Search results for: ethical progression

Authors: Shangqing Song, Bin Xu, Yajun Cheng, Zhong Wang

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miRNAs derived from exosomes exist in a body fluid such as urine were regarded as potential biomarkers for various human cancers diagnosis and prognosis, as mature miRNAs can be steadily preserved by exosomes. However, its potential value in clear cell renal cell carcinoma (ccRCC) diagnosis and prognosis remains unclear. In the present study, differentially expressed miRNAs from urinal exosomes were identified by next-generation sequencing (NGS) technology. The 16 differentially expressed miRNAs were identified between ccRCC patients and healthy donors. To explore the specific diagnosis biomarker of ccRCC, we validated these urinary exosomes from 70 early-stage renal cancer patients, 30 healthy people and other urinary system cancers, including 30 early-stage prostate cancer patients and 30 early-stage bladder cancer patients by qRT-PCR. The results showed that urinary exosome miR-30c-5p could be stably amplified and meanwhile the expression of miR-30c-5p has no significant difference between other urinary system cancers and healthy control, however, expression level of miR-30c-5p in urinary exosomal of ccRCC patients was lower than healthy people and receiver operation characterization (ROC) curve showed that the area under the curve (AUC) values was 0.8192 (95% confidence interval was 0.7388-0.8996, P= 0.0000). In addition, up-regulating miR-30c-5p expression could inhibit renal cell carcinoma cells growth. Lastly, HSP5A was found as a direct target gene of miR-30c-5p. HSP5A depletion reversed the promoting effect of ccRCC growth casued by miR-30c-5p inhibitor, respectively. In conclusion, this study demonstrated that urinary exosomal miR-30c-5p is readily accessible as diagnosis biomarker of early-stage ccRCC, and miR-30c-5p might modulate the expression of HSPA5, which correlated with the progression of ccRCC.

Keywords: clear cell renal cell carcinoma, exosome, HSP5A, miR-30c-5p

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Authors: Zwelenkani Mdlalose

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From the moment Covid 19 was declared a pandemic it became clear that conspiracy theories would significantly impact our response to the crisis that the virus was to become. Central to the interest in conspiracy theories evoked by a pandemic is a more general concern for the impact they have on society and social harmony. The specific brand of Conspiracy Theory that is in question is not any and all theories about conspiracies but rather those conspiracy theories which contradict official accounts. For example, where the official account on the terrorist attacks of September 11 2001 is of a conspiracy involving 19 militants associated with the Islamic extremist group al-Qaeda against targets in the United States, the nature of conspiracy theory under study is the one contradicting this official account to the extent that its attributes the attacks not to al-Qaeda militants but to actors in the United States government itself. The study is not an investigation into the truth value of conspiracy theories but rather an attempt at observing the essential qualities of the type of belief that is belief in conspiracy theories compared to belief in official accounts provided by authoritative sources such as governments, experts and mainstream media. These qualities include the psychological, epistemic and socio-political foundations on which belief in conspiracy theories are established. Based on a foundational understanding of the sort of belief that are beliefs in conspiracy theories, we may then extrapolate implied ethical demands on both authoritative bodies and actors as well as believers in conspiracy theories. For example: in their unofficial ‘non-factual’ status, is there not some violation of epistemic right in the same way we observe in cases where people are prejudiced because of their religious beliefs? In other words, is there an epistemic injustice suffered by believers in conspiracy theories in the way their beliefs are rejected as illegitimate? Conversely, to what extent do believers bear an epistemic responsibility in their adoption of their beliefs in conspiracy theories. From this position, perhaps we can then develop responses to the problem that foster greater social harmony even in the midst of suspicion and distrust.

Keywords: conspiracy theories, subjugated knowledge, epistemic injustice, epistemic responsibility

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Authors: Atena Sadat Hosseini, Mohammadhossein Habibi

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Acute myeloid leukemia (AML) is the most typically diagnosed leukemia. In older adults, AML imposes a dismal outcome. AML originates with a dominant mutation, then adds collaborative, transformative mutations leading to myeloid transformation and clinical/biological heterogeneity. Several chemotherapeutic drugs are used for this cancer. These drugs are naturally associated with several side effects, and finding a more accurate molecular mechanism of these drugs can have a significant impact on the selection and better candidate of drugs for treatment. In this study, we evaluated bortezomibin myeloma cells using bioinformatics analysis and evaluation of RNA-Seq data. Then investigated the molecular pathways proteins- proteins interactions associated with this chemotherapy drug. A total of 658upregulated genes and 548 downregulated genes were sorted.AUF1 (hnRNP D0) binds and destabilizes mRNA, degradation of GLI2 by the proteasome, the role of GTSE1 in G2/M progression after G2 checkpoint, TCF dependent signaling in response to WNT demonstrated in upregulated genes. Besides insulin resistance, AKT phosphorylates targets in the nucleus, cytosine methylation, Longevity regulating pathway, and Signal Transduction of S1P Receptor were related to low expression genes. With respect to this results, HIST2H2AA3, RP11-96O20.4, ZED9, PRDX1, and DOK2, according to node degrees and betweenness elements candidates from upregulated genes. in the opposite side, PYURF, NRSN1, FGF23, UPK3BL, and STAG3 were a prominent role in downregulated genes. Sum up, Using in silico analysis in the present study, we conducted a precise study ofbortezomib molecular mechanisms in myeloma cells. so that we could take further evaluation to discovermolecular cancer therapy. Naturally, more additional experimental and clinical procedures are needed in this survey.

Keywords: myeloma cells, acute myeloid leukemia, bioinformatics analysis, bortezomib

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Authors: Richard O’Riordan, Saritha Unnikrishnan

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Autonomous Vehicles (AVs) are incorporating an increasing number of ADAS features, including automated lane-keeping systems. In recent years, many research papers into lane detection algorithms have been published, varying from computer vision techniques to deep learning methods. The transition from lower levels of autonomy defined in the SAE framework and the progression to higher autonomy levels requires increasingly complex models and algorithms that must be highly reliable in their operation and functionality capacities. Furthermore, these algorithms have no room for error when operating at high levels of autonomy. Although the current research details existing computer vision and deep learning algorithms and their methodologies and individual results, the research also details challenges faced by the algorithms and the resources needed to operate, along with shortcomings experienced during their detection of lanes in certain weather and lighting conditions. This paper will explore these shortcomings and attempt to implement a lane detection algorithm that could be used to achieve improvements in AV lane detection systems. This paper uses a pre-trained LaneNet model to detect lane or non-lane pixels using binary segmentation as the base detection method using an existing dataset BDD100k followed by a custom dataset generated locally. The selected roads will be modern well-laid roads with up-to-date infrastructure and lane markings, while the second road network will be an older road with infrastructure and lane markings reflecting the road network's age. The performance of the proposed method will be evaluated on the custom dataset to compare its performance to the BDD100k dataset. In summary, this paper will use Transfer Learning to provide a fast and robust lane detection algorithm that can handle various road conditions and provide accurate lane detection.

Keywords: ADAS, autonomous vehicles, deep learning, LaneNet, lane detection

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Authors: Sherif D. El Wakil, John Rice

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The aim of the current work was to employ the finite element method to model a slab, with a small hole across its width, undergoing plastic plane strain deformation. The computational model had, however, to be validated by comparing its results with those obtained experimentally. Since they were in good agreement, the finite element method can therefore be considered a reliable tool that can help gain better understanding of the mechanism of ductile failure in structural members having stress raisers. The finite element software used was ANSYS, and the PLANE183 element was utilized. It is a higher order 2-D, 8-node or 6-node element with quadratic displacement behavior. A bilinear stress-strain relationship was used to define the material properties, with constants similar to those of the material used in the experimental study. The model was run for several tensile loads in order to observe the progression of the plastic deformation region, and the stress concentration factor was determined in each case. The experimental study involved employing the visioplasticity technique, where a circular mesh (each circle was 0.5 mm in diameter, with 0.05 mm line thickness) was initially printed on the side of an aluminum slab having a small hole across its width. Tensile loading was then applied to produce a small increment of plastic deformation. Circles in the plastic region became ellipses, where the directions of the principal strains and stresses coincided with the major and minor axes of the ellipses. Next, we were able to determine the directions of the maximum and minimum shear stresses at the center of each ellipse, and the slip-line field was then constructed. We were then able to determine the stress at any point in the plastic deformation zone, and hence the stress concentration factor. The experimental results were found to be in good agreement with the analytical ones.

Keywords: finite element method to model a slab, slab undergoing plastic deformation, stress distribution around a circular hole, visioplasticity

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Authors: Iveta Eimontaite, Sarah R. Fletcher, Michele Surico, Alfio Minissale, Fabio F. Abba

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Industry 4.0 offers possibilities for increased production volumes and greater efficiency whilst at the same time presenting new opportunities and challenges for the human workforce. Exoskeletons have been used in healthcare and are now starting to be adopted in manufacturing. The potential benefits of reducing fatigue and physical strain are attractive prospects of the technology for industry; however, the novelty of exoskeletons and surrounding ethical issues raise concerns amongst the stakeholders. The current case study investigated the introduction of an upper body exoskeleton designed to support posture but not increase physical strength in a factory over three time points: before the exoskeleton was introduced, and one and two months post-introduction once operators had experienced working with it. The main focus was to evaluate changes in operators' workload, situation awareness, technology self-efficacy, and physical discomfort following the introduction of the exoskeleton. After using the exoskeleton over two months, operators reported a decrease in temporal demand and an increase in performance of the NASA TLX instrument. Furthermore, over the second month, operators' self-reported technology self-efficacy scores increased, but at the same time, their situation awareness decreased. Interestingly, operators' physical discomfort after using the exoskeleton for two months increased from not uncomfortable to quite uncomfortable in the shoulder, arm, and middle back regions. The results suggest that self-perceived task efficiency improved; however, increased discomfort and decreased situation awareness scores indicate that two months might not be long enough for the exoskeleton to be integrated into operators’ mental body schema. The paper will discuss further implications and suggestions for exoskeleton introduction to manufacturing environments.

Keywords: exoskeleton, manufacturing, mental workload, physical discomfort, situation awareness, technology self-efficacy

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Authors: Amenador Kate Benedicta, Wang Zhiwei

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Since the later parts of the 20th century, the notion of equivalence continues to be a central and critical concept in the development of translation theory. After decades of arguments over word-for-word and free translations methods, scholars attempting to develop more systematic and efficient translation theories began to focus on fundamental translation concepts such as equivalence. Although the concept of equivalence has piqued the interest of many scholars, its definition, scope, and applicability have sparked contentious arguments within the discipline. As a result, several distinct theories and explanations on the concept of equivalence have been put forward over the last half-century. Thus, this study explores and discusses the evolution of the critical concept of equivalence in translation studies through a bibliometric method of investigation of manual and digital books and articles by analyzing different scholars' key contributions and limitations on equivalence from various theoretical perspectives. While analyzing them, emphasis is placed on the innovations that each theory has brought to the comprehension of equivalence. In order to achieve the aim of the study, the article began by discussing the contributions of linguistically motivated theories to the notion of equivalence in translation, followed by functionalist-oriented contributions, before moving on to more recent advancements in translation studies on the concept. Because equivalence is such a broad notion, it is impossible to discuss each researcher in depth. As a result, the most well-known names and their equivalent theories are compared and contrasted in this research. The study emphasizes the developmental progression in our comprehension of the equivalence concept and equivalent effect. It concluded that the various theoretical perspective's contributions to the notion of equivalence rather complement and make up for the limitations of each other. The study also highlighted how troublesome the equivalent concept might become in terms of identifying the nature of translation and how central and unavoidable the concept is in every translation action, despite its limitations. The significance of the study lies in its synthesis of the different contributions and limitations of the various theories offered by scholars on the notion of equivalence, lending literature to both student and scholars in the field, and providing insight on future theoretical development

Keywords: equivalence, functionalist translation theories, linguistic translation approaches, translation theories, Skopos

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Authors: Melvin Ouma

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Language is one of the most crucial tools in medical interaction. Its importance is as great today as it was many decades ago. Difficulty in openly discussing certain diseases and body parts is one of the challenges in language use in medical contexts. Guided by H. P. Grice’s Cooperative Principle, this paper explores the flouting of the cooperative principles in Swahili speaking medical setting. The paper examines how men flout the maxims using the Swahili language when reporting reproductive health problems to the doctor. The data used was gathered from a qualitative study carried out in a reproductive health clinic in a public facility in Nakuru County, Kenya. All the research protocols were observed by acquiring all the research permits. Respondents' ethical considerations of consent, privacy, and confidentiality were observed. The respondents recruited were men who visited the reproductive health clinic and voluntarily agreed to participate in the study without coercion or compensation. Participant observation was the key data collection tool, with the doctor and patient conversation digitally recorded. The researcher was allowed into the clinic in a socially acceptable role. Male patients flouted the maxims of quantity, quality, relation, and manner in order to describe their reproductive health problems without embarrassment using the Swahili language. The flouting was done through the discursive strategies of narration and circumlocution. Flouting of the maxims was acceptable to the doctor and patient due to the fact that sexual intercourse and private body parts are taboo topics and uncomfortable to talk about. The quality of health care received by the patient depended on the doctor’s patience when all the maxims were flouted. In the reproductive health clinic, flouting of maxims hindered communication and, at the same time, enhanced communication between the doctor and patient.

Keywords: cooperative principle, doctor, men, reproductive health

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Authors: Zhipeng Yan, Janice Wing-Tung Kwong, Ching-Lung Lai

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Background: Advanced melanoma accounts for the majority of skin cancer death due to its poor prognosis. Nivolumab and ipilimumab are monoclonal antibodies targeting programmed cell death protein 1 (PD-1) and cytotoxic T-lymphocytes antigen 4 (CTLA-4). Nivolumab and ipilimumab combination therapy has been proven to be effective for advanced melanoma. This systematic review and meta-analysis are to evaluate its clinical efficacy and adverse events. Method: A systematic search was done on databases (Pubmed, Embase, Medline, Cochrane) on 21 June 2020. Search keywords were nivolumab, ipilimumab, melanoma, and randomised controlled trials. Clinical trials fulfilling the inclusion criteria were selected to evaluate the efficacy of combination therapy in terms of prolongation of progression-free survival (PFS), overall survival (OS), and objective response rate (ORR). The odd ratios and distributions of grade 3 or above adverse events were documented. Subgroup analysis was performed based on PD-L1 expression-status and BRAF-mutation status. Results: Compared with nivolumab monotherapy, the hazard ratios of PFS, OS and odd ratio of ORR in combination therapy were 0.64 (95% CI, 0.48-0.85; p=0.002), 0.84 (95% CI, 0.74-0.95; p=0.007) and 1.76 (95% CI, 1.51-2.06; p < 0.001), respectively. Compared with ipilimumab monotherapy, the hazard ratios of PFS, OS and odd ratio of ORR were 0.46 (95% CI, 0.37-0.57; p < 0.001), 0.54 (95% CI, 0.48-0.61; p < 0.001) and 6.18 (95% CI, 5.19-7.36; p < 0.001), respectively. In combination therapy, the odds ratios of grade 3 or above adverse events were 4.71 (95% CI, 3.57-6.22; p < 0.001) compared with nivolumab monotherapy, and 3.44 (95% CI, 2.49-4.74; p < 0.001) compared with ipilimumab monotherapy, respectively. High PD-L1 expression level and BRAF mutation were associated with better clinical outcomes in patients receiving combination therapy. Conclusion: Combination therapy is effective for the treatment of advanced melanoma. Adverse events were common but manageable. Better clinical outcomes were observed in patients with high PD-L1 expression levels and positive BRAF-mutation.

Keywords: nivolumab, ipilimumab, advanced melanoma, systematic review, meta-analysis

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Authors: Sonja Grobler

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Background: Leadership and specifically Leader, member exchange has a definite impact on employee behaviour and attitudes, and specifically their state of psychological capital. The interactionist construct of person-organisational fit (P-O fit), consisting of a combination of supplementary fit (indirect fit or value congruence) and complementary fit (direct or person-job fit, as well as needs-supply fit) may, however, impact on the relationship between LMX and psychological capital. The unique permutations of these relationships are important not only for conceptualisation purposes but also for intervention design to enhance the employees’ psychological capital; this would contribute to positive employee behaviour and attitudes. Aim: The purpose of this study was to determine whether a relationship exists between Leader, Member Exchange (LMX) and psychological capital, with possible mediation by P-O fit. Setting: The research was conducted with ± 60 employees from each of 43 private sectors and four public sector organisations in South Africa. Method: This study utilised a positivist methodology based on an empirical approach while using a cross-sectional design and quantitative analysis. The sample is relatively representative (in terms of race, gender, and the South African work force), as it consisted of 60 employees from each of the 43 South African organisations that participated in the study, with 2 486 respondents in total. Results: Significant, positive relationships were found between LMX, P-O fit, and psychological capital. Additionally, it was found that P-O fit partially mediates the relationship between ethical leadership and supervisory trust, confirming the proposed model. Conclusion: A strong, positive relationship exists between LMX (consisting of Affect, Loyalty, Contribution, and Professional Respect) and psychological capital (consisting of Self-efficacy, Hope, Resilience and Optimism) which is partially mediated by P-O fit (consisting of supplementary fit and complementary fit).

Keywords: leader and member exchange, person-organisational fit, psychological capital, positive psychology, interactionist approach

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Authors: Nsimbe Allan

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The study examines the impact of Building Information Modeling (BIM) on the cost management of engineering projects, focusing specifically on the Mombasa Port Area Development Project. The objective of this research venture is to determine the mechanisms through which Building Information Modeling (BIM) facilitates stakeholder collaboration, reduces construction-related expenses, and enhances the precision of cost estimation. Furthermore, the study investigates barriers to execution, assesses the impact on the project's transparency, and suggests approaches to maximize resource utilization. The study, selected for its practical significance and intricate nature, conducted a Systematic Literature Review (SLR) using credible databases, including ScienceDirect and IEEE Xplore. To constitute the diverse sample, 69 individuals, including project managers, cost estimators, and BIM administrators, were selected via stratified random sampling. The data were obtained using a mixed-methods approach, which prioritized ethical considerations. SPSS and Microsoft Excel were applied to the analysis. The research emphasizes the crucial role that project managers, architects, and engineers play in the decision-making process (47% of respondents). Furthermore, a significant improvement in cost estimation accuracy was reported by 70% of the participants. It was found that the implementation of BIM resulted in enhanced project visibility, which in turn optimized resource allocation and facilitated the process of budgeting. In brief, the study highlights the positive impacts of Building Information Modeling (BIM) on collaborative decision-making and cost estimation, addresses challenges related to implementation, and provides solutions for the efficient assimilation and understanding of BIM principles.

Keywords: cost management, resource utilization, stakeholder collaboration, project transparency

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Authors: Paula M. Lantz

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In the United States, significant socioeconomic and racial inequalities exist in many population-based indicators of health and social welfare. Although a number of effective prevention programs and interventions are available, local and state governments often do not pursue prevention in the face of budgetary constraints and more acute problems. There is growing interest in and excitement about Pay for Success” (PFS) strategies, also referred to as social impact bonds, as an approach to financing and implementing promising prevention programs and services that help the public sector either save money or achieve greater value for an investment. The PFS finance model implements evidence-based interventions using capital from investors who only receive a return on their investment from the government if agreed-upon, measurable outcomes are achieved. This paper discusses the current landscape regarding social impact bonds in the U.S., and their potential and challenges in addressing serious health and social problems. The paper presents an analysis of a number of social science issues that are fundamental to the potential for social impact bonds to successfully address social inequalities in health and social welfare. This includes: a) the economics of the intervention and a potential public payout; b) organizational and management issues in intervention implementation; c) evaluation research design and methods; d) legal/regulatory issues in public payouts to investors; e) ethical issues in the design of social impact bond deals and their evaluation; and f) political issues. Despite significant challenges in the U.S. context, there is great potential for social impact bonds as a type of social impact investing to encourage private investments in evidence-based interventions that address important public health and social problems in underserved populations and provide a return on investment.

Keywords: pay for success, public/private partnerships, social impact bonds, social impact investing

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Authors: Laurin Zemmrich, Nicolai Stickler

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With the ongoing debate over how to incorporate sustainability, resilience, and value creation into business strategies, many procurement departments are put under pressure by governments, consumers, non-governmental organizations, and other stakeholders to disclose more information about their supply chains. According to practitioners and experts, procurement benefits the supply chain by increasing transparency and accountability, recruiting new suppliers, and supporting sustainable and ethical sourcing strategies. While most procurement departments establish these objectives, the bulk of activities are not carried out or are not regularly monitored. With the full potential of targeted sourcing still to be realized, procurement executives, in particular, are seeking for short-term cost-cutting impacts to appease external shareholders. We overcome this limitation by using an abductive approach to research and integrating empirical data from a Gioia methodology study design with relevant literature. Our analysis demonstrates that the procurement department has six essential levers aligned with sustainability, resilience, and value creation objectives and contributes to developing a new intra- and interorganizational purpose within the supply chain. Three enablers are identified as having a value-creating effect on supply chain interactions. Additionally, we discovered two impacts that alter the power balance between buyers and suppliers during transactions and have a cost-cutting or cost-avoiding effect. While cost-cutting, cost-avoidance, and dependency-reduction impacts are desirable, redistributing power may also have negative consequences. The article establishes a first strategy framework for evaluating the influence of the procurement department on supply chain transactions, allowing managers to understand better and apply the sourcing function inside a supply chain and embed it throughout the business.

Keywords: supply chain management, resilience, sustainability, value creation, purpose

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Authors: Tadesse Melaku Abegaz

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Background: there was paucity of data on the self-reported adverse drug reactions (ADRs), level of adherence and clinical outcomes with antidepressants among major depressive disorder (MDD) patients in Ethiopia. Hence, the present study sought to determine the level of adherence for and clinical outcome with antidepressants and the magnitude of ADRs. Methods: A prospective cross-sectional study was employed on MDD patients from September 2016 to January 2017 at Gondar university hospital psychiatry clinic. All patients who were available during the study period were included under the study population. The Naranjo adverse drug reaction probability scale was employed to assess the adverse drug reaction. The rate of medication adherence was determined using morisky medication adherence measurement scale eight. Clinical Outcome of patients was measured by using patient health questionnaire. Multivariable logistic carried out to determine factors for adherence and patient outcome. Results: two hundred seventy patients were participated in the study. More than half of the respondents were males 122(56.2%). The mean age of the participants was 30.94 ± 8.853. More than one-half of the subjects had low adherence to their medications 124(57.1%). About 186(85.7%) of patients encountered ADR. The most common ADR was weight gain 29(13.2). Around 198(92.2%) ADRs were probable and 19(8.8%) were possible. Patients with long standing MDD had high risk of non-adherence COR: 2.458[4.413-4.227], AOR: 2.424[1.185-4.961]. More than one-half 125(57.6) of respondents showed improved outcome. Optimal level of medication adherence was found to be associated with reduced risk of progression of the diseases COR: 0.37[0.110-5.379] and AOR: 0.432[0.201-0.909]. Conclusion: Patient reported adverse drug reactions were more prevalent in major depressive disorder patients. Adherence to medications was very poor in the setup. However, the clinical outcome was relatively higher. Long standing depression was associated with non-adherence. In addition, clinical outcome of patients were affected by non-adherence. Therefore, adherence enhancing interventions should be provided to improve medication adherence and patient outcome.

Keywords: adverse drug reactions, clinical outcomes, Ethiopia, prospective study, medication adherence

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Authors: Ambrish Tiwari, Sudhasini Panda, Archana Singh, Kalpana Luthra, S. K. Sharma

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Introduction: On the basis of available literature we know that various host factors play a role in outcome of Tuberculosis (TB) infection by modulating innate immunity. One such factor is Inducible Nitric Oxide Synthase enzyme (iNOS) which help in the production of Nitric Oxide (NO), an antimicrobial agent. Expression of iNOS is in control of various host factors in which Vitamin D along with its nuclear receptor Vitamin D receptor (VDR) is one of them. Vitamin D along with its receptor also produces cathelicidin (antimicrobicidal agent). With this background, we attempted to investigate the levels of Vitamin D and NO along with their associated molecules in tuberculosis patients and household contacts as compared to healthy controls and assess the implication of these findings in susceptibility to tuberculosis (TB). Study subjects and methods: 100 active TB patients, 75 household contacts, and 70 healthy controls were taken. VDR and iNOS mRNA levels were studied using real-time PCR. Serum VDR, cathelicidin, iNOS levels were measured using ELISA. Serum Vitamin D levels were measured in serum samples using chemiluminescence based immunoassay. NO was measured using colorimetry based kit. Results: VDR and iNOS mRNA levels were found to be lower in active TB group compared to household contacts and healthy controls (P=0.0001 and 0.005 respectively). The serum levels of Vitamin D were also found to be lower in active TB group as compared to healthy controls (P =0.001). Levels of cathelicidin and NO was higher in patient group as compared to other groups (p=0.01 and 0.5 respectively). However, the expression of VDR and iNOS and levels of vitamin D was significantly (P < 0.05) higher in household contacts compared to both active TB and healthy control groups. Inference: Higher levels of Vitamin D along with VDR and iNOS expression in household contacts as compared to patients suggest that vitamin D might have a protective role against TB which prevents activation of the disease. From our data, we can conclude that decreased vitamin D levels could be implicated in disease progression and we can use cathelicidin and NO as a biomarker for early diagnosis of pulmonary tuberculosis.

Keywords: vitamin D, VDR, iNOS, tuberculosis

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Authors: Farida Habib, Haya Alfozan, Eman Miligi, Najla Alotaibi

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Background: Women’s satisfaction with maternity services, especially care during labor and birth, has become highly significant to healthcare providers, administrators, and policymakers. Purpose: The aims of this study were to assess maternal satisfaction regarding the quality of care during labor and to compare the level of maternal satisfaction between women who delivered by physicians and those delivered by midwives. Methodology: A descriptive, cross-sectional, correlational design was used. A convenient sample of 180 low-risk cases of immediate postpartum women who delivered at King Abdul-Aziz medical city was recruited. Women whose babies were diagnosed with serious health problems were excluded from the study. Data were collected using a self-administered questionnaire. The validity and reliability of the questionnaire were ensured. The questionnaire included three parts, namely: demographics data, medical history, and obstetrical history, and the last part is the satisfaction assessment tool. Ethical confederations were ensured. Maternal satisfaction during labor was classified in terms of health care, health workers' communication, and the environment. Results: Regarding health care, women were highly satisfied with care received from nurse (M = 4.21 + 0.88), medical care received (M = 4.17 + 0.79), and comfort techniques (M = 4.04 + 0.91). Regarding health workers' communication, women were highly satisfied with the provider to treat with dignity and respect (M = 4.03 + 0.91) and orientation to the toilet, bathroom, washing area (M = 4.00 + 0.93). Regarding the environment, women were highly satisfied with the experience of their baby's birth (M = 4.18 + 0.98) and supplies with drugs and supplies (M = 4.09 + 0.97). There was no statistically significant difference in maternal satisfaction between women who delivered by physicians and those delivered by midwives. Conclusion: Women were generally satisfied with their labor and delivery experience. There was no difference in maternal satisfaction on the labor process between women who delivered by physicians and those delivered by midwives.

Keywords: maternity, satisfaction, labor, delivery

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Authors: Mehak Nagpal, T. S. Sathyanarayan Rao

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Background: Sexual functioning is a neglected aspect of health in women with diabetes, though it contributes greatly towards quality of life and feeling of wellbeing. Also women with DM are at higher risk than men of developing sexual dysfunction and depression. Materials and Methods: Cross-sectional comparison study. Sample size: 100 previously diagnosed type 2DM patients attending Outpatient Diabetic Clinic at Medicine department JSS Hospital Mysore; aged 20-65 years and 60 normal healthy female subjects for Control group. Data was collected with ethical approval over a period of 2 years. Tools Used: 1) Hamilton Depression Rating Scale (HAMD – 17 item) 2) Female Sexual Functioning Index (FSFI) 3) Arizona Sexual Experience Scale (ASEX-F) for female-for screening. 4) The Appraisal of Diabetes Scale (ADS). Results: Statistically significant differences were observed in prevalence rate and severity of depression between diabetic group (45% vs 11% syndromal depression) and controls. Depression scores correlated significantly with glycaemic control, adherence to treatment, BMI and the cognitive appraisal of diabetes. There was significantly greater impairment in the sexual functioning of women with type 2 diabetes mellitus as compared to controls; both prevalence (62% vs 38.3%) and severity (p value < 0.01). Arousal (74.2% vs 53.3%), Desire (76.3% vs 50%) and Satisfaction (76.7% vs 63.7%) were most affected and 64.5% were affected in 2 or more domains. A negative illness appraisal on ADS correlated significantly with poor glycaemic control, higher rates of depression and also more severe female sexual dysfunction (p value < 0.05). Conclusion: Diabetes specific factors that correlated significantly with FSD in this study included the psychological appraisal of diabetes, duration of diabetes, presence of complications and BMI.

Keywords: depression, female sexual dysfunction, India, type 2 diabetes mellitus

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Authors: Javad Sarvestan, Zdenek Svoboda

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Force-time (F-T) curvature characteristics are globally referenced as the main indicators of athletic jump performance. Nevertheless, to the best of authors’ knowledge, no investigation tried to deeply study the relationship between F-T curve variables and real-game jump performance among elite volleyball players. To this end, this study was designated to investigate the association between F-T curve variables, including movement timings, force, velocity, power, rate of force development (RFD), modified reactive strength index (RSImod), and net impulse with spike jump height during real-game circumstances. Twelve young elite volleyball players performed 3 countermovement jump (CMJ) and 3 spike jump in real-game circumstances with 1-minute rest intervals to prevent fatigue. Shapiro-Wilk statistical test illustrated the normality of data distribution, and Pearson’s product correlation test portrayed a significant correlation between CMJ height and peak RFD (0.85), average RFD (r=0.81), RSImod (r=0.88) and concentric net impulse (r=0.98), and also significant correlation between spike jump height and peak RFD (0.73), average RFD (r=0.80), RSImod (r=0.62) and concentric net impulse (r=0.71). Multiple regression analysis also reported that these factors have a strong contribution in predicting of CMJ (98%) and spike jump (77%) heights. Outcomes of this study confirm that the RFD, concentric net impulse, and RSImod values could precisely monitor and track the volleyball attackers’ explosive strength, muscular stretch-shortening cycle function efficiency, and ultimate spike jump height. To this effect, volleyball coaches and trainers are advised to have an in-depth focus on their athletes’ progression or the impacts of strength trainings by observing and chasing the F-T curve variables such as RFD, net impulse, and RSImod.

Keywords: net impulse, reactive strength index, rate of force development, stretch-shortening cycle

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Authors: Shahryar Eslamitabar

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Currently, the internet plays an important role in the various scientific, commercial and service practices. Thanks to information and communication technology, the healthcare industry via the internet, generally known as cyber-medicine, can offer professional medical service in a wider geographical area. Having some appealing benefits such as convenience in offering healthcare services, improved accessibility to the services, enhanced information exchange, cost-effectiveness, time-saving, etc. Tele-health has increasingly developed innovative models of healthcare delivery. However, it presents many potential hazards to cyber-patients, inherent in the use of the system. First, there are legal issues associated with the communication and transfer of information on the internet. These include licensure, malpractice, liabilities and jurisdictions as well as privacy, confidentiality and security of personal data as the most important challenge brought about by this system. Additional items of concern are technological and ethical. Although, there are some rules to deal with pitfalls associated with cyber-medicine practices in the USA and some European countries, yet for all developments, it is being practiced in a legal vacuum in many countries. In addition to the domestic legislations to deal with potential problems arisen from the system, it is also imperative that some international or regional agreement should be developed to achieve the harmonization of laws among countries and states. This article discusses some implications posed by the practice of cyber-medicine in the healthcare system according to the experience of some developed countries using a comparative study of laws. It will also review the status of tele-health laws in Iran. Finally, it is intended to pave the way to outline a plan for countries like Iran, with newly-established judicial system for health laws, to develop appropriate regulations through providing some recommendations.

Keywords: tele-health, cyber-medicine, telemedicine, criminal laws, legislations, time-saving

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Authors: Abhijit Dasgupta

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This paper explores the everyday lives of the Christians residing in a Bengali Christian neighborhood in Kolkata, termed here as the larger Christian para (para meaning neighborhood in Bengali). Through ethnography and reading of secondary sources, the paper discerns how various Christians across denominations – Protestants, Catholics and Pentecostals implicate the role of bishwas (faith and belief) in their interpersonal neighborhood relations. The paper attempts to capture the role of bishwas in producing, transforming and revising the meaning of 'neighbourhood' and 'neighbours' and puts forward the argument of the neighbourhood as a theological product. By interrogating and interpreting bishwas through everyday theological discussions and reflections, the paper examines and analyses the ways everyday theology becomes an essential source of power and knowledge for the Bengali Christians in reimagining their neighbourhood compared to the nearby Hindu neighbourhoods. Borrowing literature from everyday theology, faith and belief, the paper reads and analyses various interpretations of theological knowledge across denominations to probe the prominence of bishwas within the Christian community and its role in creating a difference in their place of dwelling. The paper argues that the meaning of neighbourhood is revisited through prayers, sermons and biblical verses. At the same time, the divisions and fissures are seen among Protestants and Catholics and also among native Bengali Protestants and non-native Protestant pastors, which informs us about the complexity of theology in constituting everyday life. Thus, the paper addresses theology's role in creating an ethical Christian neighbourhood amidst everyday tensions and hostilities of diverse religious persuasions. At the same time, it looks into the processes through which multiple theological knowledge leads to schism and interdenominational hostilities. By attempting to answer these questions, the paper brings out Christians' negotiation with the neighbourhood.

Keywords: anthropology, bishwas, christianity, neighbourhood, theology

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Authors: Dean J. Hill

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This paper undertakes the task of conducting an in-depth textual analysis of the cli-fi genre. It examines how writing in the genre contributes to expressing and facilitating the articulation of environmental consciousness through the form of narrative. The paper begins by situating cli-fi within the literary continuum of ecological narratives and identifying the unique textual characteristics and thematic preoccupations of this area. The paper unfolds how cli-fi transforms the esoteric nature of climate science into credible narrative forms by drawing on language use, metaphorical constructs, and narrative framing. It also involves how descriptive and figurative language in the description of nature and disaster makes climate change so vivid and emotionally resonant. The work also points out the dialogic nature of cli-fi, whereby the characters and the narrators experience inner disputes in the novel regarding the ethical dilemma of environmental destruction, thus demanding the readers challenge and re-evaluate their standpoints on sustainability and ecological responsibilities. The paper proceeds with analysing the feature of narrative voice and its role in eliciting empathy, as well as reader involvement with the ecological material. In looking at how different narratorial perspectives contribute to the emotional and cognitive reaction of the reader to text, this study demonstrates the profound power of perspective in developing intimacy with the dominating concerns. Finally, the emotional arc of cli-fi narratives, running its course over themes of loss, hope, and resilience, is analysed in relation to how these elements function to marshal public feeling and discourse into action around climate change. Therefore, we can say that the complexity of the text in the cli-fi not only shows the hard edge of the reality of climate change but also influences public perception and behaviour toward a more sustainable future.

Keywords: cli-fi genre, ecological narratives, emotional arc, narrative voice, public perception

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Authors: Simmi Chopra

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In the last few years, there has been a surge of Autoimmune diseases that have become more like an epidemic all over the world. The reasons vary from stress, insufficient sleep, smoking, genetics, environmental pollution, adulterated foods, and a diet full of “the deadly white,” which is white sugar and white flour. Most of the people diagnosed with these diseases are given steroids, opioids, supplements, or elimination diets to manage their lives, but most of them continue suffering to varying degrees. On the other hand, Ayurveda can help manage autoimmune problems effectively. Ayurveda is a 5000 years old holistic medical system from India that has an individualistic approach where health problems are looked at from the lens of balancing body and mind and by targeting the root cause of the problem. A combination of diet and lifestyle according to Ayurvedic principles, Ayurvedic herbal formulations and Ayurvedic therapies can help in the management of autoimmune and other chronic diseases. Panchkarma, which is an intense six weeks detox method, helps balance our body and mind, and has been very effective in managing autoimmune problems. The paper will introduce the basic concepts of Ayurveda and describe the terminologies- doshas, agni and ama. The paper will discuss the importance of diet and lifestyle according to the individual’s imbalance in the three functional parameters - doshas, which govern every aspect of our body and mind, our cells and tissues. The significance of agni, which can be correlated to digestive strength and ama, which can be correlated to toxins that are formed in our body leading to health problems, will be outlined. The Ayurvedic pathophysiology of autoimmune diseases will be discussed with emphasis on Rheumatoid arthritis, Multiple sclerosis and Psoriasis. Ayurvedic management will be discussed for these autoimmune conditions. As Ayurveda is an individualistic system, one protocol will not work for everyone. Therefore, case studies with Ayurvedic protocols for the above autoimmune disease will be presented. Conclusion: Ayurveda can help in managing as well as arresting the progression of autoimmune problems. Ayurveda is an ancient medical system, is much more needed today than ever. It is a tried and tested holistic system which has been practiced for the past many generations in India.

Keywords: ayurveda, autoimmune, diseases, nutrition

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Authors: Peter David Reiss

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The concept of the psychosis prodrome has allowed for the identification of adolescent and young adult patients who have a significantly elevated risk of developing schizophrenia spectrum disorders. A number of different interventions have been tested in order to prevent or delay progression of symptoms. To date, there has been no consistent meta-analytical evidence to support efficacy of antipsychotic treatment for patients in the prodromal state, and their use remains therefore inconclusive. Although antipsychotics may manage symptoms transiently, they have not been found to prevent or delay onset of psychotic disorders. Furthermore, pharmacological intervention in high-risk individuals remains controversial, because of the antipsychotic side effect profile in a population in which only about 20 to 35 percent will eventually convert to psychosis over a two-year period, with even after two years conversion rates not exceeding 30 to 40 percent. This general estimate is additionally problematic, in that it ignores the fact that there is significant variation in individual risk among clinical high-risk cases. The current lack of reliable tests for at-risk patients makes it difficult to justify individual treatment decisions. Preventive treatment should ideally be dictated by an individual’s risk while minimizing potentially harmful medication exposure. This requires more accurate predictive assessments by using valid and accessible prognostic markers. The following will compare prediction and risk modification potential of behavioral biomarkers such as disturbances of basic sense of self and emotion awareness, neurocognitive biomarkers such as attention, working and declarative memory, and neurophysiological biomarkers such as glutamatergic abnormalities and NMDA receptor dysfunction. Identification of robust biomarkers could therefore not only provide more reliable means of psychosis prediction, but also help test and develop new clinical interventions targeted at the prodromal state.

Keywords: at-risk mental state, biomarkers, glutamatergic system, NMDA receptor, psychosis prodrome, schizophrenia

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Authors: B. I. Waziri, M. A. Yahaya

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Background: Practice of shisha smoking involves the use of a multi-stemmed instrument to smoke tobacco or non-tobacco herbal mixture where the smoke is designed to pass through water or other liquid before reaching the smoker. The presence of tobacco content and the use of charcoal when burning the ingredients in this popular practice necessitate for investigation of many physiological parameters of habitual shisha smokers in our environment. Methods: 103 young shisha smokers, regular in the practice for more than three years living in Nasarawa, Kano state, Nigeria, were recruited for the study. The controls were 100 university students (nonsmokers) match for age (18 - 30 years), sex and BMI (20 - 24) with the smokers. Participants with known history of cigarette smoking, cardiovascular or respiratory diseases were excluded. Ethical approval was obtained from the Ministry of Health, Kano Nigeria. Hear rate, blood pressure and percentage oxygen saturation (SPO₂) were measured using stethoscope, sphygmomanometer and pulse oximeter respectively. Data were analyzed using IBM SPSS version 20 and mean values of the measured parameters were compared between the smokers and controls using independent sample t-test. P-values < 0.05 were considered significant. Results: The mean Heart rate was found to be significantly higher (p = 0.01) in the shisha smokers (91.32 ± 0.84) compared to controls (79.19 ± 1.18). Systolic and diastolic blood pressure was also higher (p = 0.00) in the shisha smokers (128.75 ± 1.11 and 85.85 ± 0.78 respectively) compared to controls with the systolic and diastolic pressure of 116.64 ± 0.82 and 80.39 ± 0.83 respectively. SPO₂ was significantly lower (p = 0.00) in the shisha smokers (91.98% ± 0.42%) compared to the controls (97.98 ± 0.18). Conclusion: Habitual Shisha Smoking caused a significant increase in Heart rate, both systolic and diastolic blood pressure and a significant decrease in SPO2 among youth in Kano State, Nigeria.

Keywords: blood pressure, heart rate, shisha, youth

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Authors: Martin Dupuy, Solange Grunenwald, Pierre-Louis Colombo, Laurence Mahieu, Pomone Richard, Philippe Bartoli

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Endonasal endoscopic trans-sphenoidal surgery for pituitary tumours has become a mainstay of treatment over the last two decades. Although it is generally accepted that there is no significant difference between endoscopic versus microscopic approach for surgical outcomes (endocrine and ophthalmologic status), nasal morbidity seems to the benefit of endoscopic procedures. Minimally invasive endoscopic surgery needs an operative learning curve to achieve surgeon’s efficiency. This learning curve is now well known for surgical outcomes and complications rate, however, few data are available for nasal morbidity. The aim of our series is to document operative experience and nasal quality of life after (NQOL) endoscopic trans-sphenoidal surgery. The prospective pituitary surgical cohort consisted of 525 consecutives patients referred to our Skull Base Diseases Department. Endoscopic procedures were performed by a single neurosurgeon using an uninostril approach. NQOL was evaluated using the Sino-Nasal Test (SNOT-22), the Anterior Base Nasal Inventory (ASBNI) and the Skull Base Inventory Score (SBIS). Data were collected before surgery during hospital stay and 3 months after the surgery. The seventy first patients were compared to the latest 70 patients. There was no significant difference between comparison score before versus after surgery for SNOT-22, ASBNI and SBIS during the single surgeon’s learning curve. Our series demonstrates that in our institution there is no statistically significant learning curve for NQOL after uninostril endoscopic pituitary surgery. A careful progression through sinonasal structures with very limited mucosal incision is associated with minimal morbidity and preserves nasal function. Conservative and minimal invasive approach could be achieved early during learning curve.

Keywords: pituitary surgery, quality of life, minimal invasive surgery, learning curve, pituitary tumours, skull base surgery, endoscopic surgery

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Authors: Ganetsou Evanthia, Koutsikos Emmanouil, Austin Anna Maria

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Information technology has long served the needs of individuals for learning and entertainment, but much less for children in sickness. The aim of the proposed online video game is to provide immersive learning opportunities as well as essential social and emotional scenarios for hospital-bound children with long-term illness. Online self-paced courses on chosen school subjects, including specialised software and multisensory assessments, aim at enhancing children’s academic achievement and sense of inclusion, while doctor minigames familiarise and educate young patients on their medical conditions. Online ethical dilemmas will offer children opportunities to contemplate on the importance of medical procedures and following assigned medication, often challenging for young patients; they will therefore reflect on their condition, reevaluate their perceptions about hospitalisation, and assume greater personal responsibility for their progress. Children’s emotional and psychosocial needs are addressed by engaging in social conventions, such as interactive, daily, collaborative mini games with other hospitalised peers, like virtual competitive sports games, weekly group psychodrama sessions, and online birthday parties or sleepovers. Social bonding is also fostered by having a virtual pet to interact with and take care of, as well as a virtual nurse to discuss and reflect on the mood of the day, engage in constructive dialogue and perspective taking, and offer reminders. Access to the platform will be available throughout the day depending on the patient’s health status. The program is designed to minimise escapism and feelings of exclusion, and can flexibly be adapted to offer post-treatment and a support online system at home.

Keywords: long-term illness, children, hospital, interactive games, cognitive, socioemotional development

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Authors: Mercy E. Makpor

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Traditional Corporate Social Responsibility (CSR) idea has gone beyond just ensuring safety environments, caring about global warming and ensuring good living standards and conditions for the society at large. The paradigm shift is towards a focus on strategic objectives and the long-term value creation for both businesses and the society at large for a realistic future. As an important approach to solving social and environment issues, CSR has been accepted globally. Yet the approach is expected to go beyond where it is currently. So much is expected from businesses and governments at every level globally and locally. This then leads to the original idea of the concept, that is, how it originated and how it has been perceived over the years. Little wonder there has been a lot of definitions surrounding the concept without a major globally acceptable definition of it. The definition of CSR given by the European Commission will be considered for the purpose of this paper. Sustainable Development (SD), on the other hand, has been viewed in recent years as an ethical concept explained in the UN-Report termed “Our Common Future,” which can also be referred to as the Brundtland report. The report summarises the need for SD to take place in the present without comprising the future. However, the recent 21st-century framework on sustainability known as the “Triple Bottom Line (TBL)” framework, has added its voice to the concepts of CSR and sustainable development. The TBL model is of the opinion that businesses should not only report on their financial performance but also on their social and environmental performances, highlighting that CSR has gone beyond just the “material-impact” approach towards a “Future-Oriented” approach (sustainability). In this paper, the concept of CSR is revisited by exploring the various theories therein. The discourse on the concepts of sustainable development and sustainable development frameworks will also be indicated, thereby inducing these into how CSR can benefit both businesses and their stakeholders as well as the entirety of the society, not just for the present but for the future. It does this by exploring the importance of both concepts (CSR and SD) and concludes by making recommendations for a more empirical research in the near future.

Keywords: corporate social responsibility, sustainable development, sustainability, triple bottom line model

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Authors: Freyedon Ahmadi

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Corporate citizenship is considered as one of the most discussed topics in the developed countries, in which a citizen considers a Corporate just like a usual citizen with every civil right as respectful for corporate as for actual citizens, and in return citizens expect that corporate would pay a reciprocal respect to them. The current study’s purpose is to identify the impact of the current state of corporate citizenship along effective factors on its condition on industrial producing units, in order to find an accession plane for corporate citizenship development. In this study corporate citizenship is studied in four dimensions like legal corporate, economical corporate, ethical corporate and voluntary corporate. Moreover, effective factors’ impact on corporate citizenship is explored based on threefold dimensional model: behavioral, structural, and content factors, as well. In this study, 50 corporate of Food industry and of petrochemical industry, along with 200 selected individuals from directors’ board on Tehran province’s scale with stratified random sampling method, are chosen as actuarial sample. If based on functional goal and compilation methods, the present study is a description of correlation type; questionnaire is used for accumulation of initial Data. For Instrument Validity expert’s opinion is used and structural equations and its reliability is qualified by using Cronbach Alpha. The results of this study indicate that close to 70 percent of under survey corporate have not a good condition in corporate citizenship. And all of structural factors, behavioral factors, contextual factors, have a great deal of impression and impact on the advent corporate citizenship behavior in the producing Units. Among the behavioral factors, social responsibility; among structural factors, organic structure and human centered orientation, medium size, high organizational capacity; and among the contextual factors, the clientele’s positive viewpoints toward corporate had the utmost importance in impression on under survey Producing units.

Keywords: corporate citizenship, structural factors, behavioral factors, contextual factors, producing units

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Authors: Naz Najma, Grace T. M. Dal Sasso, Maria de Lourdes de Souza

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The development of information and communication technologies and the accessibility of mobile devices has increased the possibilities of the teaching and learning process anywhere and anytime. Mobile and web application allows the production of constructive teaching and learning models in various educational settings, showing the potential for active learning in nursing. The objective of this study was to present the development of an educational technology (Savinglife®, an app) for learning cardiopulmonary resuscitation and advanced cardiovascular life support training. Savinglife® is a technological production, based on the concept of virtual learning and problem-based learning approach. The study was developed from January 2016 to November 2016, using five phases (analyze, design, develop, implement, evaluate) of the instructional systems development process. The technology presented 10 scenarios and 12 simulations, covering different aspects of basic and advanced cardiac life support. The contents can be accessed in a non-linear way leaving the students free to build their knowledge based on their previous experience. Each scenario is presented through interactive tools such as scenario description, assessment, diagnose, intervention and reevaluation. Animated ECG rhythms, text documents, images and videos are provided to support procedural and active learning considering real life situation. Accessible equally on small to large devices with or without an internet connection, Savinglife® offers a dynamic, interactive and flexible tool, placing students at the center of the learning process. Savinglife® can contribute to the student’s learning in the assessment and management of basic and advanced cardiac life support in a safe and ethical way.

Keywords: problem-based learning, cardiopulmonary resuscitation, nursing education, advanced cardiac life support, educational technology

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Authors: Kingston Rajiah, Mari Kannan Maharajan, Si Jen Yeen, Sara Lew

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Parkinson’s disease (PD) is a progressive neurodegenerative disorder with evolving layers of complexity. Both motor and non-motor symptoms of PD may affect patients’ quality of life (QoL). Life expectancy for an individual with Parkinson’s disease depends on the level of care the individual has access to, can have a direct impact on length of life. Therefore, improvement of the QoL is a significant part of therapeutic plans. Patients with PD, especially those who are in advanced stages, are in great need of assistance, mostly from their family members or caregivers in terms of medical, emotional, and social support. The role of a caregiver becomes increasingly important with the progression of PD, the severity of motor impairment and increasing age of the patient. The nature and symptoms associated with PD can place significant stresses on the caregivers’ burden. As the prevalence of PD is estimated to more than double by 2030, it is important to recognize and alleviate the burden experienced by caregivers. This study focused on the impact of the clinical features on the QoL of PD patients, and of their caregivers. This study included PD patients along with their caregivers and was undertaken at the Malaysian Parkinson's Disease Association from June 2016 to November 2016. Clinical features of PD patients were assessed using the Movement Disorder Society revised Unified Parkinson Disease Rating Scale (MDS-UPDRS); the Hoehn and Yahr Staging of Parkinson's Disease were used to assess the severity and Parkinson's disease activities of daily living scale were used to assess the disability of Parkinson’s disease patients. QoL of PD patients was measured using the Parkinson's Disease Questionnaire-39 (PDQ-39). The revised version of the Zarit Burden Interview assessed caregiver burden. At least one of the clinical features affected PD patients’ QoL, and at least one of the QoL domains affected the caregivers’ burden. Clinical features ‘Saliva and Drooling’, and ‘Dyskinesia’ explained 29% of variance in QoL of PD patients. The QoL domains ‘stigma’, along with ‘emotional wellbeing’ explained 48.6% of variance in caregivers’ burden. Clinical features such as saliva, drooling and dyskinesia affected the QoL of PD patients. The PD patients’ QoL domains such as ‘stigma’ and ‘emotional well-being’ influenced their caregivers’ burden.

Keywords: carers, quality of life, clinical features, Malaysia

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