Search results for: improved remission rate

Authors: Kim Kennedy, Daren Gibson, Stephanie Flukes, Chandra Diwakarla, Lisa Spalding, Leanne Pilkington, Andrew Redfern

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Introduction: The mortality gap in Aboriginal Head and Neck Cancer is well known, but the reasons for poorer survival are not well established. Aim: We aimed to evaluate the locoregional and metastatic involvement, and stage at diagnosis, in Aboriginal compared with non-Aboriginal patients. Methods: We performed a retrospective cohort analysis of 320 HNC patients from a single centre in Western Australia, identifying 80 Aboriginal patients and 240 non-Aboriginal patients matched on a 1:3 ratio by sites, histology, rurality, and age. We collected data on the patient characteristics, tumour features, regions involved, stage at diagnosis, treatment history, and survival and relapse patterns, including sites of metastatic and locoregional involvement. Results: Aboriginal patients had a significantly higher incidence of lung metastases (26.3% versus 13.7%, p=0.009). Aboriginal patients also had a numerically but non-statistically significant higher incidence of thoracic nodal involvement (10% vs 5.8%) and malignant pleural effusions (3.8% vs 2.5%). Aboriginal patients also had a numerically but not statistically significantly higher incidence of adrenal and bony involvement. Interestingly, non-Aboriginal patients had an increased rate of cutaneous (2.1% vs 0%) and liver metastases (4.6% vs 2.5%) compared with Aboriginal patients. In terms of locoregional involvement, Aboriginal patients were more than twice as likely to have contralateral neck involvement (58.8% vs 24.2%, p<0.00001), and 30% more likely to have ipsilateral neck lymph node involvement (78.8% vs 60%, p=0.002) than non-Aboriginal patients. Aboriginal patients had significantly more advanced disease at diagnosis (p=0.008). Aboriginal compared with non-Aboriginal patients were less likely to present with stage I (7.5% vs 22.5%), stage II (11.3% vs 13.8%), or stage III disease (13.8% vs 17.1%), and more likely to present with more advanced stage IVA (42.5% vs 34.6%), stage IVB (15% vs 7.1%), or stage IVC (10% vs 5%) disease (p=0.008). Number of regions of disease involvement was higher in Aboriginal patients (median 3, mean 3.64, range 1-10) compared with non-Aboriginal patients (median 2, mean 2.80, range 1-12). Conclusion: Aboriginal patients had a significantly higher incidence of lung metastases, and significantly more frequent involvement of ipsilateral and contralateral neck lymph nodes. Aboriginal patients also had significantly more advanced disease at presentation with a higher stage at diagnosis. We are performing further analyses to investigate explanations for these findings.

Keywords: head and neck cancer, Aboriginal, metastases, locoregional, pattern of relapse, sites of disease

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Authors: James Kinyua Gitonga, Toshio Fujimi

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Vulnerability assessment and analysis is essential to solving the degree of damage and loss as a result of natural disasters. Urban flooding causes a major economic loss and casualties, at Mathare residential area in Nairobi, Kenya. High population caused by rural-urban migration, Unemployment, and unplanned urban development are among factors that increase flood vulnerability in Mathare area. This study aims to analyse flood risk physical vulnerabilities in Mathare based on scientific data, research data that includes the Rainfall data, River Mathare discharge rate data, Water runoff data, field survey data and questionnaire survey through sampling of the study area have been used to develop the risk curves. Three structural types of building were identified in the study area, vulnerability and risk curves were made for these three structural types by plotting the relationship between flood depth and damage for each structural type. The results indicate that the structural type with mud wall and mud floor is the most vulnerable building to flooding while the structural type with stone walls and concrete floor is least vulnerable. The vulnerability of building contents is mainly determined by the number of floors, where households with two floors are least vulnerable, and households with a one floor are most vulnerable. Therefore more than 80% of the residential buildings including the property in the building are highly vulnerable to floods consequently exposed to high risk. When estimating the potential casualties/injuries we discovered that the structural types of houses were major determinants where the mud/adobe structural type had casualties of 83.7% while the Masonry structural type had casualties of 10.71% of the people living in these houses. This research concludes that flood awareness, warnings and observing the building codes will enable reduce damage to the structural types of building, deaths and reduce damage to the building contents.

Keywords: flood loss, Mathare Nairobi, risk curve analysis, vulnerability

Procedia PDF Downloads 239

Authors: Chikwelu Edward Emenike, Ogbuagu Uchenna Fredrick

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About 34% of the solar radiant energy reaching the earth is immediately reflected back to space as incoming radiation by clouds, chemicals, dust in the atmosphere and by the earth’s surface. Most of the remaining 66% warms the atmosphere and land. Most of the incoming solar radiation not reflect away is degraded into low-quality heat and flows into space. The rate at which this energy returns to space as low-quality heat is affected by the presence of molecules of greenhouse gases. Gaseous emission was measured with the aid of Growen gas Analyzer with a digital readout. Total measurements of eight parameters of twelve selected sample locations taken at two different seasons within two months were made. The ambient air quality investigation in Anambra State has shown the overall mean concentrations of gaseous emission at twelve (12) locations. The mean gaseous emissions showed (NO2=0.66ppm, SO2=0.30ppm, CO=43.93ppm, H2S=2.17ppm, CH4=1.27ppm, CFC=1.59ppb, CO2=316.33ppm, N2O=302.67ppb and O3=0.37ppm). These values do not conform to the National Ambient Air Quality Standard (NAAQS) and thus contribute significantly to the global warming. Because some of these gaseous emissions (SO2, NO2) are oxidizing agents, they act as irritants that damage delicate tissues in the eyes and respiratory passages. These can impair lung function and trigger cardiovascular problems as the heart tries to compensate for lack of Oxygen by pumping faster and harder. The major sources of air pollution are transportation, industrial processes, stationary fuel combustion and solid waste disposal, thus much is yet to be done in a developing country like Nigeria. Air pollution control using pollution-control equipment to reduce the major conventional pollutants, relocating people who live very close to dumpsites, processing and treatment of gases to produce electricity, heat, fuel and various chemical components should be encouraged.

Keywords: ambient air, atmosphere, greenhouse gases, anambra state

Procedia PDF Downloads 433

Authors: Fidelia A. Orji, Julita Vassileva

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This research aims to develop machine learning models for students' academic performance and study strategy prediction, which could be generalized to all courses in higher education. Key learning attributes (intrinsic, extrinsic, autonomy, relatedness, competence, and self-esteem) used in building the models are chosen based on prior studies, which revealed that the attributes are essential in students’ learning process. Previous studies revealed the individual effects of each of these attributes on students’ learning progress. However, few studies have investigated the combined effect of the attributes in predicting student study strategy and academic performance to reduce the dropout rate. To bridge this gap, we used Scikit-learn in python to build five machine learning models (Decision Tree, K-Nearest Neighbour, Random Forest, Linear/Logistic Regression, and Support Vector Machine) for both regression and classification tasks to perform our analysis. The models were trained, evaluated, and tested for accuracy using 924 university dentistry students' data collected by Chilean authors through quantitative research design. A comparative analysis of the models revealed that the tree-based models such as the random forest (with prediction accuracy of 94.9%) and decision tree show the best results compared to the linear, support vector, and k-nearest neighbours. The models built in this research can be used in predicting student performance and study strategy so that appropriate interventions could be implemented to improve student learning progress. Thus, incorporating strategies that could improve diverse student learning attributes in the design of online educational systems may increase the likelihood of students continuing with their learning tasks as required. Moreover, the results show that the attributes could be modelled together and used to adapt/personalize the learning process.

Keywords: classification models, learning strategy, predictive modeling, regression models, student academic performance, student motivation, supervised machine learning

Procedia PDF Downloads 129

Authors: Misra Ayse Adsiz, Selim Selvi

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In today's world, technology is competing with time. In order to catch up with the world's companies and adapt quickly to the changes, it is necessary to speed up the processes and keep pace with the rate of change of the technology. The missile system design processes, which are handled with classical methods, keep behind in this race. Because customer requirements are not clear, and demands are changing again and again in the design process. Therefore, in the system design process, a methodology suitable for the missile system design dynamics has been investigated and the processes used for catching up the era are examined. When commonly used design processes are analyzed, it is seen that any one of them is dynamic enough for today’s conditions. So a hybrid design process is established. After a detailed review of the existing processes, it is decided to focus on the Scrum Framework and Agile Philosophy. Scrum is a process framework. It is focused on to develop software and handling change management with rapid methods. In addition, agile philosophy is intended to respond quickly to changes. In this study, it is aimed to integrate Scrum framework and agile philosophy, which are the most appropriate ways for rapid production and change adaptation, into the missile system design process. With this approach, it is aimed that the design team, involved in the system design processes, is in communication with the customer and provide an iterative approach in change management. These methods, which are currently being used in the software industry, have been integrated with the product design process. A team is created for system design process. The roles of Scrum Team are realized with including the customer. A scrum team consists of the product owner, development team and scrum master. Scrum events, which are short, purposeful and time-limited, are organized to serve for coordination rather than long meetings. Instead of the classic system design methods used in product development studies, a missile design is made with this blended method. With the help of this design approach, it is become easier to anticipate changing customer demands, produce quick solutions to demands and combat uncertainties in the product development process. With the feedback of the customer who included in the process, it is worked towards marketing optimization, design and financial optimization.

Keywords: agile, design, missile, scrum

Procedia PDF Downloads 168

Authors: Mona Nada, Fahmy Fahmy

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Background: Pleomorphic dermal sarcoma is a rare form of skin cancer affecting cutaneous layer and, in some cases associated with recurrence and metastasis, very commonly to seen in elderly patient affecting the area of head and neck. Pleomorphic dermal sarcoma rises in ultraviolet light exposed areas. The symptoms and severity of this kind of skin cancer varies according to histological factors. The differentiation of Pleomorphic dermal sarcoma needs extensive immunohistochemistry, as the diagnosis depends mainly on exclusion to rule out other malignancy like poorly differentiated squamous cell carcinoma, melanoma, angiosarcoma and leiomyosarcoma. Objective: assessing the management of Pleomorphic dermal sarcoma in our unit and compared to the updated guidelines. Design: Retrospective study Collection of patient data from medical records at countess of Chester plastic surgery unit of the last 5 years, all histologically confirmed Pleomorphic dermal sarcoma (2017-2023). Data were collected confirmed to be Pleomorphic dermal sarcoma were included in the study. The data collected: clinical description of the lesions at first presentation, operation time, multidisciplinary team discussion, plan, referral as well as second operation and investigation done. With comparison of histological examination, immunohistochemistry staining, the excision and rate of recurrence. Results: data collected N19 from (2017-2023) showed the disease predominantly affecting males and the lesion mainly in head and neck, the diagnosis needed extensive immunohistochemistry to differentiate between other malignancy. recurrence present in numbers of the cases which managed after multidisciplinary team discussion either by excision or radiotherapy. Conclusion: Pleomorphic dermal sarcoma is a rare malignancy which needs more understanding and avoid missing as it is aggressive form of skin cancer, there is a chance of metastasis and recurrence which makes it very important to understand the process of development of the cancer and frequent review of the management guidelines.

Keywords: pleomorphic dermal sarcoma, recurrence, radiotherapy, surgical

Procedia PDF Downloads 72

Authors: Eniola Akande

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Introduction: English vocabulary and reading comprehension are core to academic achievement in many school subjects. Deficiency in both accounts for dismal performance in internal and external examinations among primary school pupils in Ibadan Metropolis, Nigeria. Previous studies largely focused on factors influencing pupils’ achievement in English vocabulary and reading comprehension. In spite of what literature has shown, the problem still persists, implying the need for other kinds of intervention. This study was therefore carried out to determine the effect of two transactional strategies Picture Walk (PW) and Know-Want to Learn-Learnt (KWL) on primary four pupils’ achievement in English vocabulary and reading comprehension in Ibadan Metropolis. The moderating effects of gender and learning style were also examined. Methodology: The study was anchored on Rosenblatt’s Transactional Reading and Piaget’s Cognitive Development theories; pretest-posttest control group quasi-experimental design with 3x2x3 factorial matrix was adopted. Six public primary schools were purposively selected based on the availability of qualified English language teachers in Primary Education Studies. Six intact classes (one per school) with a total of 101 primary four pupils (48 males and 53 females) participated. The intact classes were randomly assigned to PW (27), KWL (44) and conventional (30) groups. Instruments used were English Vocabulary (r=0.83), Reading Comprehension (r=0.84) achievement tests, Pupils’ Learning Style Preference Scale (r=0.93) and instructional guides. Treatment lasted six weeks. Data were analysed using the Descriptive statistics, Analysis of Covariance and Bonferroni post-hoc test at 0.05 level of significance. The mean age was 8.86±0.84 years. Result: Treatment had a significant main effect on pupils’ reading comprehension (F(2,82)=3.17), but not on English vocabulary. Participants in KWL obtained the highest post achievement means score in reading comprehension (8.93), followed by PW (8.06) and control (7.21) groups. Pupils’ learning style had a significant main effect on pupils’ achievement in reading comprehension (F(2,82)=4.41), but not on English vocabulary. Pupils with preference for tactile learning style had the highest post achievement mean score in reading comprehension (9.40), followed by the auditory (7.43) and the visual learning style (7.37) groups. Gender had no significant main effect on English vocabulary and reading comprehension. There was no significant two-way interaction effect of treatment and gender on pupils’ achievement in English vocabulary and reading comprehension. The two-way interaction effect of treatment and learning style on pupils’ achievement in reading comprehension was significant (F(4,82)=3.37), in favour of pupils with tactile learning style in PW group. There was no significant two-way interaction effect of gender and learning style on pupils’ achievement in English vocabulary and reading comprehension. The three-way interaction effects were not significant on English vocabulary and reading comprehension. Conclusion: Picture Walk and Know-Want to learn-Learnt instructional strategies were effective in enhancing pupils’ achievement in reading comprehension but not on English vocabulary. Learning style contributed considerably to achievement in reading comprehension but not to English vocabulary. Primary school, English language teachers, should put into consideration pupils’ learning style when adopting both strategies in teaching reading comprehension for improved achievement in the subject.

Keywords: comprehension-based intervention, know-want to learn-learnt, learning style, picture walk, primary school pupils

Procedia PDF Downloads 144

Authors: P. S. Percin, O. Inanli, S. Karakaya

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Bitter melon (Momordica charantia) is a medicinal vegetable, which is used traditionally to remedy diabetes. Bitter melon contains several classes of primary and secondary metabolites. In traditional Turkish medicine bitter melon is used for wound healing and treatment of peptic ulcers. Nowadays, bitter melon is used for the treatment of diabetes and ulcerative colitis in many countries. The main constituents of bitter melon, which are responsible for the anti-diabetic effects, are triterpene, protein, steroid, alkaloid and phenolic compounds. In this study total phenolics, total carotenoids and β-carotene contents of mature and immature bitter melons were determined. In addition, in vitro α-amylase and α-glucosidase activities of mature and immature bitter melons were studied. Total phenolic contents of immature and mature bitter melon were 74 and 123 mg CE/g bitter melon respectively. Although total phenolics of mature bitter melon was higher than that of immature bitter melon, this difference was not found statistically significant (p > 0.05). Carotenoids, a diverse group of more than 600 naturally occurring red, orange and yellow pigments, play important roles in many physiological processes both in plants and humans. The total carotenoid content of mature bitter melon was 4.36 fold higher than the total carotenoid content of immature bitter melon. The compounds that have hypoglycaemic effect of bitter melon are steroidal saponins known as charantin, insulin-like peptides and alkaloids. α-Amylase is one of the main enzymes in human that is responsible for the breakdown of starch to more simple sugars. Therefore, the inhibitors of this enzyme can delay the carbohydrate digestion and reduce the rate of glucose absorption. The immature bitter melon extract showed α-amylase and α-glucosidase inhibitory activities in vitro. α-Amylase inhibitory activity was higher than that of α-glucosidase inhibitory activity when IC50 values were compared. In conclusion, the present results provide evidence that aqueous extract of bitter melon may have an inhibitory effect on carbohydrate breakdown enzymes.

Keywords: bitter melon, in vitro antidiabetic activity, total carotenoids, total phenols

Procedia PDF Downloads 241

Authors: A. Terfous, Y. Liu, A. Ghenaim, P. A. Garambois

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With increasing urbanization worldwide, it is crucial to sustainably manage sediment flows in urban networks and especially in stormwater detention basins. One key aspect is to propose optimized designs for detention tanks in order to best reduce flood peak flows and in the meantime settle particles. It is, therefore, necessary to understand complex flows patterns and sediment deposition conditions in stormwater detention basins. The aim of this paper is to study flow structure and particle deposition pattern for a given tank geometry in view to control and maximize sediment deposition. Both numerical simulation and experimental works were done to investigate the flow and sediment distribution in a storm tank with a cavity. As it can be indicated, the settle distribution of the particle in a rectangular tank is mainly determined by the flow patterns and the bed shear stress. The flow patterns in a rectangular tank differ with different geometry, entrance flow rate and the water depth. With the changing of flow patterns, the bed shear stress will change respectively, which also play an influence on the particle settling. The accumulation of the particle in the bed changes the conditions at the bottom, which is ignored in the investigations, however it worth much more attention, the influence of the accumulation of the particle on the sedimentation should be important. The approach presented here is based on the resolution of the Reynolds averaged Navier-Stokes equations to account for turbulent effects and also a passive particle transport model. An analysis of particle deposition conditions is presented in this paper in terms of flow velocities and turbulence patterns. Then sediment deposition zones are presented thanks to the modeling with particle tracking method. It is shown that two recirculation zones seem to significantly influence sediment deposition. Due to the possible overestimation of particle trap efficiency with standard wall functions and stick conditions, further investigations seem required for basal boundary conditions based on turbulent kinetic energy and shear stress. These observations are confirmed by experimental investigations processed in the laboratory.

Keywords: storm sewers, sediment deposition, numerical simulation, experimental investigation

Procedia PDF Downloads 327

Authors: Fumihiro Ima, Shinichi Watanabe, Shingo Maeda, Haruna Imai, Hiroki Niimi

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It is important to know growth rate of brain tumors before surgery because it influences treatment planning including not only surgical resection strategy but also adjuvant therapy after surgery. Amide proton transfer (APT) imaging is an emerging molecular magnetic resonance imaging (MRI) technique based on chemical exchange saturation transfer without administration of contrast medium. The underlying assumption in APT imaging of tumors is that there is a close relationship between the proliferative activity of the tumor and mobile protein synthesis. We aimed to evaluate the diagnostic performance of APT imaging of pre-and post-treatment brain tumors. Ten patients with brain tumor underwent conventional and APT-weighted sequences on a 3.0 Tesla MRI before clinical intervention. The maximum and the minimum APT-weighted signals (APTWmax and APTWmin) in each solid tumor region were obtained and compared before and after clinical intervention. All surgical specimens were examined for histopathological diagnosis. Eight of ten patients underwent adjuvant therapy after surgery. Histopathological diagnosis was glioma in 7 patients (WHO grade 2 in 2 patients, WHO grade 3 in 3 patients and WHO grade 4 in 2 patients), meningioma WHO grade1 in 2 patients and primary lymphoma of the brain in 1 patient. High-grade gliomas showed significantly higher APTW-signals than that in low-grade gliomas. APTWmax in one huge parasagittal meningioma infiltrating into the skull bone was higher than that in glioma WHO grade 4. On the other hand, APTWmax in another convexity meningioma was the same as that in glioma WHO grade 3. Diagnosis of primary lymphoma of the brain was possible with APT imaging before pathological confirmation. APTW-signals in residual tumors decreased dramatically within one year after adjuvant therapy in all patients. APT imaging demonstrated excellent diagnostic performance for the planning of surgery and adjuvant therapy of brain tumors.

Keywords: amides, magnetic resonance imaging, brain tumors, cell proliferation

Procedia PDF Downloads 139

Authors: Elsayed A. Elkhatib, Ahmed M. Mahdy, Mohamed L. Moharem, Mohamed O. Mesalem

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Mercury (Hg) is one of the most toxic and bio-accumulative heavy metal in the environment. However, cheap and effective in situ remediation technology is lacking. In this study, the effects of water treatment residuals nanoparticles (nWTR) on mobility, fractionation and speciation of mercury in an arid zone soil from Egypt were evaluated. Water treatment residual nanoparticles with high surface area (129 m 2 g-1) were prepared using Fritsch planetary mono mill. Scanning and transmission electron microscopy revealed that the nanoparticles of WTR nanoparticles are spherical in shape, and single particle sizes are in the range of 45 to 96 nm. The x-ray diffraction (XRD) results ascertained that amorphous iron, aluminum (hydr)oxides and silicon oxide dominating all nWTR, with no apparent crystalline iron–Al (hydr)oxides. Addition of nWTR, greatly increased the Hg sorption capacities of studied soils and greatly reduced the cumulative Hg released from the soils. Application of nWTR at 0.10 and 0.30 % rates reduced the released Hg from the soil by 50 and 85 % respectively. The power function and first order kinetics models well described the desorption process from soils and nWTR amended soils as evidenced by high coefficient of determination (R2) and low SE values. Application of nWTR greatly increased the association of Hg with the residual fraction. Meanwhile, application of nWTR at a rate of 0.3% greatly increased the association of Hg with the residual fraction (>93%) and significantly increased the most stable Hg species (Hg(OH)2 amor) which in turn enhanced Hg immobilization in the studied soils. Fourier transmission infrared spectroscopy analysis indicated the involvement of nWTR in the retention of Hg (II) through OH groups which suggest inner-sphere adsorption of Hg ions to surface functional groups on nWTR. These results demonstrated the feasibility of using a low-cost nWTR as best management practice to immobilize excess Hg in contaminated soils.

Keywords: release kinetics, Fourier transmission infrared spectroscopy, Hg fractionation, Hg species

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Authors: Manish Chand, Subhrojit Bagchi, R. Kumar

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A new dry tube (DT) has been installed in the tank of KAMINI research reactor, Kalpakkam India. This tube will be used for neutron activation analysis of small to large samples and testing of neutron detectors. DT tube is 375 cm height and 7.5 cm in diameter, located 35 cm away from the core centre. The experimental thermal flux at various axial positions inside the tube has been measured by irradiating the flux monitor (¹⁹⁷Au) at 20kW reactor power. The measured activity of ¹⁹⁸Au and the thermal cross section of ¹⁹⁷Au (n,γ) ¹⁹⁸Au reaction were used for experimental thermal flux measurement. The flux inside the tube varies from 10⁹ to 10¹⁰ and maximum flux was (1.02 ± 0.023) x10¹⁰ n cm⁻²s⁻¹ at 36 cm from the bottom of the tube. The Au and Zr foils without and with cadmium cover of 1-mm thickness were irradiated at the maximum flux position in the DT to find out the irradiation specific input parameters like sub-cadmium to epithermal neutron flux ratio (f) and the epithermal neutron flux shape factor (α). The f value was 143 ± 5, indicates about 99.3% thermal neutron component and α value was -0.2886 ± 0.0125, indicates hard epithermal neutron spectrum due to insufficient moderation. The measured flux profile has been validated using theoretical model of KAMINI reactor through Monte Carlo N-Particle Code (MCNP). In MCNP, the complex geometry of the entire reactor is modelled in 3D, ensuring minimum approximations for all the components. Continuous energy cross-section data from ENDF-B/VII.1 as well as S (α, β) thermal neutron scattering functions are considered. The neutron flux has been estimated at the corresponding axial locations of the DT using mesh tally. The thermal flux obtained from the experiment shows good agreement with the theoretically predicted values by MCNP, it was within ± 10%. It can be concluded that this MCNP model can be utilized for calculating other important parameters like neutron spectra, dose rate, etc. and multi elemental analysis can be carried out by irradiating the sample at maximum flux position using measured f and α parameters by k₀-NAA standardization.

Keywords: neutron flux, neutron activation analysis, neutron flux shape factor, MCNP, Monte Carlo N-Particle Code

Procedia PDF Downloads 164

Authors: Habtamu Wolde Engudai

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Background: Sedation can be provided to facilitate a procedure or to stabilize patients admitted in pediatric intensive care unit (PICU). Sedation is often necessary to maintain optimal care for critically ill children requiring mechanical ventilation. However, if sedation is too deep or too light, it has its own adverse effects, and hence, it is important to monitor the level of sedation and maintain an optimal level. Objectives: The objective is to assess the level of sedation and associated factors among intubated critically ill children admitted to PICU of JUMC, Jimma. Methods: A prospective observation study was conducted in the PICU of JUMC in September 2021 in 105 patients who were going to be admitted to the PICU aged less than 14 and with GCS >8. Data was collected by residents and nurses working in PICU. Data entry was done by Epi data manager (version 4.6.0.2). Statistical analysis and the creation of charts is going to be performed using SPSS version 26. Data was presented as mean, percentage and standard deviation. The assumption of logistic regression and the result of the assumption will be checked. To find potential predictors, bi-variable logistic regression was used for each predictor and outcome variable. A p value of <0.05 was considered as statistically significant. Finally, findings have been presented using figures, AOR, percentages, and a summary table. Result: in this study, 105 critically ill children had been involved who were started on continuous or intermittent forms of sedative drugs. Sedation level was assessed using a comfort scale three times per day. Based on this observation, we got a 44.8% level of suboptimal sedation at the baseline, a 36.2% level of suboptimal sedation at eight hours, and a 24.8% level of suboptimal sedation at sixteen hours. There is a significant association between suboptimal sedation and duration of stay with mechanical ventilation and the rate of unplanned extubation, which was shown by P < 0.05 using the Hosmer-Lemeshow test of goodness of fit (p> 0.44).

Keywords: level of sedation, critically ill children, Pediatric intensive care unit, Jimma university

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Authors: Insaf Ajili, Malik Mallem, Jean-Yves Didier

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Human motion recognition has been extensively increased in recent years due to its importance in a wide range of applications, such as human-computer interaction, intelligent surveillance, augmented reality, content-based video compression and retrieval, etc. However, it is still regarded as a challenging task especially in realistic scenarios. It can be seen as a general machine learning problem which requires an effective human motion representation and an efficient learning method. In this work, we introduce a descriptor based on Laban Movement Analysis technique, a formal and universal language for human movement, to capture both quantitative and qualitative aspects of movement. We use Discrete Hidden Markov Model (DHMM) for training and classification motions. We improve the classification algorithm by proposing two DHMMs for each motion class to process the motion sequence in two different directions, forward and backward. Such modification allows avoiding the misclassification that can happen when recognizing similar motions. Two experiments are conducted. In the first one, we evaluate our method on a public dataset, the Microsoft Research Cambridge-12 Kinect gesture data set (MSRC-12) which is a widely used dataset for evaluating action/gesture recognition methods. In the second experiment, we build a dataset composed of 10 gestures(Introduce yourself, waving, Dance, move, turn left, turn right, stop, sit down, increase velocity, decrease velocity) performed by 20 persons. The evaluation of the system includes testing the efficiency of our descriptor vector based on LMA with basic DHMM method and comparing the recognition results of the modified DHMM with the original one. Experiment results demonstrate that our method outperforms most of existing methods that used the MSRC-12 dataset, and a near perfect classification rate in our dataset.

Keywords: human motion recognition, motion representation, Laban Movement Analysis, Discrete Hidden Markov Model

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Authors: Thifhuriwi Emmanuel Madzunye, Patricia Harpur, Ephias Ruhode

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A review of the pertinent literature identified a gap concerning the hindrances and opportunities accompanying the implementation of real-time online learning systems (RTOLs) in rural areas. Whilst RTOLs present a possible solution to teaching and learning issues in rural areas, little is known about the implementation of digital strategies among schools in isolated communities. This study explores associated guidelines that have the potential to inform decision-making where Internet-based education could improve educational opportunities. A systematic literature review has the potential to consolidate and focus on disparate literature served to collect interlinked data from specific sources in a structured manner. During qualitative data analysis (QDA) of selected publications via the application of a QDA tool - ATLAS.ti, the following overarching themes emerged: digital divide, educational strategy, human factors, and support. Furthermore, findings from data collection and literature review suggest that signiant factors include a lack of digital knowledge, infrastructure shortcomings such as a lack of computers, poor internet connectivity, and handicapped real-time online may limit students’ progress. The study recommends that timeous consideration should be given to the influence of the digital divide. Additionally, the evolution of educational strategy that adopts digital approaches, a focus on training of role-players and stakeholders concerning human factors, and the seeking of governmental funding and support are essential to the implementation and success of RTOLs.

Keywords: communication, digital divide, digital skills, distance, educational strategy, government, ICT, infrastructures, learners, limpopo, lukalo, network, online learning systems, political-unrest, real-time, real-time online learning, real-time online learning system, pass-rate, resources, rural area, school, support, teachers, teaching and learning and training

Procedia PDF Downloads 335

Authors: Sardar Khana, Zar Ali Khana

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Rapid industrial development and urbanization contribute a lot to wastewater discharge. The wastewater enters into natural aquatic ecosystems from industrial activities and considers as one of the main sources of water pollution. Discharge of effluents loaded with heavy metals into the surrounding environment has become a key issue regarding human health risk, environment, and food chain contamination. Nickel causes fatigue, cancer, headache, heart problems, skin diseases (Nickel Itch), and respiratory disorders. Nickel compounds such as Nickel Sulfide and Nickel oxides in industrial environment, if inhaled, have an association with an increased risk of lung cancer. Therefore the removal of Nickel from effluents before discharge is necessary. Removal of Nickel by low-cost biosorbents is an efficient method. This study was aimed to investigate the efficiency of activated carbon and Pinusroxburgiisaw dust for the removal of Nickel from industrial effluents using commercial Activated Carbon, and raw P.roxburgii saw dust. Batch and column adsorption experiments were conducted for the removal of Nickel. The study conducted indicates that removal of Nickel greatly dependent on pH, contact time, Nickel concentration, and adsorbent dose. Maximum removal occurred at pH 9, contact time of 600 min, and adsorbent dose of 1 g/100 mL. The highest removal was 99.62% and 92.39% (pH based), 99.76% and 99.9% (dose based), 99.80% and 100% (agitation time), 92% and 72.40% (Ni Conc. based) for P.roxburgii saw dust and activated Carbon, respectively. Similarly, the Ni removal in column adsorption was 99.77% and 99.99% (bed height based), 99.80% and 99.99% (Concentration based), 99.98%, and 99.81% (flow rate based) during column studies for Nickel using P.Roxburgiisaw dust and activated carbon, respectively. Results were compared with Freundlich isotherm model, which showed “r2” values of 0.9424 (Activated carbon) and 0.979 (P.RoxburgiiSaw Dust). While Langmuir isotherm model values were 0.9285 (Activated carbon) and 0.9999 (P.RoxburgiiSaw Dust), the experimental results were fitted to both the models. But the results were in close agreement with Langmuir isotherm model.

Keywords: nickel removal, batch, and column, activated carbon, saw dust, plant uptake

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Authors: Radwa Elshorbagy, Alaa Elden Balbaa, Khaled Ayad, Waleed Reda

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Introduction: Ankle sprain is a common lower limb injury that is complicated by high recurrence rate. The cause of recurrence is not clear; however, changes in motor control have been postulated. Objective: to determine the contribution of proximal hip strategy to dynamic postural control in patients with recurrent ankle sprain. Methods: Fifteen subjects with recurrent ankle sprain (group A) and fifteen healthy control subjects (group B) participated in this study. Abductor-adductors as well as flexor-extensor hip musculatures control was abolished by fatigue using the Biodex Isokinetic System. Dynamic postural control was measured before and after fatigue by the Biodex Balance System. Results: Repeated measures MANOVA was used to compare between and within group differences, in group A fatiguing of hip muscles (flexors-extensors and abductors-adductors) increased overall stability index (OASI), anteroposterior stability index (APSI) and mediolateral stability index (MLSI) significantly (p=0.00) whereas; in group B fatiguing of hip flexors-extensors increased significantly OASI and APSI only (p= 0.017, 0.010; respectively) while fatiguing of hip abductors-adductors has no significant effect on these variables. Moreover, patients with ankle sprain had significantly lower dynamic balance after hip muscles fatigue compared to the control group. Specifically, after hip flexor-extensor fatigue, the OASI, APSI and MLSI were increased significantly than those of the control values (p= 0.002, 0.011, and 0.003, respectively) whereas fatiguing of hip abductors-adductors increased significantly in OASI and APSI only (p=0.012, 0.026, respectively). Conclusion: To maintain dynamic balance, patients with recurrent ankle sprain seem to rely more on the hip strategy. This means that those patients depend on a top to down instead of down to top strategy clinical relevance: patients with recurrent ankle sprain less efficient in maintaining the dynamic postural control due to the change in motor strategies. Indicating that health care providers and rehabilitation specialists should treat CAI as a global/central and not just as a simple local or peripheral injury.

Keywords: hip strategy, ankle strategy, postural control, dynamic balance

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Authors: Shantala Herlekar

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Introduction: Entrainment effect of music on cardiovascular parameters is well established. Music is being used in the background by medical students while studying. However, does it really help them relax faster and concentrate better? Objectives: This study was done to compare the effects of classical instrumental background music versus no music on blood pressure response over time and on successively performed divided attention test in Indian and Malaysian 1st-year medical students. Method: 60 Indian and 60 Malaysian first year medical students, with an equal number of girls and boys were randomized into two groups i.e music group and control group thus creating four subgroups. Three different forms of Symbol Digit Modality Test (to test concentration ability) were used as a pre-test, during music/control session and post-test. It was assessed using total, correct and error score. Simultaneously, multiple Blood Pressure recordings were taken as pre-test, during 1, 5, 15, 25 minutes during music/control (+SDMT) and post-test. The music group performed the test with classical instrumental background music while the control group performed it in silence. Results were analyzed using students paired t test. p value < 0.05 was taken as statistically significant. A drop in BP recording was indicative of relaxed state and a rise in BP with task performance was indicative of increased arousal. Results: In Symbol Digit Modality Test (SDMT) test, Music group showed significant better results for correct (p = 0.02) and total (p = 0.029) scores during post-test while errors reduced (p = 0.002). Indian music group showed decline in post-test error scores (p = 0.002). Malaysian music group performed significantly better in all categories. Blood pressure response was similar in music and control group with following variations, a drop in BP at 5minutes, being significant in music group (p < 0.001), a steep rise in values till 15minutes (corresponding to SDMT test) also being significant only in music group (p < 0.001) and the Systolic BP readings in controls during post-test were at lower levels compared to music group. On comparing the subgroups, not much difference was noticed in recordings of Indian student’s subgroups while all the paired-t test values in the Malaysian music group were significant. Conclusion: These recordings indicate an increased relaxed state with classical instrumental music and an increased arousal while performing a concentration task. Music used in our study was beneficial to students irrespective of their nationality and preference of music type. It can act as an “active coping” strategy and alleviate stress within a very short period of time, in our study within a span of 5minutes. When used in the background, during task performance, can increase arousal which helps the students perform better. Implications: Music can be used between lectures for a short time to relax the students and help them concentrate better for the subsequent classes, especially for late afternoon sessions.

Keywords: blood pressure, classical instrumental background music, ethnicity, symbol digit modality test

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Authors: Keith Diamond, Tracy Collier, Ciara Sterling, Ben Kraal

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The increased frequency and intensity of disaster events in the Asia-Pacific region is likely to require organisations to better understand how their initiatives, and the support they provide to their customers, intersect with other organisations aiming to support communities in achieving disaster resilience. While there is a growing awareness that disaster response and recovery rebuild programmes need to adapt to more integrated, community-led approaches, there is often a discrepancy between how programmes intend to work and how they are collectively experienced in the community, creating undesired effects on community resilience. Following Australia’s North Queensland Monsoon Disaster of 2019, this research set out to understand and evaluate how the service and support ecosystem impacted on the local community’s experience and influenced their ability to respond and recover. The purpose of this initiative was to identify actionable, cross-sector, people-centered improvements that support communities to recover and thrive when faced with disaster. The challenge arose as a group of organisations, including utility providers, banks, insurers, and community organisations, acknowledged that improving their own services would have limited impact on community wellbeing unless the other services people need are also improved and aligned. The research applied human-centred service design methods, typically applied to single products or services, to design a new way to understand a whole-of-community journey. Phase 1 of the research conducted deep contextual interviews with residents and small business owners impacted by the North Queensland Monsoon and qualitative data was analysed to produce community journey maps that detailed how individuals navigated essential services, such as accommodation, finance, health, and community. Phase 2 conducted interviews and focus groups with frontline workers who represented industries that provided essential services to assist the community. Data from Phase 1 and Phase 2 of the research was analysed and combined to generate a systems map that visualised the positive and negative impacts that occurred across the disaster response and recovery service ecosystem. Insights gained from the research has catalysed collective action to address future Australian disaster events. The case study outlines a transformative way for sectors and industries to rethink their corporate social responsibility activities towards a cross-sector partnership model that shares responsibility and approaches disaster response and recovery as a single service that can be designed to meet the needs of communities.

Keywords: corporate social responsibility, cross sector partnerships, disaster resilience, human-centred design, service design, systems change

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Authors: L. Le Priol, A. Nesterenko, K. El Kirat, K. Saleh

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Introduction and objectives: Polyunsaturated fatty acids (PUFAs) omega-3 and omega-6 are widely recognized as being beneficial to the health and normal growth. Unfortunately, due to their highly unsaturated nature, these molecules are sensitive to oxidation and thermic degradation leading to the production of toxic compounds and unpleasant flavors and smells. Hence, it is necessary to find out a suitable way to protect them. Microencapsulation by spray-drying is a low-cost encapsulation technology and most commonly used in the food industry. Many compounds can be used as wall materials, but there is a growing interest in the use of biopolymers, such as proteins and polysaccharides, over the last years. The objective of this study is to increase the oxidative stability of sunflower oil by microencapsulation in plant protein matrices using spray-drying technique. Material and methods: Sunflower oil was used as a model substance for oxidable food oils. Proteins from brown rice, hemp, pea, soy and sunflower seeds were used as emulsifiers and microencapsulation wall materials. First, the proteins were solubilized in distilled water. Then, the emulsions were pre-homogenized using a high-speed homogenizer (Ultra-Turrax) and stabilized by using a high-pressure homogenizer (HHP). Drying of the emulsion was performed in a Mini Spray Dryer. The oxidative stability of the encapsulated oil was determined by performing accelerated oxidation tests with a Rancimat. The size of the microparticles was measured using a laser diffraction analyzer. The morphology of the spray-dried microparticles was acquired using environmental scanning microscopy. Results: Pure sunflower oil was used as a reference material. Its induction time was 9.5 ± 0.1 h. The microencapsulation of sunflower oil in pea and soy protein matrices significantly improved its oxidative stability with induction times of 21.3 ± 0.4 h and 12.5 ± 0.4 h respectively. The encapsulation with hemp proteins did not significantly change the oxidative stability of the encapsulated oil. Sunflower and brown rice proteins were ineffective materials for this application, with induction times of 7.2 ± 0.2 h and 7.0 ± 0.1 h respectively. The volume mean diameter of the microparticles formulated with soy and pea proteins were 8.9 ± 0.1 µm and 16.3 ± 1.2 µm respectively. The values for hemp, sunflower and brown rice proteins could not be obtained due to the agglomeration of the microparticles. ESEM images showed smooth and round microparticles with soy and pea proteins. The surfaces of the microparticles obtained with sunflower and hemp proteins were porous. The surface was rough when brown rice proteins were used as the encapsulating agent. Conclusion: Soy and pea proteins appeared to be efficient wall materials for the microencapsulation of sunflower oil by spray drying. These results were partly explained by the higher solubility of soy and pea proteins in water compared to hemp, sunflower, and brown rice proteins. Acknowledgment: This work has been performed, in partnership with the SAS PIVERT, within the frame of the French Institute for the Energy Transition (Institut pour la Transition Energétique (ITE)) P.I.V.E.R.T. (www.institut-pivert.com) selected as an Investments for the Future (Investissements d’Avenir). This work was supported, as part of the Investments for the Future, by the French Government under the reference ANR-001-01.

Keywords: biopolymer, edible oil, microencapsulation, oxidative stability, release, spray-drying

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Authors: D. Pogliana, A. Maso, N. Milani, D. Panzin, S. Rivaroli, J. Konin

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This case aims to identify the role of movement quality during the final stage of return to sport (RTS) in a male amateur football player 13 years old after passing the acute phase of the bilateral Osgood-Schlatter disease (OSD). The patient, after a year from passing the acute phase of OSD with the abstention of physical activity, reports bilateral anterior knee pain at the beginning of the football sport activity. Interventions: After the orthopedist check, who recommended physiotherapy sessions for the correction of motor patterns and the isometric reinforcement of the muscles of the quadriceps, the rehabilitation intervention was developed in 7 weeks through 14 sessions of neuro-motor training (NMT) with a frequency of two weekly sessions and six sessions of muscle-strengthening with a frequency of one weekly session. The sessions of NMT were carried out through free body exercises (or with overloads) with visual bio-feedback with the help of two cameras (one with anterior vision and one with lateral vision of the subject) and a big touch screen. The aim of these sessions of NMT was to modify the dysfunctional motor patterns evaluated by the 2D motion analysis test. The test was carried out at the beginning and at the end of the rehabilitation course and included five movements: single-leg squat (SLS), drop jump (DJ), single-leg hop (SLH), lateral shuffle (LS), and change of direction (COD). Each of these movements was evaluated through the video analysis of dynamic valgus knee, pelvic tilt, trunk control, shock absorption, and motor strategy. A free image analysis software (Kinovea) was then used to calculate scores. Results: Baseline assessment of the subject showed a total score of 59% on the right limb and 64% on the left limb (considering an optimal score above 85%) with large deficits in shock absorption capabilities, the presence of dynamic valgus knee, and dysfunctional motor strategies defined “quadriceps dominant.” After six weeks of training, the subject achieved a total score of 80% on the right limb and 86% on the left limb, with significant improvements in shock absorption capabilities, the presence of dynamic knee valgus, and the employment of more hip-oriented motor strategies on both lower limbs. The improvements shown in dynamic knee valgus, greater hip-oriented motor strategies, and improved shock absorption identified through six weeks of the NMT program can help a teenager amateur football player to manage the anterior knee pain during sports activity. In conclusion, NMT was a good choice to help a 13 years old male amateur football player to return to performance without pain after OSD and can also be used with all this type of athletes of the other teams' sports.

Keywords: movement analysis, neuro-motor training, knee pain, movement strategies

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Authors: Tuji Jemal Ahmed, Abdi Mohammed, Geremew Geidare Kailo

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Food security, foodborne illness, and food safety are critical issues that affect the East Harerghe region of Oromia, Ethiopia. Despite the region's potential for agriculture, food insecurity remains a significant problem, with many households experiencing chronic hunger and malnutrition. The region also experiences high rates of foodborne illnesses, including cholera, typhoid, and diarrhea, which are caused by poor hygiene and sanitation practices. Additionally, food safety is a significant challenge, particularly in rural areas, where there is a lack of infrastructure, inadequate food storage facilities, and limited access to information about food safety. There are several factors that contribute to the current situation in the East Harerghe region; firstly, the region is susceptible to natural disasters, for instance, drought, which affects crop yields and livestock production. Secondly, the region also experiences poor infrastructure, which affects the storage and transportation of food, particularly in rural areas. Thirdly, there is a lack of awareness and knowledge on good hygiene and sanitation practices, specifically during food handling, processing, and storage. Fourthly, unitability due to conflict and other forms of land degradation exacerbates food insecurity and malnutrition. Finally, limited access to financial resources and markets commonly affects smallholder farmers by their ability to produce and sell food. To address the current situation in that area, several potential solutions can be implemented; investment in infrastructure is necessary, especially in rural areas, to improve the storage and transportation of food. Education and awareness programs on good hygiene and sanitation practices should target local communities, smallholder farmers, and food vendors. Financial resources and markets should be made more accessible to smallholder farmers, particularly through the provision of credit and improved access to markets. Addressing the underlying causes of conflict and promoting peaceful coexistence can help to reduce displacement and loss of livelihoods. Finally, the enforcement of food safety regulations and the implementation of standards for food processing and storage facilities are necessary to ensure food safety. In conclusion, addressing the challenges of food security, foodborne illness, and food safety in the East Harerghe region requires a coordinated effort from various stakeholders, including the government, non-governmental organizations, and local communities. By implementing the solutions outlined above, the region can improve its food security, prevent foodborne illnesses, and keep food safe for its population. Eventually, building the resilience of communities to shocks such as droughts, floods, and conflict is necessary to ensure long-term food security in the region.

Keywords: foodborne illness, food handling, food safety, food security

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Authors: Mohammad Zafar-ul Islam

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The breeding programme of Houbara bustard was started in Saudi Arabia in 1986 to undertake the restoration of native species such as Houbara through a programme of re-introduction, involving the release of captive-bred birds in the wild. Two sites were selected for houbara re-introduction, i.e., Mahazat as-Sayd and Saja Umm Ar-Rimth protected areas in 1988 and 1998 respectively. Both the areas are fenced fairly level, sandy plain with a few rock outcrops. Captive bred houbara have been released in Mahazat since 1992 by NWRC and those birds have been successfully breeding since then. The nesting season of the houbara at Mahazat recorded from February to May and on an average 20-25 nests are located each year but no nesting recorded in Saja. Houbara are monitored using radio transmitters through aerial tracking technique and also a vehicle for terrestrial tracking. Total population of houbara in Mahazat is roughly estimated around 300-400 birds, using the following: N = n1+n2+n3+n4+n5 (n1 = released or wild-born, radio, regularly monitored/checked; n2 = radio tagged missing; n3 = wild born chicks not recorded; n4 = wild born chicks, recorded but not tagged; n5 = immigrants). However, in Saja only 4-7 individuals of houbara have been survived since 2001 because most of the birds are predated immediately after the release. The mean annual home was also calculated using Kernel and Convex polygons methods with Range VII software. The minimum density of houbara was also calculated. In order to know the houbara movement or their migration to other regions, two captive-reared male houbara that were released into the wild and one wild born female were fitted with Platform Transmitter Terminals (PTT). The home range shows that wild-born female has larger movement than two males. More areas need to be selected for reintroduction programme to establish the network of sites to provide easy access to move these birds and mingle with the wild houbara. Some potential sites have been proposed which require more surveys to check the habitat suitability.

Keywords: re-introduction, survival rate, home range, Saudi Arabia

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Authors: Eyob Seife

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Immunization is a life-saving intervention which prevents needless suffering through sickness, disability, and death. Emphasis on data quality and use will become even stronger with the development of the immunization agenda 2030 (IA2030). Quality of data is a key factor in generating reliable health information that enables monitoring progress, financial planning, vaccine forecasting capacities, and making decisions for continuous improvement of the national immunization program. However, ensuring data of sufficient quality and promoting an information-use culture at the point of the collection remains critical and challenging, especially in hard-to-reach and pastoralist areas where Degehabur district is selected based on a hypothesis of ‘there is no difference in reported and recounted immunization data consistency. Data quality is dependent on different factors where organizational, behavioral, technical, and contextual factors are the mentioned ones. A cross-sectional quantitative study was conducted on September 2022 in the Degehabur district. The study used the world health organization (WHO) recommended data quality self-assessment (DQS) tools. Immunization tally sheets, registers, and reporting documents were reviewed at 5 health facilities (2 health centers and 3 health posts) of primary health care units for one fiscal year (12 months) to determine the accuracy ratio. The data was collected by trained DQS assessors to explore the quality of monitoring systems at health posts, health centers, and the district health office. A quality index (QI) was assessed, and the accuracy ratio formulated were: the first and third doses of pentavalent vaccines, fully immunized (FI), and the first dose of measles-containing vaccines (MCV). In this study, facility-level results showed both over-reporting and under-reporting were observed at health posts when computing the accuracy ratio of the tally sheet to health post reports found at health centers for almost all antigens verified where pentavalent 1 was 88.3%, 60.4%, and 125.6% for Health posts A, B, and C respectively. For first-dose measles-containing vaccines (MCV), similarly, the accuracy ratio was found to be 126.6%, 42.6%, and 140.9% for Health posts A, B, and C, respectively. The accuracy ratio for fully immunized children also showed 0% for health posts A and B and 100% for health post-C. A relatively better accuracy ratio was seen at health centers where the first pentavalent dose was 97.4% and 103.3% for health centers A and B, while a first dose of measles-containing vaccines (MCV) was 89.2% and 100.9% for health centers A and B, respectively. A quality index (QI) of all facilities also showed results between the maximum of 33.33% and a minimum of 0%. Most of the verified immunization data accuracy ratios were found to be relatively better at the health center level. However, the quality of the monitoring system is poor at all levels, besides poor data accuracy at all health posts. So attention should be given to improving the capacity of staff and quality of monitoring system components, namely recording, reporting, archiving, data analysis, and using information for decision at all levels, especially in pastoralist areas where such kinds of study findings need to be improved beside to improving the data quality at root and health posts level.

Keywords: accuracy ratio, Degehabur District, regular childhood immunization program, quality of monitoring system, Somali Region-Ethiopia

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Authors: Zia Ul Haq, Saleem Muhammad, Naeem Ullah, Abbas Shah, Abdullah Shah

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Pakistan being the developing country is facing double burden of communicable and non-communicable disease. The aspect of secondary prevention of ischemic heart disease in developing countries is the dire need for public health specialists, clinicians and policy makers. There is some evidence that psychotherapeutic measures, including psychotherapy, recreation, exercise and stress management training have positive impact on secondary prevention of cardiovascular diseases but there are some contradictory findings as well. Cardiac rehabilitation program (CRP) has not yet fully implemented in Pakistan. Psychological, physical and specific health-related quality of life (HRQoL) outcomes needs assessment with respect to its practicality, effectiveness, and success. Objectives: To determine the effect of cardiac rehabilitation program (CRP) on the health-related quality of life (HRQoL) measures of post MI patients compared to the usual care. Hypothesis: Post MI patients who receive the interventions (CRP) will have better HRQoL as compared to those who receive the usual cares. Methods: The randomized control trial was conducted at a Cardiac Rehabilitation Unit of Lady Reading Hospital (LRH), Peshawar. LRH is the biggest hospital of the Province Khyber Pakhtunkhwa (KP). A total 206 participants who had recent first myocardial infarction were inducted in the study. Participants were randomly allocated into two group i.e. usual care group (UCG) and cardiac rehabilitation group (CRG) by permuted-block randomization (PBR) method. CRP was conducted in CRG in two phases. Three HRQoL outcomes i.e. general health questionnaire (GHQ), self-rated health (SRH) and MacNew quality of life after myocardial infarction (MacNew QLMI) were assessed at baseline and follow-up visits among both groups. Data were entered and analyzed by appropriate statistical test in STATA version 12. Results: A total of 195 participants were assessed at the follow-up period due to lost-to-follow-up. The mean age of the participants was 53.66 + 8.3 years. Males were dominant in both groups i.e. 150 (76.92%). Regarding educational status, majority of the participants were illiterate in both groups i.e. 128 (65.64%). Surprisingly, there were 139 (71.28%) who were non-smoker on the whole. The comorbid status was positive in 120 (61.54%) among all the patients. The SRH at follow-up among UCG and CRG was 4.06 (95% CI: 3.93, 4.19) and 2.36 (95% CI: 2.2, 2.52) respectively (p<0.001). GHQ at the follow-up of UCG and CRG was 20.91 (95% CI: 18.83, 21.97) and 7.43 (95% CI: 6.59, 8.27) respectively (p<0.001). The MacNew QLMI at follow-up of UCG and CRG was 3.82 (95% CI: 3.7, 3.94) and 5.62 (95% CI: 5.5, 5.74) respectively (p<0.001). All the HRQoL measures showed strongly significant improvement in the CRG at follow-up period. Conclusion: HRQOL improved in post MI patients after comprehensive CRP. Education of the patients and their supervision is needed when they are involved in their rehabilitation activities. It is concluded that establishing CRP in cardiac units, recruiting post-discharged MI patients and offering them CRP does not impose high costs and can result in significant improvement in HRQoL measures. Trial registration no: ACTRN12617000832370

Keywords: cardiovascular diseases, cardiac rehabilitation, health-related quality of life, HRQoL, myocardial infarction, quality of life, QoL, rehabilitation, randomized control trial

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Authors: Rana Waqar Aslam, Urooj Saeed, Hammad Mehmood, Hameed Ullah, Imtiaz Younas

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This research has been conducted to assess the water quality in and around Lahore Metropolitan area on the basis of three different land uses, i.e. residential, commercial, and industrial land uses. For this, 29 sample sites have been selected on the basis of simple random sampling technique. Samples were collected at the source (WASA tube wells). The criteria for selecting sample sites are to have a maximum concentration of population in the selected land uses. The results showed that in the residential land use the proportion of nitrate and turbidity is at their highest level in the areas of Allama Iqbal Town and Samanabad Town. Commercial land use of Gulberg and Data Gunj Bakhsh Town have highest level of proportion of chlorides, calcium, TDS, pH, Mg, total hardness, arsenic and alkalinity. Whereas in industrial type of land use in Ravi and Wahga Town have the proportion of arsenic, Mg, nitrate, pH, and turbidity are at their highest level. The high rate of concentration of these parameters in these areas is basically due to the old and fractured pipelines that allow bacterial as well as physiochemical contaminants to contaminate the portable water at the sources. Furthermore, it is seen in most areas that waste water from domestic, industrial, as well as municipal sources may get easy discharge into open spaces and water bodies, like, cannels, rivers, lakes that seeps and become a part of ground water. In addition, huge dumps located in Lahore are becoming the cause of ground water contamination as when the rain falls, the water gets seep into the ground and impures the ground water quality. On the basis of the derived results with the help of Geo-spatial technology ACRGIS 9.3 Interpolation (IDW), it is recommended that water filtration plants must be installed with specific parameter control. A separate team for proper inspection has to be made for water quality check at the source. Old water pipelines must be replaced with the new pipelines, and safe water depth must be ensured at the source end.

Keywords: GIS, remote sensing, pH, nitrate, disaster, IDW

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Authors: Ahn Christine Myunghee, Sim Wonjin, Cho Kristina, Ahn Mira, Hong Yeju, Kwok Jihae, Lim Sooyeon, Park Hansol

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With a sharp increase in the prevalence rate for mental health issues in Korea, there is a need for specific and effective intervention strategies in counseling and psychotherapy for use with Korean clients. With the cultural emphasis on restraining emotional expression and not disclosing personal and familial problems to outsiders, clients often find it difficult to discuss their emotional issues even to therapists. Exploring a client’s internal psychological processes bypassing this culture-specific mode of therapeutic communication often becomes a challenge in the therapeutic setting. Given this socio-cultural context, the purpose of the current study was to investigate the effectiveness of using dream work to individuals in Korea. The current study conducted one 60-90 minute dream session and analyzed the dream content of 39 Korean young adults to evaluate the effectiveness of the Hill dream model in accessing the intra-psychic materials, determining essential emotional themes, and learning how the individuals interpreted the contents of their dreams. The transcribed data, which included a total of 39 sessions from 39 volunteer university students, were analyzed by the Consensus Qualitative Research (CQR) approach in terms of domains and core ideas. Self-report measures on Dream Salience, Gains from Dream Interpretations and the Session Evaluation Scale were administered before and after each of their dream sessions. The results indicated that dream work appears to be an effective way to understand unconscious motivations, thoughts, and feelings related to a person’s sense of self, and also how these people relate to other people. Current findings need to be replicated with clients referred for counseling and psychotherapy to determine if the dream work is an appropriate and useful intervention in counseling settings. Limitations of the current study and suggestions for future follow-ups are included in the discussion.

Keywords: dream work, dream interpretation, Korean, young adults, CQR

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Authors: Tania Viju, Bimal P., Naseer M. A.

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This study aims to develop a conceptual framework for the decision support system (DSS), that helps the decision-makers to dynamically choose appropriate safety measures for each identified accident blackspot. An accident blackspot is a segment of road where the frequency of accident occurrence is disproportionately greater than other sections on roadways. According to a report by the World Bank, India accounts for the highest, that is, eleven percent of the global death in road accidents with just one percent of the world’s vehicles. Hence in 2015, the Ministry of Road Transport and Highways of India gave prime importance to the rectification of accident blackspots. To enhance road traffic safety and reduce the traffic accident rate, effectively identifying and rectifying accident blackspots is of great importance. This study helps to understand and evaluate the existing methods in accident blackspot identification and prediction that are used around the world and their application in Indian roadways. The decision support system, with the help of IoT, ICT and smart systems, acts as a management and planning tool for the government for employing efficient and cost-effective rectification strategies. In order to develop a decision criterion, several factors in terms of quantitative as well as qualitative data that influence the safety conditions of the road are analyzed. Factors include past accident severity data, occurrence time, light, weather and road conditions, visibility, driver conditions, junction type, land use, road markings and signs, road geometry, etc. The framework conceptualizes decision-making by classifying blackspot stretches based on factors like accident occurrence time, different climatic and road conditions and suggesting mitigation measures based on these identified factors. The decision support system will help the public administration dynamically manage and plan the necessary safety interventions required to enhance the safety of the road network.

Keywords: decision support system, dynamic management, road accident blackspots, road safety

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Authors: Emmanuel A. David, Rebecca O. Soremekun, Roseline I. Aderemi-Williams

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Background: The complexities involved in the management of diabetes mellitus require a multi-dimensional, multi-professional collaborative and continuous care by health care providers and a substantial self-care by the patients in order to achieve desired treatment outcomes. The effect of pharmacists’ care in the management of diabetes in resource-endowed nations is well documented in literature, but randomised-controlled assessment of the impact of pharmacist-led care among patients with diabetes in resource-limited settings like Nigeria and sub-Saharan Africa countries is scarce. Objective: To evaluate the impact of Pharmacist-led care on glycaemic control in patients with uncontrolled type 2 diabetes, using a randomised-controlled study design Methods: This study employed a prospective randomised controlled design, to assess the impact of pharmacist-led care on glycaemic control of 108 poorly controlled type 2 diabetic patients. A total of 200 clinically diagnosed type 2 diabetes patients were purposively selected using fasting blood glucose ≥ 7mmol/L and tested for long term glucose control using Glycated haemoglobin measure. One hundred and eight (108) patients with ≥ 7% Glycated haemoglobin were recruited for the study and assigned unique identification numbers. They were further randomly allocated to intervention and usual care groups using computer generated random numbers, with each group containing 54 subjects. Patients in the intervention group received pharmacist-structured intervention, including education, periodic phone calls, adherence counselling, referral and 6 months follow-up, while patients in usual care group only kept clinic appointments with their physicians. Data collected at baseline and six months included socio-demographic characteristics, fasting blood glucose, Glycated haemoglobin, blood pressure, lipid profile. With an intention to treat analysis, Mann-Whitney U test was used to compared median change from baseline in the primary outcome (Glycated haemoglobin) and secondary outcomes measure, effect size was computed and proportion of patients that reached target laboratory parameter were compared in both arms. Results: All enrolled participants (108) completed the study, 54 in each study. Mean age was 51±11.75 and majority were female (68.5%). Intervention patients had significant reduction in Glycated haemoglobin (-0.75%; P<0.001; η2 = 0.144), with greater proportion attaining target laboratory parameter after 6 months of care compared to usual care group (Glycated haemoglobin: 42.6% vs 20.8%; P=0.02). Furthermore, patients who received pharmacist-led care were about 3 times more likely to have better glucose control (AOR 2.718, 95%CI: 1.143-6.461) compared to usual care group. Conclusion: Pharmacist-led care significantly improved glucose control in patients with uncontrolled type 2 diabetes mellitus and should be integrated in the routine management of diabetes patients, especially in resource-limited settings.

Keywords: glycaemic control , pharmacist-led care, randomised-controlled trial , type 2 diabetes mellitus

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Authors: Zintle Sikhunyana

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Management of public finance in many countries such as South Africa is affected by political decisions and by policies around fiscal decentralization amongst the government spheres. Economic success is said to be determined by efficient management of public finance and by the policies or strategies that are implemented to support efficient public finance management. Policymakers focus on pay attention to how economic policies have been implemented and how they are directed into ensuring stable development. This will allow policymakers to address economic challenges through the usage of fiscal policy parameters that are linked to the achieved rate of economic growth and development. Efficient public finance management reduces the likelihood of corruption and corruption is said to have negative effects on economic growth and development. Corruption in public finance refers to an act of using funds for personal benefits. To achieve macroeconomic objectives, governments make use of government expenditure and government expenditure is financed through tax revenue. The main aim of this paper is to investigate the potential impact of public finance management on economic growth and development in South Africa. The secondary data obtained from the South African Reserve Bank (SARB) and World Bank for 1980- 2020 has been utilized to achieve the research objectives. To test the impact of public finance management on economic growth and development, the study will use Seeming Unrelated Regression Equation (SURE) Modelling that allows researchers to model multiple equations with interdependent variables. The advantages of using SUR are that it efficiently allows estimation of relationships between variables by combining information on different equations and SUR test restrictions that involve parameters in different equations. The findings have shown that there is a positive relationship between efficient public finance management and economic growth/development. The findings also show that efficient public finance management has an indirect positive impact on economic growth and development. Corruption has a negative impact on economic growth and development. It results in an efficient allocation of government resources and thereby improves economic growth and development. The study recommends that governments who aim to stimulate economic growth and development should target and strengthen public finance management policies or strategies.

Keywords: corruption, economic growth, economic development, public finance management, fiscal decentralization

Procedia PDF Downloads 203