Search results for: health awareness education

Authors: Koteswara Rao Pagolu, Raghava Rao Tamanam

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The present study was aimed to find out the prevalence of DD's in Visakhapatnam, one of the north coastal districts of Andhra Pradesh, India during a span of five years. A cross-sectional investigation was held at District early intervention center (DEIC), Visakhapatnam from 2016 to 2020. To identify the pattern and trend of different DD's including seasonal variations, a retrospective analysis of the health center's inpatient database for the past 5 years was done. Male and female children aged 2 months-18 years are included in the study with the prior permission of the concerned medical officer. The screening tool developed by the Ministry of health and family welfare, India, was used for the study. Among 26,423 cases, children with birth defects are 962, 2229 with deficiencies, 7516 with diseases, and 15716 with disabilities were admitted during the study period. From birth defects, congenital deafness occurred in large numbers with 22.66%, and neural tube defect observed in a small number of cases with 0.83% during the period. From the side of deficiencies, severe acute malnutrition has mostly occurred (66.80 %) and a small number of children were affected with goiter (1.70%). Among the diseases, dental carriers (67.97%) are mostly found and these cases were at peak during the years 2016 and 2019. From disabilities, children with vision impairment (20.55%) have mostly approached the center. Over the past 5 years, the admission rate of down's syndrome and congenital deafness cases showed a rising trend up to 2019 and then declined. Hearing impairment, motor delay, and learning disorder showed a steep rise and gradual decline trend, whereas severe anemia, vitamin-D deficiency, otitis media, reactive airway disease, and attention deficit hyperactivity disorder showed a declining trend. However, congenital heart diseases, dental caries, and vision impairment admission rates showed a zigzag pattern over the past 5 years. This center had inadequate diagnostic facilities related to genetic disease management. For advanced confirmation, the cases are referred to a district government hospital or private diagnostic laboratories in the city for genetic tests. Information regarding the overall burden and pattern of admissions in the health center is obtained by the review of DEIC records. Through this study, it is observed that the incidence of birth defects, as well as genetic disease burden, is high in the Visakhapatnam district. Hence there is a need for strengthening of management services for these diseases in this region.

Keywords: child health screening, developmental delays, district early intervention center, genetic disease management, infrastructural facility, Visakhapatnam district

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Authors: Vijayalaxmi Khopade

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The Prima facie caste system is intrinsic to Indian society. It is an ancient system of intense social stratification based upon birth and enjoying religious sanction. The uppermost strata and privileges are ascribed and enjoyed by brahmins (priestly class), while the lowest strata are occupied by Dalits who are not ascribed with any privileges. The caste system is inherently hierarchical, patriarchal, and systematic and thrives solely on exploitation justified through means of the Brahminical system of hegemony based singularly on birth. The caste system has extended its tentacles to other religions like Christianity, Buddhism, Jainism, and Islam in South Asia. Term Dalit is colloquially used to categorize persons belonging to lower strata in the caste hierarchy. However, this category is heterogenous and highly stratified, following practices like untouchability and exclusion amongst themselves. The modern Indian legal system acknowledges the existence of Caste and its perils. Therefore, by virtue of the Indian Constitution, provisions for affirmative action for the protection and development of Dalits are made. Courts in India have liberally interpreted laws to benefit Dalits. However, the modern system of governance is not immune from Caste based biases. These biases are reflected in the implementation of governance, including the dispensation of justice. The economic reforms of the 1990s gave a huge boost to the Indian diaspora. Persons of Indian origin are now seen making great strides in almost every sector and enjoying positions of power globally. As one peels off the layer of ethnic Indian origin, a deep seated layer of Caste and Caste based patriarchy is clearly visible. Indian diaspora enjoying positions of power essentially belongs to upper castes and carry Caste based biases with them. These castes have long enjoyed the benefits of education; therefore, they were the first ones to benefit from LPG (Liberalization, Privatization, Globalization) model adopted in the 1990s. Dalits, however, had little formal education until recently. The western legal system, to the best of our knowledge, does not recognize Caste and, therefore, cannot afford protection for Dalits, wherein discrimination and exploitation take place solely on the basis of Caste. Therefore, Dalits are left with no legal remedy outside domestic jurisdiction. Countries like the UK have made an attempt to include Caste in their Equality Bill 2010. This has met with tough resistance from Upper caste Hindus who shy away from recognizing their caste privileges and, therefore, the existence of Caste. In this paper, an attempt for comparative analysis is made between various legal protections accorded to Dalits in India vis-à-vis international human rights as protected by the United Nations under its declaration of Universal Human rights. An attempt has been made to mark a distinction between race and Caste and to establish a position of women in Caste based hierarchy. The paper also makes an argument for the inclusion of atrocities committed against Dalits as a violation of international human rights, their protection by the United Nations, and the trial of their violations by International Courts. The paper puts into perspective the need for an external agency like the United Nations and International courts to interfere in rights guaranteed by the Indian Constitution, even with the existence of a modern legal system in a sovereign democratic country.

Keywords: atrocity, caste, diaspora, legal framework

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Authors: Syamimi Shamsuddin, Hanafiah Yussof, Fazah Akhtar Hanapiah, Salina Mohamed, Nur Farah Farhan Jamil, Farhana Wan Yunus

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Robot-based intervention for children with autism is an evolving research niche in human-robot interaction (HRI). Recent studies in this area mostly covered the role of robots in the clinical and experimental setting. Our previous work had shown that interaction with a robot pose no adverse effects on the children. Also, the presence of the robot, together with specific modules of interaction was associated with less autistic behavior. Extending this impact on school-going children, interactions that are in-tune with special education lessons are needed. This methodological paper focuses on how a robot can be incorporated in a current learning environment for autistic children. Six interaction scenarios had been designed based on the existing syllabus to teach communication skills, using the Applied Behavior Analysis (ABA) technique as the framework. Development of the robotic experience in class also covers the required set-up involving participation from teachers. The actual research conduct involving autistic children, teachers and robot shall take place in the next phase.

Keywords: autism spectrum disorder, ASD, humanoid robot, communication skills, robot-assisted learning

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Authors: Chandra Mukherjee

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The prevalent knowledge of the biological systems is based on the standard scientific perception of natural equilibrium, determination and predictability. Recently, a rethinking of concepts was presented and a new scientific perspective emerged that involves complexity theory with deterministic chaos theory, nonlinear dynamics and theory of fractals. The unpredictability of the chaotic processes probably would change our understanding of diseases and their management. The mathematical definition of chaos is defined by deterministic behavior with irregular patterns that obey mathematical equations which are critically dependent on initial conditions. The chaos theory is the branch of sciences with an interest in nonlinear dynamics, fractals, bifurcations, periodic oscillations and complexity. Recently, the biomedical interest for this scientific field made these mathematical concepts available to medical researchers and practitioners. Any biological network system is considered to have a nominal state, which is recognized as a homeostatic state. In reality, the different physiological systems are not under normal conditions in a stable state of homeostatic balance, but they are in a dynamically stable state with a chaotic behavior and complexity. Biological systems like heart rhythm and brain electrical activity are dynamical systems that can be classified as chaotic systems with sensitive dependence on initial conditions. In biological systems, the state of a disease is characterized by a loss of the complexity and chaotic behavior, and by the presence of pathological periodicity and regulatory behavior. The failure or the collapse of nonlinear dynamics is an indication of disease rather than a characteristic of health.

Keywords: HRV, HRVI, LF, HF, DII

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Authors: Nashwa Elyamany

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In visual cultures, namely that of the United States, media representations are such influential and pervasive reflections of societal norms and expectations to the extent that they impact the manner in which both genders view themselves. Health and fitness magazines fall within the realm of visual culture. Since the main goal of communication is to ensure proper dissemination of information in order for the target audience to grasp the intended messages, it becomes imperative that magazine publishers, editors, advertisers and image producers use different modes of communication within their reach to convey messages to their readers and viewers. A rapid waxing flow of multimodality floods popular discourse, particularly health and fitness magazine cover pages. The use of well-crafted cover lines and visual images is imbued with agendas, consumerist ideologies and properties capable of effectively conveying implicit and explicit meaning to potential readers and viewers. In essence, the primary goal of this thesis is to interrogate the multi-semiotic operations and manifestations of hegemonic masculinity and femininity in male and female body culture, particularly on the cover pages of the twin American magazines Men's Health and Women's Health using corpora that spanned from 2011 to the mid of 2016. The researcher explores the semiotic resources that contribute to shaping and legitimizing a new form of postmodern, consumerist, gendered discourse that positions the reader-viewer ideologically. Methodologically, the researcher carries out analysis on the macro and micro levels. On the macro level, the researcher takes on a critical stance to illuminate the ideological nature of the multimodal ensemble of the cover pages, and, on the micro level, seeks to put forward new theoretical and methodological routes through which the semiotic choices well invested on the media texts can be more objectively scrutinized. On the macro level, a 'themes' analysis is initially conducted to isolate the overarching themes that dominate the fitness discourse on the cover pages under study. It is argued that variation in terms of frequencies of such themes is indicative, broadly speaking, of which facets of hegemonic masculinity and femininity are infused in the fitness discourse on the cover pages. On the micro level, this research work encompasses three sub-levels of analysis. The researcher follows an SF-MMDA approach, drawing on a trio of analytical frameworks: Halliday's SFG for the verbal analysis; Kress & van Leeuween's VG for the visual analysis; and CMT in relation to Sperber & Wilson's RT for the pragma-cognitive analysis of multimodal metaphors and metonymies. The data is presented in terms of detailed descriptions in conjunction with frequency tables, ANOVA with alpha=0.05 and MANOVA in the multiple phases of analysis. Insights and findings from this multi-faceted, social-semiotic analysis are interpreted in light of Cultivation Theory, Self-objectification Theory and the literature to date. Implications for future research include the implementation of a multi-dimensional approach whereby linguistic and visual analytical models are deployed with special regards to cultural variation.

Keywords: gender, hegemony, magazine cover page, multimodal discourse analysis, multimodal metaphor, multimodal metonymy, systemic functional grammar, visual grammar

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Authors: Udaykumar R., M. S. Ganachari

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In order to engage community pharmacies in Tuberculosis care, a survey has been conducted in Belgaum city, Karnataka state, India. After the survey divided into two groups one is control group and another one is intervention group. One is dispensing of anti-tuberculosis drugs, and another one is non-availability of anti-tuberculosis drugs. Those community pharmacists who are voluntarily interesting for becoming DOTS (Directly observed treatment short course) provider and RNTCP (Revised national tuberculosis control programme) objectives. Structured training is conducted for community pharmacist who are dispensing anti-tuberculosis drugs. The training module includes record maintaining, reporting to the RNTCP, Medication adherence etc. In case of non-availability of anti-tuberculosis drugs, the district RNTCP has been given training for community pharmacist by providing free of drugs to the community pharmacies. So, community pharmacies can dispense anti-tuberculosis drugs to the patients. The target of this study is Private community pharmacies. A simple random sampling method is used and 550 private community pharmacy shops has been involved in Belgaum city of Karnataka state, India. Significance of the Study: This study mainly focused on training of DOTS (Directly observed treatment short course) to the private community pharmacist. Indian Govt. Considers Private Providers as Assets for TB Control and Care to Achieve National Strategic Plan for TB Elimination 2017-2025. The Govt. has not fully tapped the Potential of Private Pharmacies to Fight TB. Providing DOTS as per patient’s convenience through community DOT Providers with periodic monitoring may reduce the treatment Default. We explore RNTCP objectives interventions that can have directly managed by private community pharmacy shop. Objectives: Survey of anti-tuberculosis drugs in Community pharmacy shop in Belgaum city. Interested community pharmacist who are willing to become DOTS (Directly observed treatment short course) Provider. Major Findings:Most of the community pharmacist are dispensing anti-tuberculosis drugs without having knowledge of DOTS therapy and RNTCP objectives. No community pharmacist is aware of RNTCP and Tuberculosis burden in India. Most of the Pharmacist agreed to come for RNTCP Training module for the community pharmacist. Some of the community pharmacist not dispensing anti-tuberculosis drugs and they agreed to become official DOTS provider. Concluding Statement: Awareness of role of community pharmacist on tuberculosis control and care has been neglected. More than 50% of tuberculosis patients seeking treatments from privatesector. In this study finds the major gap between government and private sector on tuberculosis treatment.

Keywords: community pharmacist, directly observed treatment short course(DOTS), revised national tuberculosis control programme (RNTCP), private pharmacies, anti-tuberculosis drugs

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Authors: Andrew Read, Alice Parry, Kate Woods

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Since the advent of the SARS-CoV-2 pandemic, the search for medications that can reduce mortality and morbidity has been a global research priority. Several multi-center trials have recently demonstrated improved mortality associated with the use of Tocilizumab, an interleukin-6 receptor antagonist, in patients with severe SARS-CoV-2 pneumonia. Initial data supported the administration in patients requiring respiratory support (non-invasive or invasive ventilation), but more recent data has shown benefit in all hypoxic patients. At the height of the second wave of COVID-19 infections in London, our hospital introduced the use of Tocilizumab for patients with severe COVID-19. Tocilizumab is licensed for use in chronic inflammatory conditions and has been associated with an increased risk of severe bacterial and fungal infections, as well as reactivation of chronic viral infections (e.g., hepatitis B). It is a specialist drug that suppresses the formation of C-reactive protein (CRP) for 6 – 12 weeks. It is not widely used by the general medical community. We aimed to assess Tocilizumab use in our hospital and to implement changes to the protocol as required to ensure administration was safe and appropriate. A retrospective study design was used to assess prescriptions over an initial 3-week period in both intensive care and on the medical wards. This amounted to a total of 13 patients. The initial data collection identified four key areas of concern: adherence to national and local inclusion & exclusion criteria; a collection of appropriate screening blood prior to administration; documentation of informed consent or best interest decision and documentation of Tocilizumab administration on patient discharge information, to alert future healthcare providers that typical measures of inflammation and infection, such as CRP, are unreliable for up to 3-months. Data were collected from electronic notes, blood results and observation charts, and cross referenced with pharmacy data. Initial results showed that all four key areas were completed in approximately 50% of cases. Of particular concern was adherence to exclusion criteria, such as current evidence of bacterial infection, and ensuring the correct screening blood was sent to exclude infections such as hepatitis. To remedy this and improve patient safety, the initial data was presented to relevant healthcare professionals. Subsequently, three interventions were introduced and education on each provided to hospital staff. An electronic ‘order set’ collating the appropriate screening blood was created simplifying the screening process. Pre-formed electronic documentation which can be inserted into the notes was created to provide a framework for consent discussions and reduce the time needed for junior doctors to complete this task. Additionally, a ‘Tocilizumab’ administration card was created and administered via pharmacy. This was distributed to each patient on discharge to ensure future healthcare professionals were aware of the potential effects of Tocilizumab administration, including suppression of CRP. Following these changes, repeat data collection over two months illustrated that each of the 4 safety aspects was met with a 100% success rate in every patient. Although this demonstrates good progress and effective interventions the challenge will be to maintain this progress. The audit data collection is ongoing

Keywords: education, patient safety , SARS-CoV-2, Tocilizumab

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Authors: Aggrey Daniel Maina Thuo

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Rapid urban population growth means an increasing demand for urban land, particularly for housing, and also for various other urban uses. This land is not available within cities but in peri-urban areas. The expansion of the cities into the peri-urban areas is creating direct and indirect impacts with those living there facing new challenges and opportunities in meeting their life needs and accommodating the by-products of urbanization. Although urbanization of these areas provides opportunities for employment, better housing, education, knowledge and technology transfer, and ready markets for the agricultural products, increase in population places enormous stress on natural resources and existing social services and infrastructure, therefore causing environmental degradation. This environmental degradation is affecting agriculture for those still holding onto their farms for agricultural purposes. This paper, using a multiple theoretical framework and qualitative research approach, attempts to describe the positive and adverse effects of urbanization on peri-urban agriculture, using the Town Council of Karuri within Nairobi peri-urban areas as a case study.

Keywords: peri-urban agriculture, urbanization, land use, environmental degradation, planning

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Authors: Hosen Tilat Mahal, Monir Hossain

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Despite being a food-sufficient country after revolutionary changes in agricultural inputs, Bangladesh still has food insecurity and undernutrition. This study examines the association between agricultural practices (as social practices) and food security concentrating on the potential impact of sociodemographic factors and climate change. Using data from the 2012 Bangladesh Integrated Household Survey (BIHS), this study shows how modifiedagricultural practices are strongly associated with climate change and different sociodemographic factors (land ownership, religion, gender, education, and occupation) subsequently affect the status of food security in Bangladesh. We used linear and logistic regression models to analyze the association between modified agricultural practices and food security. The findings indicate that socioeconomic statuses are significant predictors of determining agricultural practices in a society like Bangladesh and control food security at the household level. Moreover, climate change is adversely impactingeven the modified agricultural and food security association version. We conclude that agricultural practices must consider climate change while boosting food security. Therefore, future research should integrate climate change into the agriculture and food-related mitigation and resiliency models.

Keywords: food security, agricultural productivity, climate change, bangladesh

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Authors: Ntite Orji Kalu, Martina Kurowski

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Until recently, the Czech Republic had an educational system dominated by indigenous people, who accounted for 95% of the school population. With the increasing influx of migrants and foreign students, especially from outside European Union, came a great disparity among the quality of learners and their learning needs and consideration for the challenges associated with being a minority and living within a foreign culture. This has prompted the research into ways of tailoring the educational system to meet the rising demand of learning styles and needs for the diverse learners in the Czech classrooms. Literature is reviewed regarding the various ways to accommodate the international students considering racial differences, focusing on theoretical approach and pedagogical principles. This study examines the compulsory educational system of the Czech Republic and the position and responsibility of the teacher in fostering a culturally sensitive and inclusive learning environment. Descriptive and content analysis is relied upon for this study. Recommendations are made for stakeholders to imbibe a more responsive environment that enhances the cultural and social integration of all learners.

Keywords: culturally responsive teaching, cultural competence, diversity, learners, inclusive education, Czech schools

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Authors: M. Siedlikowski, F. Rauch, A. Tsimicalis

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Osteogenesis Imperfecta (OI) is a genetic disorder of childhood onset that causes frequent fractures after minimal physical stress. To date, OI research has focused on medically- and surgically-oriented outcomes with little attention on the perspective of the affected child. It is a challenge to elicit the child’s voice in health care, in other words, their own perspective on their symptoms, but software development offers a way forward. Sisom (Norwegian acronym derived from ‘Si det som det er’ meaning ‘Tell it as it is’) is an award-winning, rigorously tested, interactive, computerized tool that helps children with chronic illnesses express their symptoms to their clinicians. The successful Sisom software tool, that addresses the child directly, has not yet been adapted to attend to symptoms unique to children with OI. The purpose of this study was to develop a Sisom paper prototype for children with OI by seeking the perspectives of end users, particularly, children with OI and clinicians. Our descriptive qualitative study was conducted at Shriners Hospitals for Children® – Canada, which follows the largest cohort of children with OI in North America. Purposive sampling was used to recruit 12 children with OI over three cycles. Nine clinicians oversaw the development process, which involved determining the relevance of current Sisom symptoms, vignettes, and avatars, as well as generating new Sisom OI components. Data, including field notes, transcribed audio-recordings, and drawings, were deductively analyzed using content analysis techniques. Guided by the following framework, data pertaining to symptoms, vignettes, and avatars were coded into five categories: a) Relevant; b) Irrelevant; c) To modify; d) To add; e) Unsure. Overall, 70.8% of Sisom symptoms were deemed relevant for inclusion, with 49.4% directly incorporated, and 21.3% incorporated with changes to syntax, and/or vignette, and/or location. Three additions were made to the ‘Avatar’ island. This allowed children to celebrate their uniqueness: ‘Makes you feel like you’re not like everybody else.’ One new island, ‘About Me’, was added to capture children’s worldviews. One new sub-island, ‘Getting Around’, was added to reflect accessibility issues. These issues were related to the children’s independence, their social lives, as well as the perceptions of others. In being consulted as experts throughout the co-creation of the Sisom OI paper prototype, children coded the Sisom symptoms and provided sound rationales for their chosen codes. In rationalizing their codes, all children shared personal stories about themselves and their relationships, insights about their OI, and an understanding of the strengths and challenges they experience on a day-to-day basis. The child’s perspective on their health is a basic right, and allowing it to be heard is the next frontier in the care of children with genetic diseases. Sisom OI, a methodological breakthrough within OI research, will offer clinicians an innovative and child-centered approach to capture this neglected perspective. It will provide a tool for the delivery of health care in the center that established the worldwide standard of care for children with OI.

Keywords: child health, interactive computerized communication tool, participatory approach, symptom management

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Authors: Karin M. Granstrom

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Paper mills produce wastewater with a high content of organic substances. Treatment usually consists of sedimentation, biological treatment of activated sludge basins, and chemical precipitation. The resulting sludges are currently a waste problem, deposited in landfills or used as low-grade fuels for incineration. There is a growing awareness of the need for energy efficiency and environmentally sound management of sludge. A resource-efficient method would be to digest the wastewater sludges anaerobically to produce biogas, refine the biogas to biomethane for use in the transportation sector, and utilize the resulting digestate for soil improvement. The biomethane yield of pulp and paper wastewater sludge is comparable to that of straw or manure. As a bonus, the digestate has an improved dewaterability compared to the feedstock biosludge. Limitations of this process are predominantly a weak economic viability - necessitating both sufficiently large-scale paper production for the necessary large amounts of produced wastewater sludge, and the resolving of remaining questions on the certifiability of the digestate and thus its sales price. A way to improve the practical and economical feasibility of using paper mill wastewater for biomethane production and soil improvement is to co-digest it with other feedstocks. In this study, pulp and paper sludge were co-digested with (1) silage and manure, (2) municipal sewage sludge, (3) food waste, or (4) microalgae. Biomethane yield analysis was performed in 500 ml batch reactors, using an Automatic Methane Potential Test System at thermophilic temperature, with a 20 days test duration. The results show that (1) the harvesting season of grass silage and manure collection was an important factor for methane production, with spring feedstocks producing much more than autumn feedstock, and pulp mill sludge benefitting the most from co-digestion; (2) pulp and paper mill sludge is a suitable co-substrate to add when a high nitrogen content cause impaired biogas production due to ammonia inhibition; (3) the combination of food waste and paper sludge gave higher methane yield than either of the substrates digested separately; (4) pure microalgae gave the highest methane yield. In conclusion, although pulp and paper mills are an almost untapped resource for biomethane production, their wastewater is a suitable feedstock for such a process. Furthermore, through co-digestion, the pulp and paper mill wastewater and mill sludges can aid biogas production from more nutrient-rich waste streams from other industries. Such co-digestion also enhances the soil improvement properties of the residue digestate.

Keywords: anaerobic, biogas, biomethane, paper, sludge, soil

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Authors: S. Gordon

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Dual language immersion is growing fast in language teaching today. This study provides an overview and evaluation of the different models of Dual language immersion programs in US K-12 schools. First, the paper provides a brief current literature review on the theory of Dual Language Immersion (DLI) in Second Language Acquisition (SLA) studies. Second, examples of several types of DLI language teaching models in US K-12 public schools are presented (including 50/50 models, 90/10 models, etc.). Third, we focus on the unique example of DLI education in the state of Utah, a successful, growing program in K-12 schools that includes: French, Chinese, Spanish, and Portuguese. The project investigates the theory and practice particularly of the case of public elementary and secondary school children that study half their school day in the L1 and the other half in the chosen L2, from kindergarten (age 5-6) through high school (age 17-18). Finally, the project takes the observations of Utah French DLI elementary through secondary programs as a case study. To conclude, we look at the principal challenges, pedagogical objectives and outcomes, and important implications for other US states and other countries (such as France currently) that are in the process of developing similar language learning programs.

Keywords: dual language immersion, second language acquisition, language teaching, pedagogy, teaching, French

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Authors: Kaoutar Ben Azzou, Hanaa Talei

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Human resources is an important department in each organization as it manages the life cycle of employees from recruitment training to retirement or termination of contracts. The recruitment process starts with a job opening, followed by a selection of the best-fit candidates from all applicants. Matching the best profile for a job position requires a manual way of looking at many CVs, which requires hours of work that can sometimes lead to choosing not the best profile. The work presented in this paper aims at reducing the workload of HR personnel by automating the preliminary stages of the candidate screening process, thereby fostering a more streamlined recruitment workflow. This tool introduces an automated system designed to help with the recruitment process by scanning candidates' CVs, extracting pertinent features, and employing machine learning algorithms to decide the most fitting job profile for each candidate. Our work employs natural language processing (NLP) techniques to identify and extract key features from unstructured text extracted from a CV, such as education, work experience, and skills. Subsequently, the system utilizes these features to match candidates with job profiles, leveraging the power of classification algorithms.

Keywords: automated recruitment, candidate screening, machine learning, human resources management

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Authors: Jessica A. Hellings, Piyushkumar Jani

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Background: Systemic autoimmune disorders are increasingly implicated in neuropsychiatric illness, especially in the setting of treatment resistance in individuals of all ages. Gluten allergy in fullest extent results in celiac disease, affecting multiple organs including central nervous system (CNS). Clinicians often lack awareness of the association between neuropsychiatric illness and gluten allergy, partly since many such research studies are published in immunology and gastroenterology journals. Methods: Following a Pubmed literature search and online searches on celiac disease websites, 40 articles are critically reviewed in detail. This work reviews celiac disease, gluten intolerance and current evidence of their relationship to neuropsychiatric and systemic illnesses. The review also covers current work-up and diagnosis, as well as dietary interventions, gluten restriction outcomes, and future research directions. Results: Gluten allergy in susceptible individuals damages the small intestine, producing a leaky gut and malabsorption state, as well as allowing antibodies into the bloodstream, which attack major organs. Lack of amino acid precursors for neurotransmitter synthesis together with antibody-associated brain changes and hypoperfusion may result in neuropsychiatric illness. This is well documented; however, studies in neuropsychiatry are often small. In the large CATIE trial, subjects with schizophrenia had significantly increased antibodies to tissue transglutaminase (TTG), and antigliadin antibodies, both significantly greater gluten antibodies than in control subjects. On later follow up, TTG-6 antibodies were identified in these subjects’ brains but not in their intestines. Significant evidence mostly from small studies also exists for gluten allergy and celiac-related depression, anxiety disorders, attention-deficit/hyperactivity disorder, autism spectrum disorders, ataxia, and epilepsy. Dietary restriction of gluten resulted in remission in several published cases, including for treatment-resistant schizophrenia. Conclusions: Ongoing and larger studies are needed of the diagnosis and treatment efficacy of the gluten-free diet in neuropsychiatric illness. Clinicians should ask about the patient history of anemia, hypothyroidism, irritable bowel syndrome and family history of benefit from the gluten-free diet, not limited to but especially in cases of treatment resistance. Obtaining gluten antibodies by a simple blood test, and referral for gastrointestinal work-up in positive cases should be considered.

Keywords: celiac, gluten, neuropsychiatric, translational

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Authors: Dominic Kwaku Danso Mensah

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The study examined conflict management strategies among head teachers and teachers in selected basic schools in Okai-Koi sub metro in the greater region of Ghana. In all, 270 participants were engaged in the study, comprising 237 teachers, 32 head teachers, and one officer in charge of the Metropolis. The study employed descriptive survey while using purposive and simple random sampling techniques to sample participants. Interview guides and questionnaires were the main instruments used for gathering primary data. The study found that conflict is inevitable in the schools. Conflicts in schools are usually subtle and hardly noticed by outsiders even though they occur on daily basis. The causes of conflict include among other things, high expectation from head teachers, inability to attain goals set, communication from head teachers and power struggle. The study found out that, in managing and resolving conflicts, issues such as identifying and focusing on the problem, building of trust and cooperation, clarifying goals and objectives were seen to be effective means of managing conflict and recommended that management should design and develop conflict management strategies to quickly resolve conflict.

Keywords: basic education, conflict management, organizational harmony, power

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Authors: Liqun Zou, Ling Wang, Xiaoli Chen

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Objective: Through the questionnaire about emergency nurses’ knowledge and attitudes regarding pain management to understand whether they are well mastered and practiced the related knowledge about pain management, providing a reference for continuous improvement of the quality of nursing care in acute pain and for improving the effect of management on emergency pain patients. Method: The Chinese version questionnaire about KASRP (knowledge and attitudes survey regarding pain) was handed out to 132 emergency nurses to do a study about the knowledge and attitude of pain management. Meanwhile, SPSS17.0 was used to do a descriptive analysis and variance analysis on collected data. Results: The emergency nurses’ correct answer rate about KASRP questionnaire is from 25% to 65% and the average correct rate is (44.65 + 7.85)%. In addition, there are 10 to 26 items being given the right answer. Therefore, the average correct items are (17.86 ± 3.14). Moreover, there is no statistical significant on the differences about the correct rate for different age, gender and work experience to answer; however, the difference of the correct rate in different education background and the professional title is significant. Conclusion: There is a remarkable lack of knowledge and attitude towards pain management in emergency nurses, whose basic knowledge of pain is sufficient. Besides, there is a deviation between the knowledge of pain management and clinical practice, which needs to be improved.

Keywords: emergency nurse, pain, KASRP questionnaire, pain management

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Authors: Namrata Jain, Vishaka Karnad

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Fashion has always fascinated people through ages. Indian women’s wear in particular women's western formal wear has gone through transformational phases during the past decade. Increasing number of working women, independence in deciding financial matters, media exposure and awareness of current trends has provided a different dimension to the apparel segment. With globalization and sharing of cultures, in India formal women’s wear is no longer restricted to ethnic outfits like a sari or salwarkameez. Strong western influence has been observed in the process of designing, production and use of western formal wear by working women as consumers. The present study focuses on the psychographics parameters, consumer buying preferences and their relation to the present market scenario. Qualitative and quantitative data was gathered through a observation, consumer survey and study of brands. A questionnaire was prepared and uploaded as a google form to gather primary data from hundred consumer respondents. The respondent samples were drawn through snowball and purposive sampling technique. Consumers’ buying behavior is influenced by various aspects like age group, occupation, income and their personal preferences. Frequency of use, criteria for brand selection, styles of formal wear and motivating factors for purchase of western formals by working women were the other influential factors under consideration. It was observed that higher consumption and more popularity was indicated by women in the age group of 21-30 years. Amongst western formal wear shirts and trousers were noted to be the most preferred in Mumbai. It may be noted that consumers purchased and used branded western formal wear for reasons of comfort and value for money. Past experience in using the product and price were some of the important criteria for brand loyalty but the need for variety lured consumers to look for other brands. Fit of the garment was rated as the most important motivational factor while selecting products for purchase. With the advancement of women’s economic status, self-reliance, women role and image in the society, impulsive buying has increased with increase in consumerism. There is an ever growing demand for innovations in cuts, styles, designs, colors and fabrics. The growing fashion consciousness at the work place has turned women’s formal wear segment into a lucrative and highly evolving market thus providing space for new entrepreneurs to become a part of this developing sector.

Keywords: buying behavior, consumerism, fashion, western formal wear

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Authors: Funke Morenike Jiyah, Joshua Jiyah

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The occurrence of various health issues have been linked to excessive noise pollution in all works of life as evident in many research efforts. This study provides empirical analysis of the effects of noise pollution on the well-being of the residents of Bida Local Government Area, Niger State, Nigeria. The study adopted a case study research design, involving cross-sectional procedure. Field observations and medical reports were obtained to support the respondents’ perception on the state of their well-being. The sample size for the study was selected using the housing stock in the various wards. One major street in each ward was selected. A total of 1,833 buildings were counted along the sampled streets and 10% of this was selected for the administration of structured questionnaire.The environmental quality of the wards was determined by measuring the noise level using Testo 815 noise meters. The result revealed that Bariki ward which houses the GRA has the lowest noise level of 37.8 dB(A)while the noise pollution levels recorded in the other thirteen wards were all above the recommended levels. The average ambient noise level in sawmills, commercial centres, road junctions and industrial areas were above 90 dB(A). The temporal record from the Federal Medical Centre, Bida revealed that, apart from malaria, hypertension (5,614 outpatients) was the most prevalent health issue in 2013 alone. The paper emphasised the need for compatibility consideration in the choice of residential location, the use of ear muffler and effective enforcement of zoning regulations.

Keywords: bida, decibels, environmental quality, noise, well-being

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Authors: Janaina Pereira, Barbara Gonzalez, Valentina Chitas, Teresa Molina

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Intro: The positive impact of opioid maintenance programs on the health of heroin addicts, and on public health in general, has been widely recognized, namely on the prevalence reduction of infectious diseases as HIV, and on the social reintegration of this population. Nevertheless, a part of patients in these programs cannot remain heroin abstinent, or has relapses, during the treatment. Method: Thus, this cross-sectional research aims at analyzing the relation between a set of psychological and psychosocial variables, which have been associated with the onset of heroin use, and assess if they are also associated with absence of abstinence in participants in an opioid maintenance program. A total of 62 patients, aged between 26 and 58 years old (M= 40.87, DP= 7.39) with a time in opioid maintenance program between 1 and 10 years (M= 5.42, DP= 3.05), 77.4% male and 22.6% female, participated in this research. To assess the criterion variable (heroin use) we used the mean value of positive results in urine tests during the participation in the program, weighted according to the number of months in program. The predictor variables were the coping strategies, the dispositional sensation seeking, and the existence of Posttraumatic stress disorder (PTSD). Results: The results showed that only 33.87% of the patients were totally abstinent of heroin use since the beginning of the program, and the absence of abstinence, as the number of positive heroin tests, was primarily predicted by less proactive coping, and secondarily by a higher level of sensation seeking. 16.13% of the sample fulfilled diagnosis criteria for PTSD, and 67.74 % had at least one traumatic experience throughout their lives. The total of PTSD symptoms had a positive correlation with the number of physical health problems, and with the lack of professional occupation. These results have several implications for the clinical practice in this field, and we suggest the promotion of proactive coping strategies should integrate these opioid maintenance programs, as they represent the tendency to face future events as challenges and opportunities, being positively related to positive results on several fields. The early identification of PTSD in the participants, before entering the opioid maintenance programs, would be important as it is related to negative features that hinder social reintegration, Finally, to identify individuals with a sensation seeking profile would be relevant, not only because they face a higher risk of relapse, but also because the therapeutical approaches should not ignore this dispositional feature in the alternatives they propose to the patients.

Keywords: opioid maintenance programs, proactive coping, PTSD, sensation seeking

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Authors: Annette McArthur

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The traditional model of teaching and learning, where ICT sits as a separate entity is not a model for a 21st century school. It is imperative that teaching and learning embraces technological advancements. The challenge in schools lies in shifting the mindset of teachers so they see ICT as integral to their teaching, learning and curriculum rather than a separate E-Learning curriculum stream. This research project investigates how the effective, planned, intentional integration of ICT into a STEM curriculum, can enable the shift in the teacher mindset. The project incorporated: • Developing a professional coaching relationship with key STEM teachers. • Facilitating staff professional development involving student centered project based learning pedagogy in the context of a STEM curriculum. • Facilitating staff professional development involving digital literacy. • Establishing a professional community where collaboration; sharing and reflection were part of the culture of the STEM community. • Facilitating classroom support for the effective delivery innovative STEM curriculum. • Developing STEM learning spaces where technologies were used to empower and engage learners to participate in student-centered, project-based learning.

Keywords: e-learning, ICT, project based learning, STEM

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Authors: Mesfin Nigussie Ibido

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The study is designed to explore the effects of land certification in securing women’s land rights of two rural villages in Robe district at Arsi Zone of Oromia regional state. The land is very critical assets for human life survival and the backbone for rural women livelihood. Equal access and control power to the land have given a chance for rural women to participate in different economic activities and improve their bargaining ability for decision making on their rights. Unfortunately, women were discriminated and marginalized from access and control of land for centuries through customary practices. However, in many countries, legal reform is used as a powerful tool for eliminating discriminatory provisions in property rights. Among other equity and efficiency concerns, the land certification program in Ethiopia attempts to address gender bias concerns of the current land-tenure system. The existed rural land policy was recognizing a women land rights and benefited by strengthened wives awareness of their land rights and contribute to the strong involvement of wives in decision making. However, harmful practices and policy implementation problems still against women do not fully exercise a provision of land rights in a different area of the country. Thus, this study is carried out to examine the effect of land certification in securing women’s land rights by eliminating the discriminatory nature of cultural abuses of study areas. Probability and non-probability sampling types were used, and the sample size was determined by using the sampling distribution of the proportion method. Systematic random sampling method was applied by taking the nth element of the sample frame. Both quantitative and qualitative research methods were applied, and survey respondents of 192 households were conducted and administering questionnaires in the quantitative method. The qualitative method was applied by interviews with focus group discussions with rural women, case stories, Village, and relevant district offices. Triangulation method was applied in data collection, data presentation and in the analysis of findings. Study finding revealed that the existence of land certification is affected by rural women positively by advancing their land rights, but still, some women are challenged by unsolved problems in the study areas. The study forwards recommendation on the existed problems or gaps to ensure women’s equal access to and control over land in the study areas.

Keywords: decision making, effects, land certification, land right, tenure security

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Authors: Jacklyn Yek, Clara Tong, Shin Yuet Chong, Yee Yian Ong

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Background: While emergency manuals and cognitive aids (CA) have been used in high-hazard industries for decades, this has been a nascent field in healthcare. CAs can potentially offset the large cognitive load involved in crisis resource management and possibly facilitate the efficient performance of key steps in treatment. A crisis manual was developed based on local guidelines and the latest evidence-based information and introduced to a tertiary hospital setting in Singapore. Hence, the objective of this study is to evaluate the effectiveness of the crisis manual in guiding response and management of critical events. Methods: 7 surgical teams were recruited to participate in a series of simulated emergencies in high-fidelity operating room simulator over the period of April to June 2018. All teams consisted of a surgical consultant and medical officer/registrar, anesthesia consultant and medical officer/registrar; as well as a circulating, scrub and anesthetic nurse. Each team performed a simulated operation in which 1 or more of the crisis events occurred. The teams were randomly assigned to a scenario of the crisis manual and all teams were deemed to be equal in experience and knowledge. Before the simulation, teams were instructed on proper checklist use but the use of the checklist was optional. Results: 7 simulation sessions were performed, consisting of the following scenarios: Airway fire, Massive Transfusion Protocol, Malignant Hyperthermia, Eclampsia, and Difficult Airway. Out of the 7 surgical teams, 2 teams made use of the crisis manual – of which both teams had encountered a ‘Malignant Hyperthermia’ scenario. These team members reflected that the crisis manual assisted allowed them to work in a team, especially being able to involve the surgical doctors who were unfamiliar with the condition and management. A run chart plotted showed a possible upward trend, suggesting that with increasing awareness and training, staff would become more likely to initiate the use of the crisis manual. Conclusion: Despite the high volume load in this tertiary hospital, certain crises remain rare and clinicians are often caught unprepared. A crisis manual is an effective tool and easy-to-use repository that can improve patient outcome and encourage teamwork. With training, familiarity would allow clinicians to be increasingly comfortable with reaching out for the crisis manual. More simulation training would need to be conducted to determine its effectiveness.

Keywords: crisis resource management, high fidelity simulation training, medical errors, visual aids

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Authors: A. Alhusban, M. Alqawasmeh, F. Alfawares

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Introduction: Diabetes is a chronic health problem and a major risk factor of stroke. A number of therapeutic modalities exist for diabetes management. It’s still unknown whether the different oral hypoglycemic agents would ameliorate the detrimental effect of diabetes on stroke severity. The objective of this work is to assess the effect of pretreatment with oral hypoglycemic agents, insulin and their combination on stroke severity at presentation. Patients and Methods: Patients admitted to the King Abdullah University Hospital (KAUH)-Jordan with ischemic stroke between January 2015 and December 2016 were evaluated and their comorbid diseases, treatment on admission and their neurologic severity was assessed using the National Institute of Health Stroke Scale (NIHSS) were documented. Stroke severity was compared for non-diabetic patients and diabetic patients treated with different antidiabetic agents. Results: Data from 324 patients with acute stroke was documented. The median age of participants was 69 years. Diabetes was documented in about 50% of the patients. Multinomial regression analysis identified diabetes treatment status as an independent predictor of neurological severity of stroke (p=0.032). Patients treated with oral hypoglycemic agents had a significantly lower NIHSS as compared to nondiabetic patients and insulin treated patients (p < 0.02). The positive effect of oral hypoglycemic agents was blunted by insulin co-treatment. Insulin did not alter the severity of stroke as compared to non-diabetics. Conclusion: Oral hypoglycemic agents may reduce the severity of neurologic deficit of ischemic stroke and may have neuroprotective effect.

Keywords: diabetes, stroke, neuroprotection, oral hypoglycemic agents

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Authors: Mokoena Oratilwe Penwell, Seeletse Solly Matshonisa

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The demand for quality products is a vital factor determining the success of a producing company, and the reality of this demand influences customer satisfaction. In Sefako Makgatho Health Sciences University (SMU), concerns over the quality of food being sold have been raised by mostly students and staff who are primary consumers of food being sold by the cafeteria. Suspicions of food poisoning and the occurrence of diarrhea-related to food from the cafeteria, amongst others, have been raised. However, minimal measures have been taken to resolve the issue of food quality. New service providers have been appointed, and still, the same trends are being observed, the quality of food seems to depreciate continuously. This paper uses multi-attribute failure mode analysis (MAFMA) for failure detection and minimization on the machines used for food production by SMU catering company before being sold to both staff, and students so as to improve production plant reliability, and performance. Analytical Hierarchy Process (AHP) will be used for the severity ranking of the weight criterions and development of the hierarchical structure for the cafeteria company. Amongst other potential issues detected, maintenance of the machines and equipment used for food preparations was of concern. Also, the staff lacked sufficient hospitality skills, supervision, and management in the cafeteria needed greater attention to mitigate some of the failures occurring in the food production plant.

Keywords: MAFMA, food quality, maintenance, supervision

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Authors: Mohammad Reza Boromand, Masoud Moradi, Amin Eskandari

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The present study attempts to determine ranking of managerial parameters impacting upon performance of football referees in Iran. The population consisted of all referees in Leagues 1, 2 and 3 as well as super league of Iran (N=273), of which we selected 160 referees and assistant referees in 2013-2014. A research-designed questionnaire was used for data collection which was divided into two sections: (1) Demographic details (age range, Marital status, employment, refereeing experience, education level, refereeing level and proficiency) and (2) items related to parameters impacting upon performance of referees (structural parameters, operational parameters, environmental parameters, temporal parameters, economic parameters, facilities and tools, personal performance and performance evaluation). Internal consistency was calculated by Cronbach's alpha (r=0.85). For data analysis, we performed Freedman's Test and used SPSS software (α>0.05), along with descriptive statistics. The findings showed the following ranking for the above-mentioned managerial parameters: Facilities and tools, personal performance, economic parameters, structural parameters, operational parameters, environmental parameters, temporal parameters, and performance evaluation.

Keywords: Iran, football referees, managerial parameters, performance

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Authors: Selina Studer, Maria Kleinstäuber, Cornelia Weise

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Background: Finding words to report what you have been through may be challenging, especially when dealing with stressful or highly emotional experiences. Photovoice (PV) represents a possible way of facilitating experience reporting. In this approach, people take photos about a particular topic (in our study: worries about the future) and talk about the topic based on the photos. So far, the benefits of Photovoice have been quantitatively insufficiently tested. There is a lack of randomized controlled trials investigating PV in comparison to other methods. This study aimed to fill this research gap. Methods: 65 participants took part in the study and were randomly assigned to the PV group, the writing group (WG), or the control group (CG). The PV group received the task to take photos of worries regarding the future for one week and send max. 5 of them to the interviewer before the interview. The WG had to write down the worries about the future and send max. 5 of them to the interviewer before the interview. The control group did not receive a specific assignment. The semi-structured interview consisted of six open-ended questions and was applied to all future worries. The questions included the content of the future worries, the meaning, and how the worry expressed itself emotionally and physically. The interview was recorded and later transcribed. After the interview, online questionnaires were filled out. They covered a range of variables such as access to emotional content, ability to describe feelings, the extent of self-disclosure, and relationship quality. Results: Contrary to our hypotheses, one-way ANOVA revealed no differences between the three conditions concerning all variables (access to emotional content, ability to describe feelings, the extent of self-disclosure, and so on), all p's > 0.14, BF₀₁ = 1.78-7.66. In a subsequent step, the words in the transcribed interviews were analyzed. The LIWC program counted how many emotional words occurred in the text and assigned them to predefined categories. Planned contrasts revealed that the PV reported more negative emotional words compared to the two groups t(62) = 2.62, p = .011, and also compared to the WG only, t(62) = 2.36, p = .022, BF₀₁ = 0.62. Conclusions and implications: The applied self-report instruments did not reveal any differences between the groups. However, the PV group used more negative emotional words than the other two groups. The discrepancy between self-report and observation variables regarding emotionality is noticeable. It is suggested that the highly educated and above-average female sample may not have needed PV to access emotional content. It is possible that the approach would yield clearer results in a clinical sample. This and other approaches are currently being investigated in a follow-up study.

Keywords: photovoice, controlled randomized study, online intervention, emotional awareness, self-disclosure, data triangulation, interviews

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Authors: Javier Barrachina, Piedad Garrido, Manuel Fogue, Julio A. Sanguesa, Francisco J. Martinez

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It is very common to observe, especially in Computer Science studies that students have difficulties to correctly understand how some mechanisms based on Artificial Intelligence work. In addition, the scope and limitations of most of these mechanisms are usually presented by professors only in a theoretical way, which does not help students to understand them adequately. In this work, we focus on the problems found when teaching Evolutionary Algorithms (EAs), which imitate the principles of natural evolution, as a method to solve parameter optimization problems. Although this kind of algorithms can be very powerful to solve relatively complex problems, students often have difficulties to understand how they work, and how to apply them to solve problems in real cases. In this paper, we present two interactive graphical applications which have been specially designed with the aim of making Evolutionary Algorithms easy to be understood by students. Specifically, we present: (i) TSPS, an application able to solve the ”Traveling Salesman Problem”, and (ii) FotEvol, an application able to reconstruct a given image by using Evolution Strategies. The main objective is that students learn how these techniques can be implemented, and the great possibilities they offer.

Keywords: education, evolutionary algorithms, evolution strategies, interactive learning applications

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Authors: Stephen Bahooshy

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Our understanding of gender inequality has advanced in recent years. Differences in pay and societal gendered behaviour expectations have been emphasized. It is acknowledged globally that gender shapes everyone’s experiences of health and social care, including access to care, use of services and products, and the interaction with care providers. NHS Digital in England collects data from local authorities on the number of carers and people with support needs and the services they access. This data does not provide a gender breakdown. Caring can have many positive and negative impacts on carers’ health and wellbeing. For example, caring can improve physical health, provide a sense of pride and purpose, and reduced stress levels for those who undertake a caring role by choice. Negatives of caring include financial concerns, social isolation, a reduction in earnings, and not being recognized as a carer or involved and consulted by health and social care professionals. Treating male and female carers differently is by definition unequitable and precludes one gender from receiving the benefits of caring whilst potentially overburdening the other with the negatives of caring. In order to explore the issue on a preliminary basis, five local authorities who provide statutory adult social care services in England were sent Freedom of Information requests in 2019. The authorities were selected to include county councils and London boroughs. The authorities were asked to provide data on the amount of money spent on care at home packages to people over 65 years, broken down by gender and carer gender for each financial year between 2013 and 2019. Results indicated that in each financial year, female carers supporting someone over 65 years received less financial support for care at home support packages than male carers. Over the six-year period, this difference equated to a £9.5k deficit in financial support received on average per female carer when compared to male carers. An example of a London borough with the highest disparity presented an average weekly spend on care at home for people over 65 with a carer of £261.35 for male carers and £165.46 for female carers. Consequently, female carers in this borough received on average £95.89 less per week in care at home support than male carers. This highlights a real and potentially detrimental disparity in the care support received to female carers in order to support them to continue to care in parts of England. More research should be undertaken in this area to better explore this issue and to understand if these findings are unique to these social care providers or part of a wider phenomenon. NHS Digital should request local authorities collect data on gender in the same way that large employers in the United Kingdom are required by law to provide data on staff salaries by gender. People who allocate social care packages of support should consider the impact of gender when allocating support packages to people with support needs and who have carers to reduce any potential impact of gender bias on their decision-making.

Keywords: caregivers, carers, gender equality, social care

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Authors: Özlem Canbolat, Sevgisun Kapucu

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The aim of this study was to determine the effect of a computer-assisted glycemic surveillance protocol on nursing workload in intensive care unit. The study is completed in an Education and Research Hospital in Ankara with the attendance of volunteered 19 nurse who had been worked in reanimation unit. Nurses used the written protocol and computer-assisted glycemic surveillance protocol for glycemic follow-up approach of the intensive care patients. Nurses used the written protocol first in the glycemic follow-up of the patient, then used the computer-assisted protocol. (Nurses used the written protocol first, then the computer-assisted protocol in the glycemic follow-up of the patient). Less time was spent in glycemic control with computerized protocol than written protocol and this difference is statistically significant (p < 0.001). It was determined that the computerized protocol application was completed in about 10 seconds (25% shorter) than the written protocol implementation. The computer-assisted glycemic surveillance protocol was found to be more easy and appropriate by nurses and the satisfaction level of the users was higher than with written protocol. While 79% of the nurses find it confusing to implement the written protocol, 79% were satisfied with the use of computerized protocol.

Keywords: computer-assisted protocol, glycemic control, insulin infusion protocol, intensive care, nursing workload

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