Search results for: unknown risk people

Authors: Simon Mwima, Kasule Solomon Kibirige, Evans Jennifer Mann, Bosco Mukuba, Edson Chipalo, Agnes Nzomene, Eusebius Small, Moses Okumu

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Introduction: Social workers must create, implement, and evaluate client-centered psychosocial interventions (CCPI) to reduce the impact of intersectional stigma on HIV service utilization among sexual minorities. We contribute to the scarcity of evidence about sexual minorities in Uganda by using social support theory to explore clients' perceptions that shape CCPI. Based on Focused Group Discussion (FGD) with 31 adolescents recruited from Kampala's HIV clinics in 2021, our findings reveal the positive influence of instrumental, informational, esteem, emotional, and social network support as intersectional stigma reduction interventions. Men who have sex with men, lesbians, and bisexual women used such strategies to navigate a heavily criminalized and stigmatizing setting during the COVID-19 pandemic in Uganda. Conclusion: This study provides evidence for the social work profession to develop and implement psychosocial interventions that reduce HIV stigma and discrimination among MSM, lesbians, and bisexual young people living with HIV in Uganda.

Keywords: pyschosocial interventions, social work, intersectional stigma, HIV/AIDS, adolescents, sexual minorities, Uganda

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Authors: Farouk Metiri, Halim Zeghdoudi, Mohamed Riad Remita

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Credibility theory is an experience rating technique in actuarial science which can be seen as one of quantitative tools that allows the insurers to perform experience rating, that is, to adjust future premiums based on past experiences. It is used usually in automobile insurance, worker's compensation premium, and IBNR (incurred but not reported claims to the insurer) where credibility theory can be used to estimate the claim size amount. In this study, we focused on a popular tool in credibility theory which is the Bayesian premium estimator, considering Lindley distribution as a claim distribution. We derive this estimator under entropy loss which is asymmetric and squared error loss which is a symmetric loss function with informative and non-informative priors. In a purely Bayesian setting, the prior distribution represents the insurer’s prior belief about the insured’s risk level after collection of the insured’s data at the end of the period. However, the explicit form of the Bayesian premium in the case when the prior is not a member of the exponential family could be quite difficult to obtain as it involves a number of integrations which are not analytically solvable. The paper finds a solution to this problem by deriving this estimator using numerical approximation (Lindley approximation) which is one of the suitable approximation methods for solving such problems, it approaches the ratio of the integrals as a whole and produces a single numerical result. Simulation study using Monte Carlo method is then performed to evaluate this estimator and mean squared error technique is made to compare the Bayesian premium estimator under the above loss functions.

Keywords: bayesian estimator, credibility theory, entropy loss, monte carlo simulation

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Authors: Kevin Yeo, Christine Hall, Babinchak Tim

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BAT® [Botulism Antitoxin Heptavalent (A,B,C,D,E,F,G)-(Equine)] anti-toxin is a mixture of equine immune globulin fragments indicated for the treatment of symptomatic botulism in adult and pediatric patients. The effectiveness of BAT anti-toxin is based on efficacy studies conducted in animal models. A general explanation of the pivotal animal studies, post market surveillance and outcomes of an observational patient registry for patients treated with BAT product distributed in the USA is briefly discussed. Overall it took 20 animal studies for two well-designed and appropriately powered pivotal efficacy studies – one in which the effectiveness of BAT was assessed against all 7 serotypes in the guinea pig, and the other where efficacy is confirmed in the Rhesus macaque using Serotype A. Clinical Experience for BAT to date involves approximately 600 adult and pediatric patients with suspected botulism. In pre-licensure, patient data was recorded under the US CDC expanded access program (259 adult and pediatric patients between 10 days to 88 years of age). In post licensure, greater than 350 patients to date have received BAT and been followed up by enhanced expanded access program. The analysis of the post market surveillance data provided a unique opportunity to demonstrate clinical benefit in the field study required by the animal rule. While the animal rule is applied because human efficacy studies are not ethical or feasible, a post-marketing requirement is to conduct a study to evaluate safety and clinical benefit when circumstances arise and demonstrate the favourable benefit-risk profile that supported licensure.

Keywords: botulism, threat, clinical benefit, observational patient registry

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Authors: Maria da Conceição Proença

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This case study implements the evaluation of burned areas that suffered successive wildfires in Portugal mainland during the summer of 2017, killing more than 60 people. It’s intended to show that this evaluation can be done with remote sensing data free of charges in a simple laptop, with open-source software, describing the not-so-simple methodology step by step, to make it available for county workers in city halls of the areas attained, where the availability of information is essential for the immediate planning of mitigation measures, such as restoring road access, allocate funds for the recovery of human dwellings and assess further restoration of the ecological system. Wildfires also devastate forest ecosystems having a direct impact on vegetation cover and killing or driving away from the animal population. The economic interest is also attained, as the pinewood burned becomes useless for the noblest applications, so its value decreases, and resin extraction ends for several years. The tools described in this paper enable the location of the areas where took place the annihilation of natural habitats and establish a baseline for major changes in forest ecosystems recovery. Moreover, the result allows the follow up of the surface fuel loading, enabling the targeting and evaluation of restoration measures in a time basis planning.

Keywords: image processing, remote sensing, wildfires, burned areas evaluation, sentinel-2

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Authors: Mais Qandeel

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Within the Jewish and democratic Israeli state, as dually characterized, the treatment of citizens differs according to their religious groups and nationalities. The laws and policies against Arab citizens concerning ownership and use of land are the main focus of this article. As the Jewish character has led to Jewish based legal provisions which give the privilege to Jews, first, this article examines the legal bases which distinguish between citizens in Israel based on their religion. It examines the major Israeli laws which are used to confiscate, manage, and lease properties. Second, the article demonstrates the de facto practices against Arab citizens in using lands. Most of the Palestinian land was confiscated and turned over to Jewish owners or to state land, Palestinian citizens are distinguished in using the state administered lands. They are also restricted in using full ownership rights and denied using plots of lands and housing units. Such policies have created, within the same state, a class of secondary citizens who are categorized as non-Jews. Last, within the Basic Law: Human Dignity and Freedom which has served as the constitutional bill of rights for Israelis and also the International law, particularly the International Convention on the Elimination of All Forms of Racial Discrimination, it will be concluded whether these restricted policies against Arab citizens in using land constitute a religion-based-discrimination among Israeli citizens and create a situation of separation and inequality between two groups of people in Israel.

Keywords: Israel, citizens, discrimination, equality

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Authors: Mohammad Soltani, Ayoub Saeidi, Nikoo Khosravi, Hanieh Nohbaradar, Seyedeh Parya Barzanjeh, Hassane Zouhal

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Exercise training and herbs supplement represent have role in the treatment for patients with type 2 diabetes (T2D). However, it is unclear combined effects of exercise training and herbs supplements on diabetic risk markers. This study aimed to determine the effect of 12 weeks of combined exercise and broccoli supplementation on decitin-1 and insulin resistance in men with type 2 diabetes. Forty-four type 2 diabetes men (age, 48.52 ± 4.36) were randomly allocated to training -supplement (TS, n = 11), training- placebo (TP, n = 11), supplement (S, n = 11) and control- placebo (CP, n = 11) groups. The combined exercise program included 12 weeks, three sessions per week, that each session contained 45 minutes of resistance training with intensity 60-70% of one maximal repetition and 30 minutes aerobic training (running) with intensity 60-70% of maximum heart rate. In addition supplement groups consumed 10 grams of Broccoli per day for 12 weeks. Plasma Decitin-1, HOMA-IR, Insulin, glucose and body composition were assessed before and after training. Plasma Dectin-1, HOMA-IR, glucose and BMI significantly decreased in TS, TP and S groups compared with CP group (P < .05). In addition Insulin and skeletal muscles mass showed significant increase in TS and TP groups compared with S and CP groups (P < .05). It is concluded that both combined exercise training (aerobic-resistance) or broccoli supplement can improve plasma Decitin-1 and insulin resistance in two diabetic patients however combine of exercise training and broccoli supplement have more effective on these markers.

Keywords: broccoli supplements, combined training, decitin-1, insulin resistance, type 2 diabetes

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Authors: Huraizah Arshad, Maizan Baba

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Malaysia is the country that consists of high population of Muslim community with more than 60%; as reported in year 2014. The stability of economy allowed people to contribute towards ongoing charity such as waqf and infaq. Waqf is an important component of the Islamic economic instruments since it is beneficial to help those needy in the community. Although waqf had been implemented in Malaysia for many years, there is no specific framework on how to manage and maintain the waqf properties in effective and efficient practice. Thus, a comprehensive framework related to the management and maintenance of the waqf properties is crucial to ensure that the administration of the fund is fair within the community. The objective of this article is to examine the related literatures in administration, management and maintenance of waqf for the past ten (10) years. The methodology of this article is through qualitative research based on literature on waqf administration and management; waqf planning and development and the application of maintenance concept. Data from each articles related in this field were collected and statistically analyzed using the SPSS software. A variable such as authorship patterns, number of articles published and geographical affiliation are identified in this study. The general finding in this article shows that there are still limited number of articles and papers published by the researchers related to this field. Henceforth, this article provides significant suggestions and strategies for the future research on waqf administration, management and maintenance.

Keywords: Waqf, administration and management, maintenance, improvement, facilities management

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Authors: Abubakar Salisu Garba

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The objective of the paper is to highlight the nature of entrepreneurial activities in the Sub Sahara Africa. Five countries in the Sub Sahara African that are participating in Global Entrepreneurship Monitor (GEM) research have been studied to understand the types of entrepreneurial activities and their socio-economic implications in the region. The importance of entrepreneurial activities in boosting socio-economic development has been recognized not only in developing countries, but across the entire global economies. Some people believe that the wealth and poverty of developing countries is associated with nature and type of entrepreneurial activity. Policy makers are not only concern about the rate of business start up, but the growth and development of those starts up is of paramount importance to the development of the country’s economy. Although, the supply of entrepreneurs is essential, sometimes it does not really matters in boosting economic performance. What is more important is having high impact entrepreneurs who could make meaningful contribution to the economy. High growth oriented entrepreneurs are more stable and contribute greatly in enhancing the economic performance. When entrepreneurs are facing difficulties in sustaining and growing their businesses, it may be unlikely for entrepreneurship to reduce unemployment and poverty. Inadequate financial supports, insufficient infrastructure, lack of enforcing laws protecting the right of entrepreneurs are some of the problems making business environment difficult in Sub-Saharan Africa.

Keywords: entrepreneurship, entrepreneurial activity, job creation, poverty reduction, Sub-Saharan Africa

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Authors: Rebecca Heron, Julie Karsten, Lena Schweikert

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Adverse consequences of stigma towards pedophilia can, among other things, increase dynamic risk factors for sexual offending. Decreasing stigma, therefore, is a plausible approach in the attempt to prevent child sexual abuse. Stigma research suggests that providing direct contact to a stigmatized individual is the most efficient way of reducing stigma. The present study involved an educational intervention, followed by direct contact to a pedophile, to maximize effectiveness. It aimed at finding out whether a dichotomous anti-stigma intervention can change psychology students' attitudes towards pedophiles regarding perceived dangerousness, intentionality, deviance, and punitive attitudes. In a one sample pre-post design, 162 students of the University of Groningen attended a lecture about pedophilia, which was held by a psychology master’s student. Participants learned about child sex offending and pedophilia in addition to the importance of distinguishing between pedophiles and child sex offenders (CSOs). The guest lecturer Gabriel, shared his experiences about growing up, coping, and living with pedophilia. Results of the Wilcoxon signed-rank test revealed significantly diminished negative attitudes towards pedophiles after the intervention. Students perceived pedophiles as less dangerous, having less intent, and being less psychologically deviant. Additionally, students' punitive attitudes towards pedophiles diminished significantly. Also, a thematic analysis revealed that students were highly interested in the topic of pedophilia and greatly appreciative of Gabriel sharing his story. This study was the first to provide direct contact with a pedophile within an anti-stigma intervention.

Keywords: pedophilia, anti-stigma intervention, punitive attitudes, attitude change

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Authors: Cristian Baldini

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‘Diabesity’ is a term for diabetes occurring in the context of obesity. The positive effect of LCHF diets (low-carb, high-fat diets) is well documented: LCHF diets are at least as effective as other dietary strategies for reducing body weight, improving glycaemic control, and reducing both hyperinsulinaemia and blood glucose (reduction of HbA1c) in type 2 diabetes and have unique positive effects on blood lipid concentrations and cardiovascular risk factors. Also, in obese insulin-resistant women, food fried in extra-virgin olive oil significantly reduced both insulin and C-peptide responses after a meal. This case study shows that if combined, both dietary strategies produce a strong effect on blood glucose, resulting in a “forced” reduction of exogenous insulin injection to avoid the problem of hypoglycaemia. Blood tests after three months of this dietary treatment show how HbA1c, triglycerides, and blood lipid profile (LDL, HDL, Total Cholesterol) are improved despite the reduction of exogenous insulin injection of 80% with a parallel body weight decrease of 15%. For continuous glucose monitoring (CGM), the patient used FreeStyle Libre before and after the dietary treatment. In order to check general body functions and glycosuria, the patient used the urine test Multistix 10 SG Siemens.

Keywords: diabetes, obesity, diabesity, fat, fried foods

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Authors: Jiashu Shen

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With the increase in the prevalence of divorce, the impact of divorce on children’s sexual and reproductive health has received wide attention, while few studies have investigated parent marital relationship. This study aims to study the relation of both parent divorce and perceived parental marital relationship with children’s sexual behaviors among Chinese university or vocational college students. The study used data from “National College Student Survey on Sexual and Reproductive Health 2019”, an internet-based survey conducted from November 2019 to February 2020, in 241 universities or vocational colleges in China. Statistical analyses were conducted to assess the relationship of perceived parental marital relationship and parents’ divorce of distinct occurrence time with sexual intercourse, risky sexual behaviors, unintended health outcomes and sexual abuse. Among 51,124 university or vocational college students, those whose parents had divorced accounted for 10.72%. Better perceived parental relationship was associated with a lower likelihood to have sexual intercourse (male: OR: 0.83, 95%CI: 0.80-0.86; female: OR: 0.73, 95%CI: 0.70-0.75), sexual abuse, risky sexual behaviors and unintended health outcomes. Divorce was also found to be associated with higher risk of sexual abuse, risky sexual behaviors and unintended health outcomes. The findings highlight the importance of parental marital relationship and divorce in risky sexual behavior among young adults. The findings may provide implications on intervention programs targeting at children with divorced parents from an early stage.

Keywords: college students, divorce, family relationship, sexual behavior

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Authors: Asma Ahmed, Farah Khalid, Sahlah Sohail, Saira Banusokwalla, Sabiha Banu, Inaara Akbar, Safia Awan, Syed Iqbal Azam

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Background and Objectives: The level of knowledge regarding obesity as a disease condition and health-seeking behavior regarding its management is grossly lacking. We present data from our multidisciplinary obesity clinic at the large tertiary care facility in Karachi, Pakistan, to provide baseline profiles and outcomes of patients attending these clinics. Methods: 260 who attended the obesity clinic between June 2018 to March 2020 were enrolled in this study. The analysis included descriptive and ROC analysis to identify the best cut-offs of theanthropometric measurements to diagnose obesity-related comorbid conditions. Results: The majority of the studied population were women (72.3%) and employed(43.7%) with a mean age of 35.5 years. Mean BMIwas 37.4, waist circumference was 112.4 cm, visceral fat was 11.7%, and HbA1C was 6.9%. The most common comorbidities were HTN & D.M (33 &31%, respectively). The prevalence of MetS was 16.3% in patients and was slightly higher in males. Visceral fat was the main factor in predicting D.M (0.750; 95% CI: 0.665, 0.836) and MetS (0.709; 95% CI: 0.590, 0.838) compared to total body fat, waist circumference, and BMI. The risk of predicting DM &MetS for the visceral fat above 9.5% in women had the highest sensitivity (80% for D.M & 79% for MetS) and an NPV (92.75% for D.M & 95% for MetS). Conclusions: This study describes and establishes characteristics of these obese individuals, which can help inform clinical practices. These practices may involve using visceral fat for earlier identification and counseling-based interventions to prevent more severe surgical interventions down the line.

Keywords: obesity, metabolic syndrome, tertiary care facility, BMI, waist circumference, visceral fat

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Authors: Suby Khanam, Faisal Talib, Jamshed Siddiqui

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Total Quality Management (TQM) is a managerial approach that improves the competitiveness of the industry, meanwhile Information technology (IT) was introduced with TQM for handling the technical issues which is supported by quality experts for fulfilling the customers’ requirement. Present paper aims to utilise AHP (Analytic Hierarchy Process) methodology to priorities and rank the hierarchy levels of TQM enablers and IT resource together for its successful implementation in the Information and Communication Technology (ICT) industry. A total of 17 TQM enablers (nine) and IT resources (eight) were identified and partitioned into 3 categories and were prioritised by AHP approach. The finding indicates that the 17 sub-criteria can be grouped into three main categories namely organizing, tools and techniques, and culture and people. Further, out of 17 sub-criteria, three sub-criteria: Top management commitment and support, total employee involvement, and continuous improvement got highest priority whereas three sub-criteria such as structural equation modelling, culture change, and customer satisfaction got lowest priority. The result suggests a hierarchy model for ICT industry to prioritise the enablers and resources as well as to improve the TQM and IT performance in the ICT industry. This paper has some managerial implication which suggests the managers of ICT industry to implement TQM and IT together in their organizations to get maximum benefits and how to utilize available resources. At the end, conclusions, limitation, future scope of the study are presented.

Keywords: analytic hierarchy process, information technology, information and communication technology, prioritization, total quality management

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Authors: Sophia Shi

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Acute kidney injury (AKI) is the sudden onset of kidney damage in which the kidneys cannot filter waste from the blood, requiring emergency hospitalization. AKI patient mortality rate is high in the ICU and is virtually impossible for doctors to predict because it is so unexpected. Currently, there is no hybrid model predicting AKI that takes advantage of two types of data. De-identified patient data from the MIMIC-III database and de-identified kidney images and corresponding patient records from the Beijing Hospital of the Ministry of Health were collected. Using data features including serum creatinine among others, two numeric models using MIMIC and Beijing Hospital data were built, and with the hospital ultrasounds, an image-only model was built. Convolutional neural networks (CNN) were used, VGG and Resnet for numeric data and Resnet for image data, and they were combined into a hybrid model by concatenating feature maps of both types of models to create a new input. This input enters another CNN block and then two fully connected layers, ending in a binary output after running through Softmax and additional code. The hybrid model successfully predicted AKI and the highest AUROC of the model was 0.953, achieving an accuracy of 90% and F1-score of 0.91. This model can be implemented into urgent clinical settings such as the ICU and aid doctors by assessing the risk of AKI shortly after the patient’s admission to the ICU, so that doctors can take preventative measures and diminish mortality risks and severe kidney damage.

Keywords: Acute kidney injury, Convolutional neural network, Hybrid deep learning, Patient record data, ResNet, Ultrasound kidney images, VGG

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Authors: Omkar More, Isha Saini, Gracy Mathai

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To study whether there is any clinical correlation between pterygium and dry eye and to evaluate the status of the tear film in patients with pterygium. Methods: 100 eyes with pterygium were compared with 100 control eyes without pterygium. Patients between 20 – 70 years were included in the study. A detailed history was taken and Schirmer’s test and TBUT were performed on all to evaluate the status of dry eye. Schirmer’s test ˂ 10 mm and TBUT ˂10 seconds was considered abnormal. Results: Maximum number (52) of patients affected by dry eye in both the groups were in the age group 31-40 years which statistically showed age as a significant factor of association for both pterygium and dry eye (P < 0.01).Schirmer’s test was slightly reduced in patients with pterygium(18.73±5.69 mm). TBUT was significantly reduced in the case group (12.26±2.24sec).TBUT decreased maximally in 51-60 yrs age group (13.00±2.77sec) with pterygium showing a tear film instability. On comparison of pterygia and controls with normal and abnormal tear film, Odd’s Ratio was 1.14 showing a risk of dry eye in pterygia patients to be 1.14 times higher than controls. Conclusion: Whether tear dysfunction is a precursor to pterygium growth or pterygium causes tear dysfunction is still not clear. Research and clinical evidence, however, suggest that there is a relationship between the two. This study is, therefore, undertaken to investigate the correlation between pterygium and dry eye. The patients with pterygia were compared with normals to evaluate their status regarding dryness. A close relationship exists between ocular irritation symptoms and functional evidence of tear instability. Schirmer’s test and TBUT should routinely be used in the outpatient department to diagnose dry eye in patients with pterygium and these patients should be promptly treated to prevent any sight-threatening complications.

Keywords: footfall, nursing assessment, quality improvement, six sigma

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Authors: Abderrahman Hassi, Omar Bacadi, Khaoula Zitouni

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Abdelkader El Mouaziz is a Moroccan long-distance runner with a career-best time of 2:06:46 in the Chicago Marathon. El Mouaziz is a winner of the Madrid Marathon in 1994, the London Marathon in 1999 and 2001, as well as the New York Marathon in 2001. While he was playing for the Moroccan national team, he used to train in the Ifrane-Azrou region owing to its altitude, fresh forests, non-polluted air and quietness. After winning so many international competitions and retiring, he left his native Casablanca and went back to the Ifrane-Azrou region and started a business that employs ten people. In March 2010, El Mouaziz opened a bed and breakfast called Tourtite with a nice view on the mountain near the city of Ifrane in the way to Azrou. He wanted to give back to the region that helped him become a sport legend. His management style is not different than his sport style: performance and competitiveness combined with fair play. The objective of the present case study is to further enhance the understanding of the dynamics of transferring athletic championship-winning principles to entrepreneurial activities. The case study is a real-life situation and experience designed to provoke and stimulate reflections about a particular approach of management, especially for start-up businesses.

Keywords: sport, winning principles, entrepreneurship, Abdelkader El Mouaziz

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Authors: Farina Maqbool

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Background: It is well said that children are considered the future masons of the country and a healthy brain is found in a healthy body. Therefore, a healthy generation can be produced by giving knowledge of immunization to mothers. Immunization is the most lucrative public health intrusion that has placed the greatest effect on the health of the people. The main objective of the present study was to find out the mother’s knowledge, attitude, and practices towards childhood immunization. Methods: Multistage sampling technique was used. One hundred and sixty mothers were selected conveniently who have at least one child up to two years. Data were collected through the face to face interview. The chi-square test was used to test the significance of the association between independent and dependent variables. Data were analyzed using the Statistical Package for Social Science. Results: A higher percentage of mothers (85.0%) knew vaccine-preventable diseases. Major proportion (82.5%) of the mothers had thought that immunization is important for their child’s health. A majority (66.3%) of the respondents’ children were fully immunized, whereas 26.3 percent of them were replied negatively. Remaining 7.5 percent of the respondents’ child un-immunized Chi-square value (39.14) shows a highly significant association between the education of the respondents and receiving of all recommended vaccines for children. Gamma value shows a strong positive relationship between the variables.

Keywords: attitude, childhood, immunization, knowledge, practices

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Authors: T. Garba, Y. Y. Babanyara, M. Isah, A. K. Muktari, R. Y. Abdullahi

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The increased in demand of fuel wood for heating, cooking and sometimes bakery has continued to exert appreciable impact on natural vegetation. This study focus on the use of multi-temporal data from land sat TM of 1986, land sat EMT of 1999 and lands sat ETM of 2006 to investigate the changes of Natural Vegetation resulting from charcoal production activities. The three images were classified based on bare soil, built up areas, cultivated land, and natural vegetation, Rock out crop and water bodies. From the classified images Land sat TM of 1986 it shows natural vegetation of the study area to be 308,941.48 hectares equivalent to 50% of the area it then reduces to 278,061.21 which is 42.92% in 1999 it again depreciated to 199,647.81 in 2006 equivalent to 30.83% of the area. Consequently cultivated continue increasing from 259,346.80 hectares (42%) in 1986 to 312,966.27 hectares (48.3%) in 1999 and then to 341.719.92 hectares (52.78%). These show that within the span of 20 years (1986 to 2006) the natural vegetation is depreciated by 119,293.81 hectares. This implies that if the menace is not control the natural might likely be lost in another twenty years. This is because forest cleared for charcoal production is normally converted to farmland. The study therefore concluded that there is the need for alternatives source of domestic energy such as the use of biomass which can easily be accessible and affordable to people. In addition, the study recommended that there should be strong policies enforcement for the protection forest reserved.

Keywords: charcoal, classification, data, images, land use, natural vegetation

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Authors: Sidika McNeil

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Borderline personality disorder (BPD) is a personality disorder that has been found to have strong origins in childhood trauma. One of the key symptoms of BPD is an association with irregular moods swings, as well as suicidal ideation (SI). Owing to the typically severe trauma patients experience during childhood, it is hard for them to control their emotions and thus makes it hard to emotionally regulate. It is then very common for those suffering from BPD to turn to unhealthy coping mechanisms, such as substance use, unhealthy relationships, and more, often unsuccessfully creating experiences that facilitate safety which leads to further negative experiences. With the high suicide rating among children, adolescents, and teens, and an ever-increasing number of children being diagnosed with BPD, it is very important that more research is done to find further treatments for patients who are currently suffering. Methods: Utilizing data found in prior studies, this paper will analyze the literature to focus on a comprehensive treatment plan for those with DBT. It is currently suggested that with the use of dialectical behavioral therapy (DBT), a therapy that focuses on changing negative thinking patterns and pushes for more positive ones is helpful for treatment for those with BPD. Though this therapy is not a cure to BPD, it does help mitigate the risk; this essay will explore other options that can further the treatment process, such as cognitive analytical therapy (CAT), which focuses on delving into the past to find the root causes of an issue to create coping strategies and harm reduction, a type of therapy used to aid patients in lowering the use of substances without complete cessation. Results: The research provides enough evidence to link between the treatment of BPD with the utilization of CAT.

Keywords: borderline personality disorder, cognitive analytical therapy, dialectical behavioral therapy, harm reduction, suicidal ideation

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Authors: Najmeh Arabnejad, Mohammad Hossein Yousefi

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The risk of injuring is possible in most sports. These injuries are inevitable in contact sports. Since sports injuries result in financial, physical, physiological and social problems for most athletes and endanger their professional future, studying the happening of sports injuries in sports changes to an important issue. This study can be conducted through different aspects including psychological, pathological, social, managerial, etc. Therefore, the present study was designed and conducted with the aim Survey of Sports Injuries In Ten Sports from 2006 to 2011.This descriptive study was carried out in a documentary form. Thus, data related to sports insurance and sport injuries happened in soccer, volleyball, basketball, handball, badminton, karate, track and field, taekwondo, gymnastics and wrestling was collected from Sports Medical Board of Kerman Province, as the largest province in Iran, and then was analyzed. Data collection method was library one. Furthermore, information related to 210406 insured athletes was analyzed using Descriptive Statistical Indexes in the level mean and SPSS20 Software. The research findings showed that the number of male athletes who injured was higher than female athletes in most sports within various years. Soccer, karate, volleyball, wrestling, handball, taekwondo, gymnastics, basketball, track and field, and badminton had the most injuries, respectively. Moreover, the number of injured athletes and their ratio to insured ones during six years were studied; in general, an increase in ratio of sports injuries was observed. Thus, upward movement of sports injuries in different sports, as the results of this study confirm it, is a warning which results in losing young forces and wasting of sports potential in Iran.

Keywords: sports, sports injuries, survey, Kerman

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Authors: Nura Bello

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Sokoto caliphate is the product of a hectic revolutionary movement that took place in the first decade of the nineteenth century under the leadership of Seikh Usmanu Danfodio. The movement led to the overthrow of the Sarauta system in Hausa Land, leading to the emergence of the Sokoto caliphate and Sokoto city as its headquarters. This development led to the collapse of Alkalawa (headquarters of the Gobir Kingdom) in 1808. A year later, in 1809, Sokoto city emerged as the headquarter of the Sokoto Caliphate. Due to the open door policy adopted by the leaders, the city came to experience an influx of people especially craft manufacturers from all over Hausa Land and beyond, who occupied many areas of the city and engaged in different craft production. This paper aims to highlight the development of crafts manufacturing in the 19th century Sokoto city and its contribution to transforming the city into a major economic base of the caliphate. In dealing with the above issue, qualitative research methods that mainly involve the use of oral and archival data will be adopted. Finally, the paper identified that the expansion of craft manufacturing in the 19th century Sokoto city could have resulted from the role played by the leadership of the caliphate, which favoured such development. The paper argues that if those industries were revived in Nigeria today, they would ultimately create various jobs among the younger generations, which would result in economic prosperity.

Keywords: craft manufacturing, diversification, economy, migration

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Authors: Yavuz Unal, Kemal Polat, H. Erdinc Kocer

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In this study, a decision support system comprising three stages has been proposed to detect the disc abnormalities of the lumbar region. In the first stage named the feature extraction, T2-weighted sagittal and axial Magnetic Resonance Images (MRI) were taken from 55 people and then 27 appearance and shape features were acquired from both sagittal and transverse images. In the second stage named the feature weighting process, k-means clustering based feature weighting (KMCBFW) proposed by Gunes et al. Finally, in the third stage named the classification process, the classifier algorithms including multi-layer perceptron (MLP- neural network), support vector machine (SVM), Naïve Bayes, and decision tree have been used to classify whether the subject has lumbar disc or not. In order to test the performance of the proposed method, the classification accuracy (%), sensitivity, specificity, precision, recall, f-measure, kappa value, and computation times have been used. The best hybrid model is the combination of k-means clustering based feature weighting and decision tree in the detecting of lumbar disc disease based on both sagittal and axial MR images.

Keywords: lumbar disc abnormality, lumbar MRI, lumbar spine, hybrid models, hybrid features, k-means clustering based feature weighting

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Authors: Nelson Andres, Meeko C. Masangcap, John Denver D. Catapang

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Balanga City as, the heart of Bataan, is a growing City and is now at its fast pace of development. The growth of commerce in the city results to an increase in commuters who travel back and forth through the city, leading to congestions. Consequently, queuing of vehicles along national roads and even in the highways of the city have become a regular occurrence. This common scenario of commuters flocking the city, private and public vehicles going bumper to bumper, especially during the rush hours, greatly affect the flow of traffic vehicles and is now a burden not only to the commuters but also to the government who is trying to address this dilemma. Seeing these terrible events, the implementation of an elevated Automated Guide-way transit is seen as a possible solution to help in the decongestion of the affected parts of Balanga City.In response to the problem, the researchers identify if it is feasible to have an elevated guide-way transit in the vicinity of Sapphire Street in Balanga City, Bataan. Specifically, the study aims to determine who will be the riders based on the demographic profile, where the trip can be generated and distributed, the time when volume of people usually peaks and the estimated volume of passengers. Statistical analysis is applied to the data gathered to find out if there is an important relationship between the demographic profile of the respondents and their preference of having an elevated railway transit in the City of Balanga.

Keywords: ridership, AGT, railway, elevated track

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Authors: Seon-Young Lee, Harkiran Sagoo, Katherine Whitehurst, Georgina Wellstead, Alexander Fowler, Riaz Agha, Dennis Orgill

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Introduction: Systematic reviews attempt to answer research questions by synthesising the data within primary papers. They are an increasingly important tool within evidence-based medicine, guiding clinical practice, future research and healthcare policy. We sought to determine the reporting quality of recent systematic reviews in plastic surgery. Methods: This systematic review was conducted in line with the Cochrane handbook, reported in line with the PRISMA statement and registered at the ResearchRegistry (UIN: reviewregistry18). MEDLINE and EMBASE databases were searched in 2013 and 2014 for systematic reviews by five major plastic surgery journals. Screening, identification and data extraction was performed independently by two teams. Results: From an initial set of 163 articles, 79 met the inclusion criteria. The median PRISMA score was 16 out of 27 items (59.3%; range 6-26, 95% CI 14-17). Compliance between individual PRISMA items showed high variability. It was poorest for items related to the use of review protocol (item 5; 5%) and presentation of data on risk of bias of each study (item 19; 18%), while being the highest for description of rationale (item 3; 99%) and sources of funding and other support (item 27; 95%), and for structured summary in the abstract (item 2; 95%). Conclusion: The reporting quality of systematic reviews in plastic surgery requires improvement. ‘Hard-wiring’ of compliance through journal submission systems, as well as improved education, awareness and a cohesive strategy among all stakeholders is called for.

Keywords: PRISMA, reporting quality, plastic surgery, systematic review, meta-analysis

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Authors: Kornanong Yuenyongchaiwat, Duangnate Pepatsitipong, Panthip Sangprasert

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High blood pressure and diabetes have been suggested as being non-communicable disease (NCDs), and there is one of the components of the definition of metabolic syndrome. Therefore, the purpose of this study was to evaluate the effect of a 12-week pedometer based community walking intervention on change in resting blood pressure and blood glucose in participants with overweight in the community setting. Method: Participants were recruited both males and females who had a sedentary lifestyle aged 35-59 years (mean aged 49.67 years). A longitudinal quasi-experimental study was designed with 35 overweight participants who had body mass index ≥ 25 kg/m2. These volunteers were assigned to the 12-week pedometer-based walking program (an accumulated at least 10,000 steps a day). Blood pressure and blood glucose were measured initially before and after 12-week intervention. Results: Systolic blood pressure and heart rate were significantly lower in 30 individuals who had accumulated 10,000 steps d-1 in the intervention group at 12 week follow-up (-13.74 mmHg and 5.3 bpm, respectively). In addition, reduction in blood glucose (-14.89 mmol) in the intervention participants was statistically significant (p < .001). A regression analysis indicated that reductions in systolic blood pressure were significantly related to the increase in steps per day. Conclusion: The accumulation of least 10,000 steps d-1 resulted in decreased resting systolic blood pressure and blood glucose in overweight participants. This has also shown that an increase in physical activity in overweight participants with sedentary lifestyle by accumulating at least 10,000 steps a day can reduce the risk of cardiovascular disease (e.g., hypertension and diabetes).

Keywords: blood glucose, blood pressure, diabetes, hypertension, physical activity, walking

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Authors: Aziz Rezapour, Abdosaleh Jafari, Marziye Hadian, Elaheh Mazaheri

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Introduction: Cardiac rehabilitation is an accurate educational and sporting program designed to help heart patients to increase their physical activities and reduce the risk factors that make their health worse and help to a healthier lifestyle so that they can return to their families and society with a better spirit. The aim of this study was to examine the cost-effectiveness and cost-utility of cardiac rehabilitation programs for patients with cardiovascular diseases. Methods: In the present review study, published articles related to cost-effectiveness and cost-utility of cardiac rehabilitation programs for patients with cardiovascular diseases within the time interval between 2004 and 2019 were searched using electronic databases. The methodological quality of the structure of articles was examined by Drummond’s standard checklist. Results: The results of reviewing studies showed that most of the studies related to the economic evaluation of cardiac rehabilitation programs in patients with cardiovascular disease were flawed in Drummond’s criteria, and only one study adhered to Drummond’s criteria. The results of the present study indicated use of cardiac rehabilitation programs in patients with cardiovascular disease was cost-effective. Conclusion: The results of this review study showed that although the results of the studies were different in terms of a number of aspects, such as the study perspective, the time horizons, and the costs of rehabilitation programs, they achieved a similar conclusion, they concluded that the use of cardiac rehabilitation programs in patients with cardiovascular diseases, leading to higher quality-adjusted life years (QALYs) and lower costs.

Keywords: economic evaluation, systematic review, cardiac rehabilitation, Drummond’s checklist

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Authors: Samir Kumar Pal

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Background: Targeted rapid degradation of bilirubin has the potential to thwart incipient bilirubin encephalopathy. Uncontrolled hyperbilirubinemia is a potential problem in developing countries, including India, because of the lack of reliable healthcare institutes for conventional phototherapy. In India, most of the rural subjects duel in the exchange limit during transport, leading to a risk of kernicterus when they arrive at the treatment centre. Thus, an alternative pharmaceutical agent is needed for the hours. Objective: Exploration of a distinct therapeutic strategy for the control of neonatal hyperbilirubinemia compared to conventional phototherapy in a clinical setting. Method: We synthesized, characterized and investigated a spinel-structured Manganese citrate nanocomplex (C-Mn₃O₄ NC, the nanodrug) along with conventional phototherapy in neonatal subjects. We have also observed BIND scores in order to assess neurological dysfunctions. Results: Our observational study clearly reveals that the rate of declination of bilirubin in neonatal subjects with nanodrug oral administration and phototherapy is faster compared to that in the case of phototherapy only. The associated neural dysfunctions were also found to be significantly lower in the case of combined therapy. Conclusion: This study demonstrates that combined therapy works better than conventional phototherapy only for the control of hyperbilirubinemia. We have observed that a significant portion of neonatal subjects requiring blood exchange has been prevented with the combined therapeutic strategy. Further compilation of a drug-safety-dossier is warranted to translate this novel therapeutic chemo preventive approach to clinical settings.

Keywords: nanodrug, nanoparticle, Neonatal hyperbilirubinemia, alternative to phototherapy, redox modulation, redox medicine

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Authors: Gloria Ogungbade, Ogaba Oche, Moses Duruji, Chris Ehiobuche, Lady Ajayi

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Human’s continued sustenance on earth and the quality of living are heavily dependent on the environment. The major components of the environment being air, water and land are the supporting pillars of the human existence, which they depend on directly or indirectly for survival and well-being. Unfortunately, due to some of the human activities on the environment, there seems to be a war between humans and the environment, which is evident in his over-exploitation and inadequate management of the basic components of the environment. Since the discovery of crude oil in the Niger Delta, the region has experienced various forms of degradation caused by pollution from oil spillage, gas flaring and other forms of environmental pollution, as a result of reckless way and manner with which oil is being exploited by the International Oil Corporations (IOCs) operating within the region. The Nigerian government on the other, not having strong regulations guiding the activities of the operations of these IOCs, has done almost nothing to curtail the activities of these IOCs because of the revenue generated the IOCs, as such the region is deprived of the basic social amenities and infrastructures. The degree of environmental pollution suffered within the region affects their major sources of livelihood – being fishing and farming, and has also left the region in poverty, which has led to a large number of people migrating to the urban areas to escape poverty. This paper investigates how environment degradation impact urbanization and security in the region.

Keywords: environmental degradation, environmental pollution, gas flaring, oil spillage, urbanization

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Authors: Yu-Hong Lin

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Background: An adverse drug reaction (ADR) reported is an injury which caused by taking medicines. Sometimes the severity of ADR reported may be minor, but sometimes it could be a life-threatening situation. In order to provide healthcare professionals as a better reference in clinical practice, we do data collection and analysis from our hospital. Methods: This was a retrospective study of ADRs reported performed from 2014 to 2015 in our hospital in Taiwan. We collected assessment items of ADRs reported, which contain gender and age, occurring sources, Anatomical Therapeutic Chemical (ATC) classification of suspected drugs, types of adverse reactions, Naranjo score calculating by Naranjo Adverse Drug Reaction Probability Scale and so on. Results: The investigation included two hundred and seven ADRs reported. Most of ADRs reported were occurring in outpatient department (92%). The average age of ADRs reported was 65.3 years. Less than 65 years of age were in the majority in this study (54%). Majority of all ADRs reported were males (51%). According to ATC classification system, the major classification of suspected drugs was cardiovascular system (19%) and antiinfectives for systemic use (18%) respectively. Among the adverse reactions, Dermatologic Effects (35%) were the major type of ADRs. Also, the major Naranjo scores of all ADRs reported ranged from 1 to 4 points (91%), which represents a possible correlation between ADRs reported and suspected drugs. Conclusions: Definitely, ADRs reported is still an extremely important information for healthcare professionals. For that reason, we put all information of ADRs reported into our hospital's computer system, and it will improve the safety of medication use. By hospital's computer system, it can remind prescribers to think of information about patient's ADRs reported. No drugs are administered without risk. Therefore, all healthcare professionals should have a responsibility to their patients, who themselves are becoming more aware of problems associated with drug therapy.

Keywords: adverse drug reaction, Taiwan, healthcare professionals, safe use of medicines

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Authors: Moses Aron, Elias Mwakilama, Jimmy Namangale

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Spending more time on long queues for a basic service remains a common challenge to most developing countries, including Malawi. For health sector in particular, Out-Patient Department (OPD) experiences long queues. This puts the lives of patients at risk. However, using queuing analysis to under the nature of the problems and efficiency of service systems, such problems can be abated. Based on a kind of service, literature proposes different possible queuing models. However, unlike using generalized assumed models proposed by literature, use of real time case study data can help in deeper understanding the particular problem model and how such a model can vary from one day to the other and also from each case to another. As such, this study uses data obtained from one urban HC for BP, Pediatric and General OPD cases to investigate an average queuing time for patients within the system. It seeks to highlight the proper queuing model by investigating the kind of distributions functions over patient’s arrival time, inter-arrival time, waiting time and service time. Comparable with the standard set values by WHO, the study found that patients at this HC spend more waiting times than service times. On model investigation, different days presented different models ranging from an assumed M/M/1, M/M/2 to M/Er/2. As such, through sensitivity analysis, in general, a commonly assumed M/M/1 model failed to fit the data but rather an M/Er/2 demonstrated to fit well. An M/Er/3 model seemed to be good in terms of measuring resource utilization, proposing a need to increase medical personnel at this HC. However, an M/Er/4 showed to cause more idleness of human resources.

Keywords: health care, out-patient department, queuing model, sensitivity analysis

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