Search results for: combined intervention

Authors: Hosam Alzahrani, Martin Mackey, Emmanuel Stamatakis, Marina B. Pinheiro, Manuela Wicks, Debra Shirley

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Objective: To investigate the effectiveness of incidental (non-structured) physical activity interventions compared with other commonly prescribed interventions for the management of people with low back pain (LBP). Methods: We performed a systematic review with meta-analyses of eligible randomized controlled trials obtained by searching Medline, Scopus, CINAHL, EMBASE, and CENTRAL. This review considered trials investigating the effect of incidental physical activity interventions compared to other interventions in people aged 18 years or over, diagnosed with non-specific LBP. Analyses were conducted separately for short-term (≤3 months), intermediate-term (> 3 and < 12 months), and long-term (≥ 12 months), for each outcome. The analyses were conducted using the weighted mean difference (WMD). The overall quality of evidence was assessed using the GRADE system. Meta-analyses were only performed for pain and disability outcomes as there was insufficient data on the other outcomes. Results: For pain, the pooled results did not show any significant effects between the incidental physical activity intervention and other interventions at any time point. For disability, incidental physical activity was not statistically more effective than other interventions at short-term; however, the pooled results favored incidental physical activity at intermediate-term (WMD= -6.05, 95% CI: -10.39 to -1.71, p=0.006) and long-term (WMD= -6.40 95% CI: -11.68 to -1.12, p=0.02) follow-ups among participants with chronic LBP. The overall quality of evidence was rated “moderate quality” based on the GRADE system. Conclusion: The incidental physical activity intervention provided intermediate and long disability relief for people with chronic LBP, although this improvement was small and not likely to be clinically important.

Keywords: physical activity, incidental, low back pain, systematic review, meta-analysis

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Authors: Yali Liu, Maria Avello Iturriagagoitia

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Background: Fitness applications (apps) are one of the most popular mobile health (mHealth) apps. These apps can help prevent/control health issues such as obesity, which is one of the most serious public health challenges in the developed world in recent decades. Compared with the traditional intervention like face-to-face treatment, it is cheaper and more convenient to use fitness apps to interfere with physical activities and healthy behaviors. Nevertheless, fitness applications apps tend to have high abandonment rates and low levels of user engagement. Therefore, maintaining the endurance of users' usage is challenging. In fact, previous research shows a variety of strategies -goal-setting, self-monitoring, coaching, etc.- for promoting fitness and health behavior change. These strategies can influence the users’ perseverance and self-monitoring of the program as well as favoring their adherence to routines that involve a long-term behavioral change. However, commercial fitness apps rarely incorporate these strategies into their design, thus leading to a lack of engagement with the apps. Most of today’s mobile services and brands engage their users proactively via push notifications. Push notifications. These notifications are visual or auditory alerts to inform mobile users about a wide range of topics that entails an effective and personal mean of communication between the app and the user. One of the research purposes of this article is to implement the application of behavior change strategies through push notifications. Proposes: This study aims to better understand the influence that effective use of push notifications combined with the behavioral change strategies will have on users’ engagement with the fitness app. And the secondary objectives are 1) to discuss the sociodemographic differences in utilization of push notifications of fitness apps; 2) to determine the impact of each strategy in customer engagement. Methods: The study uses a combination of the Consumer Engagement Theory and UTAUT2 based model to conduct an online survey among current users of fitness apps. The questionnaire assessed attitudes to each behavioral change strategy, and sociodemographic variables. Findings: Results show the positive effect of push notifications in the generation of consumer engagement and the different impacts of each strategy among different groups of population in customer engagement. Conclusions: Fitness apps with behavior change strategies have a positive impact on increasing users’ usage time and customer engagement. Theoretical experts can participate in designing fitness applications, along with technical designers.

Keywords: behavioral change, customer engagement, fitness app, push notification, UTAUT2

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Authors: Anthony R. Townsend, Robyn L. Fasser

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This research project provides an interpretative phenomenological analysis of a proposed conceptual model of parenting ability that has been designed to offer recommendations to guide intervention in child custody evaluations in South Africa. A recent review of the literature on child custody evaluations reveals that while there have been significant and valuable shifts in the capacity of the legal system aided by mental health professionals in understanding children and family dynamics, there remains a conceptual gap regarding the nature of parenting ability. With a view to addressing this paucity of a theoretical basis for considering parenting ability, this research project reviews a dimensional model for the assessment of parenting ability by conceiving parenting ability as a combination of good parenting and parental fitness. This model serves as a conceptual framework to guide child-custody evaluation and refine intervention in such cases to better meet the best interests of the child in a manner that bridges the professional gap between parties, legal entities, and mental health professionals. Using a model of good parenting as a point of theoretical departure, this model incorporates both intra-psychic and interpersonal attributes and behaviours of parents to form an impression of parenting ability and identify areas for potential enhancement. This research, therefore, hopes to achieve the following: (1) to provide nuanced descriptions of parents’ parenting ability; (2) to describe parents’ parenting potential; (3) to provide a parenting assessment tool for investigators in forensic family matters that will enable more useful recommendations and interventions; (4) to develop a language of consensus for investigators, attorneys, judges and parents, in forensic family matters, as to what comprises parenting ability and how this can be assessed; and (5) that all of the aforementioned will serve to advance the best interests of the children involved in such litigious matters. The evaluative promise and post-assessment prospects of this model are illustrated through three interlinking data sets: (1) the results of interviews with South African psychologists about the model, (2) retrospective analysis of care and contact evaluation reports using the model to determine if different conclusions or more specific recommendations are generated with its use and (3) the results of an interview with a psychologist who piloted this model by using it in care and contact evaluation.

Keywords: alienation, attachment, best interests of the child, care and contact evaluation, children’s act (38 of 2005), child custody evaluation, civil forensics, gatekeeping, good parenting, good-enough parenting, health professions council of South Africa, family law, forensic mental healthcare practitioners, parental fitness, parenting ability, parent management training, parenting plan, problem-determined system, psychotherapy, support of other child-parent relationship, voice of the child

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Authors: Oghenerume V. Edah, Damilola T. Aladejana

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Entrepreneurship Education is the process of developing and acquiring entrepreneur skills on how to identify a new business and launching the business with the realization of yielding profit optimally. It’s the process of knowing how to take risk and handle challenges that accompanies a new business without the mindset of closing it when it fails. It includes steps to take when a business is recognized, combined with acquiring resources (e.g. finances, labor, land) in the face of risk and launching the new business. Additionally, Entrepreneurship is defined as the ability and willingness to set a business in the event of making profit. It is the act of starting up a business to solve big problems or present a new life-changing solution in the society to generate profit. It’s a process where a business opportunity is identified; planned, acquired and needful steps are taken to launch a business. This involves taking up financial risk, acquiring natural resources, combined with land, capital and building up a team of people who would individually contribute or add value in order to make the new business a success. Moreover, Education is the learning of new skills or value. It’s the acquiring of knowledge and capability of doing new things. It is been able to differentiate what you know and what you don’t know yet. In this modern world, the emergence of entrepreneurship education has been magnificent. An average of 60 percent humans wants to start a business or become an entrepreneur without knowing the steps on how to startup. Moreover, many of them are good starters and they end up failing when the business is not managed well. The introduction of Entrepreneur Education in our world today would change the face of business phenomenally. It would involve the acquisition of entrepreneur skills, knowledge and attitude towards initiating a business venture. The impact of Entrepreneurship Education in our world today would increase the chances of business success because it would generate better entrepreneurs. The skills, values, concept and processes acquired through learning have changed the face of business to a positive direction globally and the impact can be felt. Entrepreneurship can be taught and also can be learnt. Like any skills it can be known.

Keywords: entrepreneurship, education, business, entrepreneur, skills

Procedia PDF Downloads 142

Authors: Hamida Memon, Muhammad Sanan

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A 34-year-old male with no prior health issues presented with a wound in his left leg exhibiting active pus discharge, intense inflammation, pain radiating from the buttocks to the knee, foot drop, and skin darkening. Four years prior, he sustained an untreated dislocation of the hip joint and acetabulum from a road traffic accident. Initial nerve conduction studies (NCS) and electromyography (EMG) revealed severe axonotomesis of the left sciatic nerve and reduced compound muscle action potential in the left common peroneal nerve. Despite normal venous flow, edema and cellulitis were noted. Follow-up NCS/EMG in 2022 showed improvement, but in 2023, the patient experienced recurrent infection and underwent surgical intervention with tissue culture. Postoperative care included antibiotics and pain management. NCS/EMG in 2024 indicated decreased nerve amplitudes and conduction velocities, consistent with moderate axonotmesis and ongoing recovery, alongside incidental right S1 radiculopathy. General lab tests and abdominal imaging were normal. The patient was treated with Pregabalin and Neurobion for neuropathic pain and nerve support and is currently under observation by a tertiary sector hospital for treatment. This case underscores the critical importance of prompt treatment for hip dislocations to prevent long-term complications such as neuropathy and avascular necrosis. Delays in treatment significantly increase the risk of severe outcomes, highlighting the need for timely intervention. Overall, the case illustrates the challenges of managing complex nerve injuries and the importance of comprehensive care for optimal recovery.

Keywords: sciatic nerve neuropathy, hip dislocation, acetabular fracture, radiculopathy

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Authors: Saeid Seddegh, Xiaolin Wang, Alan D. Henderson, Dong Chen, Oliver Oims

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The main objective of this research is to study the heat transfer processes and phase change behaviour of a phase change material (PCM) in shell and tube latent heat thermal energy storage (LHTES) systems. The thermal behaviour in a vertical and horizontal shell-and-tube heat energy storage system using a pure thermal conduction model and a combined conduction-convection heat transfer model is compared in this paper. The model is first validated using published experimental data available in literature and then used to study the temperature variation, solid-liquid interface, phase distribution, total melting and solidification time during melting and solidification processes of PCMs. The simulated results show that the combined convection and conduction model can better describe the energy transfer in PCMs during melting process. In contrast, heat transfer by conduction is more significant during the solidification process since the two models show little difference. Also, it was concluded that during the charging process for the horizontal orientation, convective heat transfer has a strong effect on melting of the upper part of the solid PCM and is less significant during melting of the lower half of the solid PCM. However, in the vertical orientation, convective heat transfer is the same active during the entire charging process. In the solidification process, the thermal behavior does not show any difference between horizontal and vertical systems.

Keywords: latent heat thermal energy storage, phase change material, natural convection, melting, shell and tube heat exchanger, melting, solidification

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Authors: Majid Dashtgerd, Eisa Moradi Afrapoli

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The “Yemen War” is one of the longest wars of the recent century, which was launched on 26 March 2015 after the Saudi Arabia-led alliance's military intervention in Yemen. The war began with the aim of fighting Yemen's Houthis and preventing Iranian influence in the region, and Saudi leaders expected a quick victory; However, the “Yemen War” lasted about seven years and is still going on (May 2022), and Saudi Arabia has not been able to achieve its strategic objectives. This study seeks to examine some of the most important reasons for Saudi Arabia's protracted war and failure in Yemen.

Keywords: Saudi Arabia, yemen war, houthis, Iran

Procedia PDF Downloads 117

Authors: Canan Türeli̇, İrem Nur Yeşi̇lyurt

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A total of nine stomatopod crustaceans have been reported from the eastern Mediterranean, with the eight from the Turkey coasts and three from the Levantine coast of Turkey (Squilla massavensis (Linnaeus,1758), Erugosquilla massavensis (Kossmann, 1880), Clorida albolitura (Ahyong&Naiyanetr, 2000). E. massavensis is the most successful Red Sea immigrant, and it is now the dominant eastern Levantine stomatopod. At this research, carapace length/total length- weight relationship of 2 erythrean mantis shrimp, E. massavensis and C. albolitura was studied in Yumurtalık Cove, in the Northeastern Mediterranean of Turkey. Samples were collected monthly from July 2014 to June 2015 (except February), using bottom trawl net into three different depth strata; 0- 10 m, 10-20 m, 20-50m. E. massavensis samples were caught all studied time, except winter, in the three depth range but C. albolitura samples were caught only in July, October and May's months. A total of 572 specimens of the E. massavensis and 12 specimens of the C. albolitura were collected and analyzed. Morphometric equations for the conversions of total length and weight, carapace lengths were constructed for males, females, combined sexes for E. massavensis and C. albolitura. The b-values for total length (TL)-weight (W) in males and females for E. massavensis were 2.738 and 2.725 respectively and for carapace length (CL)-total length (TL) they were 1.041 and 0.978, relatively. The b-values (total length-weight) were determined for combined sexes of E. massavensis and C. albolitura as: 2.771, 1.852 relatively. In both species, the relative growth of weight and total length was found highly positively allometric. However, carapace length showed negative allometry in females of E. Massavensis.

Keywords: Clorida albolitura, Erugosquilla massavensis, Erythrean stomatopod, length/length-weight relationships

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Authors: Mahmoud Amer, Ibrahim El-Sharkawy, Shinichi Ookawara, Ahmed Elwardany

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Gasification and carbonization are two of the most common ways for biomass utilization. Both processes are using part of the waste to be accomplished, either by incomplete combustion or for heating for both gasification and carbonization, respectively. The focus of this paper is to minimize the part of the waste that is used for heating biomass for gasification and carbonization. This will occur by combining both gasifiers and carbonization reactors in a single unit to utilize the heat in the product biogas to heating up the wastes in the carbonization reactors. Three different designs are proposed for the combined gasification/carbonization (CGC) reactor. These include a parallel combination of two gasifiers and carbonized syngas, carbonizer and combustion chamber, and one gasifier, carbonizer, and combustion chamber. They are tested numerically using ANSYS Fluent Computational Fluid Dynamics to ensure homogeneity of temperature distribution inside the carbonization part of the CGC reactor. 2D simulations are performed for the three cases after performing both mesh-size and time-step independent solutions. The carbonization part is common among the three different cases, and the difference among them is how this carbonization reactor is heated. The simulation results showed that the first design could provide only partial homogeneous temperature distribution, not across the whole reactor. This means that the produced carbonized biomass will be reduced as it will only fill a specified height of the reactor. To keep the carbonized product production high, a series combination is proposed. This series configuration resulted in a uniform temperature distribution across the whole reactor as it has only one source for heat with no temperature distribution on any surface of the carbonization section. The simulations provided a satisfactory result that either the first parallel combination of gasifier and carbonization reactor could be used with a reduced carbonized amount or a series configuration to keep the production rate high.

Keywords: numerical simulation, carbonization, gasification, biomass, reactor

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Authors: Babak Nemat

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Background and Purpose: Non-alcoholic fatty liver is one of the most common liver disorders, which, as the most important cause of death from liver disease, has unpleasant consequences and complications. The aim of this study was to investigate the effect of an educational intervention based on a health belief model to prevent non-alcoholic fatty liver among women. Materials and Methods: This experimental study was performed among 110 women referring to comprehensive health service centers in Malayer City, west of Iran, in 2023. Using the available sampling method, 110 participants were divided into experimental and control groups. The data collection tool included demographic characteristics and a questionnaire based on the health belief model. In the experimental group, three one-hour training sessions were conducted in the form of pamphlets, lectures, and group discussions. Data were analyzed using SPSS software version 21, by correlation tests, paired t-tests, and independent t-tests. Results: The mean age of participants was 38.07±6.28 years, and most of the participants were middle-aged, married, housewives with academic education, middle-income, and overweight. After the educational intervention, the mean scores of the constructs include perceived sensitivity (p=0.01), perceived severity (p=0.01), perceived benefits (p=0.01), guidance for internal (p=0.01), and external action (p=0.01), and perceived self-efficacy (p=0.01) in the experimental group were significantly higher than the control group. The score of perceived barriers in the experimental group decreased after training. The perceived obstacles score in the test group decreased after the training (15.2 ± 3.9 v.s 11.2 ± 3.3, (p<0.01). Conclusion: The findings of the study showed that the design and implementation of educational programs based on the constructs of the health belief model can be effective in preventing women from developing higher levels of non-alcoholic fatty liver.

Keywords: non-alcoholic fatty liver, health belief model, education, women

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Authors: Salah Hosseini, Hadi Ramezani, Bagher Shahbazi, Hossein Rabiei, Jafar Hooshmand, Hiwa Khaldi

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Diversity of energy portfolio and fluctuation of urban energy demand establish the need for more operational flexibility of combined Cooling, Heat, and Power Plants. Currently, the most common way to achieve these specifications is the use of heat storage devices or wet operation of gas turbines. The current work addresses using variable extraction steam turbine in conjugation with a gas turbine inlet cooling system as an alternative way for enhancement of a CCHP cycle operating range. A thermodynamic model is developed and typical apartments building in PARDIS Technology Park (located at Tehran Province) is chosen as a case study. Due to the variable Heat demand and using excess chiller capacity for turbine inlet cooling purpose, the mentioned steam turbine and TIAC system provided an opportunity for flexible operation of the cycle and boosted the independence of the power and heat generation in the CCHP plant. It was found that the ratio of power to the heat of CCHP cycle varies from 12.6 to 2.4 depending on the City heating and cooling demands and ambient condition, which means a good independence between power and heat generation. Furthermore, selection of the TIAC design temperature is done based on the amount of ratio of power gain to TIAC coil surface area, it was found that for current cycle arrangement the TIAC design temperature of 15 C is most economical. All analysis is done based on the real data, gathered from the local weather station of the PARDIS site.

Keywords: CCHP plant, GTG, HRSG, STG, TIAC, operational flexibility, power to heat ratio

Procedia PDF Downloads 274

Authors: Fatemeh Ghaemi, Padideh Feyzi, Zohreh Dortaj

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Cancer is one of the common diseases that may cause death due to malignancy. The physical problems of cancer patients can have an impact on the psychological and social aspects of their lives. Depression is one of these problems that threaten the lives of these patients and can also reduce their quality of life. Helping patients with cancer to find meaning in life can increase their level of health and improve their quality of life. This study thus examines the effectiveness of group logotherapy on the depression and quality of life of women with cancer. Depression was measured using the Beck Depression Inventory (BDI) and quality of life was measured using Quality of Life Questionnaire (WHOQL) with acceptable and reliable indicators in the pre-test and post-test stages. The experimental group received group therapy in eight, sixty-minute sessions and the control group did not receive any intervention. After collecting the questionnaires, the mean and standard deviations were used to describe the data and the statistical method of multivariate analysis of covariance was used at the significant level (P≤0.05). The results were analyzed using SPSS(22). The results showed that there was a significant difference between post-test depression scores in the experimental group and the control group. Also, there was a significant difference between the post-test scores of quality of life and its components (psychological, physical, social and environmental health) in the experimental group and control group. The findings of this study showed the effectiveness of group logotherapy in decreasing depression and improving the quality of life of cancer patients. By focusing the minds of the people on the present and changing the attitude of the human being towards themselves, life and environment can help the depressed people, and by influencing the individual's view of himself, accepting responsibility, accepting life with purpose, paying attention to life uniformly, it allows a person to maintain his quality of life even with cancer. Therefore, it is recommended that this approach be used as a group intervention in hospitals and care units for cancer patients and even in people with certain diseases.

Keywords: cancer, depression, group psychiatry, quality of life

Procedia PDF Downloads 173

Authors: Deonie Botha

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Digital transformation and the digitization of occupational health and safety training have grown exponentially due to a variety of contributing factors. The literature suggests that digitalization has numerous benefits but also has associated challenges. The aim of the paper is to develop an understanding of both the perceived benefits and challenges of digitalization in an occupational health and safety context in an effort to design and develop e-learning interventions that will optimize the benefits of digitalization and address the associated challenges. The paper proposes, deliberate and tests the design principles of an e-learning intervention to ensure alignment with the requirements of a digitally transformed environment. The results of the research are based on a literature review regarding the requirements and effect of the Fourth Industrial Revolution on learning and e-learning in particular. The findings of the literature review are enhanced with empirical research in the form of a case study conducted in an organization that designs and develops e-learning content in the occupational health and safety industry. The primary findings of the research indicated that: (i) The requirements of learners and organizations in respect of e-learning are different than previously (i.e., a pre-Fourth Industrial Revolution related work setting). (ii) The design principles of an e-learning intervention need to be aligned with the entire value chain of the organization. (iii) Digital twins support and enhance the design and development of e-learning. (iv)Learning should incorporate a multitude of sensory experiences and should not only be based on visual stimulation. (v) Data that are generated as a result of e-learning interventions should be incorporated into big data streams to be analyzed and to become actionable. It is therefore concluded that there is general consensus on the requirements that e-learning interventions need to adhere to in a digitally transformed occupational health and safety work environment. The challenge remains for organizations to incorporate data generated as a result of e-learning interventions into the digital ecosystem of the organization.

Keywords: digitalization, training, fourth industrial revolution, big data

Procedia PDF Downloads 151

Authors: Ebenezer Joseph

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Chess is a useful tool to enhance general and specific cognitive functioning in children. The present study aims to assess the impact of chess on cognitive in children and to measure the differential impact of socio-demographic factors like age and gender of the child on the effectiveness of the chess intervention.This research study used an experimental design to study the impact of the Training in Chess on the intelligence of children. The Pre-test Post-test Control Group Design was utilized. The research design involved two groups of children: an experimental group and a control group. The experimental group consisted of children who participated in the one-year Chess Training Intervention, while the control group participated in extra-curricular activities in school. The main independent variable was training in chess. Other independent variables were gender and age of the child. The dependent variable was the cognitive functioning of the child (as measured by IQ, working memory index, processing speed index, perceptual reasoning index, verbal comprehension index, numerical reasoning, verbal reasoning, non-verbal reasoning, social intelligence, language, conceptual thinking, memory, visual motor and creativity). The sample consisted of 200 children studying in Government and Private schools. Random sampling was utilized. The sample included both boys and girls falling in the age range 6 to 16 years. The experimental group consisted of 100 children (50 from Government schools and 50 from Private schools) with an equal representation of boys and girls. The control group similarly consisted of 100 children. The dependent variables were assessed using Binet-Kamat Test of Intelligence, Wechsler Intelligence Scale for Children - IV (India) and Wallach Kogan Creativity Test. The training methodology comprised Winning Moves Chess Learning Program - Episodes 1–22, lectures with the demonstration board, on-the-board playing and training, chess exercise through workbooks (Chess school 1A, Chess school 2, and tactics) and working with chess software. Further students games were mapped using chess software and the brain patterns of the child were understood. They were taught the ideas behind chess openings and exposure to classical games were also given. The children participated in mock as well as regular tournaments. Preliminary analysis carried out using independent t tests with 50 children indicates that chess training has led to significant increases in the intelligent quotient. Children in the experimental group have shown significant increases in composite scores like working memory and perceptual reasoning. Chess training has significantly enhanced the total creativity scores, line drawing and pattern meaning subscale scores. Systematically learning chess as part of school activities appears to have a broad spectrum of positive outcomes.

Keywords: chess, intelligence, creativity, children

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Authors: Hiroko Komatsu, Kaori Yagasaki

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Background: Cancer-related cognitive impairment is a common problem seen in cancer patients undergoing chemotherapy. Physical activity may show beneficial effects on the cognitive function in such patients. Therefore, we have developed a self-directed home yoga program for cancer patients with cognitive symptoms during chemotherapy. This program involves a DVD presenting a combination of yoga courses based on patient preferences to be practiced at home. This study was performed to examine the feasibility of this program. In addition, we also examined changes in cognitive function and quality of life (QOL) in these patients participating in the program. Methods: This prospective feasibility study was conducted in a 500-bed general hospital in Tokyo, Japan. The study population consisted of breast cancer patients undergoing chemotherapy as the initial therapy. This feasibility study used a convenience sample with estimation of recruitment rate in a single facility with the availability of trained nurses and physicians to ensure safe yoga intervention. The aim of the intervention program was to improve cognitive function by means of both physical and mental activation via yoga, consisting of physical practice, breathing exercises, and meditation. Information on the yoga program was provided as a booklet, with an instructor-guided group yoga class during the orientation, and a self-directed home yoga program on DVD with yoga logs. Results: The recruitment rate was 44.7%, and the study population consisted of 18 women with a mean age of 43.9 years. This study showed high rates of retention, adherence, and acceptability of the yoga program. Improvements were only observed in the cognitive aspects of fatigue, and there were serious adverse events during the program. Conclusion: The self-directed home yoga program discussed here was both feasible and safe for breast cancer patients showing cognitive symptoms during chemotherapy. The patients also rated the program as useful, interesting, and satisfactory. Participation in the program was associated with improvements in cognitive fatigue but not cognitive function.

Keywords: yoga, cognition, breast cancer, chemotherapy, quality of life

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Authors: Akshay Patil

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Objective: Mediation analysis identifies causal pathways by testing the relationships between the NCR, the OS, and an intermediate variable that mediates the relationship between the Nimotuzumab-cisplatin-radiation (NCR) and OS. Introduction: In randomized controlled trials, the primary interest is in the mechanisms by which an intervention exerts its effects on the outcomes. Clinicians are often interested in how the intervention works (or why it does not work) through hypothesized causal mechanisms. In this work, we highlight the value of understanding causal mechanisms in randomized trial by applying causal mediation analysis in a randomized trial in oncology. Methods: Data was obtained from a phase III randomized trial (Subgroup of HPVNOCP). NCR is reported to significantly improve the OS of patients locally advanced head and neck cancer patients undergoing definitive chemoradiation. Here, based on trial data, the mediating effect of NCR on patient overall survival was systematically quantified through progression-free survival(PFS), disease free survival (DFS), Loco-regional failure (LRF), and the disease control rate (DCR), Overall response rate (ORR). Effects of potential mediators on the HR for OS with NCR versus cisplatin-radiation (CR) were analyzed by Cox regression models. Statistical analyses were performed using R software Version 3.6.3 (The R Foundation for Statistical Computing) Results: Effects of potential mediator PFS was an association between NCR treatment and OS, with an indirect-effect (IE) 0.76(0.62 – 0.95), which mediated 60.69% of the treatment effect. Taking into account baseline confounders, the overall adjusted hazard ratio of death was 0.64 (95% CI: 0.43 – 0.96; P=0.03). The DFS was also a significant mediator and had an IE 0.77 (95% CI; 0.62-0.93), 58% mediated). Smaller mediation effects (maximum 27%) were observed for LRF with IE 0.88(0.74 – 1.06). Both DCR and ORR mediated 10% and 15%, respectively, of the effect of NCR vs. CR on the OS with IE 0.65 (95% CI; 0.81 – 1.08) and 0.94(95% CI; 0.79 – 1.04). Conclusion: Our findings suggest that PFS and DFS were the most important mediators of the OS with nimotuzumab to weekly cisplatin-radiation in HPVNOCP.

Keywords: mediation analysis, cancer data, survival, NCR, HPV negative oropharyngeal

Procedia PDF Downloads 138

Authors: WonSun Chen, James Boylan, Erwin Muharemovic, Denny Meyer

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In Australia, drivers aged between 18 and 24 remained at high risk of road fatality over the last decade. Despite the successful implementation of the Graduated Licensing System (GLS) that supports young drivers in their early phases of driving, the road fatality statistics for these drivers remains high. In response to these statistics, studies conducted in Australia prior to the start of the COVID-19 pandemic have demonstrated the benefits of using telematics devices for improving driving behaviour, However, the impact of COVID-19 lockdown on young drivers’ driving behaviour has emerged as a global concern. Therefore, this naturalistic study aimed to evaluate and compare the driving behaviour(such as acceleration, braking, speeding, etc.) of young drivers with the adoption of in-vehicle telematics devices. Forty-two drivers aged between 18 and 30 and residing in the Australian state of Victoria participated in this study during the period of May to October 2022. All participants drove with the telematics devices during the first 30-day. At the start of the second 30-day, twenty-one participants were randomised to an intervention group where they were provided with an additional telematics ray device that provided visual feedback to the drivers, especially when they committed to aggressive driving behaviour. The remaining twenty-one participants remined their driving journeys without the extra telematics ray device (control group). Such trustworthy data enabled the assessment of changes in the driving behaviour of these young drivers using a machine learning approach in Python. Results are expected to show participants from the intervention group will show improvements in their driving behaviour compared to those from the control group.Furthermore, the telematics data enable the assessment and quantification of such improvements in driving behaviour. The findings from this study are anticipated to shed some light in guiding the development of customised campaigns and interventions to further address the high road fatality among young drivers in Australia.

Keywords: driving behaviour, naturalistic study, telematics data, young drivers

Procedia PDF Downloads 119

Authors: Chung-Yuan Wang, Min Hsu, Bo-Ya Juan, Hsiv Ching Lin, Hsveh Min Lin, Hsiu-Fang Yeh

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The success of Taiwan's National Health Insurance (NHI) system attracts widespread praise from the international society. However, the availability of medical care in a emote area is limited. Without the convenient public transportation system and mature social welfare policy, these people are difficult to regain their health and prevent disability. Preterm children have more risk to get development delay. Preterm children in a remote area have the human right to get rehabilitation resources as those in the city area. Therefore, the aim of this study was to show the importance of development screening to preterm children in a remote area and a tract the government to notice the issue. In Pingtung, children who are suspected development delay would be suggested to take a skillful screening evaluation in our hospital. Those preterm children (within 1-year-old) visited our pediatric clinic would also be referred to take the development evaluation. After the physiatrist’s systemic evaluation, the subjects would be scheduled to take the development evaluation. Gross motor, fine motor, speech comprehension/expression and mental study were included. The evaluation was in-charged by a physical therapist, occupational therapy, speech therapist and pediatric psychologist. The tools were Peabody developmental scale, Bayley Scales of Infant and Toddler Development (Bayley-III) and Wechsler Preschool & Primary Scale of Intelligence-Revised (WPPSI-R). In 2013, 459 children received the service in our hospital. Among these children, fifty-seven were noted with preterm baby history (gestation within 37 weeks). Thirty-six of these preterm children, who had never receive development evaluation, were included in this study. Thirty-six subjects (twenty-six male and ten female) were included. Nineteen subjects were found development delay. Six subjects were found suspected development delay. In gross motor, six subjects were development delay and eight were suspected development delay. In fine motor, five subjects were development delay and three were suspected development delay. In speech, sixteen subjects were development delay and six were suspected development delay. In our study, through the provision of development evaluation service, 72.2% preterm baby were found their development delay or suspected delay. They need further early intervention rehabilitation service. We made their parents realize that when development delay was recognized at the early stage, they are often reversible. No only the patients but also their families were improved their health status. The number of the subjects was limited in our study. Further study might be needed. Compared with 770 physical therapist (PT) and 370 occupational therapy (OT) in Taipei, there are only 108 PT and 54 OT in Pingtung. Further, there are much fewer therapists working on the field of pediatric rehabilitation. Living healthy is a human's right, no matter where does he live. For those development delay children in remote area, particularly preterm children, early detection, and early intervention rehabilitation service could play an important role in decreasing their disability and improving their quality of life. Through this study, we suggest the government to add more national resources on the development evaluation to preterm children in a remote area.

Keywords: development, early intervention, preterm children, rehabilitation

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Authors: Md Maruf Hossain Koli

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The issue of child labor is enormous and cannot be ignored in Bangladesh. The problem of child exploitation is a socio-economic reality of Bangladesh. This paper will indicate the causes, consequences, and possibilities of using microfinance as remedies of hazardous child labor in Bangladesh. Poverty is one of the main reasons for children to become child laborers. It is an indication of economic vulnerability, inadequate law, and enforcement system and cultural and social inequities along with the inaccessible and low-quality educational system. An attempt will be made in this paper to explore and analyze child labor scenario in Bangladesh and will explain holistic intervention of BRAC, the largest nongovernmental organization in the world to address child labor through promoting incubation support to youth-led enterprises. A combination of research methods were used to write this paper. These include non-reactive observation in the form of literature review, desk studies as well as reactive observation like site visits and, semi-structured interviews. Hazardous Child labor is a multi-dimensional and complex issue. This paper was guided by the answer following research questions to better understand the current context of hazardous child labor in Bangladesh, especially in Dhaka city. The author attempted to figure out why child labor should be considered as a development issue? Further, it also encountered why child labor in Bangladesh is not being reduced at an expected pace? And finally what could be a sustainable solution to eradicate this situation. One of the most challenging characteristics of child labor is that it interrupts a child’s education and cognitive development hence limiting the building of human capital and fostering intergenerational reproduction of poverty and social exclusion. Children who are working full-time and do not attend school, cannot develop the necessary skills. This leads them and their future generation to remain in poor socio-economic condition as they do not get a better paying job. The vicious cycle of poverty will be reproduced and will slow down sustainable development. The outcome of the research suggests that most of the parents send their children to work to help them to increase family income. In addition, most of the youth engaged in hazardous work want to get training, mentoring and easy access to finance to start their own business. The intervention of BRAC that includes classroom and on the job training, tailored mentoring, health support, access to microfinance and insurance help them to establish startup. This intervention is working in developing business and management capacity through public-private partnerships and technical consulting. Supporting entrepreneurs, improving working conditions with micro, small and medium enterprises and strengthening value chains focusing on youth and children engaged with hazardous child labor.

Keywords: child labour, enterprise development, microfinance, youth entrepreneurship

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Authors: Tso Sheng-Yang, Wang Tien-Ni

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Introduction and Purpose: Previous researchers have documented children with ASD (Autism Spectrum Disorders) prefer to escaping internal privates and external privates when they face tough conditions they can’t control or they don’t like.Especially, when children with ASD need to learn challenging tasks, such us Chinese language, their inappropriate behaviors will occur apparently. Recently, researchers apply positive behavior support strategies for children with ASD to enhance their self-efficacy and therefore to reduce their adverse behaviors. Thus, the purpose of this research was to design a series of lecture based on art therapy and to evaluate its effectiveness on the child’s self-efficacy. Method: This research was the single-case design study that recruited a high school boy with ASD. Whole research can be separated into three conditions. First, baseline condition, before the class started and ended, the researcher collected participant’s competencies of self-efficacy every session. In intervention condition, the research used dramatic conventions to teach the child in Chinese language twice a week.When the data was stable across three documents, the period entered to the maintenance condition. In maintenance condition, the researcher only collected the score of self-efficacynot to do other interventions five times a month to represent the effectiveness of maintenance.The time and frequency of data collection among three conditions are identical. Concerning art therapy, the common approach, e.g., music, drama, or painting is to use art medium as independent variable. Due to visual cues of art medium, the ASD can be easily to gain joint attention with teachers. Besides, the ASD have difficulties in understanding abstract objectives Thus, using the drama convention is helpful for the ASD to construct the environment and understand the context of Classical Chinese. By real operation, it can improve the ASD to understand the context and construct prior knowledge. Result: Bassd on the 10-points Likert scale and research, we product following results. (a) In baseline condition, the average score of self-efficacyis 1.12 points, rangedfrom 1 to 2 points, and the level change is 0 point. (b)In intervention condition, the average score of self-efficacy is 7.66 points rangedfrom 7 to 9 points, and the level change is 1 point. (c)In maintenance condition, the average score of self-efficacy is 6.66 points rangedfrom 6 to 7 points, and the level change is 1 point. Concerning immediacy of change, between baseline and intervention conditions, the difference is 5 points. No overlaps were found between these two conditions. Conclusion: According to the result, we find that it is effective that using dramatic conventions a s teaching strategies to teach children with ASD. The result presents the score of self-efficacyimmediately enhances when the dramatic conventions commences. Thus, we suggest the teacher can use this approach and adjust, based on the student’s trait, to teach the ASD on difficult task.

Keywords: dramatic conventions, autism spectrum disorder, slef-efficacy, teaching strategy

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Authors: Kumudini Achchi

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India, being known for its rich cultural values has given a special place to women who are also been victims of humiliation, torture, and exploitation. The major share of Human Trafficking goes to sex trafficking which is recognised as world’s second most huge social evil. The original form of sex trafficking in India is prostitution with and without religious sanction. Today the situation of such women reached as an issue of human rights where they rights are denied severely. This situation demanded intervention to protect them from the exploitative situation. NGO are the proactive initiatives which offer support to the exploited women in sex trade. To understand the intervention programs of NGOs in South India, a study was conducted covering four states and a union territory considering 32 NGOs based on their preparedness to participate in the research study. Descriptive and diagnostic research design was adopted along with interview schedule as a tool for collecting data. The study reveals that these NGOs believes in the possibility of mainstreaming commercially sexually exploited women and found adopted seven different programs in the process such as rescue, rehabilitation, reintegration, prevention, developmental, advocacy and research. Each area involves different programs to reach and prepare the exploited women towards mainstreamed society which has been discussed in the paper. Implementation of these programs is not an easy task for the organizations rather they are facing hardships in the areas such as social, legal, financial, political which are hindering the successful operations. Rescue, advocacy, and research are the least adopted areas by the NGOs because of lack of support as well as knowledge in the area. Rehabilitation stands as the most adopted area in implementation. The paper further deals with the challenges in the implementation of the programs as well as the remedial measures in social work point of view having Indian cultural background.

Keywords: NGOs, commercially sexually exploited women, programmes, South India

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Authors: Jocelyn Jones

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The objective of this literature review is to provide an assessment of the current literature concerning gender-based violence (GBV) within indigenous communities in Argentina and Costa Rica, and various public intervention strategies that have been implemented to counter the increasing rates of violence within these populations. The review will address some of the unique challenges and contextual factors influencing the prevalence and response to such violence, including the enduring impact of colonialism on familial structures, community dynamics, and the perpetuation of violence. Drawing on indigenous feminist perspectives, the paper critically assesses the intersectionality of gender, ethnicity, and socio-economic status in shaping the experiences of indigenous women, men, and gender-diverse individuals. In comparing the two nations, the literature review identifies commonalities and divergences in policy frameworks, legal responses, and grassroots initiatives aimed at addressing GBV. Regarding the assessment of the efficacy of existing interventions, the paper will consider the role of cultural revitalization, community engagement, and collaborative efforts between indigenous communities and external agencies in the development of future policies. Moreover, the review will highlight the importance of decolonizing methodologies in research and intervention strategies, and the need to emphasise culturally sensitive approaches that respect and integrate indigenous worldviews and traditional knowledge systems. Additionally, the paper will explore the potential impact of colonial legacies, resource extraction, and land dispossession on exacerbating vulnerabilities to GBV within indigenous communities. The aim of this paper is to contribute to a more in-depth understanding of GBV in indigenous contexts in order to promote cross-cultural learning and inform future research. Ultimately, this review will demonstrate the necessity of adopting a holistic and context-specific approach to address gender-based violence in indigenous communities.

Keywords: gender based violence, indigenous, colonialism, literature review

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Authors: Boshra Mozaffar, Arash Ardavani, Iskandar Idris

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Food taste and flavor affect food choice and acceptance, which are essential to maintain good health and quality of life. Reduced circulating zinc levels have been shown to adversely affect taste which can result in reduced appetite, weight loss and psychological problems, but the efficacy of Zinc supplementation to treat disorders of taste remains unclear. In this systematic review and meta-analysis, we aimed to examine the efficacy of zinc supplementation in the treatment of taste disorders. We searched four electronic bibliographical databases; Ovid MEDLINE, Ovid Embase, Ovid AMAD and PubMed. Article bibliographies were also searched, which yielded additional relevant studies. To facilitate the collection and identification of all available and relevant articles published before 7 December 2020, there were no restrictions on the publication date. We performed a systematic review and meta-analysis according to the PRISMA Statement. This review was registered at PROSPERO and given the identification number CRD42021228461. In total, we included 12 randomized controlled trials with 938 subjects. Intervention includes zinc (sulfate, gluconate, picolinate, polaprezinc and acetate); the pooled results of the meta-analysis indicate that improvements in taste disorder occurred more frequently in the intervention group compared to the control group (RR = 1.8; 95% CI:1.27 -2.57, p=0.009). The doses are equivalent to 17 mg- 86.7 mg of elemental zin for three to six months. Zinc supplementation is an effective treatment for taste disorders in patients with zinc deficiency or idiopathic taste disorders when given in high doses ranging from 68–86.7 mg/d for up to three months. However, we did not find sufficient evidence to determine the effectiveness of zinc supplementation in patients with taste disorders induced by chronic renal failure.

Keywords: taste change, taste disorder, zinc, zinc sulfate or Zn, deficiency, supplementation.

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Authors: Dina Muharib

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Specific metabolic challenges are present following spinal cord injury. The acute stage is characterized by a reduction in metabolic activity, as well as a negative nitrogen balance that cannot be corrected, even with aggressive nutritional support. Metabolic demands need to be accurately monitored to avoid overfeeding. Enteral feeding is the optimal route following SCI. When oral feeding is not possible, nasogastric, followed by nasojejunal, then by percutaneous endoscopic gastrostomy, if necessary, is suggested.

Keywords: SCI, energy, protein, nutrition assessment, eneral feeding, nitrogen balance

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Authors: Teguh Endah Saraswati, Kusumandari Kusumandari, Candra Purnawan, Annisa Dinan Ghaisani, Aufara Mahayum

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The present study aims to investigate the degradation of methylene blue (MB) using TiO₂-carbon (TiO₂-C) photocatalyst combined with dielectric discharge (DBD) plasma. The carbon materials used in the photocatalyst were activated carbon and graphite. The thin layer of TiO₂-C photocatalyst was prepared by ball milling method which was then deposited on the plastic sheet. The characteristic of TiO₂-C thin layer was analyzed using X-ray diffraction (XRD), scanning electron microscopy (SEM) with energy dispersive X-ray (EDX) spectroscopy, and UV-Vis diffuse reflectance spectrophotometer. The XRD diffractogram patterns of TiO₂-G thin layer in various weight compositions of 50:1, 50:3, and 50:5 show the 2θ peaks found around 25° and 27° are the main characteristic of TiO₂ and carbon. SEM analysis shows spherical and regular morphology of the photocatalyst. Analysis using UV-Vis diffuse reflectance shows TiO₂-C has narrower band gap energy. The DBD plasma reactor was generated using two electrodes of Cu tape connected with stainless steel mesh and Fe wire separated by a glass dielectric insulator, supplied by a high voltage 5 kV with an air flow rate of 1 L/min. The optimization of the weight composition of TiO₂-C thin layer was studied based on the highest reduction of the MB concentration achieved, examined by UV-Vis spectrophotometer. The changes in pH values and color of MB indicated the success of MB degradation. Moreover, the degradation efficiency of MB was also studied in various higher concentrations of 50, 100, 200, 300 ppm treated for 0, 2, 4, 6, 8, 10 min. The degradation efficiency of MB treated in combination system of photocatalysis and DBD plasma reached more than 99% in 6 min, in which the greater concentration of methylene blue dye, the lower degradation rate of methylene blue dye would be achieved.

Keywords: activated carbon, DBD plasma, graphite, methylene blue, photocatalysis

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Authors: Olubunmi S. Shittu, Olufemi J. Ayodele, Augustus O. A. Ilori, Abidemi O. Filani, Adetola T. Afuye

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Indiscriminate refuse dumping in and around Ado-Ekiti combined with improper management of few available dumpsites, such as Ilokun dumpsite, posed the threat of heavy metals pollution in the surrounding soils and underground water that needs assessment using pollution indices. Surface soils (0-15 cm) were taken from the centre of Ilokun dumpsite (0 m) and environs at different directions and distances during the dry and wet seasons, as well as a background sample at 1000 m away, adjacent to the dumpsite at Ilokun, Ado-Ekiti, Nigeria. The concentration of heavy metals used to calculate the pollution indices for the soils were determined using Atomic Adsorption Spectrophotometer. The soils recorded high concentrations of all the heavy metals above the background concentrations irrespective of the season with highest concentrations at the 0 m except Ni and Fe at 50 m during the dry and wet season, respectively. The heavy metals concentration were in the order of Ni > Mn > Pb > Cr > Cu > Cd > Fe during the dry season, and Fe > Cr > Cu > Pb > Ni > Cd > Mn during the wet season. Using the Contamination Factor (CF), the soils were classified to be moderately contaminated with Cd and Fe to very high contamination with other metals during the dry season and low Cd contamination (0.87), moderate contamination with Fe, Pb, Mn and Ni and very high contamination with Cr and Cu during the wet season. At both seasons, the Pollution Load Index (PLI) indicates the soils to be generally polluted with heavy metals and the Geoaccumulation Index (I_geo) calculated shown the soils to be in unpolluted to moderately polluted levels. Enrichment Factor (EF) implied the soils to be deficiently enriched with all the heavy metals except Cr (7.90) and Cu (6.42) that were at significantly enrichment levels during the wet season. Modified Degree of Contamination (mC_d) recorded, indicated the soils to be of very high to extremely high degree of contamination during the dry season and moderate degree of contamination during the wet season except 0 m with high degree of contamination. The concentration of heavy metals in the soils combined with some of the pollution indices indicated the soils in and around the Ilokun Dumpsite are being polluted with heavy metals from anthropogenic sources constituted by the indiscriminate refuse dumping.

Keywords: contamination factor, enrichment factor, geoaccumulation index, modified degree of contamination, pollution load index

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Authors: T. Arkle, D. Pournaras, S. Lam, B. Kumar

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Introduction: Fundoplication is widely recognised as the best surgical option for gastro-oesophageal reflux disease (GORD) in the general population. However, there is controversy surrounding the use of conventional fundoplication in obese patients. Whilst the intra-operative failure of fundoplication, including wrap disruption, is reportedly higher in obese individuals, the more significant issue surrounds symptom recurrence post-surgery. Could a bariatric procedure be considered in obese patients for weight management, to treat the GORD, and to also reduce the risk of recurrence? Roux-en-Y gastric bypass, a widely performed bariatric procedure, has been shown to be highly successful both in controlling GORD symptoms and in weight management in obese patients. Furthermore, NICE has published clear guidelines on eligibility for bariatric surgery, with the main criteria being type 3 obesity or type 2 obesity with the presence of significant co-morbidities that would improve with weight loss. This study aims to identify the proportion of patients who undergo conventional fundoplication for GORD and/or hiatus hernia, which would have been eligible for bariatric surgery referral according to NICE guidelines. Methods: All patients who underwent fundoplication procedures for GORD and/or hiatus hernia repair at a single NHS foundation trust over a 10-year period will be identified using the Trust’s health records database. Pre-operative patient records will be used to find BMI and the presence of significant co-morbidities at the time of consideration for surgery. This information will be compared to NICE guidelines to determine potential eligibility for the bariatric surgical referral at the time of initial surgical intervention. Results: A total of 321 patients underwent fundoplication procedures between January 2011 and December 2020; 133 (41.4%) had available data for BMI or to allow BMI to be estimated. Of those 133, 40 patients (30%) had a BMI greater than 30kg/m², and 7 (5.3%) had BMI >35kg/m². One patient (0.75%) had a BMI >40 and would therefore be automatically eligible according to NICE guidelines. 4 further patients had significant co-morbidities, such as hypertension and osteoarthritis, which likely be improved by weight management surgery and therefore also indicated eligibility for referral. Overall, 3.75% (5/133) of patients undergoing conventional fundoplication procedures would have been eligible for bariatric surgical referral, these patients were all female, and the average age was 60.4 years. Conclusions: Based on this Trust’s experience, around 4% of obese patients undergoing fundoplication would have been eligible for bariatric surgical intervention. Based on current evidence, in class 2/3 obese patients, there is likely to have been a notable proportion with recurrent disease, potentially requiring further intervention. These patient’s may have benefitted more through undergoing bariatric surgery, for example a Roux-en-Y gastric bypass, addressing both their obesity and GORD. Use of patient written notes to obtain BMI data for the 188 patients with missing BMI data and further analysis to determine outcomes following fundoplication in all patients, assessing for incidence of recurrent disease, will be undertaken to strengthen conclusions.

Keywords: bariatric surgery, GORD, Nissen fundoplication, nice guidelines

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Authors: Ioanna Skoufali

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The present study is directed towards adaptation to climate change closely related to the phenomenon of the urban heat island (UHI). This issue is widespread and common to different urban realities, but particularly in Mediterranean cities that are characterized by dense urban. The attention of this work of redevelopment of the open space is focused on mitigation techniques aiming to solve local problems such as microclimatic parameters and the conditions of thermal comfort in summer, related to urban morphology. This quantitative analysis, evaluation, and verification survey involves the methodological elaboration applied in a real study case by Serres, through the experimental support of the ENVImet Pro V4.1 and BioMet software developed: i) in two phases concerning the anteoperam (phase a1 # 2013) and the post-operam (phase a2 # 2016); ii) in scenario A (+ 25% of green # 2017). The first study tends to identify the main intervention strategies, namely: the application of cool pavements, the increase of green surfaces, the creation of water surface and external fans; moreover, it obtains the minimum results achieved by the National Program 'Bioclimatic improvement project for public open space', EPPERAA (ESPA 2007-2013) related to the four environmental parameters illustrated below: the TAir = 1.5 o C, the TSurface = 6.5 o C, CDH = 30% and PET = 20%. In addition, the second study proposes a greater potential for improvement than postoperam intervention by increasing the vegetation within the district towards the SW/SE. The final objective of this in-depth design is to be transferable in homogeneous cases of urban regeneration processes with obvious effects on the efficiency of microclimatic mitigation and thermal comfort.

Keywords: cool pavements, microclimate parameters (TAir, Tsurface, Tmrt, CDH), mitigation strategies, outdoor thermal comfort (PET & UTCI)

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Authors: Fasil Wagnew, Kefyalew Addis Alene, Setegn Eshetie, Tom Wingfield, Matthew Kelly, Darren Gray

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Introduction: Undernutrition is a major and under-appreciated risk factor for TB, which is estimated to be responsible for 1.9 million TB cases per year globally. The effectiveness of micronutrient supplementation on TB treatment outcomes and its prognostic markers such as sputum conversion and serum zinc, retinol, and hemoglobin levels has been poorly understood. This systematic review and meta-analysis aimed to determine the association between zinc and vitamin A supplementation and TB treatment outcomes and its prognostic markers. Methods: A systematic literature search for randomized controlled trials (RCTs) was performed in PubMed, Embase, and Scopus databases. Meta-analysis with a random effect model was performed to estimate risk ratio (RR) and mean difference (MD), with a 95% confidence interval (CI), for dichotomous and continuous outcomes, respectively. Results: Our search identified 2,195 records. Of these, nine RCTs consisting of 1,375 participants were included in the final analyses. Among adults with pulmonary TB, zinc (RR: 0.94, 95%CI: 0.86, 1.03), vitamin A (RR: 0.90, 95%CI: 0.80, 1.01), and combined zinc and vitamin A (RR: 0.98, 95%CI: 0.89, 1.08) supplementation were not significantly associated with TB treatment success. Combined zinc and vitamin A supplementation was significantly associated with increased sputum smear conversion at 2 months (RR: 1.16, 95%CI: 1.03, 1.32), serum zinc levels at 2 months (MD of 0.86umol/l, 95% CI: 0.14, 1.57), serum retinol levels at 2 months (MD: 0.06umol/l, 95 % CI: 0.04, 0.08) and 6 months (MD: 0.12umol/l, 95 % CI: 0.10, 0.14), and serum hemoglobin level at 6 months (MD: 0.29 ug/dl, 95% CI: 0.08 to 0.51), among adults with TB. Conclusions: Providing zinc and vitamin A supplementation to adults with pulmonary TB during treatment may increase early sputum smear conversion, serum zinc, retinol, and hemoglobin levels. However, the use of zinc, vitamin A, or both were not associated with TB treatment success.

Keywords: zinc and vitamin A supplementation, tuberculosis, treatment outcomes, meta-analysis, RCT

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Authors: Ahmed Kadry, Gwyn Dodd

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There has been a growing call globally for police forces to embed evidence-based policing research methods into police interventions in order to better understand and evaluate their impact. This research study highlights the success and challenges that police forces may encounter when trying to embed evidence-based research methods within their organisation. 10 in-depth qualitative interviews were conducted with police officers and staff at Greater Manchester Police (GMP) who were tasked with integrating evidence-based research methods into their operational interventions. The findings of the study indicate that with adequate resources and individual expertise, evidence-based research methods can be applied to operational work, including the testing of initiatives with strict controls in order to fully evaluate the impact of an intervention. However, the findings also indicate that this may only be possible where an operational intervention is heavily resourced with police officers and staff who have a strong understanding of evidence-based policing research methods, attained for example through their own graduate studies. In addition, the findings reveal that ample planning time was needed to trial operational interventions that would require strict parameters for what would be tested and how it would be evaluated. In contrast, interviewees underscored that operational interventions with the need for a speedy implementation were less likely to have evidence-based research methods applied. The study contributes to the wider literature on evidence-based policing by providing considerations for police forces globally wishing to apply evidence-based research methods to more of their operational work in order to understand their impact. The study also provides considerations for academics who work closely with police forces in assisting them to embed evidence-based policing. This includes how academics can provide their expertise to police decision makers wanting to underpin their work through evidence-based research methods, such as providing guidance on how to evaluate the impact of their work with varying research methods that they may otherwise be unaware of.  

Keywords: evidence based policing, evidence-based practice, operational policing, organisational change

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