Search results for: urinary urogenital distress inventory

Authors: Michelle Bulawan, Mei-Hua Chen

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Reading comprehension is crucial for acquiring information, analyzing critically, and achieving academic proficiency. However, there is a lack of growth in reading comprehension skills beyond fourth grade. The developmental shift from "learning to read" to "reading to learn" occurs around this stage. Factual knowledge and diverse views in articles enhance reading comprehension abilities. Nevertheless, some face difficulties due to evolving textual requirements, such as expanding vocabulary and using longer, more complex terminology. Most research on reading strategies has been conducted at the tertiary and secondary levels, while few have focused on the elementary levels. Furthermore, the use of character, ask, problem, solution (CAPS) charts in teaching reading has also been hardly explored. Thus, the researcher decided to explore the facilitation of active reading strategies through the CAPS chart and address the following research questions: a) What differences existed in elementary EFL learners' reading competency among those who engaged in active reading strategies and those who did not? b) What are the learners’ metacognitive skills of those who engage in active reading strategies and those who do not, and what are their effects on their reading competency? c) For those participants who engage in active reading activities, what are their perceptions about incorporating active reading activities into their English classroom learning? Two groups of elementary EFL learners, each with 18 students of the same level of English proficiency, participated in this study. Group A served as the control group, while Group B served as the experimental group. Two teachers also participated in this research; one of them was the researcher who handled the experimental group. The treatment lasts for one whole semester or seventeen weeks. In addition to the CAPS chart, the researcher also used the metacognitive awareness of reading strategy inventory (MARSI) and a ten-item, five-point Likert scale survey.

Keywords: active reading, EFL learners, metacognitive skills, reading competency, student’s perception

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Authors: Jeremy Bekker, Guy Salazar

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Introduction: Nature-exposure interventions on university campuses may serve as an effective addition to overburdened counseling and student support centers. Nature-exposure interventions can work as a preventative well-being enhancement measure on campuses, which can be used adjacently with existing health resources. Specifically, this paper analyzes how spending time in nature impacts psychological well-being, cognitive functioning, and physical health. The poster covers the core findings and recommendations of this paper, which has been previously published in the BYU undergraduate psychology journal Intuition. Research Goals and Method: The goal of this paper was to outline the potential benefits of nature exposure for students’ physical health, mental well-being, and academic success. Another objective of this paper was to outline potential research-based interventions that use campus green spaces to improve student outcomes. Given that the core objective of this paper was to identify and establish research-based nature exposure interventions that could be used on college campuses, a broad literature review focused on these areas. Specifically, the databases Scopus and PsycINFO were used to screen for research focused on psychological well-being, physical health, cognitive functioning, and nature exposure interventions. Outcomes: Nature exposure has been shown to help increase positive affect, life satisfaction, happiness, coping ability and subjective well-being. Further, nature exposure has been shown to decrease negative affect, lower mental distress, reduce cognitive load, and decrease negative psychological symptoms. Finally, nature exposure has been shown to lead to better physical health. Findings and Recommendations: Potential interventions include adding green space to university buildings and grounds, dedicating already natural environments as nature restoration areas, and providing means for outdoor excursions. Potential limitations and suggested areas for future research are also addressed. Many campuses already contain green spaces, defined as any part of an environment that is predominately made of natural elements, and these green spaces comprise an untapped resource that is relatively cheap and simple.

Keywords: nature exposure, preventative care, undergraduate mental health, well-being intervention

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Authors: Rahul Paul, Kedar Nath Das

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The paradigm of Reinforcement Learning (RL) has become prominent in training intelligent agents to make decisions in environments that are both dynamic and uncertain. The primary objective of RL is to optimize the policy of an agent in order to maximize the cumulative reward it receives throughout a given period. Nevertheless, the process of optimization presents notable difficulties as a result of the inherent trade-off between exploration and exploitation, the presence of extensive state-action spaces, and the intricate nature of the dynamics involved. Evolutionary Optimization Methods (EOMs) have garnered considerable attention as a supplementary approach to tackle these challenges, providing distinct capabilities for optimizing RL policies and value functions. The ongoing advancement of research in both RL and EOMs presents an opportunity for significant advancements in autonomous decision-making systems. The convergence of these two fields has the potential to have a transformative impact on various domains of artificial intelligence (AI) applications. This article highlights the considerable influence of EOMs in enhancing the capabilities of RL. Taking advantage of evolutionary principles enables RL algorithms to effectively traverse extensive action spaces and discover optimal solutions within intricate environments. Moreover, this paper emphasizes the practical implementations of EOMs in the field of RL, specifically in areas such as robotic control, autonomous systems, inventory problems, and multi-agent scenarios. The article highlights the utilization of EOMs in facilitating RL agents to effectively adapt, evolve, and uncover proficient strategies for complex tasks that may pose challenges for conventional RL approaches.

Keywords: machine learning, reinforcement learning, loss function, optimization techniques, evolutionary optimization methods

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Authors: Beeto W. C. Leung, Nicole C. Y. Lee

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It was well known that college students experienced a high level of stress and anxiety. College athletes, a special group of college students, may even encounter a higher level of pressure and distress due to their dual endeavors in academic and athletic settings. Due to the high demands and costs of mental health services, easily accessible, web-based self-help interventions are getting more popular. The aim of the present experimental study was to examine the potential intervention effect of a mindfulness-based self-help mobile App, called 'Smiling Mind', on mindfulness and psychological well-being. Forty-six college athletes, recruited from athletic teams of two local universities in Hong Kong, were randomly assigned to the Mindfulness App Group (MAG) and the Control Group (CG). All participants were administered the Mindful Attention Awareness Scale, Geriatric Depression Scale, and Perceived Stress Scale-10 before the study (Time 1, T1) and after the 4-week intervention (Time 2, T2). MAG was requested to use the app and follow the instructions every day for at least 5 days per week. Participants were also asked to record their daily app usage time. Results showed that, for MAG, from T1 to T2, mindfulness has been increased from 3.25 to 3.92; depressive symptoms and stress has been significantly decreased from 8.6 to 5.1 and 24.8 to 13.5 respectively while for the CG, mindfulness has been decreased slightly from 3.29 to 3.13; depressive symptoms and stress has been slightly increased from 7.1 to 7.3 and 24.1 to 27.1 respectively. Three mixed-design ANOVAs with time (T1, T2) as the within-subjects factor and intervention group (MAG, CG) as the between-subjects factor revealed a main effect of time on mindfulness, F(1, 41) = 10.28, p < 0.01, depressive symptoms, F(1, 41) = 6.55, p < 0.02 and stress, F(1, 41) = 16.96, p < 0.001 respectively. Both predicted interaction between time and intervention group on mindfulness, F(1, 41) = 26.6, p < 0.001, ηp 2 =0.39, depressive symptoms, F(1, 41) = 8.00, p < 0.01, ηp 2 =0.16 and Stress F(1, 41) = 49.3, p < 0.001, ηp 2 =0.55 were significant meaning that participants using the Mindfulness Mobile App in the intervention did experienced a significant increase in mindfulness and significant decrease in depressive symptoms and perceived level of stress after the 4-week intervention when compared with the control group. The present study provided encouraging empirical support for using Smiling Mind, a self-help mobile app, to promote mindfulness and mental health in a cost-effective way. Further studies should examine the potential use of Smiling Mind in different samples, including children and adolescence, as well as, investigate the lasting effects of using the app on other psychosocial outcomes such as emotional regulations.

Keywords: college athletes, experimental study, mindfulness mobile apps, psychological well-being

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Authors: Syed Tahir Shah, Fazal Muhammad, Syed Kashif Shah, Maleeha Gul

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In recent days, natural gas has become a relatively clean and quality source of energy, which is recovered from deep wells by expensive drilling activities. The recovered substance is purified by processing in multiple stages to remove the unwanted/containments like dust, dirt, crude oil and other particles. Mostly, gas utilities are concerned with essential objectives of quantity/quality of natural gas delivery, financial outcome and safe natural gas volumetric inventory in the transmission gas pipeline. Gas quantity and quality are primarily related to standards / advanced metering procedures in processing units/transmission systems, and the financial outcome is defined by purchasing and selling gas also the operational cost of the transmission pipeline. SNGPL (Sui Northern Gas Pipelines Limited) Pakistan has a wide range of diameters of natural gas transmission pipelines network of over 9125 km. This research results in answer a few of the issues in accuracy/metering procedures via multiple advanced gadgets for gas flow attributes after being utilized in the transmission system and research. The effects of good pressure management in transmission gas pipeline network in contemplation to boost the gas volume deposited in the existing network and finally curbing gas losses UFG (Unaccounted for gas) for financial benefits. Furthermore, depending on the results and their observation, it is directed to enhance the maximum allowable working/operating pressure (MAOP) of the system to 1235 PSIG from the current round about 900 PSIG, such that the capacity of the network could be entirely utilized. In gross, the results depict that the current model is very efficient and provides excellent results in the minimum possible time.

Keywords: natural gas, pipeline network, UFG, transmission pack, AGA

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Authors: Manoj Kumar Reddy Pulim, Lakshmi Muthukrishnan, Geetha Jayapathy, Radhika Raman

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Introduction: In the past two decades, noninvasive positive pressure ventilation (NIPPV) emerged as one of the most important advances in the management of both acute and chronic respiratory failure in children. In the acute setting, it is an alternative to intubation with a goal to preserve normal physiologic functions, decrease airway injury, and prevent respiratory tract infections. There is a need to determine the clinical profile and parameters which point towards the need for NIV in the pediatric emergency setting. Objectives: i) To study the clinical profile of children who required non invasive ventilation and invasive ventilation, ii) To study the clinical parameters common to children who required non invasive ventilation. Methods: All children between one month to 18 years, who were intubated in the pediatric emergency department and those for whom decision to commence Non Invasive Ventilation was made in Emergency Room were included in the study. Children were transferred to the Paediatric Intensive Care Unit and started on Non Invasive Ventilation as per our hospital policy and followed up in the Paediatric Intensive Care Unit. Clinical profile of all children which included age, gender, diagnosis and indication for intubation were documented. Clinical parameters such as respiratory rate, heart rate, saturation, grunting were documented. Parameters obtained were subject to statistical analysis. Observations: Airway disease (Bronchiolitis 25%, Viral induced wheeze 22%) was a common diagnosis in 32 children who required Non Invasive Ventilation. Neuromuscular disorder was the common diagnosis in 27 children (78%) who were Intubated. 17 children commenced on Non Invasive Ventilation who later needed invasive ventilation had Neuromuscular disease. High frequency nasal cannula was used in 32, and mask ventilation in 17 children. Clinical parameters common to the Non Invasive Ventilation group were age < 1 year (17), tachycardia n = 7 (22%), tachypnea n = 23 (72%) and severe respiratory distress n = 9 (28%), grunt n = 7 (22%), SPO2 (80% to 90%) n = 16. Children in the Non Invasive Ventilation + INTUBATION group were > 3 years (9), had tachycardia 7 (41%), tachypnea 9(53%) with a male predominance n = 9. In statistical comparison among 3 groups,'p' value was significant for pH, saturation, and use of Ionotrope. Conclusion: Invasive ventilation can be avoided in the paediatric Emergency Department in children with airway disease, by commencing Non Invasive Ventilation early. Intubation in the pediatric emergency department has a higher association with neuromuscular disorders.

Keywords: clinical parameters, indications, non invasive ventilation, paediatric emergency room

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Authors: Princess Ncube

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In the context of South Africa's banking sector, the prevention of bank failures is of paramount importance to ensure financial stability and economic growth. This paper focuses on the role of regulatory frameworks in safeguarding the resilience of South African banks and mitigating the risks of failures. It aims to assess the effectiveness of existing regulatory measures and proposes strategies to enhance the resilience of financial institutions in the country. The paper begins by examining the specific regulatory frameworks in place in South Africa, including capital adequacy requirements, stress testing methodologies, risk management guidelines, and supervisory practices. It delves into the evolution of these measures in response to lessons learned from past financial crises and their relevance in the unique South African banking landscape. Drawing on empirical evidence and case studies specific to South Africa, this paper evaluates the effectiveness of regulatory frameworks in preventing bank failures within the country. It analyses the impact of these frameworks on crucial aspects such as early detection of distress signals, improvements in risk management practices, and advancements in corporate governance within South African financial institutions. Additionally, it explores the interplay between regulatory frameworks and the specific economic environment of South Africa, including the role of macroprudential policies in preventing systemic risks. Based on the assessment, this paper proposes recommendations to strengthen regulatory frameworks and enhance their effectiveness in bank failure prevention in South Africa. It explores avenues for refining existing regulations to align capital requirements with the risk profiles of South African banks, enhancing stress testing methodologies to capture specific vulnerabilities, and fostering better coordination among regulatory authorities within the country. Furthermore, it examines the potential benefits of adopting innovative approaches, such as leveraging technology and data analytics, to improve risk assessment and supervision in the South African banking sector.

Keywords: banks, resolution, liquidity, regulation

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Authors: Marimuthu Gurusamy

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In vibration analysis (with accelerometers) of rotating machines with rolling element bearing, the customers are interested to know the failure of the machine well in advance to plan the spare inventory and maintenance. But in real world most of the machines fails before the prediction of vibration analyst or Expert analysis software. Presently the prediction of failure is based on ISO 10816 vibration limits only. But this is not enough to monitor the failure of machines well in advance. Because more than 50% of the machines will fail even the vibration readings are within acceptable zone as per ISO 10816.Hence it requires further detail analysis and different techniques to predict the failure well in advance. In vibration Analysis, the velocity spectrum is used to analyse the root cause of the mechanical problems like unbalance, misalignment and looseness etc. The envelope spectrum are used to analyse the bearing frequency components, hence the failure in inner race, outer race and rolling elements are identified. But so far there is no correlation made between these two concepts. The author used both velocity spectrum and Envelope spectrum to analyse the machine behaviour and bearing condition to correlated the changes in dynamic load (by unbalance, misalignment and looseness etc.) and effect of impact on the bearing. Hence we could able to predict the expected life of the machine and bearings in the rotating equipment (with rolling element bearings). Also we used process parameters like temperature, flow and pressure to correlate with flow induced vibration and load variations, when abnormal vibration occurs due to changes in process parameters. Hence by correlation of velocity spectrum, envelope spectrum and process data with 20 years of experience in vibration analysis, the author could able to predict the rotating Equipment and its component’s deterioration and expected duration for maintenance.

Keywords: vibration analysis, velocity spectrum, envelope spectrum, prediction of deterioration

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Authors: Wee Akina Sia Seng Lee, Shabeshan Rengasamy, Lim Boon Hooi, Chandrakalavaratharajoo, Mohd Ibrahim K. Azeez

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This study was conducted to examine the effectiveness of Teaching Games For Understanding (TGFU) in improving the hockey tactical skills and state self-confidence among 16-year-old students. Two hundred fifty nine (259) school students were selected for the study based on the intact sampling method. One class was used as the control group (Boys=60, Girls=70), while another as the treatment group (Boys=60, Girls=69) underwent intervention with TGFU in physical education class conducted twice a week for four weeks. The Games Performance Assessment Instrument was used to observe the hockey tactical skills and The State Self-Confidence Inventory was used to determine the state of self-confidence among the students. After four weeks, ANCOVA analysis indicated the treatment groups had significant improvement in hockey tactical skills with F (1, 118) =313.37, p < .05 for school boys, and F (1, 136) =92.62, p < .05 for school girls. The Mann Whitney U test also showed the treatment groups had significant improvement in state self-confidence with U=428.50, z= -7.22, p < .05, r=.06 for school boys. ANCOVA analysis also showed the treatment group had significant improvement in state self-confidence with F (1, 136) =74.40, p < .05 for school girls. This indicates that TGFU in a 40 minute physical education class conducted twice a week for four weeks can significantly improve the hockey tactical skills and state self-confidence among 16-year-old students. The findings give new knowledge to PE teachers to implement the TGFU method as it enhances the hockey tactical skills and state self-confidence among 16-year-old students. Some recommendation was suggested for future research.

Keywords: Teaching Games For Understanding (TGFU), traditional teaching, hockey tactical skills, state self-confidence

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Authors: Anthony Schmiedeler

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Reliable measurements for body esteem and time perspective have been constructed to acquire additional knowledge into these two distinct and personal domains of individuals. The Body Esteem Scale (BES) assesses the multidimensional body self-esteems of males and females and produces a particular score. A higher BES score indicates an individual has strong positive feelings relating to particular aspects of the individual’s body. The Zimbardo Time Perspective Inventory (ZTPI) measures individuals’ time perspectives and identifies their dominant time perspective profiles. Higher scores in a time perspective profile, such as Past Positive (i.e., nostalgically remembering the past), suggest an individuals’ inclination toward that specific way of orienting oneself with respect to time. Both scales rely on measurements that are similarly grounded in personality traits and reveal valuable insight into individuals’ personalities. Studying the two scales could provide insight into a possible relationship and allow for a better comprehension and more nuanced understanding of the utilities of the instruments. In a completed study, 69 adults completed both the ZTPI and BES. Analyses show that adult females’ higher BES scores positively correlate with higher scores of the Past Positive and Present Hedonistic time perspective profiles of the ZTPI. Male participants also had higher overall BES scores positively correlate with the Present Hedonistic profile in addition to the Positive Future time perspective profile. The results of this study suggest that individuals with certain body esteem scores have a pattern of corresponding with certain time orientations. These correlations could help in explaining the rationales behind individuals’ varying levels of body esteem. With a foundation for better understanding of body esteem by incorporating these time perspectives, future research could be conducted to develop instruments that more accurately reflect individuals’ body esteem measurements.

Keywords: BES, body esteem, time perspective, ZTPI

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Authors: Umer Malik, David Armstrong, Mark Ashworth, Alex Dregan, Veline L'Esperance, Lucy McDonnell, Mariam Molokhia, Patrick White

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Introduction: The microbiota lining epithelial surfaces is thought to play an important role in many human physiological functions including defense against pathogens and modulation of immune response. The microbiota is susceptible to disruption from external influences such as exposure to antibiotic medication. It is thought that antibiotic-induced disruption of the microbiota could predispose to pathogen overgrowth and invasion. We hypothesized that antibiotic use would be associated with increased risk of future infections. We carried out a systematic review of evidence of associations between antibiotic use and subsequent risk of community-acquired infections. Methods: We conducted a review of the literature for observational studies assessing the association between antibiotic use and subsequent community-acquired infection. Eligible studies were published before April 29th, 2016. We searched MEDLINE, EMBASE, and Web of Science and screened titles and abstracts using a predefined search strategy. Infections caused by Clostridium difficile, drug-resistant organisms and fungal organisms were excluded as their association with prior antibiotic use has been examined in previous systematic reviews. Results: Eighteen out of 21,518 retrieved studies met the inclusion criteria. The association between past antibiotic exposure and subsequent increased risk of infection was reported in 16 studies, including one study on Campylobacter jejuni infection (Odds Ratio [OR] 3.3), two on typhoid fever (ORs 5.7 and 12.2), one on Staphylococcus aureus skin infection (OR 2.9), one on invasive pneumococcal disease (OR 1.57), one on recurrent furunculosis (OR 16.6), one on recurrent boils and abscesses (Risk ratio 1.4), one on upper respiratory tract infection (OR 2.3) and urinary tract infection (OR 1.1), one on invasive Haemophilus influenzae type b (Hib) infection (OR 1.51), one on infectious mastitis (OR 5.38), one on meningitis (OR 2.04) and five on Salmonella enteric infection (ORs 1.4, 1.59, 1.9, 2.3 and 3.8). The effect size in three studies on Salmonella enteric infection was of marginal statistical significance. A further two studies on Salmonella infection did not demonstrate a statistically significant association between prior antibiotic exposure and subsequent infection. Conclusion: We have found an association between past antibiotic exposure and subsequent risk of a diverse range of infections in the community setting. Our findings provide evidence to support the hypothesis that prior antibiotic usage may predispose to future infection risk, possibly through antibiotic-induced alteration of the microbiota. The findings add further weight to calls to minimize inappropriate antibiotic prescriptions.

Keywords: antibiotic, infection, risk factor, side effect

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Authors: Mehmet Bulent Topkaya, Mustafa Yildirim

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Wastewater treatment systems are designed and used to minimize adverse impacts of the wastewater on the environment before discharging. Various treatment options for wastewater treatment have been developed, and each of them has different performance characteristics and environmental impacts (e.g. material and land usage, energy consumption, greenhouse gas emission, water and soil emission) during construction, operation or maintenance phases. Assessing the environmental impacts during these phases are essential for the overall evaluation of the treatment systems. In this study, wastewater treatment options, such as vegetated land treatment, constructed wetland, rotating biological contactor, conventional activated sludge treatment, membrane bioreactor, extended aeration and stabilization pond are evaluated. The comparison of the environmental impacts is conducted under the assumption that the effluents will be discharged to sensitive and less sensitive areas respectively. The environmental impacts of each alternative are evaluated by life cycle assessment (LCA) approach. For this purpose, data related to energy usage, land requirement, raw material consumption, and released emissions from the life phases were collected with inventory studies based on field studies and literature. The environmental impacts were assessed by using SimaPro 7.1 LCA software. As the scale of the LCA results is global, an MS-Excel based decision support tool that includes the LCA result is developed in order to meet also the local demands. Using this tool, it is possible to assign weight factors on the LCA results according to local conditions by using Analytical Hierarchy Process and finally the most environmentally appropriate treatment option can be selected.

Keywords: analytical hierarchy process, decision support system, life cycle assessment, wastewater treatment

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Authors: Solomon Neway Jida, Jean-Francois Hetet, Pascal Chesse

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Vehicular emission is the key source of air pollution in the urban environment. This includes both fine particles (PM_2.5) and coarse particulate matters (PM₁₀). However, particulate matter emissions from road traffic comprise emissions from exhaust tailpipe and emissions due to wear and tear of the vehicle part such as brake, tire and clutch and re-suspension of dust (non-exhaust emission). This study estimates the share of the two sources of pollutant particle emissions from on-roadside vehicles in the Addis Ababa municipality, Ethiopia. To calculate its share, two methods were applied; the exhaust-tailpipe emissions were calculated using the Europeans emission inventory Tier II method and Tier I for the non-exhaust emissions (like vehicle tire wear, brake, and road surface wear). The results show that of the total traffic-related particulate emissions in the city, 63% emitted from vehicle exhaust and the remaining 37% from non-exhaust sources. The annual roads transport exhaust emission shares around 2394 tons of particles from all vehicle categories. However, from the total yearly non-exhaust particulate matter emissions’ contribution, tire and brake wear shared around 65% and 35% emanated by road-surface wear. Furthermore, vehicle tire and brake wear were responsible for annual 584.8 tons of coarse particles (PM₁₀) and 314.4 tons of fine particle matter (PM_2.5) emissions in the city whereas surface wear emissions were responsible for around 313.7 tons of PM₁₀ and 169.9 tons of PM_2.5 pollutant emissions in the city. This suggests that non-exhaust sources might be as significant as exhaust sources and have a considerable contribution to the impact on air quality.

Keywords: Addis Ababa, automotive emission, emission estimation, particulate matters

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Authors: Yousef Daneshvar Rouyandozagh, Ece. K. Açikgöz

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Conservation of historical urban patterns in the traditional neighborhoods is a part of creating integrated urban environments that are socially more sustainable. Urbanization reflects on life conditions and social, physical, economical characteristics of the society. In this regard, historical zones and traditional regions are affected by dramatic interventions on these characteristics. This article focuses on the Uch Dukkan neighborhood located in Ardabil City in Azarbaijani region of Iran, which has been up to such interventions that leaded its transformation from the past to the present. After introducing a brief inventory of the main elements of the historical zone and the neighborhood; this study explores the changes and transformations in different periods; and their impacts on the quality of the environment and its social sustainability. The survey conducted in the neighborhood as part of this research study revealed that the Uch Dukkan neighborhood and the unique architectural heritage that it possesses have become more inactive physically and functionally in a decade. This condition requires an exploration and comparison of the present and the expected transformations of the meaning of social space from the most private unit to the urban scale. From this token, it is argued that an architectural point of view that is based on space order; use and meaning of space as a social and cultural image, should not be ignored. Based on the interplay between social sustainability, collective memory, and the urban environment, study aims to make the invisible portion of ignorance clear, that ends up with a weakness in defining the collective meaning of the neighborhood as a historic urban district. It reveals that the spatial possessions of the neighborhood are valuable not only for their historical and physical characteristics, but also for their social memory that is to be remembered and constructed further.

Keywords: urban integrity, social sustainability, collective memory, social decay

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Authors: Laid Fekih

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Background: Depression affects people in all communities across the world and in all aspects of their lives. Its spread varies from one country to another, can happen at any age and get rid of it is not easy. There is no clear policy in Algeria's higher education institutions to detect and treat these disorders or pay particular attention to those at risk. Identifying the prevalence of depression among Algerian students, its correlation with different variables, and studying gender differences in the light of a range of variables is necessary to develop an appropriate plan to raise the level of hope and love of life among students. Method: Random samples of 1500 University of Tlemcen students (967 girls and 533 boys), aged 19 to 24 years completed a self-administered questionnaire that included Beck's Depression Inventory ®-II (BDI®-II), (School Health Promotion: The Mood part), Other questions included in this survey focused on demographic characteristics including gender, age and year of study, academic performance (Annual Average Score (0-20) AAS), were examined. Results: The rate of depression (moderate, severe and extreme) varied from 03% to 13% among university students in Tlemcen University. There was no difference in the rates of depression in male and female students, which means that male and female students do have similar rates of depression. The rate of depression in the first-year of the study shows a higher score relative to students of other years. Depression has a negative relationship with academic performance, which means that depressed students have many difficulties in academic tasks at university. Conclusion: Depression among university students is an important center of interest in the world, not only because of the ease with which they can be followed, or the difficulties encountered during their studies and their technical courses but for the link between the level of depression and the quality of care of mental health services, especially if many students with mood and emotional problems don't meet the criteria for psychotherapy.

Keywords: depression, epidemiology, university students, academic performance

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Authors: Ningning Liu, Gaoding Jia, Yinshan Wang, Haimei Li, Xinian Zuo, Yufeng Wang, Lu Liu, Qiujin Qian

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Background: There has been speculation that a high IQ may not necessarily provide protection against attention deficit hyperactivity disorder (ADHD), and there may be a U-shaped correlation between IQ and ADHD symptoms. However, this speculation has not been validated in the ADHD population in any study so far. Method: We conducted a study with 5,138 children who have been professionally diagnosed with ADHD and have a wide range of IQ levels. General Linear Models were used to determine the optimal model between IQ and ADHD core symptoms with sex and age as covariates. The ADHD symptoms we looked at included the total scores (TO), inattention (IA) and hyperactivity/impulsivity (HI). Wechsler Intelligence scale were used to assess IQ [Full-Scale IQ (FSIQ), Verbal IQ (VIQ), and Performance IQ (PIQ)]. Furthermore, we examined the correlation between IQ and the execution function [Behavior Rating Inventory of Executive Function (BRIEF)], as well as between IQ and brain surface area, to determine if the associations between IQ and ADHD symptoms are reflected in executive functions and brain structure. Results: Consistent with previous research, the results indicated that FSIQ and VIQ both showed a linear negative correlation with the TO and IA scores of ADHD. However, PIQ showed an inverted U-shaped relationship with the TO and HI scores of ADHD, with 103 as the peak point. These findings were also partially reflected in the relationship between IQ and executive functions, as well as IQ and brain surface area. Conclusion: To sum up, the relationship between IQ and ADHD symptoms is not straightforward. Our study confirms long-standing academic hypotheses and finds that PIQ exhibits an inverted U-shaped relationship with ADHD symptoms. This study enhances our understanding of symptoms and behaviors of ADHD with varying IQ characteristics and provides some evidence for targeted clinical intervention.

Keywords: ADHD, IQ, execution function, brain imaging

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Authors: Emily Saurman, David Lyle

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In Australia, a well serviced rural town might have a psychiatrist visit once-a-month with more frequent visits from a psychiatric nurse, but many have no resident access to mental health specialists. Access to specialist care, would not only reduce patient distress and benefit outcomes, but facilitate the effective use of limited resources. The Mental Health Emergency Care-Rural Access Program (MHEC-RAP) was developed to improve access to specialist emergency mental health care in rural and remote communities using telehealth technologies. However, there has been no current benchmark to gauge program efficiency or capacity; to determine whether the program activity is justifiably sufficient. The evaluation of MHEC-RAP used multiple methods and applied a modified theory of access to assess the program and its aim of improved access to emergency mental health care. This was the first evaluation of a telepsychiatry service to include a time and motion study design examining program time expenditure, efficiency, and capacity. The time and motion study analysis was combined with an observational study of the program structure and function to assess the balance between program responsiveness and efficiency. Previous program studies have demonstrated that MHEC-RAP has improved access and is used and effective. The findings from the time and motion study suggest that MHEC-RAP has the capacity to manage increased activity within the current model structure without loss to responsiveness or efficiency in the provision of care. Enhancing program responsiveness and efficiency will also support a claim of the program’s value for money. MHEC-RAP is a practical telehealth solution for improving access to specialist emergency mental health care. The findings from this evaluation have already attracted the attention of other regions in Australia interested in implementing emergency telepsychiatry programs and are now informing the progressive establishment of mental health resource centres in rural New South Wales. Like MHEC-RAP, these centres will provide rapid, safe, and contextually relevant assessments and advice to support local health professionals to manage mental health emergencies in the smaller rural emergency departments. Sharing the application of this methodology and research activity may help to improve access to and future evaluations of telehealth and telepsychiatry services for others around the globe.

Keywords: access, emergency, mental health, rural, time and motion

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Authors: Kamille Beye

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Critical thinking is a topic that has been disputed in the field of education for decades, but many resulting debates have centered around strengthening critical thinking capabilities in the societies, workforces, and educational centers of the global north. In contrast, this paper provides an analysis of the teaching of critical thinking in Liberia, which has been ravaged by years of war and a recent Ebola outbreak. These crises have decimated the Liberian education sector, leading to a loss of teaching capacities that are essential to providing critical thinking education. Until recently, critical thinking had no seat at the table when the future needs of the country were discussed by the government and non-governmental agencies. Now, the University of Liberia has a bold goal to become one of the top twenty universities in West Africa in the next seven years, which has led to a focus on teaching critical thinking skills to improve learning. This paper argues that critical thinking is essential to strengthening not only the Liberian education system, but for promoting peace amongst community members, and yet it suggests that commitments to the teaching of critical thinking in Liberia have hitherto been overly superficial. Based on an initial scoping study, this paper will examine the potential impacts of teaching critical thinking skills to undergraduate students in the William V. S. Tubman School of Education at the University of Liberia on continued peacebuilding and reconstruction efforts of the country. The research contends that if critical thinking skills are taught, practiced and continually utilized, teachers and students will have the ability to engage with information and negotiate challenges to solutions in ways that are beneficial to the communities in which they live. The research will use a variety of methods, that include the California Critical Thinking Disposition Inventory. This research will demonstrate that critical thinking skills are not only needed for entering the workforce, but necessary for negotiating and expressing the needs and desires of local communities in a peaceful way.

Keywords: critical thinking, higher education, Liberia, peacebuilding, post-conflict

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Authors: Zahra Khazaeipour, Ehsan Ahmadipour, Vafa Rahimi-Movaghar, Fereshteh Ahmadipour

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Research Objectives: Chronic pain is one of the common problems associated with spinal cord injuries (SCI), which causes many complications. Therefore, this study intended to evaluate the relationship between pain and demographic, injury characteristics, socio-economic and social support in individuals with spinal cord Injury in Iran. Design: Descriptive cross-sectional study. Setting: Brain and Spinal Cord Injury Research Center (BASIR), Tehran University of Medical Sciences, Tehran, Iran, between 2012 and 2013. Participants: The participants were 140 individuals with SCI, 101 (72%) men and 39 (28%) women, with mean age of 29.4 ±7.9 years. Main Outcome Measure: The Persian version of the Brief Pain Inventory (BPI) was used to measure the pain, and the Multidimensional Scale of Perceived Social Support (MSPSS) was used to measure social support. Results: About 50.7% complained about having pain, which 79.3% had bilateral pain. The most common locations of pain were lower limbs and back. The most quality of pain was described as aching (41.4%), and tingling (32.9%). Patients with a medium level of education had the least pain compared to high and low level of education. SCI individuals with good economic situation reported higher frequency of having pain. There was no significant relationship between pain and social support. There was positive correlation between pain and impairment of mood, normal work, relations with other people and lack of sleep (P < 0.001). Conclusion: These findings revealed the importance of socioeconomic factors such as economic situation and educational level in understanding chronic pain in people with SCI and provide further support for the bio-psychosocial model. Hence, multidisciplinary evaluations and treatment strategies are advocated, including biomedical, psychological, and psycho-social interventions.

Keywords: pain, social support, socio-economic indicators, spinal cord injury

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Authors: Aisha Maroof

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Introduction: Coronavirus Disease 2019 (COVID-19) is spreading rapidly around the world with devastating consequences on patients, health care workers and health systems. Severe 2019 novel coronavirus infectious disease (COVID-19) with pneumonia is associated with high rates of admission to the intensive care unit (ICU) and they are at high risk to obtain the hospital acquire bloodstream infection (HAIs) such as central line associated bloodstream infection (CLABSI), catheter associated urinary tract infections (CAUTI) and laboratory confirm bloodstream infection (LCBSI). The chances of infection transmission increase when healthcare worker’s (HCWs) practice is inappropriate. Risk related to hand hygiene (HH) and personal protective equipment (PPE) as regards multidrug-resistant organism transmission: use of multiple gloving instead of HH and incorrect use of PPE can lead to a significant increase of device-related infections. As it reaches low- and middle-income countries, its effects could be even more, because it will be difficult for them to react aggressively to the pandemic. HAIs are one of the biggest medical concerns, resulting in increased mortality rates. Objective: To assess the effect of intervention on compliance of hand hygiene and PPE among HCWs reduce the rate of HAI in COVID-19 patients. Method: An interventional study was done between July to December, 2020. CLABSI, CAUTI and LCBSI data were collected from the medical record and direct observation. There were total of 50 Nurses, 18 doctors and all patients with laboratory-confirmed severe COVID-19 admitted to the hospital were included in this research study. Respiratory tract specimens were obtained after the first 48 h of ICU admission. Practices were observed after and before intervention. Education was provided based on WHO guidelines. Results: During the six months of study July to December, the rate of CLABSI, CAUTI and LCBSI pre and post intervention was reported. CLABSI rate decreasedd from 22.7 to 0, CAUTI rate was decreased from 1.6 to 0, LCBSI declined from 3.3 to 0 after implementation of intervention. Conclusion: HAIs are an important cause of morbidity and mortality. Most of the device related infections occurs due to lack of correct use of PPE and hand hygiene compliance. Hand hygiene and PPE is the most important measure to protect patients, through education it can be improved the correct use of PPE and hand hygiene compliance and can reduce the bacterial infection in COVID-19 patients.

Keywords: hospital acquire infection, healthcare workers, hand hygiene, personal protective equipment

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Authors: Gunay Imanguliyeva

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Burnout is one of the concerning issues in education. The present paper aimed to explore the concept of burnout among program directors and faculty working in three higher education institutions (HEIs) in Azerbaijan and identify the factors contributing to burnout and the possible consequences of this syndrome on research participants’ professional and personal life. The researcher believed that if the concept of burnout was defined precisely and explored among more faculty, administration, and educational institutions, university leadership may have looked for the ways to support program directors and faculty, which would increase job satisfaction and decrease turnover. An exploratory qualitative research design was chosen for this study. The conceptual framework of this study was based on the Maslach Burnout Inventory. The instruments of the research were semi-structured interviews, observation, and document review. Three EFL (Teaching English as a Foreign Language) instructors and three program directors of the English Language Department working in three higher educational institutions in Azerbaijan participated in this study. The major findings of this study showed that both program directors and faculty suffered from burnout. Though they were aware of the factors that caused burnout, they did not know how to deal with this feeling. While research participants had high feeling of Emotional Exhaustion and Depersonalization, they had a low feeling of Personal Accomplishment. The researcher suggests that further research is important to measure the level of burnout and to enable HEIs to increase the productivity of program directors’ and faculty’s work as well as decrease the rate of retention in future. Also, in order to help program directors and faculty to cope with burnout, the research recommends the university leadership to meet their psycho-social needs, emotional-physical needs, and personal-intellectual needs. Keywords: burnout, emotional exhaustion, factors, well-being, higher education

Keywords: burnout, well-being, higher education, factors

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Authors: Pedro Batista, André Vinha, Filipe Castelo, Bárbara Costa, Ricardo Sousa, Raquel Ricardo, André Pinto

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Background: Septic arthritis is a diagnosis that must be considered in any patient presenting with acute joint swelling and fever. Among the several risk factors for septic arthritis, such as age, rheumatoid arthritis, recent surgery, or skin infection, diabetes mellitus can sometimes be the main risk factor. Staphylococcus aureus is the most common pathogen isolated in septic arthritis; however, it is uncommon in monomicrobial necrotizing fasciitis. Objectives: A case report of concomitant septic arthritis and necrotizing fasciitis in a patient with undiagnosed diabetes based on clinical history. Study Design & Methods: We report a case of a 58-year-old Portuguese previously healthy man who presented to the emergency department with fever and left knee swelling and pain for two days. The blood work revealed ketonemia of 6.7 mmol/L and glycemia of 496 mg/dL. The vital signs were significant for a temperature of 38.5 ºC and 123 bpm of heart rate. The left knee had edema and inflammatory signs. Computed tomography of the left knee showed diffuse edema of the subcutaneous cellular tissue and soft tissue air bubbles. A diagnosis of septic arthritis and necrotising fasciitis was made. He was taken to the operating room for surgical debridement. The samples collected intraoperatively were sent for microbiological analysis, revealing infection by multi-sensitive Staphylococcus aureus. Given this result, the empiric flucloxacillin (500 mg IV) and clindamycin (1000 mg IV) were maintained for 3 weeks. On the seventh day of hospitalization, there was a significant improvement in subcutaneous and musculoskeletal tissues. After two weeks of hospitalization, there was no purulent content and partial closure of the wounds was possible. After 3 weeks, he was switched to oral antibiotics (flucloxacillin 500 mg). A week later, a urinary infection by Pseudomonas aeruginosa was diagnosed and ciprofloxacin 500 mg was administered for 7 days without complications. After 30 days of hospital admission, the patient was discharged home and recovered. Results: The final diagnosis of concomitant septic arthritis and necrotizing fasciitis was made based on the imaging findings, surgical exploration and microbiological tests results. Conclusions: Early antibiotic administration and surgical debridement are key in the management of septic arthritis and necrotizing fasciitis. Furthermore, risk factors control (euglycemic blood glucose levels) must always be taken into account given the crucial role in the patient's recovery.

Keywords: septic arthritis, Necrotizing fasciitis, diabetes, Staphylococcus Aureus

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Authors: Farhana Nosheen, Maleeha Fatima

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This study on Afghan refugee women living in Punjab, Pakistan, shows a strong relationship between poor socio-economic status and lower nutritional health status. Pakistan is one of the significant countries accepting refugees from the Afghan war. Universally, refugees are vulnerable to food security and basic life necessities. The in-hand study aimed to investigate food insecurity among afghan refugees who recently migrated to Pakistan. Purposive sampling technique was employed to collect the data from afghan women refugees settled in refugee camp settled in Capital city Islamabad, Pakistan. Data was collected through an interview tool. It revealed from data that the majority of women were underweight, about 74.7% in their reproductive years, which is an alarming situation for the forthcoming children and families. It is also shown that There’s a strong impact of their income level, education, dietary habits and food insecurity on their overall health status. It can also be observed in their Body Mass Index and in their physical appearance; they also show extremely poor levels of hemoglobin which is directly indicated anemic condition, especially iron deficiency anemia among the young Afghan refugee women. The illiteracy rate is about 93.33% among the selected participants as well as a majority of this population has 10-12 family size in comparison with their income level of about 10,000-15,000 Pakistani rupees per month, which can hardly meet their daily food expenditure. Adequate food is rarely accessible to young girls and women due to fewer national and international food aids program available in Pakistan. The majority have pale yellowish skin color (due to low iron content) along with clear white eyes (low hemoglobin level), thin hairs (protein deficiency) and spoon-shaped nails (a direct indicator of low iron level). Data showed a significant relation between appetite and BMI as their appetite is very low, which is directly indicated in their underweight body condition. About 56.67% of the participants had Urinary Tract Infections. The main causes included personal unhygienic conditions and lack of washrooms as well as drinking water facilities in their refugee camps. It is suggested that National and international food aid programs should cater to the nutritional demands of women refugees in the world to protect them from food insecurities as well as future researchers should find out better ways of analysis and treatment plans for such kind of communities who are highly prone to nutritional deficiencies and lack of basic supplies.

Keywords: food insecurity, refugees, women, vulnerable

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Authors: Alabi Olufemi, Adeyanju Taiwo, Oloruntoba Oluwasegun, Adeleye Bobola, Alabi Oyekemi

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The pastoral system is a predominant form of cattle production in Nigeria, characterized by extensive grazing on communal lands. However, this system is challenged by various factors, including tick infestation, which significantly affects cattle health and welfare hence this investigation which aims to provide an in-depth understanding of tick infestation in the context of Nigerian pastoral systems, emphasizing its impact on cattle health and welfare. The country harbors a diverse array of tick species that affect cattle. These ticks belong to different genera, including Rhipicephalus, Amblyomma, and Hyalomma, among others. Each species has unique characteristics, life cycles, and host preferences, contributing to the complexity of tick infestation dynamics in pastoral settings. Tick infestation has numerous detrimental effects on cattle health. The direct effects include blood loss, anemia, skin damage due to feeding, and the transmission of pathogens that cause diseases such as anaplasmosis, babesiosis, and theileriosis. Indirectly, tick infestation can lead to reduced productivity, weight loss, and increased susceptibility to other diseases.The welfare of cattle in Nigerian pastoral systems is significantly impacted by tick infestation. Infested cattle often exhibit signs of distress, including restlessness, reduced grazing activity, and altered behavior. Furthermore, the discomfort caused by tick bites can lead to chronic stress, compromising the overall welfare of the animals. Effective tick control is crucial for mitigating the impact of infestation on cattle health and welfare. Strategies such as acaricide application, pasture management, genetic selection for tick resistance cattle, and vaccination against tick-borne diseases are commonly used. Tick infestation presents a significant challenge to cattle production under the pastoral system in Nigeria. It not only impacts cattle health but also compromises their welfare. Addressing the issue of tick infestation requires a multifaceted approach that integrates effective control strategies with sustainable management practices. Further research is needed to develop tailored interventions that account for the unique characteristics of Nigerian pastoral systems, ultimately ensuring the well-being and productivity of cattle in these settings.

Keywords: tick infestation, pastoral system, welfare, cattle

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Authors: Aawag Mohsen Al-Awag, Wesam Salah Alaloul, M. S. Liew

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Industrialized building system (IBS) is a method of construction with concentrated practices consisting of techniques, products, and a set of linked elements which operate collectively to accomplish objectives. The Industrialised Building System (IBS) has been recognised as a viable method for improving overall construction performance in terms of quality, cost, safety and health, waste reduction, and productivity. The Malaysian construction industry is considered one of the contributors to the development of the country. The acceptance level of IBS is still below government expectations. Thus, the Malaysian government has been continuously encouraging the industry to use and implement IBS. Conventional systems have several drawbacks, including project delays, low economic efficiency, excess inventory, and poor product quality. When it comes to implementing IBS, construction companies still face several obstacles and problems, notably in terms of contractual and procurement concerns, which leads to the low adoption of IBS in Malaysia. There are barriers to the acceptance of IBS technology, focused on awareness of historical failure and risks connected to IBS practices to provide enhanced performance. Therefore, the transformation from the existing conventional building systems to the industrialized building systems (IBS) is needed more than ever. The flexibility of IBS in Malaysia’s construction industry is very low due to numerous shortcomings and obstacles. Due to its environmental, economic, and social benefits, IBS could play a significant role in the Malaysian construction industry in the future. This paper concentrates on the potential role of IBS in sustainable construction practices in Malaysia. It also highlights the awareness, barriers, advantages, and disadvantages of IBS in the construction sector. The study concludes with recommendations for Malaysian construction stakeholders to encourage and increase the utilization of industrialised building systems.

Keywords: construction industry, industrialized building system, barriers, advantages and disadvantages, construction, sustainability, Malaysia

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Authors: Tesfaye Fenta Boka, Niu Zhendong

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Recommender systems play a crucial role in connecting individuals with the items they require, as is particularly evident in the rapid growth of online grocery shopping platforms. These systems predominantly rely on user-centered recommendations, where items are suggested based on individual preferences, garnering considerable attention and adoption. However, our focus lies on the item-centered recommendation task within the grocery shopping context. In the reverse next item period recommendation (RNPR) task, we are presented with a specific item and challenged to identify potential users who are likely to consume it in the upcoming period. Despite the ever-expanding inventory of products on online grocery platforms, the cold start item problem persists, posing a substantial hurdle in delivering personalized and accurate recommendations for new or niche grocery items. To address this challenge, we propose a Graph Neural Network (GNN)-based approach. By capitalizing on the inherent relationships among grocery items and leveraging users' historical interactions, our model aims to provide reliable and context-aware recommendations for cold-start items. This integration of GNN technology holds the promise of enhancing recommendation accuracy and catering to users' individual preferences. This research contributes to the advancement of personalized recommendations in the online grocery shopping domain. By harnessing the potential of GNNs and exploring item-centered recommendation strategies, we aim to improve the overall shopping experience and satisfaction of users on these platforms.

Keywords: recommender systems, cold start item recommendations, online grocery shopping platforms, graph neural networks

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Authors: Wael Salah Shendy, Moataz Mohamed EL Semary, Hosam Salah Murad, Adham A. Mohamed

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Background: Cervicogenic headache is a major problem in many people suffering from upper cervical dysfunction with a great conflict in its physical therapy management. Objectives: To determine the effect of C1-C2 Mulligan SNAGs mobilizations on cervicogenic headache and associated dizziness symptoms. Methods: Forty-eight patients with cervicogenic headache included in the study; from the outpatient clinic of Faculty of Physical Therapy, Cairo University, and New Cairo outpatient clinics, were randomly assigned into three equal groups; group A ( Headache SNAG), group B (C1-C2 SNAG rotation) and group C (combined). Their mean age was (29.37 ± 2.6), (29.31 ± 2.54) and (29.68 ± 2.65). Neck Disability Index used to examine neck pain intensity and CEH symptoms. 6 Items Headache Impact test '6-HIT' scale used to examine headache severity and its adverse effects on social life and functions. Flexion-Rotation Test 'FRT' also used to assess rotation ROM at the level of C1-C2 by 'CROM' device. Dizziness Handicap Inventory 'DHI' scale was used to evaluate dizziness symptoms. Evaluation is done pre and post treatment, and comparison between groups was quantified. Correlations between the examined parameters were also measured. Headache SNAG and C1-C2 Rotation SNAGs were done separately in group (A- B) and combined in group C as a treatment intervention. Results: Group C has Significant improvement in whole parameters compared to group A and B, positive correlation was found between NDI and 6-HIT scores compared to negative correlation between NDI and DHI scores. Conclusion: SNAGs mobilizations used in the study were effective in reducing cervicogenic headache and dizziness symptoms in all groups with a noticeable improvement in the combined group.

Keywords: cervicogenic headache, cervical headache snag, cervical snag half rotation, cervical dizziness

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Authors: Joao Paulo Matheus, Renan Fangel

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Rheumatoid arthritis is a chronic, inflammatory, systemic and progressive disease that affects the synovial joints bilaterally, causing definitive orthopedic damage. It has a higher prevalence in postmenopausal female patients. It is a disabling disease that causes joint deformities that may compromise the functionality of the affected segment. The aim of this study was to evaluate the influence of low-intensity therapeutic laser on the perception of pain and quality of life in patients with rheumatoid arthritis. This is a randomized clinical study involving 6 women with a mean age of 56.8+6.3 years. Exclusion criteria: patients with acute pain, chronic infectious disease, underlying acute or chronic underlying disease. An AsGaAl laser with 808nm wavelength, 100mW power, beam output area of 0.028cm2, power density of 3.57W/cm2 was used. The laser was applied at pre-defined points in the interphalangeal and metacarpophalangeal joints, totaling 24 points, 2 times a week, for 4 weeks, totaling 8 sessions. The Pain Inventory (IBD) and Visual Analogue Scale (VAS) were used for the analysis of pain and for the WHOQOL-bref quality of life assessment. There was no statistical difference between the onset (5.67±2.66) and the final (4.67±3.78) of treatments (p=0.70). There was also no statistical difference between the beginning (5.67±2.66) and the final (4.67±3.78) of the treatments in the VAS analysis (p=0.68). The overall mean quality of life obtained by the questionnaire at the start of treatment was 42.3±7.6, while at the end of treatment it was 58.5±7.6 (p=0.01) and the domains of the questionnaire with significant differences were: psychological domain 42.9±6.8 and 66.7±12.9 (p=0.004), social domain 39.9±5.7 and 68.1±6.3 (p=0,0005) and environmental domain 36.3±7.3 and 56.3±12.5 (p=0.003). It can be concluded that the low-intensity therapeutic laser did not produce significant changes in the painful period of rheumatoid arthritis patients. However, there was an improvement in patients' quality of life in the psychological, social and environmental aspects.

Keywords: laser therapy, pain, quality of life, rheumatoid arthritis

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Authors: Hanan Bin Nakhi, Asaad M. Albadrawi, Maged Al Shahat, ‎Entesar Mandani

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Background:‎ Kawasaki disease (KD) is one of the most common vasculitis of childhood. ‎It is considered the leading cause of acquired heart disease in children. The ‎peak age of occurrence is 6 to 24 months, with 80% of affected children being ‎less than 5 years old. There are only a few reports of KD in infants younger ‎than 6 months. Infants had a higher incidence of atypical KD and of coronary ‎artery complications. This case report from Kuwait will reinforce considering ‎atypical KD in case of sepsis like condition with negative cultures and ‎unresponding to systemic antibiotics. Early diagnosis allows early treatment ‎with intravenous immune globulin (IVIG) and so decreases the incidence of ‎cardiac aneurysm.‎ Case Report:‎ A 2 month old female infant, product of full term normal delivery to ‎consanguineous parents, presented with fever and poor feeding. She was ‎admitted and treated as urinary tract infection as her urine routine revealed ‎pyurea. The baby continued to have persistent fever and hypoactivity inspite ‎of using intravenous antibiotics. Latter, she developed non purulent ‎conjunctivitis, skin mottling, oedema of the face / lower limb and was treated ‎in intensive care unit as a case of septic shock. In spite of her partial general ‎improvement, she continued to look unwell, hypoactive and had persistent ‎fever. Septic work up, metabolic, and immunologic screen were negative. KD ‎was suspected when the baby developed polymorphic erythematous rash and ‎noticed to have peeling of skin at perianal area and periangular area of the ‎fingers of the hand and feet. IVIG was given in dose of 2 gm/kg/day in single ‎dose and aspirin 100 mg/kg/day in four divided doses. The girl showed marked ‎clinical improvement. The fever subsided dramatically and the level acute ‎phase reactant markedly decreased but the platelets count increased to ‎‎1600000/mm3. Echo cardiography showed mild dilatation of mid right ‎coronary artery. Aspirin was continued in a dose of 5 mg/kg/d till repeating ‎cardiac echo. ‎Conclusion:‎ A high index of suspicion of KD must be maintained in young infants with ‎prolonged unexplained fever. Accepted criteria should be less restrictive to ‎allow early diagnosis of a typical KD in infants less than 6 months of age. ‎Timely appropriate treatment with IVIG is essential to avoid severe coronary ‎sequels.‎

Keywords: Kawasaki disease, atypical Kawasaki disease, infantile Kawasaki disease, hypo activity‎ ‎

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Authors: Matt Stichter

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Moral development requires learning from one’s failures, but that turnsout to be especially challenging when dealing with moral failures. The distress prompted by moral failure can cause responses ofdefensiveness or disengagement rather than attempts to make amends and work on self-change. The most potentially distressing response to moral failure is a shame. However, there appears to be two different senses of “shame” that are conflated in the literature, depending on whether the failure is appraised as the result of a global and unalterable self-defect, or a local and alterable self-defect. One of these forms of shame does prompt self-improvement in response to moral failure. This occurs if one views the failure as indicating only a specific (local) defect in one’s identity, where that’s something repairable, rather than asanoverall(orglobal)defectinyouridentity that can’t be fixed. So, if the whole of one’s identity as a morally good person isn’t being called into question, but only a part, then that is something one could work on to improve. Shame, in this sense, provides motivation for self-improvement to fix this part oftheselfinthe long run, and this would be important for moral development. One factor that looks to affect these different self-attributions in the wake of moral failure can be found in mindset theory, as reactions to moral failure in these two forms of shame are similar to how those with a fixed or growth mindset of their own abilities, such as intelligence, react to failure. People fall along a continuum with respect to how they view abilities – it is more of a fixed entity that you cannot do much to change, or it is malleable such that you can train to improve it. These two mindsets, ‘fixed’ versus ‘growth’, have different consequences for how we react to failure – a fixed mindset leads to maladaptive responses because of feelings of helplessness to do better; whereas a growth mindset leads to adaptive responses where a person puts forth effort to learn how to act better the next time. Here we can see the parallels between a fixed mindset of one’s own (im)morality, as the way people respond to shame when viewed as indicating a global and unalterable self-defect parallels the reactions people have to failure when they have a fixed mindset. In addition, it looks like there may be a similar structure to pride. Pride is, like shame, a self-conscious emotion that arises from internal attributions about the self as being the cause of some event. There are also paradoxical results from research on pride, where pride was found to motivate pro-social behavior in some cases but aggression in other cases. Research suggests that there may be two forms of pride, authentic and hubristic, that are also connected to different self-attributions, depending on whether one is feeling proud about a particular (local) aspect of the self versus feeling proud about the whole of oneself (global).

Keywords: emotion, mindset, moral development, moral psychology, pride, shame, self-regulation

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