elementary school teacher’s who responsible in School Health Program in Gamping sub-district, Sleman, Yogyakarta, i.e. 32 persons. The independent variable is training, while the dependent variable are teacher’s klowledge and skill on measurement and assesment nutrirional status children. The data was analized by t-test. The result showed that the knowledge score before training is 31,6±9,7 and after 56,4±12,6, with an increase 24,8±15,7, and p=0.00. The skill score before training is 46,6±11,1 and after 61,7±13, with an increase 15,2±14,2, p = 0.00. Training can increase the teacher’s klowledge and skill on measurement and assesment nutrirional status.

Keywords: training, school health program, nutritional status, children.

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Authors: Oluyinka Ojedokun, S. E. Idemudia

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In Nigeria, statistics is a compulsory course required from all social sciences students as part of their academic training. However, a rising number of social sciences undergraduates usually express statistics anxiety. The prevalence of statistics anxiety among undergraduates in social sciences has created a growing concern for educators and researchers in the higher education institutions, mainly because this statistics anxiety adversely affects their performance in statistics and research methods courses. From a societal perspective it is important to reverse this trend. Although scholars and researchers have highlighted some psychosocial factors that influence statistics anxiety in students but few empirical studies exist on the association between personality traits of NEO five factors and statistics anxiety. It is in the light of this situation that this study was designed to assess the extent to which the personality traits of NEO five factors influence statistics anxiety of students in social sciences courses. The participants were 282 undergraduates in the faculty of social sciences at a state owned public university in Nigeria. The findings demonstrate that the personality traits contributing to statistics anxiety include openness to experience, conscientious, extraversion, and neuroticism. These results imply that statistics anxiety is related to individual differences in personality traits and suggest that certain aspects of statistics anxiety may be relatively stable and resistant to change. An effective and simple method to reduce statistics anxiety among social sciences students is to create awareness of the statistical and methodological requirements of the social sciences courses before commencement of their programmes.

Keywords: personality traits, statistics anxiety, social sciences, students

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Authors: Jun Hong Lee

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Background: Many dementia patients complain insomnia and depressive mood, and hypnotics and antidepressants are being prescribed. As prevalence of dementia is increasing, insomnia and depressive mood are becoming more important. Objective: We evaluated insomnia and depression in outpatients of dementia center. Patients and Methods/Material and Methods: We reviewed medical records of the patients who visited outpatients clinic of NHIS Ilsan Hospital Dementia Center during 2016. Results: Total 716 patients are included; Subjective Memory Impairment (SMI) : 143 patients (20%), non-amnestic Mild Cognitive Impairment (MCI): single domain 70 (10%), multiple domain 34 (5%), amnestic MCI: single domain 74 (10%), multiple domain 159 (22%), Early onset Alzheimer´s disease (AD): 9 (1%), AD 121 (17%), Vascular dementia: 62 (9%), Mixed dementia 44 (6%). Hypnotics and antidepressants are prescribed as follows; SMI : hypnotics 14 patients (10%), antidepressants 27 (19%), non-amnestic MCI: single domain hypnotics 9 (13%), antidepressants 12 (17%), multiple domain hypnotics 4 (12%), antidepressants 6 (18%), amnestic MCI: single domain hypnotics 10 (14%), antidepressants 16 (22%), multiple domain hypnotics 22 (14%), antidepressants 24 (15%), Early onset Alzheimer´s disease (AD): hypnotics 1 (11%), antidepressants 2 (22%), AD: hypnotics 10 (8%), antidepressants 36 (30%), Vascular dementia: hypnotics 8 (13%), antidepressants 20 (32%), Mixed dementia: hypnotics 4 (9%), antidepressants 17 (39%). Conclusion: Among the outpatients of Dementia Center, MCI and SMI are majorities, and the number of MCI patients are almost half. Depression is more prevalent in AD, and Vascular dementia than MCI and SMI, and about 22% of patients are being prescribed by antidepressants and 11% by hypnotics.

Keywords: insomnia, depression, dementia, antidepressants, hypnotics

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Authors: Osiris Jorge Parcero, Néstor Gandelman, Flavia Roldán, Josef Montag

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This paper uses cross-country unbalanced panel data of up to 146 countries over the period 1996 to 2015 to be the first study to identify potential determinants of a country’s relative research output in Economics versus Business. More generally, it is also one of the first studies comparing Economics and Business. The results show that better policy-related data availability, higher income inequality, and lower ethnic fractionalization relatively favor economics. The findings are robust to two alternative fixed effects specifications, three alternative definitions of economics and business, two alternative measures of research output (publications and citations), and the inclusion of meaningful control variables. To the best of our knowledge, our paper is also the first to demonstrate the importance of policy-related data as drivers of economic research. Our regressions show that the availability of this type of data is the single most important factor associated with the prevalence of economics over business as a research domain. Thus, our work has policy implications, as the availability of policy-related data is partially under policy control. Moreover, it has implications for students, professionals, universities, university departments, and research-funding agencies that face choices between profiles oriented toward economics and those oriented toward business. Finally, the conclusions show potential lines for further research.

Keywords: research output, publication performance, bibliometrics, economics, business, policy-related data

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Authors: Roudabeh Vakil Monfared, Farhad Mashayekhi

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Breast cancer is the most common malignancy type among women with about 1 million new cases each year. The immune system plays an important role in the breast cancer development. OX40L (also known as TNFSF4), a membrane protein, which is a member of the tumor necrosis factor super family binds to its receptor OX40 and this co-stimulation has a crucial role in T-cell proliferation, survival and cytokine release. Due to the importance of the T-cells in anti-tumor activities of OX40L we studied the association of rs3850641 (T→C) polymorphism of OX40L gene with breast cancer. The study included 123 women with breast cancer and 126 healthy volunteers with no signs of cancer. Genomic DNA was extracted from blood leucocytes. Genotype and allele frequencies were determined in patients and control cases with the method of polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and the analysis was performed by Med Calc. The prevalence of genotype frequencies of TT, CT and CC were 60.9%, 30.08% and 8.9 % in patients with breast cancer and 74.6 %, 18.25 % and 7.14 % in healthy volunteers while the T and C allelic frequency was 76.01% and 23.98 % in patients and 83.73% and 16.26% in healthy controls. Respectively Statistical analysis has shown no significant difference from the comparison of either genotype (P=0.06). According to these results, the rs3850641 SNP has no association with the susceptibility of breast cancer in a population in northern Iran. However, further studies in larger populations including other genetic and environmental factors are required to achieve conclusion.

Keywords: OX40L, gene, polymorphism, breast cancer

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Authors: Saad Khalid Niaz, Arif Mahmood Siddiqui, Afzal Haqi

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Background: Estimated prevalence of Hepatitis C in Pakistan is 5% of which 78 % are Genotype 3, in which Response to conventional interferon is reported to be 70%. Objective: To determine the efficacy of pegylated interferon 20 kDa (Unipeg) plus ribavirin (Ribazole) in HCV genotype 3 patients who relapsed to conventional interferon. Methods: This is an ongoing study of 20 enrolled patients. Pegylated interferon alfa-2a 20 kDa 180 mcg weekly with ribavirin, were administered for a period of 24 weeks. Virological Responses were measured by Qualitative HCV RNA at weeks 4, 12, 24 and 48 to determine Rapid Virological Response (RVR), Early Virological Response (EVR), End of Treatment (ETR) and Sustained Virological Response (SVR), respectively. EVR was done for those who didn’t achieve RVR. Results: Males were 12 (60%) and mean age was 38.5 ±7.62 years. Out of 20 recruited patients, all completed 4 weeks therapy; RVR was achieved in 8 (40%) patients. One patient was lost to follow up and one yet to visit at 12 weeks. From 10 patients, 8 (80%) patients achieved EVR. Out of intent-to-treat patients, 15 completed 24 weeks therapy, ETR was achieved in 14 (93%) patients and 9 patients completed post therapy follow-up, of which, 8 (89%) patients achieved SVR. Conclusion: Our interim data demonstrates that Pegylated Interferon alfa-2a 20 kDa 180 mcg (Unipeg) in combination with Ribavirin (Ribazole) has shown promising results in treating HCV Genotype 3 patients who relapsed to conventional interferon. We recommend use of Pegylated Interferon in Relapsers with Genotype 3 when financial constraints limit the use of oral antivirals.

Keywords: pegylated interferon (unipeg), hepatitis c, relapsers, Pakistan

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Authors: Edward Nartey

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Although sustainability management control (SMC) systems provide information that enhances corporate sustainability decisions, reviews on the SMC implications for sustainable supply chains (SCs) demonstrate a wide research gap, particularly the sustainability performance of healthcare SCs in unusual times. This study provides preliminary empirical evidence on the level of SMC adoption and the decision-making implications for the Tripple Bottom Line (TBL) principles of SC sustainability of Ghanaian public healthcare institutions (PHIs). Using a sample of 226 public health managers, the results show that sustainable formal control has a positive and significant impact on economic sustainability but an insignificant effect on social and environmental sustainability. In addition, a positive relationship was established between informal controls and economic and environmental sustainability but an insignificant relationship with social sustainability. Although the findings highlight the prevalence of the SMC system being prioritized over regular MCS in crisis situations, the MCSs are inadequate in promoting PHIs' sustainable behaviours in SCs. It also provides little empirical evidence on the effective enhancement of the TBL principle of SC sustainability perhaps because the SMC is in misalignment with the TBL principle in crisis situations. Thus, in crisis situations, PHIs need to redesign their MCSs to support the integration of sustainability issues in SCs.

Keywords: sustainability management control, informal control, formal control, sustainable supply chain performance

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Authors: Joshua N. Edokpayi, John O. Odiyo, Titus A. M. Msagati, Elizabeth O. Popoola

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Polycyclic aromatic hydrocarbons (PAHs) are very toxic and persistent environmental contaminants. This study was undertaken to assess the concentrations and possible sources of 16 PAHs classified by the United State Environmental Protection Agency as priority pollutants in Mvudi and Nzhelele Rivers and sediments. Effluents from Thohoyandou wastewater treatment plant and Siloam waste stabilization ponds were also investigated. Diagnostic ratios were used to evaluate the possible sources of PAHs. PAHs in the water samples were extracted using 1:1 dichloromethane and n-hexane mixtures, while those in the sediment samples were extracted with 1:1 acetone and dichloromethane using ultrasonication method. The extracts were purified using SPE technique and reconstituted in n-hexane before analyses with GC-TOF-MS. The results obtained indicate the prevalence of high molecular weight PAHs in all the samples. PAHs concentrations in water and sediment samples from all the sampling sites were in the range of 13.174-26.382 mg/L and 27.10-55.93 mg/kg, respectively. Combustion of biomass was identified as the major possible source of PAHs. Effluents from wastewater treatment facilities were also considered as major anthropogenic contributions to the levels of PAHs determined in both river waters and sediments. Mvudi and Nzhelele Rivers show moderate to high contamination level of PAHs.

Keywords: polycyclic aromatic hydrocarbon, rivers, sediments, wastewater effluents

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Authors: Meriche Hacene, Gadiri Sabiha

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Introduction: Allergy to animal hair is hypersensitivity to animal appendages to look for in front of any rhinoconjunctivitis or asthma. An anamnesis associated with the prick-tests makes it possible to guide the diagnosis, which will be supplemented in case of doubt by specific immunoglobulin E (IgE) assays. The objective of our study is to study the characteristics of patients sensitized to animal hair. Patients and methods: Retrospective study conducted on 105 adult patients and 69 children over a period of 3 years, including patients who received a specific IgE assay (respiratory panel and pediatric panel) by immunodot method. Result: 105 adult patients, including 74 women and 31 men, with an average age of 41 years, of which 8.5% had sensitization to animal hair (5 men and 4 women), namely: cat (5%), horse (4.7%) and dog (3.8%). For the 69 children, a slight female predominance was noted (56%), with an average age of 7.5 years, of which (13%) are sensitized to animal hair (5 girls and 4 boys): cat (10%), while awareness of dog and horse hair was less frequent with an identical prevalence of (4.34%). The dominant symptoms are rhinorrhea and sneezing for both categories, respectively (40% and 26.6% in adults and 23% for both symptoms in children). Cross-sensitization was observed in the 2 series: 1 single cat-dog and cat-horse case and 2 dog-horse cases in adults. In children 100% of patients with sensitization to dog hair had cross-sensitization to cat hair, only 1 case was observed for cat-horse cross-reactivity. Conclusion: This work shows that allergy to animal hair is common. Studies on more representative samples are recommended.

Keywords: children, allegy to animals, specific Ig E, hypersensitivity

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Authors: Kaili Wang, Botao Zhang, Enming Zhang

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Background: Low back pain (LBP) is a common problem affecting athletes' training and competition. Although the association between a limited hip range of motion and prevalence of low back pain has been studied extensively, it has not been studied in table tennis. Aim: The main purposes of this study in table tennis players were (1) to investigate if there is a difference in hip internal rotation (HIR) and external rotation (HER) range of motion (ROM) between players with LBP and players without LBP and (2) to analyze the association between HIR and HER ROM and LBP. Methods: Forty-six table tennis players from the Chinese table tennis team were evaluated for passive maximum HIR and HER ROM. LBP was retrospectively recorded for the last 12 months before the date of ROM assessment by a physical therapist. The data were analyzed the difference in HIR and HER ROM between players with LBP and players without LBP by Mann-Whitney U test, and the association between the difference in HIR and HER ROM and LBP was analyzed via a binary logistic regression. Results: The 54% of players had developed LBP during the retrospective study period. Significant difference between LBP group and the asymptomatic group for HIR ROM (z=4.007, p<0.001) was observed. Difference between LBP group and asymptomatic group for HER ROM (z=1.117, p=0.264) was not significant. Players who had HIR ROM deficit had an increased risk of LBP compared with players without HIR ROM deficit (OR=5.344, 95%CI: 1.006-28.395, P=0.049). Conclusion: HIR ROM of a table tennis player with LBP was less than a table tennis player without LBP. Compared with player whose HIR ROM was normal, player who had HIR ROM deficit appeared to have a higher risk for LBP.

Keywords: assessment, injury prevention, low back pain, table tennis players

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Authors: Daniel Motlhanka, Neo Kerebotswe

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The strong and long history of use of medicinal plants in Botswana to address existing and emerging health threats provides undebatable evidence for their potential as innovative therapeutic tools. The prevalence of emerging health threats, such as COVID-19 and hard-to-treat non-communicable diseases, warrants the scientific community to revisit and exploit ethnopharmacology for its potential as a source of therapeutic tools. Many studies conducted on bioactivity-guided bioassays of ethnobotanical resources have proved a number of health beneficial properties of these plants, such as free radical scavenging, anti-inflammatory, antimicrobial and, most importantly, the capability of medicinal plants to alleviate oxidative stress. In this work, a number of medicinal plants used in Botswana traditional medicine were investigated for both their free radical scavenging capability and total phenolic contents using the Free Radical Scavenging Power (FRSP) and Folin Ciocalteau (FC) method. At 100 micrograms/ml all the studied plants expressed above 90% Scavenging power and expressed total phenolic contents between 5000- 8890 mg/L.GAE. These plants are promising tools for engineering active therapeutic tools against life-threatening diseases of oxidative stress origin.

Keywords: oxidative stress, non-communicable diseases, total phenolics, ethnobotanicals

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Authors: Awe Ayodeji Samson, Adeuja Yetunde Omowunmi

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Corruption is a ‘monster’ that can consume a whole nation, continent and even the world if it is not destroyed while it is still immature; It grows in the mind of the people, takes over their thinking and guides their decision-making process. Corruption snowballs into socio-economic catastrophe that might be difficult to deal with. Corruption which is a disease of the mind can be alleviated in Africa and the world at large by transforming a Corruption-Prone Mind to a Corruption-Immune Mind and to achieve this, we have to change our value system because the use of anti-graft agencies alone is not enough. Therefore, we have to fight corruption from the inside and the outside. Value System is the principle of right and wrong that are accepted by an individual or a social group; the reviewing and reordering of our value system is the solution to the problem of corruption as proposed by this research because the African society has become a ‘Money and Power Driven Society’ where the ‘I am worth concept’ which is a problematic concept has created an ‘Aggressive Society’ with grasping and money-grabbing individuals. We place more priority on money and the display of opulence. Hence, this has led to a ‘Triangular Society’ where minority is lavishing in plenty and majority is gasping for little. The get rich quick syndrome, the ethnicity syndrome, weakened educational system are signs of the prevalence of corruption in Africa This research has analyzed role and impact of the change in our value system in the fight against corruption in Africa and has therefore proposed the change in our value system as the way forward in the fight against corruption in Africa.

Keywords: corruption-prone mind, corruption-immune mind, triangular society, aggressive society, money and power-driven society

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Authors: Ashkan Forootan, Reza Rashedi

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Polyethylene has wide usage areas such as blow molding, pipe, film, cable insulation. However, regardless to its growing applications, it has some constraints such as the limited 70C operating temperature. Polyethylene thermo setting procedure whose molecules are knotted and 3D-molecular-network formed , is developed to conquer the above problem and to raise the applicable temperature of the polymer. This paper reports the cross-linking for two different molecular weight grades of LLDPE by adding 0.5, 1, and 2% of DCP (Dicumyl Peroxide). DCP was chosen for its prevalence among various cross-linking agents. Structural parameters such as molecular weight, melt flow index, comonomer, number of branches,etc. were obtained through the use of relative tests as Gel Permeation Chromatography and Fourier Transform Infra Red spectrometer. After calculating the percentage of gel content, properties of the pure and cross-linked samples were compared by thermal and mechanical analysis with DMTA and FTIR and the effects of cross-linking like viscous and elastic modulus were discussed by using various structural paprameters such as MFI, molecular weight, short chain branches, etc. Studies showed that cross-linked polymer, unlike the pure one, had a solid state with thermal mechanical properties in the range of 110 to 120C and this helped overcome the problem of using polyethylene in temperatures near the melting point.

Keywords: LLDPE, cross-link, structural parameters, DCP, DMTA, GPC

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Authors: Utsamani Cintyamena, Sandra Frans Olivia, Shita Lisyadewi, Ariane Utomo

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Family planning is one of fundamental aspects in preventing maternal morbidity and mortality. However, the prevalence rate of Indonesia’s married women in choosing contraception is low. This study purpose to assess opportunities and challenges in family planning. Methodology: We conducted a qualitative study in Banyumas District which has huge reduction of maternal mortality rate from 2013 to 2015. Four focus group discussions and four small group discussions were conducted to assess knowledge and attitude of women in using contraceptive and their method of choice, as well as in-depth interview to four health workers and two family planning field officers as triangulation. Thematic content analysis was done manually. Results: Key themes emerge across interviews including (1) first choice of contraception is the one that they previously had, provided that they did not encountered problems with it, (2) rumor and fear of side effect affected their method of choice, (3) selection of contraceptive method was influenced by approval of husband, believes, and role model in community. Conclusion: Collaboration of health worker, family planning field officers, community, as well as support from stakeholder, must be increased to socializing family planning.

Keywords: attitude, challenge, chance, family planning, knowledge

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Authors: Mohammed Qutishat, Loai Abu Sharour, Kholoud Al-Damery, Ibtisam Al Harthy, Sulaiman Al-Sabei

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Background: The 2019 coronavirus outbreak (COVID-19) has been declared a pandemic and has greatly affected both patients and healthcare workers. This study was conducted to explore the extent of posttraumatic stress disorder (PTSD) experiences among nurses as a result of the COVID-19 pandemic in Jordan. Method: This study used a cross-sectional study design with a convenience sampling approach. A sample of 259 participants completed the study questionnaires, including a sociodemographic questionnaire and the posttraumatic stress disorder checklist for DSM‐5, between May and July 2020. Result: The prevalence of PTSD among the study participants was 37.1%. The majority of study participants who exhibited PTSD symptoms presented the lowest level of PTSD (17%). The results indicated significant differences in overall COVID-19-related PTSD according to the participant’s age (F = 14.750, P = .000), gender (F = 30.340, P = .000), level of education (F = 51.983, P =.000), years of experience (F = 52.33, P = .000), place of work (F = 19.593, P = .000), and working position (F = 11.597, P = .000), as determined by one-way ANOVA. Conclusion: Nurses must be qualified and accredited to cope with reported PTSD cases and their consequences in relation to COVID-19 outbreaks. Close collaboration with a multidisciplinary team is required to recognise, manage, and encourage safety literacy among health care professionals and individuals diagnosed with or suspected of PTSD due to COVID-19 outbreaks or any other viral outbreaks.

Keywords: PTSD, nursing, coronavirus, pandemic, infectious disease

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Authors: Mahmoud Tarek, Alaa Obeida, Mai Magdy, Khalid Hussein, Aly Shalaby

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Background: More doctors are complaining of burnout than before, Burnout is a state of physical and mental exhaustion caused by the doctor’s lifestyle, unfortunately, Medical errors are also more likely in those suffering from burnout and these may result in malpractice suits. Methodology: It is a retrospective audit of burnout response on all neonatologists over a 9 months period. We gathered data using burnout questionnaire, it was obtained from 23 physicians, the physicians divided into 5 categories according to the final score of the 28 questions in the questionnaire. Category 1 with score from 28-38 with almost no work stress, category 2 with score (38-50) who express a low amount of job related stress, category 3 with score (51-70) with moderate amount of stress, category 4 with score (71-90) those express a high amount of job stress and begun to burnout, category 5 with score (91 and above) who are under a dangerous amount of stress and advanced stage of burnout. Results: 33 neonatologists have received the questionnaire, 23 responses were sent back with a response rate of 69.6%. The results showed that 61% of physicians fall in category 4, 31% of the physician in category 5, while 8% of physicians equally distributed between category 2 and 3 (4% each of them). On the other hand, there is no physician present in category 1. Conclusion: Burnout is prevalent in SNICUs, So interventions to minimize burnout prevalence may be of greater importance as this may be reflected indirectly on medical conditions of the patients and physicians, efforts should be done to decrease this high rate of burnout.

Keywords: Cairo, work overload, exhaustion, surgery, neonatal ICU

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Authors: Maria Melania Muda, Retno Wibawanti, Retno Asti Werdhani

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Background: Flight attendant (FA) is a job that is often exposed to ergonomic stressors; thus, they are very susceptible to symptoms of musculoskeletal disorders (MSDs). One of the ways to overcome musculoskeletal complaints is by stretching. This study aimed to examine the prevalence of MSDs and the effect of a 2-week stretching exercise program using the Indonesian Ministry of Health's stretching video on changes in musculoskeletal pain intensity in FA on commercial aircraft in Indonesia. Methods: A pre-post study was conducted using Nordic Musculoskeletal Questionnaire (NMQ) for MSDs’ identification and Visual Analog Scale (VAS) as pain intensity measurement. Data was collected and then analyzed using SPSS with Wilcoxon test. The change in pain intensity was considered significant if the p value was less than 0.05. Results: The results showed that 92% of the FA (n=75) had MSDs in at least 1 area of the body in the last 12 months. Thirty-four respondents participated as subjects. The complaint level score in 28 body areas before intervention was a median of 34 (29-84), with pain intensity of a median of 6 (2-9) became a median of 32 (28-67) and a median of 3 (0-9) after the intervention, respectively, with p-value <0.001. Conclusion: The stretching exercise program showed significant changes in the complaint level scores in 28 body areas (p < 0.001) and pain intensity before and after the stretching exercise intervention (p < 0.001).

Keywords: flight attendant, MSDs, Nordic Musculoskeletal Questionnaire, stretching exercise program, visual analog scale

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Authors: Abilio Pires Zacarias

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Analyzing company boards of directors is a relevant and timely topic. As the representative of shareholders, the board is the most senior management body of this type of company. Therefore, ascertaining the best kind of candidates to nominate, namely the most appropriate characteristics for leading the board to achieve better levels of performance, is certainly of great interest. The companies selected for this study were the 1,000 largest non-financial companies and the 100 largest financial companies in Portugal according to the Instituto Nacional de Estatística for 2010. The information stemmed from a questionnaire addressed to the person in charge of daily company management and then processed through STATA 17 with the multivariate analysis of variables - MANOVA. The study may correspondingly report that the vast majority of boards in the sample operate a dual leadership structure. By in terms of its prevalence, unitary leadership represents only a minority. Agency theory and stewardship theory postulate different characteristics for the ideal chairman but neither receive confirmation from our results. On the other hand, our findings do validate the behavioral theory of firms (BToF), concluding that experience is associated with organizational performance. This study is also relevant due to its analysis of companies not listed on the financial markets not only because of their weighting in the economy but also because they remain only very poorly studied in this field and thus also correspondingly contributing to deepening the literature.

Keywords: agency theory, behavioral theory of the firm, board of directors, corporate governance, stewardship theory

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Authors: Sahar Shams

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Coeliac disease (CD) is a widely reported disease particularly in countries with predominant Caucasian populations. It presents with many signs and symptoms including iron deficiency (ID) and iron deficiency anaemia/anaemia (IDA/A). The exact association between ID, IDA/A and CD and how accurate these signs are in diagnosing CD is not fully known. This systematic review was conducted to investigate the accuracy of both ID & IDA/A as a diagnostic indicator for CD and whether it warrants point of care testing. A systematic review was performed looking at studies published in MEDLINE, Embase, Cochrane Library, and Web of Science. QUADAS-2 tool was used to assess risk of bias in each study. ROC curve and forest plots were generated as part of the meta-analysis after data extraction. 16 studies were identified in total, 13 of which were IDA/A studies and 3 ID studies. The prevalence of CD regardless of diagnostic indicator was assumed as 1%. The QUADAS-2 tool indicated most of studies as having high risk of bias. The PPV for CD was higher in those with ID than for those with IDA/A. Meta-analysis showed the overall odds of having CD is 5 times higher in individuals with ID & IDA/A. The ROC curve showed that there is definitely an association between both diagnostic indicators and CD, the association is not a particularly strong one due to great heterogeneity between studies. Whilst an association between IDA/A & ID and coeliac disease was evident, the results were not deemed significant enough to prompt coeliac disease testing in those with IDA/A & ID.

Keywords: anemia, iron deficiency anemia, coeliac disease, point of care testing

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Authors: Iman Nazari, Behrouz Shaabani, Ali Ramouz

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Regarding to the dramatic rise of cancer prevalence of cancers in Iran and also base on the investigations around environmental factors which causes cancer, The air and water pollution is in high level in Iran’s capital city this issue motivated us to start an investigation on concentration of heavy metals and nitrate in Tehran’s Tap water, additionally we investigated the effects of this contaminations on public health, it is clear that heavy metals and also nitrate are causes cancers directly and indirectly, we divided the city to four districts: (1) North, (2) East, (3) West, (4) South and totally collected over 30 samples from noted districts, we obvious difference in concentrations, after a study we founded the reasons of this difference, the old distribution system, non-standard sewage disposal system, travel up from contaminated rains, releasing industrial wastes waters without any pretreatment, the most important one is the old distribution system, Tehran is an old city hence distribution system is old too we know that the old water pipes were built from alloys which containing several of this harmful heavy metals, releasing of this heavy metals from pipes to the tap water is one of the most Important reasons, as the result we presented the concentrations by districts and the alternatives to decreasing the level of this contaminations.

Keywords: water quality, heavy metals, drinking water, environmental toxinology

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Authors: Shachi Joshi

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Purpose: The primary aim of this study was to determine the prevalence of pelvic dysfunction symptoms following OASI. The secondary aim was to assess the scope of a dedicated perineal trauma clinic in identifying and investigating women that have experienced faecal incontinence after OASI and if a transitional clinic arrangement to colorectal surgeons would be useful. Methods: The clinical database was used to identify and obtain information about 118 women who sustained an OASI (3rd/ 4th degree tear) between August 2016 and July 2017. A questionnaire was designed to assess symptoms of pelvic dysfunction; this was sent via the post in November 2018. Results: The questionnaire was completed by 45 women (38%). Faecal incontinence was experienced by 42% (N=19), flatus incontinence by 47% (N=21), urinary incontinence by 76% (N=34), dyspareunia by 49% (N=22) and pelvic pain by 33% (N=15). Of the questionnaire respondents, only 62% (N=28) had attended a perineal trauma clinic appointment. 46% (N=13) of these women reported having experienced difficulty controlling flatus or faeces in the questionnaire, however, only 23% (N=3) of these reported ongoing symptoms at the time of clinic attendance and underwent an endoanal ultrasound scan. Conclusion: Pelvic dysfunction symptoms are highly prevalent following an OASI. Perineal trauma clinic attendance alone is not sufficient for identification and follow up of symptoms. Transitional care is needed between obstetric and colorectal teams, to recognize and treat women with ongoing faecal incontinence.

Keywords: incontinence, obstetric anal sphincter, injury, repair

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Authors: S. I. Nwadioha, M. S. Odimayo, G. T. A. Jombo, E. O. P. Nwokedi

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Aims and Objectives: To determine the baseline CD4 positive T lymphocytes count of HIV/AIDS treatment naïve adults clients presenting for the first time treatment in Benue State University Teaching Hospital. Subjects and Methods: A total of 700 subjects age between 18 years to 70 years, were recruited for the study, comprising 600 HIV sero-positive patients and 100 healthy controls in Benue State University Teaching Hospital, Makurdi from 2013 to 2014. The CD4 counts of the subjects were evaluated using a Partec flow cytometer. Results: CD4 count of 200-299 cells/μl peaked with 25% (n=150/600)[control; 0%( n= 0/100)]. The study also showed that 44% (266/600) of HIV subjects had acquired immunodeficiency syndrome as defined by low CD4 counts below 200 cells/μl. Seventy-five per cent (n=451/600)of our patients would require to be placed on antiretroviral therapy with CD4 count of less than 350 cells/μl. At CD4 350 baseline criterion, age group 20-29 years had the highest demand 35%(160/451) for ARV followed by age groups 30-39 and 40-49 years with 28%(128/451) and 22%(98/451) respectively. Conclusion: There is a high prevalence of acquired immunodeficiency syndrome as defined by CD4 counts below 200 cells/μl, among the young active productive age group. The strict adopting of the ART WHO 2010 scale- up criteria doubles the number of the HIV clients that would qualify for ART with its attendant health benefits on the long run.

Keywords: CD4 counts, HIV patients, young age group, Nigeria

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Authors: Jinu Phonamontham

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Coronavirus, also referred to as COVID-19, is a virus caused by the SARS-Cov-2 virus. The pandemic has caused over 10 million cases and 500,000 deaths worldwide through the end of June 2020. In a previous study, HLA-DQA1*01:02 allele was associated with COVID-19 disease (p-value = 0.0121). Furthermore, there was a statistical significance between HLA- DQB1*06:02 and COVID-19 in the Italian population by Bonferroni’s correction (p-value = 0.0016). Nevertheless, there is no data describing the distribution of HLA alleles as a valid marker for prediction of COVID-19 in the Thai population. We want to investigate the prevalence of HLA-DQA1*01:02 and HLA-DQB1*06:02 alleles that are associated with severe COVID-19 in the Thai population. In this study, we recruited 200 healthy Thai individuals. Genomic DNA samples were isolated from EDTA blood using Genomic DNA Mini Kit. HLA genotyping was conducted using the Lifecodes HLA SSO typing kits (Immucor, West Avenue, Stamford, USA). The frequency of HLA-DQA1 alleles in Thai population, consisting of HLA-DQA1*01:01 (27.75%), HLA-DQA1*01:02 (24.50%), HLA-DQA1*03:03 (13.00%), HLA-DQA1*06:01 (10.25%) and HLA-DQA1*02:01 (6.75%). Furthermore, the distributions of HLA-DQB1 alleles were HLA-DQB1*05:02 (21.50%), HLA-DQB1*03:01 (15.75%), HLA-DQB1*05:01 (14.50%), HLA-DQB1*03:03 (11.00%) and HLA-DQB1*02:02 (8.25%). Particularly, HLA- DQA1*01:02 (29.00%) allele was the highest frequency in the NorthEast group, but there was not significant difference when compared with the other regions in Thais (p-value = 0.4202). HLA-DQB1*06:02 allele was similarly distributed in Thai population and there was no significant difference between Thais and China (3.8%) and South Korea (6.4%) and Japan (8.2%) with p-value > 0.05. Whereas, South Africa (15.7%) has a significance with Thais by p-value of 0.0013. This study supports the specific genotyping of the HLA-DQA1*01:02 and HLA-DQB1*06:02 alleles to screen severe COVID-19 in Thai and many populations.

Keywords: HLA-DQA1*01:02, HLA-DQB1*06:02, Asian, Thai population

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Authors: Tripta Dixit, Smita Sahu, William Selvamurthy, Sadhana Srivastava

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India is battling with the issues of accessibility, affordability and availability of quality health to the masses. Indian medical heritage which dated back to 3000 BC unveils the rich knowledge pool which has undergone a perceptible change over years, such as eradication of many communicable diseases, increasing individual awareness of quality health and import driven medical device market etc. Despite a slew of initiatives the holistic slogan of ‘health for all’ remains elusive and a concern for the nation. The 21st-century projects a myriad of challenges like cultural diversity, large population, demographic dividend and geographical segmentation leading to varied needs of people as per their regional conditions of climate, disease prevalence, nutrition and sanitation. But these challenges are also opportunities for the development of indigenous, low cost and accessible technologies to tackle them. This requires reinforcing the potential of indigenous technologies in coordination with prevailing health issues in various regions of country. This paper emphasis on the strategy for exploring the indigenous technologies with entrusted up-scaling to meet the diverse needs of the people. This review proposes to adopt technology transfer as a strategy to establish a vibrant ecosystem for identifying and up-scaling the indigenous medical technologies with diligent hand-holding for public health.

Keywords: health, indigenous, medical technology, technology transfer

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Authors: Siriniya Siribrahmanakul

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Introduction:SARsCOVID-19 is rapidly spreading, and some people may exhibit severe symptoms. Mortality rate of 2.0–3.0% with COVID-19 infection atworldwide. Human leukocyte antigen (HLA), located on chromosome 6, consist of HLA class I and class II. HLA are used by the immune system to attach self-antigens. Previous studies, HLA-DRB1*01:01,HLA-DRB1*12:01and HLA-DRB1*14:04 were, showed significant difference with severe COVID-19 in the Chinese population by p-value < 0.05. Objective: We investigated the prevalence of HLA-DRB1 alleles associated with severe COVID-19 in Thai population. Materials and Methods:200 DNA samples were isolated from EDTA blood using the MagNAprue Compact Nucleic Acid Isolation kits.HLA-DRB1alleles were genotyped using sequence-specific oligonucleotides (PCR-SSOs). Results:The frequency of HLA-DRB1 alleles in Thai population wereHLA-DRB1*12:02 (15.75%), HLA-DRB1*15:02 (14.50%), HLA-DRB1*09:01 (11.50%), HLA-DRB1*07:01 (9.50%), HLA-DRB1*03:01,HLA-DRB1*05:01 (5.75%), HLA-DRB1*14:01 (5.50%), HLA-DRB1*16:02 (4.50%), HLA-DRB1*04:05 (4.00%), HLA-DRB1*14:03 (3.25%), HLA-DRB1*10:01 (2.25%) and HLA-DRB1*13:02 (2.00%). Particularly, HLA-DRB1*12:02 allele was the highest allele frequency presented in the four regions groups of Thai population. Furthermore, the HLA-DRB1* alleles associated with severe COVID-19, which consists ofHLA-DRB1*14:04(2.00 %) and HLA-DRB1*12:01(0.50%) in Thai population, whereas HLA-DRB1*01:01 allele was not found in this population. HLA-DRB1*14:04 and HLA-DRB1*12:01alleles were similarly distributed in four regions populations in Thailand (p-value > 0.05). The alleles frequencies of HLA-DRB1*14:04 and HLA-DRB1*12:01, which associated with severe COVID-19, had no significant differences between Thai population, South China population, South Africa population, and South Koreapopulation (p-value > 0.05). Conclusions: Particularly, this study has focused on allele frequency of HLA-DRB1*14:04in a healthy Thai population to evaluating their impact on the severe COVID-19. Furthermore, our research needs to be done in larger numbers of Thai patients.

Keywords: HLA-DRB1, allele frequency, Thai population, COVID-19 marker

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Authors: Polycarp A. Igbojekwe, Chizoba Amajuoyi, Peterson Nwokorie

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The main purpose of this study was to carry out a survey of customer’s aggression towards hotel workers and make contributions on the prevalence and rationale behind customer’s aggression. Data for the study were gathered with a four-point Likert type rating scale. Samples were drawn from frontline hotel employees, managers and customers of twelve (12) hotels selected from three zones of Imo State. Data analyses were conducted using simple percentage, descriptive statistics; and Z-test statistical technique was used to test hypotheses. Among other factors, service failure and verbal abuse by service providers and poor quality product compared to price were identified by customers as the three major factors that can lead to customer aggression. Frontline employees indentified verbal abuse as the most common mode of aggression and that customer aggression causes emotional disturbance in them. The study also revealed that customer aggression is more prevalent in the 1&2 star hotels than it is in 3-5 star hotels. Most of the hotels have not institutionalized systematic approaches needed to effectively face the challenges of customer aggression, thus, customer aggression has become a common feature in the industry. Frontline jobs demand high emotional input. Therefore, we recommend that frontline employees should be given emotional support by their managers and also trained on how to cope with emotional disturbance.

Keywords: customer aggression, emotional disturbance, employee well-being, service failure, verbal abuse

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Authors: Nazirah Hassan, Andrew Kendrick

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This study investigates the prevalence of perpetration behavior and victimization in juvenile correctional institutions. It investigates the dimensions of institutional environments and explores which environmental features relate to perpetration behaviors. The project focused on two hundred and eighty nine male and female young offenders aged 12 to 21 years old, in eight juvenile institutions in Malaysia. The research collected quantitative and qualitative data using a mixed-method approach. All participants completed the scale version of Direct and Indirect Prisoner behavior Checklist (DIPC-SCALED) and the Measuring the Quality of Prison life (MQPL). In addition, twenty-four interviews were carried out which involved sixteen residents and eight institutional staff. The findings showed that 95 per cent reported at least one behavior indicative of perpetration, and 99 per cent reported at least one behavior indicative of victimization in the past month. The DIPC-SCALED scored significantly higher on the verbal sub-scale. In addition, factors such as harmony, staff professionalism, security, family and wellbeing showed significant relation to the perpetration behavior. In the interviews, the residents identified circumstances, which affected their behavior within the institutions. This reflected the choices and decisions about how to confront the institutional life. These findings are discussed in terms of existing literature and their practical implications are considered.

Keywords: juvenile institutions, incarcerated offenders, perpetration, victimization

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Authors: Natalie Thorburn

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New Zealand legalised and regulated prostitution 13 years ago with the hope of eradicating unsafe or exploitative practices in the sex trade, but the extent to which this has been successful has been hotly contested, with the New Zealand Government denying any existence of sex trafficking and evidence generally indicating the success of the 2004 reform. The aim of the research was therefore to establish the circumstances in which sex trafficking may be occurring without using any previously instrumental gatekeepers of the New Zealand sex industry. 14 survivors of gang, family, or intimate partner trafficking (all of whom had first been trafficked prior to the age of 16) were interviewed, as well as several key informants. It was found that there was a perceived lack of commitment by Police to investigate instances of trafficking, and this was considered to be linked to the legal status of prostitution. The lack of recognition at both community and political levels of the existence and prevalence of trafficking also meant that medical and social service practitioners were unaware trafficking was occurring, and would not know who to refer to if it was disclosed. Participants commonly normalised coercion into sex, seeing this as a continuation of prior sexually abusive experiences that were prevalent in their childhood and early adolescent environments. Their experiences with the helping services were typically either negative or non-existent, and they expressed frustration regarding the absence of justice, the lack of awareness, and health and outcomes they suffered in relation to their experiences of having been trafficked. Barriers to engagement and strategies to facilitate meaningful and sustainable engagement with this population group are therefore presented.

Keywords: legalisation, regulation, service access, socio-political context

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