Search results for: medical sector students

Authors: Yi-Fung Lin, Yuan-Mei Liao

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Background: Pain is common among patients with cancer and is also one of the most disturbing symptoms. As this suffering is subjective, if patients proactively participate in their pain self-management, pain could be alleviated effectively. However, not everyone can carry out self-management very well because human behavior is a product of the cognition process. In this process, we can see that "self-efficacy" plays an essential role in affecting human behaviors. Methods: We used the eight steps of concept analysis proposed by Walker and Avant to clarify the concept of “self-efficacy for cancer pain management.” A comprehensive literature review was conducted for relevant publications that were published during the period of 1977 to 2021. We used several keywords, including self-efficacy, self-management, concept analysis, conceptual framework, and cancer pain, to search the following databases: PubMed, CINAHL, Web of Science, and Embase. Results: We identified three defining attributes for the concept of self-efficacy for cancer pain management, including pain management abilities, confidence, and continuous pain monitoring, and recognized six skills related to pain management abilities: problem-solving, decision-making, resource utilization, forming partnerships between medical professionals and patients, planning actions, and self-regulation. Five antecedents for the concept of self-efficacy for cancer pain management were identified: pain experience, existing cancer pain, pain-related knowledge, a belief in pain management, and physical/mental state. Consequences related to self-efficacy for cancer pain management were achievement of pain self-management, well pain control, satisfying quality of life, and containing motivation. Conclusions: This analysis provides researchers with a clearer understanding of the concept of “self-efficacy for cancer pain management.” The findings presented here provide a foundation for future research and nursing interventions to enhance self-efficacy for cancer pain management.

Keywords: cancer pain, concept analysis, self-efficacy, self-management

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Authors: Hao Cheng, Yingzhou Ni, Amr M. Bakry, Li Liang

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Functional foods containing bioactive nutrients offer benefits beyond basic nutrition and hence the possibility of delaying and preventing chronic diseases. However, many bioactive nutrients degrade rapidly under food processing and storage conditions. Encapsulation can be used to overcome these limitations. Food proteins have been widely used as carrier materials for the preparation of nano/micro-particles because of their ability to form gels and emulsions and to interact with polysaccharides. The mechanisms of interaction between bioactive nutrients and proteins must be understood in order to develop protein-based lipid-free delivery systems. Beta-lactoglobulin, a small globular protein in milk whey, exhibits an affinity to a wide range of compounds. Alfa-tocopherol, resveratrol and folic acid were respectively bound to the central cavity, the outer surface near Trp19–Arg124 and the hydrophobic pocket in the groove between the alfa-helix and the beta-barrel of the protein. Beta-lactoglobulin could thus bind the three bioactive nutrients simultaneously to form protein-multi-ligand complexes. Beta-casein, an intrinsically unstructured but major milk protein, could also interact with resveratrol and folic acid to form complexes. These results suggest the potential to develop milk-protein-based complex carrier systems for encapsulation of multiple bioactive nutrients for functional food application and also pharmaceutical and medical uses.

Keywords: milk protein, bioactive nutrient, interaction, protection

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Authors: Sachin Deshmukh

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Mind and body synchronization occurs through memory and sensation production. Sensations are the guiding language of subconscious mind for conscious mind to take a proper action. Mind-mechanism is based upon memories collected so far since intrauterine life. There are three universal triggers for memory creation; they are persons, situations and objects. Memory is created as sensations experienced by special senses. Based upon experiencing comfort or discomfort, the triggers are categorized as safe or unsafe triggers. A memory comprises of ‘safe or unsafe feeling for triggers, and actions taken for that feeling’. Memories for triggers are created slowly, thoughtfully and consciously by the conscious mind, and archived in the subconscious mind for future references. Later on, similar triggers can come in contact with the individual. Subconscious mind uses these stored feelings to decide whether these triggers are safe or unsafe. It produces comfort or discomfort sensations as emotions accordingly and reacts in the same way as has been recorded in memory. Speed of sensing and processing the triggers, and reacting by subconscious mind is that of the speed of bioelectricity. Hence, formula for human emotions has been designed in this paper as follows: Emotion (Stress or Peace) = Trigger (Person or Situation or object) x Mass of feelings (stressful or peaceful) associated with the Trigger x Speed of Light². We also establish modern medical scientific facts about relationship between reflex activity and memory. This research further develops the ‘Rational Memory Therapy’ focusing on therapeutic feelings conversion techniques, for stress prevention and management.

Keywords: memory, sensations, feelings, emotions, rational memory therapy

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Authors: Jarel Elgin Tolentino, Arby Denise Nera, Mary Rose Roco, Angela Vianca Aspa, Nikko Beltran, Else Dapat

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Drug resistance by cells has been the problem in the medical field for decades now. The use of medicinal plants as a source of creating powerful drugs has been nowadays recognized worldwide to treat such resistant diseases. In the present study, the potential for Diospyros philippinensis A. DC. to inhibit growth of both bacteria and cancer cell line was conducted. The leaf crude extracts were screened for the presence of phytochemicals and examined for potential bioactivities by employing several assays like Kirby-Bauer disc diffusion method, DPPH (2,2-diphenyl-1-picryl-hydrazyl-hydrate) assay and MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) tetrazolium assay for the antibacterial, antioxidant and cytotoxic activities of the extract, respectively. Phytochemical test results of the extracts revealed the presence of alkaloids, flavonoids, saponins, phenols, quinones, cardiac glycosides, phlobatannins, carbohydrate, cardenolides and proteins. The leaf extracts were found to exhibit antibacterial activity against gram-positive bacteria, high antioxidant activity (99.22% ± 0.005) but did not show any sign of cytotoxicity towards HCT116 (ATCC CCL-247). The study therefore concludes that D. philippinensis A. DC. leaf extract can be a source of antibacterial and chemopreventive agents. This claim may be used as basis for future investigation.

Keywords: bioassay, medicinal plants, plant crude extracts, phytochemical screening

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Authors: Farnaz Jafari

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The surge in mass timber construction represents a pivotal moment in sustainable building practices, yet the lack of comprehensive education in construction management poses a challenge in harnessing this innovation effectively. This research endeavors to bridge this gap by developing a curriculum framework integrating mass timber construction into undergraduate and industry certificate programs. To optimize learning outcomes, the study explores the impact of two prototype formats -Virtual Reality (VR) simulations and physical mock-ups- on students' understanding and skill development. The curriculum framework aims to equip future construction managers with a holistic understanding of mass timber, covering its unique properties, construction methods, building codes, and sustainable advantages. The study adopts a mixed-methods approach, commencing with a systematic literature review and leveraging surveys and interviews with educators and industry professionals to identify existing educational gaps. The iterative development process involves incorporating stakeholder feedback into the curriculum. The evaluation of prototype impact employs pre- and post-tests administered to participants engaged in pilot programs. Through qualitative content analysis and quantitative statistical methods, the study seeks to compare the effectiveness of VR simulations and physical mock-ups in conveying knowledge and skills related to mass timber construction. The anticipated findings will illuminate the strengths and weaknesses of each approach, providing insights for future curriculum development. The curriculum's expected contribution to sustainable construction education lies in its emphasis on practical application, bridging the gap between theoretical knowledge and hands-on skills. The research also seeks to establish a standard for mass timber construction education, contributing to the field through a unique comparative analysis of VR simulations and physical mock-ups. The study's significance extends to the development of best practices and evidence-based recommendations for integrating technology and hands-on experiences in construction education. By addressing current educational gaps and offering a comparative analysis, this research aims to enrich the construction management education experience and pave the way for broader adoption of sustainable practices in the industry. The envisioned curriculum framework is designed for versatile integration, catering to undergraduate programs and industry training modules, thereby enhancing the educational landscape for aspiring construction professionals. Ultimately, this study underscores the importance of proactive educational strategies in preparing industry professionals for the evolving demands of the construction landscape, facilitating a seamless transition towards sustainable building practices.

Keywords: curriculum framework, mass timber construction, physical vs. virtual prototypes, sustainable building practices

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Authors: Samar Rabah

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Background: Incense woods are special kind of trees called Agarwood, which characterized by good smelling odors and many medical benefits. Incense smoke is heavily used in Saudi Arabia although comprehensive studies of its effects on health are limited. The present study demonstrated lung ultrastructure changes of mice after exposure and cessation to Incense smoke. Eighty mice are divided equally into four groups, three groups are exposed to different concentrations of Incense smoke (2, 4 and 6 gm) for three months, while the fourth group is control one. At the end of each month, lungs of five animals from each group are gathered, while the last five animals from each group are kept for another 60 days without exposure to the Incense smoke to allow for recovery. Results: Transmission electron microscope investigations of all exposed groups showed hypertrophy and hyperplasia in Clara Cells and some an enlargement of the macrophage to the point that it fills a large part of the alveolar lumen. Scanning electron microscope marks presence of mucus materials attached to the epithelial bronchioles. After prevention of exposure to the Incense smoke for 60 days, necrosis and degeneration in some cells of epithelial bronchioles, fibrosis of peribronchial, thickening in alveolar walls and aggregation of lymphoid cells were demonstrated. Conclusion: Based on the above findings and other related studies (not published), we conclude that exposure to Incense smoke causes harmful effects due to sever changes in pulmonary ultrastructure, such effects do not disappear even when Incense smoke inhalation was stopped. Therefore, we recommend that Incense smoke should use only in open places to reduce its harms.

Keywords: Incense smoke, lungs, ultrastructure of lungs, Agarwood

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Authors: Akeem Akinboro, Bala Alhaj Kegun

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Haemoglobinopathy is a genetic disorder that has the potentiality to cause death of individuals in whom both the alpha (α) and beta (β) globin chains of the haemoglobin molecule are defective due to mutations in their genes. The haemoglobin genotype variants among some residents of Niger state, Nigeria, were determined using the secondary data available at Bida, Minna and Kotangora general hospitals of the state. A total of 1,639 data, representing 434, 655 and 550, collected from the outside patients who visited the medical laboratory units of the three general hospitals, respectively, over five years period (2015-2020) were analyzed into gene frequency, sex and age to determine their haemoglobin genotypes status. More males (51.6 – 58.7%) than females (41.3 – 48.4%) visited the three hospitals during the period covered and most of the patients were between 11 - 20 years old. The frequency of HbA allele in the human population was 0.72, 0.65, 0.68 for Bida, Minna and Kotangora, respectively, while it was 0.25, 0.29 and 0.28 for HbS allele. The HbC allele was prevalent at 0.03, 0.06 and 0.05 among the human population in Bida, Minna and Kotangora cities of Niger state. In overall, the prevalence of HbA, HbS and HbC alleles in Niger state of Nigeria was 0.68, 0.28 and 0.05. Minna being the capital city of Niger state and the most populous among the three cities in the state seems to have influx of more people who are carriers of abnormal haemoglobin genotypes which has resulted to higher frequency of HbS and HbC than those of the other two cities in this study. These results show that the pattern of haemoglobin genotypes frequency of Kontagora could be a prediction for the whole of Niger state. It is therefore necessary and important to take screening of blood for haemoglobin genotype serious among intending couples to prevent and reduce the possibility of having increase in the number of people with abnormal haemoglobin genotypes in the state.

Keywords: haemoglobin, genotype, niger state, gene frequency, general hospitals

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Authors: Anum Rafiq

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Adolescence is a vulnerable period for youth across the world. It is a period of new learning with opportunities to understand and develop perspectives on health and well-being. With youth beginning to engage in intimate relationships at an earlier age in the 21st century, concentrating on the learning opportunity they have in school is paramount. The nature of what has been deemed important to teach in schools has changed throughout history, and the focus has shifted from home/family skills to teaching youth how to be competitive in the job market. Amidst this emphasis, opportunities for them exist to learn about building healthy intimate relationships, one of the foundational elements of most people’s lives. Using an Institutional Ethnography (IE), the lived experiences of youth in how they understand intimate relationships and how their learning experience is organized through the high school Health and Physical Education (H&PE) course is explored. An empirical inquiry into how the actual work of teachers and youth are socially organized by a biomedical, employment-related, and efficiency-based discourse is provided. Through thirty-two qualitative interviews with teachers and youth, a control of ruling relations such as institutional accountability circuits, performance reports, and timetabling over the experience of teachers and youth is found. One of the facets of the institutional accountability circuit is through the social organization of teaching and learning about healthy intimate relationships being framed through a biomedical discourse. In addition, the role of a hyper-focus on performance and evaluation is found as paramount in situating healthy intimacy discussions as inferior to neoliberally charged productivity measures such as employment skills. Lastly, due to the nature of institutional policies such as regulatory guidelines, teachers are largely influenced to avoid diving into discussions deemed risky or taboo by society, such as healthy intimacy in adolescence. The findings show how texts such as the H&PE curriculum, the Ontario College of Teachers (OCT) guidelines, Ministry of Education Performance Reports, and the timetable organize the day-to-day activities of teachers and students and reproduce different disjunctures for youth. This disjuncture includes some of their experiences being subordinated, difficulty relating to curriculum, and an experience of healthy living discussions being skimmed over across sites. The findings detail that the experience of youth in learning about healthy intimate relationships is not akin to the espoused vision outlined in policy documents such as the H&PE (2015) curriculum policy. These findings have implications for policymakers, activists, and school administration alike, which call for an investigation into who is in power when it comes to youth’s learning needs, as a pivotal period where youth can be equipped with life-changing knowledge is largely underutilized. A restructuring of existing institutional practices that allow for the social and institutional flexibility required to broach the topic of healthy intimacy in a comprehensive manner is required.

Keywords: health policy, intimate relationships, youth, education, ruling relations, sexual education, violence prevention

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Authors: Volker Wannack

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Regional, national, and international strategies focusing on hydrogen (H₂) and blockchain are driving significant advancements in hydrogen and blockchain technology worldwide. These strategies lay the foundation for the groundbreaking "Blockchain Based Hydrogen Market (BBH₂)" project. The primary goal of this project is to develop a functional Blockchain Minimum Viable Product (B-MVP) for the hydrogen market. The B-MVP will leverage blockchain as an enabling technology with a common database and platform, facilitating secure and automated transactions through smart contracts. This innovation will revolutionize logistics, trading, and transactions within the hydrogen market. The B-MVP has transformative potential across various sectors. It benefits renewable energy producers, surplus energy-based hydrogen producers, hydrogen transport and distribution grid operators, and hydrogen consumers. By implementing standardized, automated, and tamper-proof processes, the B-MVP enhances cost efficiency and enables transparent and traceable transactions. Its key objective is to establish the verifiable integrity of climate-friendly "green" hydrogen by tracing its supply chain from renewable energy producers to end users. This emphasis on transparency and accountability promotes economic, ecological, and social sustainability while fostering a secure and transparent market environment. A notable feature of the B-MVP is its cross-border operability, eliminating the need for country-specific data storage and expanding its global applicability. This flexibility not only broadens its reach but also creates opportunities for long-term job creation through the establishment of a dedicated blockchain operating company. By attracting skilled workers and supporting their training, the B-MVP strengthens the workforce in the growing hydrogen sector. Moreover, it drives the emergence of innovative business models that attract additional company establishments and startups and contributes to long-term job creation. For instance, data evaluation can be utilized to develop customized tariffs and provide demand-oriented network capacities to producers and network operators, benefitting redistributors and end customers with tamper-proof pricing options. The B-MVP not only brings technological and economic advancements but also enhances the visibility of national and international standard-setting efforts. Regions implementing the B-MVP become pioneers in climate-friendly, sustainable, and forward-thinking practices, generating interest beyond their geographic boundaries. Additionally, the B-MVP serves as a catalyst for research and development, facilitating knowledge transfer between universities and companies. This collaborative environment fosters scientific progress, aligns with strategic innovation management, and cultivates an innovation culture within the hydrogen market. Through the integration of blockchain and hydrogen technologies, the B-MVP promotes holistic innovation and contributes to a sustainable future in the hydrogen industry. The implementation process involves evaluating and mapping suitable blockchain technology and architecture, developing and implementing the blockchain, smart contracts, and depositing certificates of origin. It also includes creating interfaces to existing systems such as nomination, portfolio management, trading, and billing systems, testing the scalability of the B-MVP to other markets and user groups, developing data formats for process-relevant data exchange, and conducting field studies to validate the B-MVP. BBH₂ is part of the "Technology Offensive Hydrogen" funding call within the research funding of the Federal Ministry of Economics and Climate Protection in the 7th Energy Research Programme of the Federal Government.

Keywords: hydrogen, blockchain, sustainability, innovation, structural change

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Authors: Caroline Correia, Stefani Perna, John Gaughan, Elizabeth Cerceo

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Introduction: The COVID-19 pandemic has brought unprecedented changes to how hospitals function on a daily basis. Increased personal protective equipment (PPE) usage and measures to pre-package, separate, and decontaminate have the potential to increase the waste load. However, limiting non-essential surgeries drastically reduces operating room (OR) waste, and restricting visitation policies to contain outbreaks may help conserve resources. The impact of these policy changes with increased disposable PPE usage on hospital production of waste is unknown. Methods: Waste produced in pounds (lbs) was measured for January through June during both 2019 and 2020 through Stericycle in Cooper University Hospital in Camden, NJ. This timeframe was selected since the pandemic began in January 2020 in the US. The total waste produced during this time was 328,623 lbs in 2019 and 306,454 lbs in 2020. Using Poisson counts (α=.05), less waste was produced in 2020 (p < 0.001). The amount of sharps and regulated medical waste (grossly bloody items) were both significantly decreased as well (p < 0.0001, p=0.0002), and these account for 10-15% of the total waste produced. Discussion: Despite the increased usage of disposable PPE, overall hospital waste was decreased during the pandemic as compared to prior. As surgeries are estimated to be responsible for up to one-half of waste produced by hospitals, it is possible that constraint on elective procedures contributed to the decreased waste in all three categories; estimates of a 35% decrease in surgical volume would be expected to impact waste production. The effects of the pandemic on waste production should continue to be monitored to understand the environmental impact as health systems resume backlogged surgeries at a higher volume.

Keywords: COVID-19, hospital, surgery, waste

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Authors: Dylan Treger, Lujia Zhang, Xiaoxiao Jia, Jessica H. Hui, Munkh-Amgalan Gantumur, Mizhou Hui, Li Liu

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Hyaluronic acid (HA) is involved in wound healing via inflammation, granulation, and re-epithelialization mechanisms. The poor physical properties of natural high-molecular-weight polymers limit their direct use in the medical field. In this clinical study, we investigated whether the local injection of a tissue-permeable 35 kDa HA fragment (HA35) could favor the healing process in patients with chronic wounds accompanied by neuropathic pain. The HA35 fragments were freshly manufactured by degradation of high-molecular-weight HA with bovine testis-derived hyaluronidase PH20. Twenty patients in this study had nonhealing wounds and wound-related pain for more than 3 months. Freshly produced HA35 was locally injected into healthy skin immediately surrounding chronic wounds once a day for 10 days. Wound-associated pain and the degree of wound healing were evaluated. The injection of HA35 relieved the pain associated with chronic wounds in 24 hours. HA35 treatment significantly promoted the healing of chronic wounds, including expanded fresh granulation tissue on the wounds; reduced darkness or redness, dryness, and damaged areas on the surface of the skin surrounding the wounds; and decreased the size of the wound area. It can be concluded that the topical injection of tissue-permeable HA35 around chronic wounds has great potential to promote wound healing.

Keywords: 35 kDa hyaluronan fragment HA35, chronic wound, wound healing, tissue permeability

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Authors: Sumita Srivastava

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Despite several measures taken by the Government of India, entrepreneurship is still not perceived as a viable career option by the young generation. Although the rate of startups has improved a little after the penetration of e portals as business platforms, still the numbers are not very significant. It is also important to note that entrepreneurial initiatives are mostly taken up by graduates of premier institutions of India like Indian Institute of Technology (IITs) and Indian Institute of Management (IIMs). The scenario is not very satisfactory amongst the masses graduating from mainstream universities of the country. Indian youth at large are not attracted towards entrepreneurship as a career choice. The reason probably lies in the social fabric of the country and inappropriate education system which does not support the entrepreneurship at large amongst youth in the country. Education is critical to the development of an economy from the poverty level to the level of self-sustenance and development. The current curriculum in the majority of business schools in India prepares the average graduate to become employed by the available firms or business owners in society. For graduates in other streams, employment opportunities are very limited. The aim of this study was to identify and design entrepreneurship education contents to encourage undergraduates to pursue entrepreneurship as a career choice. This comprehensive study was conducted in multiple stages. Extensive research was conducted at each stage with an appropriate methodology. These stages of the project study were interconnected with each other, and each preceding stage provided inputs for the following stage of the study. In the first stage of the study, an empirical analysis was conducted to understand the current state of entrepreneurial intentions of undergraduates of Agra city. Various stakeholders were contacted at the stage, including students (n = 500), entrepreneurs (n = 20) and academicians and field experts (n = 10). At the second stage of the project study, a systems science technique, Nominal Group Technique (NGT) was used to identify the critical elements of entrepreneurship education in India based upon the findings of stage 1. The application of the Nominal Group Technique involved a workshop format; 15 domain experts participated in the workshop. Throughout the process, a democratic process was followed to avoid individual dominance and premature focusing on a single idea. The study obtained 63 responses from experts for effective entrepreneurship education in India. The responses were reduced to seven elements after a few thematic iterations. These elements were then segregated into content (knowledge, skills and attitude) and learning interaction on the basis of experts’ responses. After identifying critical elements of entrepreneurship education in the previous stage, the course was designed and validated at stage 3 of the project. Scientific methods were used at this stage to validate the curriculum contents and training interventions experimentally. The educational and training interventions designed through this study would not only help in developing entrepreneurial intentions but also creating skills relevant to the local entrepreneurial opportunities in the vicinity.

Keywords: curriculum design, entrepreneurial intention, entrepreneuship education, nominal group technique

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Authors: Severino Machingambi

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Most academics entering Higher education as lecturers in South Africa do not have qualifications in Education or teaching. This creates serious problems since they are not sufficiently equipped with pedagogical approaches and theories that inform their facilitation of learning strategies. This, arguably, is one of the reasons why higher education institutions are experiencing high student failure rate. In order to mitigate this problem, it is critical that higher education institutions devise internal academic staff development programmes to capacitate academics with pedagogical skills and competencies so as to enhance the quality of student learning. This paper reported on how the Teaching and Learning Development Centre of a university used design-based research methodology to conceptualise and implement an academic staff development programme for new academics at a university of technology. This approach revolves around the designing, testing and refining of an educational intervention. Design-based research is an important methodology for understanding how, when, and why educational innovations work in practice. The need for a professional development course for academics arose due to the fact that most academics at the university did not have teaching qualifications and many of them were employed straight from industry with little understanding of pedagogical approaches. This paper examines three key aspects of the programme namely, the preliminary phase, the teaching experiment and the retrospective analysis. The preliminary phase is the stage in which the problem identification takes place. The problem that this research sought to address relates to the unsatisfactory academic performance of the majority of the students in the institution. It was therefore hypothesized that the problem could be dealt with by professionalising new academics through engagement in an academic staff development programme. The teaching experiment phase afforded researchers and participants in the programme the opportunity to test and refine the proposed intervention and the design principles upon which it was based. The teaching experiment phase revolved around the testing of the new academics professional development programme. This phase created a platform for researchers and academics in the programme to experiment with various activities and instructional strategies such as case studies, observations, discussions and portfolio building. The teaching experiment phase was followed by the retrospective analysis stage in which the research team looked back and tried to give a trustworthy account of the teaching/learning process that had taken place. A questionnaire and focus group discussions were used to collect data from participants that helped to evaluate the programme and its implementation. One of the findings of this study was that academics joining university really need an academic induction programme that inducts them into the discourse of teaching and learning. The study also revealed that existing academics can be placed on formal study programmes in which they acquire educational qualifications with a view to equip them with useful classroom discourses. The study, therefore, concludes that new and existing academics in universities should be supported through induction programmes and placement on formal studies in teaching and learning so that they are capacitated as facilitators of learning.

Keywords: academic staff, pedagogy, programme, staff development

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Authors: Michael Dolgin, Oz Hamtzani, Talma Kushnir

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A literature review has shown that while parents of children with cancer experience increased levels of psychological distress associated with their child's medical condition, considerable variability in parental adjustment is evident. Of the factors that may account for this variability, little attention has been devoted to the simultaneous interaction of three coping constructs and their role in parental adjustment: (1) Coping techniques employed, (2) Repertoire of coping techniques, and (3) Flexibility in applying coping techniques. While these constructs have been studied individually in relation to adjustment in general, studies to date have not included them together within a single conceptual model and research design and evaluated them in a clinical population. The objective of the current study was to determine how these three coping technique constructs interact to impact parental adjustment to pediatric cancer. A cross-sectional sample of 145 parents of children in active cancer treatment completed standardized measures of coping techniques, repertoire, flexibility, and parental distress. A hierarchical multiple regression analysis demonstrated that 37% of the variance in parental distress was predicted by the use of avoidance-focused coping techniques [F(1,118)=69.843, p<.001], with an additional 3% predicted by coping repertoire [F(2,117)=7.63, p=.00] for a total of 40% variance explained. Coping flexibility was found to mediate the relationship between coping repertoire and parental distress. These findings suggest that coping techniques employed by parents (problem/emotion-focused vs. avoidance-focused), as well as coping repertoire, significantly impact parental adjustment. Flexibility in applying coping techniques within one’s coping repertoire further contributes to parental adjustment. Implications for further study and clinical intervention will be presented.

Keywords: coping techniques, repertoire, flexibility, adjustment

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Authors: Saira Mehnaz, Ali Jafar Abedi, Shazia Farooq Fazli, Sakeena Mushfiq, Zulfia Khan, M. Athar Ansari

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Introduction: Public health spending is a necessity in an underdeveloped country like India. The people are already suffering from poverty and that clubbed with out of pocket expenditure leads them to a very catastrophic situation, reducing the overall access to healthcare. Objectives: This study was designed to determine the usual source of medical care opted, the illness pattern, the expenditure incurred on illness and its source of procurement by the study population. It also intended to assess this expenditure as a determinant of access to health care. Methodology: Cities like Aligarh, which are classified as B grade cities in India are thought to be ripe sites for getting livelihood and hence are almost half filled with migrants living in urban slums. A cross sectional study was done to study the newer slum pockets. 3409 households with a population of 16,978 were studied with the help of pretested questionnaire; SPSS 20 was used for statistical analysis. Results and Conclusions: In our study, we found that almost all the households suffered from catastrophic health expenditure. The study population, which was already vulnerable owing to their low socio-economic and migrant status was further being forced with into poverty and indebtedness on account of expenditure on illness. This lead to a significant decrease in access to health. National health financing systems should be designed to protect households from financial catastrophe, by reducing out-of-pocket spending.

Keywords: access to healthcare, catastrophic health expenditure, new urban slums, out of pocket expenditure

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Authors: Bavneet Kaur Sidhu, Manoj Tiwari

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Global Developmental Delay (GDD) is a common pediatric condition. Etiologies of GDD might, however, differ in developing countries. In the last decade, sporadic families are being reported in various countries. As to the author’s best knowledge, many risk factors and their correlation with the prevalence of GDD have been studied but its statistical correlation has not been done. Thus we propose the present study by targeting the risk factor, prevalence and their statistical correlation with GDD. FMR1 gene was studied to confirm the disease and its penetrance. A complete questionnaire-based performance was designed for the statistical studies having a personal, past and present medical history along with their socio-economic status as well. Methods: We distributed the children’s age in 4 different age groups having 5-year intervals and applied structural equation modeling (SEM) techniques, Spearman’s rank correlation coefficient, Karl Pearson correlation coefficient, and chi-square test.Result: A total of 1100 families were enrolled for this study; among them, 330 were clinically and biologically confirmed (radiological studies) for the disease, 204 were males (61.8%), 126 were females (38.18%). We found that 27.87% were genetic and 72.12 were sporadic, out of 72.12 %, 43.277% cases from urban and 56.72% from the rural locality, the mothers' literacy rate was 32.12% and working women numbers were 41.21%. Conclusions: There is a significant association between mothers' age and GDD prevalence, which is also followed by mothers' literacy rate and mothers' occupation, whereas there was no association between fathers' age and GDD.

Keywords: global developmental delay, FMR1 gene, spearman’ rank correlation coefficient, structural equation modeling

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Authors: Ajay Agrawal, Pritha Basnet, Achala Thakur, Pappu Rizal, Rubina Rai

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Context: Rapid expulsion of fetus in intrauterine fetal death (IUFD) is usually requested without any medical grounds for it. So; an efficient, safe method for induction of labor (IOL) is required. Objective: To determine if pre-treatment with mifepristone followed by IOL with misoprostol in late IUFD is more efficacious. Methods: We conducted a randomized controlled trial in 100 patients. Group-A women received single oral dose of 200 mg mifepristone, followed by induction with vaginal misoprostol after 24-hour. Group-B women were induced only with vaginal misoprostol. In each group 5 dose of misoprostol was used 4 hourly. If first cycle was unsuccessful, after break of 12 hour, second course of misoprostol was started. The primary outcome was a measure of induction to delivery time and vaginal delivery within 24 hours. Secondary outcome was to measure need of oxytocin and complications. Results: Maternal age, parity and period of gestation were comparable between groups. Number of misoprostol dose needed in group A was significantly less than group B. Mann Whitney U test showed, women in group A had significantly earlier onset of labor, however total induction to delivery interval was not significant. In group-A, 85.7% delivered within 24 hours of first dose of misoprostol while in group-B 70% delivered within 24 hour (p=0.07). More women in Group B required oxytocin. Conclusion: Pretreatment with mifepristone before IOL following late IUFD is an effective and safe regimen. It appears to shorten the duration of induction to onset of labor.

Keywords: induction of labor, intrauterine fetal death, mifepristone, misoprostol

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Authors: Thomas Rockstuhl, Soon Ang, Kok Yee Ng, Linn Van Dyne

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Intercultural interactions are often challenging and fraught with conflicts. To shed light on how to interact effectively across cultures, academics and practitioners alike have advanced a plethora of intercultural competence models. However, the majority of this work has emphasized distal outcomes, such as job performance and cultural adjustment, rather than proximal outcomes, such as how individuals resolve inevitable intercultural conflicts. As a consequence, the processes by which individuals negotiate challenging intercultural conflicts are not well understood. The current study advances theorizing on intercultural conflict resolution by exploring antecedents of how people resolve intercultural conflicts. To this end, we examine creativity – the generation of novel and useful ideas – in the context of resolving cultural conflicts in intercultural interactions. Based on the dual-identity theory of creativity, we propose that individuals with greater international experience will display greater creativity and that the relationship is accentuated by individual’s cultural intelligence. Two studies test these hypotheses. The first study comprises 84 senior university students, drawn from an international organizational behavior course. The second study replicates findings from the first study in a sample of 89 executives from eleven countries. Participants in both studies provided protocols of their strategies for resolving two intercultural conflicts, as depicted in two multimedia-vignettes of challenging intercultural work-related interactions. Two research assistants, trained in intercultural management but blind to the study hypotheses, coded all strategies for their novelty and usefulness following scoring procedures for creativity tasks. Participants also completed online surveys of demographic background information, including their international experience, and cultural intelligence. Hierarchical linear modeling showed that surprisingly, while international experience is positively associated with usefulness, it is unrelated to novelty. Further, a person’s cultural intelligence strengthens the positive effect of international experience on usefulness and mitigates the effect of international experience on novelty. Theoretically, our findings offer an important theoretical extension to the dual-identity theory of creativity by identifying cultural intelligence as an important individual difference moderator that qualifies the relationship between international experience and creative conflict resolution. In terms of novelty, individuals higher in cultural intelligence seem less susceptible to rigidity effects of international experiences. Perhaps they are more capable of assessing which aspects of culture are relevant and apply relevant experiences when they brainstorm novel ideas. For utility, individuals high in cultural intelligence are better able to leverage on their international experience to assess the viability of their ideas because their richer and more organized cultural knowledge structure allows them to assess possible options more efficiently and accurately. In sum, our findings suggest that cultural intelligence is an important and promising intercultural competence that fosters creative resolutions to intercultural conflicts. We hope that our findings stimulate future research on creativity and conflict resolution in intercultural contexts.

Keywords: cultural Intelligence, intercultural conflict, intercultural creativity, international experience

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Authors: Evgeniya V. Gavrilova, Sofya S. Belova

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The present study was aimed at clarifying the relationship between general intellectual abilities and efficiency in free recall and rhymed words generation task after incidental exposure to linguistic stimuli. The theoretical frameworks stress that general intellectual abilities are based on intentional mental strategies. In this context, it seems to be crucial to examine the efficiency of incidentally presented information processing in cognitive task and its relation to general intellectual abilities. The sample consisted of 32 Russian students. Participants were exposed to pairs of words. Each pair consisted of two common nouns or two city names. Participants had to decide whether a city name was presented in each pair. Thus words’ semantics was processed intentionally. The city names were considered to be focal stimuli, whereas common nouns were considered to be peripheral stimuli. Along with that each pair of words could be rhymed or not be rhymed, but this phonemic aspect of stimuli’s characteristic (rhymed and non-rhymed words) was processed incidentally. Then participants were asked to produce as many rhymes as they could to new words. The stimuli presented earlier could be used as well. After that, participants had to retrieve all words presented earlier. In the end, verbal and non-verbal abilities were measured with number of special psychometric tests. As for free recall task intentionally processed focal stimuli had an advantage in recall compared to peripheral stimuli. In addition all the rhymed stimuli were recalled more effectively than non-rhymed ones. The inverse effect was found in words generation task where participants tended to use mainly peripheral stimuli compared to focal ones. Furthermore peripheral rhymed stimuli were most popular target category of stimuli that was used in this task. Thus the information that was processed incidentally had a supplemental influence on efficiency of stimuli processing as well in free recall as in word generation task. Different patterns of correlations between intellectual abilities and efficiency in different stimuli processing in both tasks were revealed. Non-verbal reasoning ability correlated positively with free recall of peripheral rhymed stimuli, but it was not related to performance on rhymed words’ generation task. Verbal reasoning ability correlated positively with free recall of focal stimuli. As for rhymed words generation task, verbal intelligence correlated negatively with generation of focal stimuli and correlated positively with generation of all peripheral stimuli. The present findings lead to two key conclusions. First, incidentally processed stimuli had an advantage in free recall and word generation task. Thus incidental information processing appeared to be crucial for subsequent cognitive performance. Secondly, it was demonstrated that incidentally processed stimuli were recalled more frequently by participants with high nonverbal reasoning ability and were more effectively used by participants with high verbal reasoning ability in subsequent cognitive tasks. That implies that general intellectual abilities could benefit from operating by different levels of information processing while cognitive problem solving. This research was supported by the “Grant of President of RF for young PhD scientists” (contract № is 14.Z56.17.2980- MK) and the Grant № 15-36-01348a2 of Russian Foundation for Humanities.

Keywords: focal and peripheral stimuli, general intellectual abilities, incidental information processing

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Authors: Ibrahim Nadeem, Mohammed Rahman, Yasser Ad-Dab’Bagh, Mahmood Akhtar

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Depression is one of the most prevalent mental illnesses and is often associated with various other medical disorders. In this review, we aim to evaluate existing systematic reviews that investigate the use of probiotics as a treatment for depressive symptoms. Five online databases were searched for relevant studies up to December 2017. Systematic reviews that included randomized controlled trials assessing the efficacy of probiotics in the treatment of depressive symptoms were included. Seven systematic reviews met the inclusion criteria. Three of these reviews conducted meta-analyses, out of which, two found probiotics to significantly improve depressive symptoms in the sample population. Two meta-analyses conducted subgroup analysis based on health status, and both found probiotics to significantly decrease depressive symptoms in patients with major depressive disorder, but only one review found it to significantly decrease in healthy patients. Another subgroup analysis was conducted based on age, and found probiotics to produce significant effects on subjects under the age of 60, but close to no effect on patients over the age of 65. Out of the four reviews that conducted qualitative analysis, three reviews concluded that probiotics have the potential to be used as a treatment. Due to the differences in clinical trials, a definitive effect of probiotics on depressive symptoms cannot be concluded. Nonetheless, probiotics seem to produce a significant therapeutic effect for subjects with pre-existing depressive symptoms. Further studies are warranted for definitive conclusions.

Keywords: depression, gut-brain axis, gut microbiota, probiotic, psychobiotic

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Authors: Hannah Riva, Sarah Mazal, Jessica L. Marquez, Michael Rains

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A 70-year-old female with a Fitzpatrick skin phenotype II presented with a 13-year history of a scaly rash located on the left breast and bilateral pretibial regions. The patient’s past medical history was otherwise unremarkable, with the exception of surgery involving the left breast. Physical examination revealed infiltrative hyperpigmented scaly plaques and nodules located on the left breast and pretibial regions bilaterally. A negative systemic workup excluded organ involvement. A clinical diagnosis of cutaneous sarcoidosis was made. Prior treatments included triamcinolone 0.1% topical cream and clobetasol 0.05% ointment, which failed to show improvement. Full-body narrow-band UVB (NBUVB) treatment was performed on a tri-weekly basis for eight months. NBUVB dosage was slowly titrated from 300 mJ/cm2 to a final dose of 1800 mJ/cm2 to prevent discomfort and burning sensations. Throughout the duration of her treatment, the patient adhered to a regimen of clobetasol 0.05% topical ointment applied twice daily in two-week intervals. Improvement was noticed after two months, with continued improvement up to eight months. The patient is continuing NBUVB phototherapy treatments for maintenance. In our case, NBUVB phototherapy treatment demonstrated promising results with improvement after two months of treatment. Physicians should consider NBUVB phototherapy as an effective option for patients presenting with cutaneous sarcoidosis.

Keywords: dermatology, sarcoidosis, phototherapy, ultraviolet

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Authors: Liya Abraham

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Eritrea is located along the Red Sea, north of the Horn of Africa, between Djibouti and Sudan and has a population of about 3.2 million as of 2010. It has six administrative regions; Anseba, Debub, Debubawi K’eyih Bahri, Gash-Barka, Ma'akel, and Semenawi K’eyih Bahri. Eritrea has got its independence in 1991 after 30 years war of liberation. The country is blessed with various medicinal flora and fauna, and marine and terrestrial biodiversity. Traditional Medicine (TM) has been an integral part of the Eritrean culture for centuries. So far, more than 19 TM modalities have been recognized, and are broadly categorized as; herbal, procedure-based and spiritual. Despite the availability of modern medicine to the majority of the population, TM is still widely practiced. The rationale behind widespread use is accessibility, affordability and cultural acceptability. Hence, TM is of great contribution to the Eritrean health care system. As a matter of fact, harnessing the potential contribution of effective and safe TM in order to attain Universal Health Coverage (UHC) has been emphasized in the WHO TM strategy 2014-2023. The Eritrean TM, however, was operating without regulation and reliable scientific justification behind its safety and efficacy. Thus, the Ministry of Health (MoH), in recognition of the role of TM in primary healthcare and safeguard public health, established a regulatory body for TM so-called as Traditional Medicine Unit (TMU) in 2012. The mission of the unit is to ensure rational TM use through an integrated health service delivery system and contribute to the country’s economic and social development. The unit has established its national TM policy in 2017. The activities of the unit are guided by the National TM Advisory Committee (TMAC), responsible for the provision of technical assistance and advisory role. Moreover, the Legal Framework and Code of Ethics and Practice which provide a legal basis for the regulation of TM have also been drafted. In recognition of the importance of TM research and development, the unit launched a nationwide TM survey in 2017 and had surveyed two zones (Gash-Barka and Debub). The findings of the survey were subjected to a research dissemination workshop and publication in international journals. Furthermore, TM-related adverse events reporting tool (Green Form) aiming to guide regulatory interventions and researches have been established by the unit, and ever since reports are flowing. The unit has also been offering training to THPs, pharmacy students and health care professionals regarding TM and its regulatory activities. In addition, as part of the establishment of the national medicinal plants' database and herbal monograph, more than 329 and 30 medicinal plants, have been compiled respectively. In conclusion, TM is still widely accepted and practiced in Eritrea. The TMU ever since its establishment is endeavoring to ensure the safety and efficacy of the TM, and its integration in the mainstream health service delivery system.

Keywords: efficacy, regulation, safety, traditional medicine, traditional medicine unit, universal health coverage

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Authors: Sadia Suri Kashif, Raheeda Fatima, Maqsood Ahmed Khan

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Purpose of the study: The objective of this research was to determine the perception of Pakistani physicians (whether primary care, specialists or residents) in Karachi, being one of the largest and highly populated cities of Pakistan, regarding clinical approaches towards diet, exercise, and therapy in obese patients. This research determines their understanding of obesity and employability of obesity management in their daily practices. Research methodology: This is a questionnaire-based survey. A minimum of 300 questionnaires (N=300) were distributed and filled by practicing physicians in a random selection of medical setups in Karachi. Randomly 246 physicians responded to the survey. The survey tested their views regarding weight management, importance of general awareness and their strategies to control weight. Results: In the first part of survey the physicians responded to almost 66% regarding the seriousness of obesity management with advising diet modification, physical exercise and decreasing calorie intake; 57% failed to employ Body Mass Index and Waist Hip Ratio as weight measurement tools in their daily practice; 50% disagreed on using pharmacotherapy as an option; 67% were not sure about the proper dosage and indication of anti-obesity medication while almost same disagreed on using surgical options for management of obesity; 83.3% physicians agreed on the increased obesity pandemic in Pakistan. Conclusion: The findings indicate that there is a gap between awareness and knowledge among Pakistani practicing physicians regarding pharmacotherapy for obesity. There is a need to frequently update latest guidelines to help manage this condition, which is becoming more prevalent in our country day by day. Physicians should be obligated to use updated knowledge for managing obesity.

Keywords: obesity, physicians, BMI, weight management, obesity awareness

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Authors: Delia Gabriela Moisa, Demos Parapanos, Tim Heap

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The tourism sector is mainly comprised of small and medium-sized tourism enterprises (SMEs), representing approximately 80% of global businesses in this field. These entities require focused attention and support to address challenges, ensuring their competitiveness and relevance in a dynamic industry characterized by continuously changing customer preferences. To address these challenges, it becomes imperative to consider not only socio-demographic factors but also delve into the intricate interplay of psychological elements influencing consumer behavior. This study investigates the impact of personality traits and travel motivations on visitor activities in Cumbria, United Kingdom, an iconic region marked by UNESCO World Heritage Sites, including The Lake District National Park and Hadrian's Wall. With a £4.1 billion tourism industry primarily driven by SMEs, Cumbria serves as an ideal setting for examining the relationship between tourist psychology and activities. Employing the Big Five personality model and the Travel Career Pattern motivation theory, this study aims to explain the relationship between psychological factors and tourist activities. The study further explores SME perspectives on personality-based market segmentation, providing strategic insights into addressing evolving tourist preferences.This pioneering mixed-methods study integrates quantitative data from 330 visitor surveys, subsequently complemented by qualitative insights from tourism SME representatives. The findings unveil that socio-demographic factors do not exhibit statistically significant variations in the activities pursued by visitors in Cumbria. However, significant correlations emerge between personality traits and motivations with preferred visitor activities. Open-minded tourists gravitate towards events and cultural activities, while Conscientious individuals favor cultural pursuits. Extraverted tourists lean towards adventurous, recreational, and wellness activities, while Agreeable personalities opt for lake cruises. Interestingly, a contrasting trend emerges as Extraversion increases, leading to a decrease in interest in cultural activities. Similarly, heightened Agreeableness corresponds to a decrease in interest in adventurous activities. Furthermore, travel motivations, including nostalgia and building relationships, drive event participation, while self-improvement and novelty-seeking lead to adventurous activities. Additionally, qualitative insights from tourism SME representatives underscore the value of targeted messaging aligned with visitor personalities for enhancing loyalty and experiences. This study contributes significantly to scholarship through its novel framework, integrating tourist psychology with activities and industry perspectives. The proposed conceptual model holds substantial practical implications for SMEs to formulate personalized offerings, optimize marketing, and strategically allocate resources tailored to tourist personalities. While the focus is on Cumbria, the methodology's universal applicability offers valuable insights for destinations globally seeking a competitive advantage. Future research addressing scale reliability and geographic specificity limitations can further advance knowledge on this critical relationship between visitor psychology, individual preferences, and industry imperatives. Moreover, by extending the investigation to other districts, future studies could draw comparisons and contrasts in the results, providing a more nuanced understanding of the factors influencing visitor psychology and preferences.

Keywords: personality trait, SME, tourist behaviour, tourist motivation, visitor activity

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Authors: Anjula Negi, Sanjay Gupta

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Paradigms studied inform inadequacies of financial resources, be it to finance metro rails for construction or to meet operational revenues or to derive profits in the long term. Funding sustainability is far and wide for much-needed public transport modes, like urban rail or metro rails, to be successfully operated. India embarks upon a sustainable transport journey and has proposed metro rail systems countrywide. As an emerging economic leader, its fiscal constraints are paramount, and the land value capture (LVC) mechanism provides necessary support and innovation toward development. India’s metro rail policy promotes multiple methods of financing, including private-sector investments and public-private-partnership. The critical question that remains to be addressed is what factors can make such mechanisms work. Globally, urban rail is a revolution noted by many researchers as future mobility. Researchers in this study deep dive by way of literature review and empirical assessments into factors that can lead to the adoption of LVC mechanisms. It is understood that the adoption of LVC methods is in the nascent stages in India. Research posits numerous challenges being faced by metro rail agencies in raising funding and for incremental value capture. A few issues pertaining to land-based financing, inter alia: are long-term financing, inter-institutional coordination, economic/ market suitability, dedicated metro funds, land ownership issues, piecemeal approach to real estate development, property development legal frameworks, etc. The question under probe is what are the parameters that can lead to success in the adoption of land value capture (LVC) as a financing mechanism. This research provides insights into key parameters crucial to the adoption of LVC in the context of Indian metro rails. Researchers have studied current forms of LVC mechanisms at various metro rails of the country. This study is significant as little research is available on the adoption of LVC, which is applicable to the Indian context. Transit agencies, State Government, Urban Local Bodies, Policy makers and think tanks, Academia, Developers, Funders, Researchers and Multi-lateral agencies may benefit from this research to take ahead LVC mechanisms in practice. The study deems it imperative to explore and understand key parameters that impact the adoption of LVC. Extensive literature review and ratification by experts working in the metro rails arena were undertaken to arrive at parameters for the study. Stakeholder consultations in the exploratory factor analysis (EFA) process were undertaken for principal component extraction. 43 seasoned and specialized experts participated in a semi-structured questionnaire to scale the maximum likelihood on each parameter, represented by various types of stakeholders. Empirical data was collected on chosen eighteen parameters, and significant correlation was extracted for output descriptives and inferential statistics. Study findings reveal these principal components as institutional governance framework, spatial planning features, legal frameworks, funding sustainability features and fiscal policy measures. In particular, funding sustainability features highlight sub-variables of beneficiaries to pay and use of multiple revenue options towards success in LVC adoption. Researchers recommend incorporation of these variables during early stage in design and project structuring for success in adoption of LVC. In turn leading to improvements in revenue sustainability of a public transport asset and help in undertaking informed transport policy decisions.

Keywords: Exploratory factor analysis, land value capture mechanism, financing metro rails, revenue sustainability, transport policy

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Authors: Ayten Tahirli

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Settlements and grave monuments discovered by archeological excavations conducted in Nakhchivan Autonomous Republic have a special place in studying the Ancient history of Azerbaijan between the 4th century B.C. and the 3rd century A.C. From this point of view, the archeological excavations and investigations conducted at Oglankala, Goshatapa, Babatapa, Pusyan, Agvantapa, Meydantapa and other monuments in Nakhchivan have a specific place. From this point of view, the conclusions of archeological research conducted at the Oglankala settlement enable studying of Nakhchivan history, economic life and trade relationships broadly. Oglankala, which is located on Garatapa Mountain with a space of 50 ha, was the largest fortress in Nakhchivan and one of the largest fortresses in the South Caucasus during the Middle Iron Age. The territory where the monument is located is very important in terms of keeping Sharur Lowland, which has great importance for agriculture and is the most productive territory in Nakhchivan, where Arpachay passes starting from the Lesser Caucasus. During the excavations between 1988 and 1989 at Oglankala, covering the fortress's history belonging to the Early and Middle Iron Ages, indisputable proofs showing that the territory was an important political center were discovered at that territory. Oglankala was the capital city of an independent government during the Middle Iron Age. It maintained economic and cultural relationships with the neighboring Urartu Government and was the capital city of a city government covered by a strong protection system in the centuries after the collapse of the Achaemenid Empire. It is need say that broader archeological excavations at Oglankala City were first started by Vali Bakhshaliyev, the Department Head of the Institute of History, Ethnography and Archeology of ANAS Nakhchivan Branch. Between 1988 and 1989, V.B. Bakhshaliyev conducted an excavation within an area of 320 square meters at Oglankala. Since 2006, Oglankala has become a research object for the International Azerbaijan-USA archeological expedition. In 2006, Lauren Ristvet from Pennsylvania State University, Veli Bakhshaliyev from the Nakhchivan Branch of Azerbaijan National Academy of Sciences and Safar Ashurov from Baku Office of Azerbaijan National Academy of Sciences, together with their other colleagues and students, started to study the ancient history of that magic area. During the archeological research conducted by an international expedition between 2008 and 2011 under the supervision of Vali Bakhshaliyev, the remnants of a palace and the protective walls of a citadel constructed between late 9th century B.C. and early 8th century A.C. were discovered in that residential area. It was found out that Oglankala was the capital city of a small government established at Sharur Lowland during the Middle Iron Age and struggled against the Urartu by establishing a union with the local tribes. That government had a specific cuneiform script. Between the 4th and 2nd centuries B.C., Oglankala and the territory it covered was one of the major political centers of the Atropathena Government.

Keywords: Nakhchivan, Oglankala, settlement, ceramic, archaeological excavation

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Authors: Pedro Ferraz-Gameiro

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Introduction: The Pellegrini-Stieda lesion is the result of post-traumatic calcification and/or ossification on the medial collateral ligament (MCL) of the knee. When this calcification is accompanied by gonalgia and limitation of knee flexion, it is called Pellegrini-Stieda syndrome. The pathogenesis is probably the calcification of a post-traumatic hematoma at least three weeks after the initial trauma or secondary to repetitive microtrauma. On anteroposterior radiographs, a Pellegrini-Stieda lesion is a linear vertical ossification or calcification of the proximal portion of the MCL and usually near the medial femoral condyle. Patients with Pellegrini-Stieda syndrome present knee pain associated with loss of range of motion. The treatment is usually conservative with analgesic and anti-inflammatory drugs, either systemic or intra-articular. Physical medicine and rehabilitation techniques associated with shock wave therapy can be a way of reduction of pain/inflammation. Patients who maintain instability with significant limitation of knee mobility may require surgical excision. Methods: Research was done using PubMed central using the terms Pellegrini-Stieda syndrome. Discussion/conclusion: Medical treatment is the rule, with initial rest, anti-inflammatory, and physiotherapy. If left untreated, this ossification can potentially form a significant bone mass, which can compromise the range of motion of the knee. Physical medicine and rehabilitation techniques associated with shock wave therapy are a way of reduction of pain/inflammation.

Keywords: knee, Pellegrini-Stieda syndrome, rehabilitation, shock waves therapy

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Authors: Sara Mercedes Barroso Pinzón, Antonio Javier Sanchéz Herencia, Begoña Ferrari, Álvaro Jesús Castro

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The current need for durable implants and bone substitutes characterised by biocompatibility, bioactivity and mechanical properties, without immunological rejection, is a major challenge for scientists. Hydroxyapatite (HAp) has been considered for decades as an ideal biomaterial for bone regeneration due to its chemical and crystallographic similarity to the mineral structure bioapatites. However, the lack of trace elements in the hydroxyapatite structure gives it very low mechanical and biological properties. In this sense, the objective of the research is to address the synthesis of hydroxyapatite with Mg from phosphate rock from sedimentary deposits in the central-eastern region of Colombia, taking advantage of the release of the species contained as natural precursors of Ca, P and Mg. The minerals present were studied, fluorapatite as the mineral of interest associated with mineralogical species of magnesium carbonates and quartz. The chemical and mineralogical composition was determined by X-ray fluorescence (XRF) and X-ray diffraction (XRD), scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDX); as well as the evaluation of the surface physicochemical properties of zeta potential (PZC), with the aim of studying the surface behaviour of the microconstituents present in the phosphate rock and to elucidate the synergistic mechanism between the minerals and establish the optimum conditions for the wet concentration process. From the products obtained and characterised by XRD, XRF, SEM, FTIR, RAMAN, HAp-Mg biocomposite scaffolds are fabricated and the influence of Mg on the morphometric parameters, mechanical and biological properties of the designed materials is evaluated.

Keywords: phosphate rock, hydroxyapatite, magnesium, biomaterials

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Authors: Jenn Gallup, Onur Kocaoz, Onder Islek

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In their pursuit of postsecondary transitions, individuals with disabilities tend to experience, academic, behavioral, and emotional challenges to a greater extent than their typically developing peers. These challenges result in lower rates of graduation, employment, independent living, and participation in college than their peers without disabilities. The lack of friendships and support systems has had a negative impact on those with a disability transitioning to postsecondary settings to include, employment, independent living, and university settings. Establishing friendships and support systems early on is an indicator of potential success and persistence in postsecondary education, employment, and independent living for typically developing college students. It is evident that a deficit in friendships and supports is a key deficit also for individuals with disabilities. To address the specific needs of this group, a mentor program was developed for a transition program held at the university for youth aged 18-21. Pre-service teachers enrolled in the special education program engaged with youth in the transition program in a variety of activities on campus. The mentorship program had two purposes: to assist young adults with disabilities who were transitioning to a workforce setting to help increase social skills, self-advocacy, supports and friendships, and confidence; and to give their peers without disabilities who were enrolled in a secondary special education course as a pre-service teacher the experience of interacting with and forming friendships with peers who had a disability for the purposes of career development. Additionally, according to researchers mobile technology has created a virtual world of equality and opportunity for a large segment of the population that was once marginalized due to physical and cognitive impairments. All of the participants had access to smart phones; therefore, technology was explored during this study to determine if it could be used as a compensatory tool to allow the young adults with disabilities to do things that otherwise would have been difficult because of their disabilities. Additionally, all participants were asked to incorporate technology such as smart phones to communicate beyond the activities, collaborate using virtual platform games which would support and promote social skills, soft-skills, socialization, and relationships. The findings of this study confirmed that a peer mentorship program that harnessed the power of technology supported outcomes specific to young adults with and without disabilities. Mobile technology and virtual game-based platforms, were identified as a significant contributor to personal, academic, and career growth for both groups. The technology encouraged friendships, provided an avenue for rich social interactions, and increased soft-skills. Results will be shared along with the development of the program and potential implications to the field.

Keywords: career outcomes, mentorship, soft-skills, technology, transition

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Authors: Phang Moon Leng

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Automated Early Warning Scores is a newly developed clinical decision tool that is used to streamline and improve the process of obtaining a patient’s vital signs so a clinical decision can be made at an earlier stage to prevent the patient from further deterioration. This technology provides immediate update on the score and clinical decision to be taken based on the outcome. This paper aims to study the use of an automated early warning score system on whether the technology has assisted the hospital in early detection and escalation of clinical condition and improve patient outcome. The hospital adopted the Modified Early Warning Scores (MEWS) Scoring System and MEWS Clinical Response into Philips IntelliVue Guardian Automated Early Warning Score equipment and studied whether the process has been leaned, whether the use of technology improved the usage & experience of the nurses, and whether the technology has improved patient care and outcome. It was found the steps required to obtain vital signs has been significantly reduced and is used more frequently to obtain patient vital signs. The number of deaths, and length of stay has significantly decreased as clinical decisions can be made and escalated more quickly with the Automated EWS. The automated early warning score equipment has helped improve work efficiency by removing the need for documenting into patient’s EMR. The technology streamlines clinical decision-making and allows faster care and intervention to be carried out and improves overall patient outcome which translates to better care for patient.

Keywords: automated early warning score, clinical quality and safety, patient safety, medical technology

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