Search results for: background

Authors: Saeed Dehnavi, Zahra Dehnavi

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Background: Psychodrama, as a form of art therapy, helps people to enact and use role-plays for a specific problem, rather than just talking about it, in an effort to review the problem, gain feedback from group members, find appropriate solutions, and practice them for their life. This paper evaluated the effectiveness of psychodrama on enhancing self-esteem of young adolescent boys. Methodology: This is aquasi-experimental research study, using a pre-post testing plan with control group.From four secondary schools in Kermanshah – Iran, 210 adolescent boys (aged 13 and 14 years) were asked to complete Koper Smith's self-esteem measure scale. Given the low self-esteem scores (less than the cut-off of 23), a number of 20 individuals were selected and randomly placed into two control and experimental groups. The experimental group participated in a twelve-session psychodrama therapy plan for 6 weeks, while the control group received no intervention. Data analysis was carried out by the analysis of covariance (ANCOVA). Results: The results of ANCOVA analysis showed an increase in the post-test scores for self-esteem, and such increase was statistically significant. Conclusion: The findings indicated the effectiveness of psychodrama on self-esteem enhancement of young boys. During psychodrama sessions, the adolescents learned to take the initiative, communicate with others in an excited state, and improve their self-esteem with positive and constructive experiences.

Keywords: psychodrama, self-esteem, young adolescents, boys

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Authors: Rebecca Quinlan

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Background: The pandemic has caused a surge in eating disorders (ED). The prevalence of ED is higher in athletes than in the general population. It would therefore be expected that there will be a rise in ED among athletic populations. Coaches regularly work with athletes and should be in a position to identify signs of ED in their athletes. However, there is limited awareness of ED among coaches. Given the effects of the pandemic, it is crucial that coaches have the skills and knowledge to identify ED. This research will explore the effects of the pandemic on athletes, current knowledge of ED among coaches, and possible solutions for building back better from the pandemic. Methods: Freedom of Information requests were conducted, and a systematic review of the literature was undertaken regarding ED in sports and following the pandemic. Results: The systematic review of the literature showed that there had been a rise in ED in athletes due to the pandemic. Freedom of Information results revealed that ED is not covered in level 1 coaching courses. This lack of education has resulted in many coaches stating they feel unable to identify ED. Discussion: The increased prevalence of ED in athletes, coupled with the negative effects of the pandemic, highlight the need for action. Recommendations are provided, which include Level 1 coaching courses to include compulsory ED education, including signs and symptoms, what to do if an athlete has an ED, and resources/contacts. It is anticipated that the findings will be used to improve coaching knowledge of ED and support offered to athletes, with the overarching aim of building back better and faster from the pandemic.

Keywords: eating disorders, sport, athletes, pandemic

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Authors: Asnakech Zekiwos

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Background: Stress in nursing refers to the reactions nurses experience when faced with work demands that exceed their knowledge, skills, or ability to cope. Nursing, as a profession, is particularly susceptible to work-related stress. Methods: A cross-sectional study was conducted among 405 randomly selected nurses working in Hadiya Zone Public Hospitals from March 1 to 30, 2023. Data were collected using a pre-tested self-administered questionnaire. The data were entered using Epi-data version 3.1 and analyzed using SPSS version 20.0. Multivariable logistic regression analysis was performed to identify factors associated with the level of work stress. Variables with a p-value <0.05 were considered statistically significant. Results: In this study, 56% (95% CI 50.9-61.2) of the participants reported being stressed in their work. Several factors were found to be associated with work stress, including being female (AOR=1.94, 95% CI 1.19-3.16), rotating shifts (AOR=2.06, 95% CI 1.31-3.25), working in the intensive care unit (AOR=3.42, 95% CI 1.20-9.73), and having post-basic training (AOR=0.55, 95% CI 0.34-0.92). Conclusion: The study revealed a high level of work stress among nurses in the study area. The zonal health unit takes measures to address work stress by providing job orientation during the hiring process, rotation, and on-the-job training to help nurses cope with and manage stressful events. Stress in public hospitals and among nurses is an important issue that needs attention.

Keywords: stress, nurses, public hospitals, expanded stress scale

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Authors: Nana Saralidze, Nino Sharashenidze, Zurab Kevanishvili

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Hidden hearing loss may occur in humans exposed to prolonged high-level sound. It is the loss of ability to hear high-level background noise while having normal hearing in quiet. We compared the hearing of people who regularly listen 3 hours and more to personal music players and those who do not. Forty participants aged 18-30 years were divided into two groups: regular users of music players and people who had never used them. And the third group – elders aged 50-55 years, had 15 participants. Pure-tone audiometry (125-16000 Hz), auditory brainstem response (ABR) (70dB SPL), and ability to identify speech in noise (4-talker babble with a 65-dB signal-to-noise ratio at 80 dB) were measured in all participants. All participants had normal pure-tone audiometry (all thresholds < 25 dB HL). A significant difference between groups was observed in that regular users of personal audio systems correctly identified 53% of words, whereas the non-users identified 74% and the elder group – 63%. This contributes evidence supporting the presence of a hidden hearing loss in humans and demonstrates that speech-in-noise audiometry is an effective method and can be considered as the GOLD standard for detecting hidden hearing loss.

Keywords: mp3 player, hidden hearing loss, speech audiometry, pure tone audiometry

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Authors: Jun Hong Lee

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Background: Many dementia patients complain insomnia and depressive mood, and hypnotics and antidepressants are being prescribed. As prevalence of dementia is increasing, insomnia and depressive mood are becoming more important. Objective: We evaluated insomnia and depression in outpatients of dementia center. Patients and Methods/Material and Methods: We reviewed medical records of the patients who visited outpatients clinic of NHIS Ilsan Hospital Dementia Center during 2016. Results: Total 716 patients are included; Subjective Memory Impairment (SMI) : 143 patients (20%), non-amnestic Mild Cognitive Impairment (MCI): single domain 70 (10%), multiple domain 34 (5%), amnestic MCI: single domain 74 (10%), multiple domain 159 (22%), Early onset Alzheimer´s disease (AD): 9 (1%), AD 121 (17%), Vascular dementia: 62 (9%), Mixed dementia 44 (6%). Hypnotics and antidepressants are prescribed as follows; SMI : hypnotics 14 patients (10%), antidepressants 27 (19%), non-amnestic MCI: single domain hypnotics 9 (13%), antidepressants 12 (17%), multiple domain hypnotics 4 (12%), antidepressants 6 (18%), amnestic MCI: single domain hypnotics 10 (14%), antidepressants 16 (22%), multiple domain hypnotics 22 (14%), antidepressants 24 (15%), Early onset Alzheimer´s disease (AD): hypnotics 1 (11%), antidepressants 2 (22%), AD: hypnotics 10 (8%), antidepressants 36 (30%), Vascular dementia: hypnotics 8 (13%), antidepressants 20 (32%), Mixed dementia: hypnotics 4 (9%), antidepressants 17 (39%). Conclusion: Among the outpatients of Dementia Center, MCI and SMI are majorities, and the number of MCI patients are almost half. Depression is more prevalent in AD, and Vascular dementia than MCI and SMI, and about 22% of patients are being prescribed by antidepressants and 11% by hypnotics.

Keywords: insomnia, depression, dementia, antidepressants, hypnotics

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Authors: S. H. Atef, N. H. Mahmoud, S. Abdrahman, A. Fattoh

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Background: The aim of the study is to assess the diagnostic value of fibrotest and hyaluronic acid in discriminate between insignificant and significant fibrosis. Also, to find out if these parameters could replace liver biopsy which is currently used for selection of chronic hepatitis C patients eligible for antiviral therapy. Study design: This study was conducted on 52 patients with HCV RNA detected by polymerase chain reaction (PCR) who had undergone liver biopsy and attending the internal medicine clinic at Ain Shams University Hospital. Liver fibrosis was evaluated according to the METAVIR scoring system on a scale of F0 to F4. Biochemical markers assessed were: alpha-2 macroglobulin (α2-MG), apolipoprotein A1 (Apo-A1), haptoglobin, gamma-glutamyl transferase (GGT), total bilirubin (TB) and hyaluronic acid (HA). The fibrotest score was computed after adjusting for age and gender. Predictive values and ROC curves were used to assess the accuracy of fibrotest and HA results. Results: For fibrotest, the observed area under curve for the discrimination between minimal or no fibrosis (F0-F1) and significant fibrosis (F2-F4) was 0.6736 for cutoff value 0.19 with sensitivity of 84.2% and specificity of 85.7%. For HA, the sensitivity was 89.5% and specificity was 85.7% and area under curve was 0.540 at the best cutoff value 71 mg/dL. Multi-use of both parameters, HA at 71 mg/dL with fibrotest score at 0.22 give a sensitivity 89.5%, specificity 100 and efficacy 92.3% (AUC 0.895). Conclusion: The use of both fibrotest score and HA could be as alternative to biopsy in most patients with chronic hepaitis C putting in consideration some limitations of the proposed markers in evaluating liver fibrosis.

Keywords: fibrotest, liver fibrosis, HCV RNA, biochemical markers

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Authors: Esther Burkitt, Dawn Watling

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Background: Four types of patterns of simultaneous mixed emotions have been identified in middle childhood, adolescence and adulthood. The present study applied an analogue emotion scale which permits measuring of intensity of opposite valence emotions over time rather than bipolar ratings and used an exhaustive coding scheme to investigate whether children in early childhood experience previously identified and additional types of mixed emotional experiences. Methods: To explore the presence of simultaneous mixed emotion experiences in early childhood, 112 children (59 girls) aged 5 years 1 month - 7 years 2 months (X=6 years 1 month; SD = 10 months) were recruited across the UK. They were allocated on the basis of alternation by gender on class lists to one of two conditions hearing vignettes describing mixed emotion events in an age and gender matched protagonist or themselves (other, n = 57 and self, n = 55). Findings: New types of flexuous, vertical and other experiences were identified alongside sequential, prevalent, highly parallel and inverse types of experiences identified in older populations. Conclusions: The analogue emotion scale uncovered a broader range of simultaneous mixed emotional experiences than previously identified. The value of exploring the utility of the findings in emotion assessments is discussed along with suggestions to explore impacts of educational and cultural influences on children’s mixed emotional experiences.

Keywords: childhood, emotion, graphing, self

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Authors: Joella Mukashyaka, Rose Mukarubayiza, Emmanuel Habumugisha, Francois-Xavier Sunday, Kellen Muganwa, Valens Mbarushimana, Pamela Meharry

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Background: Breastfeeding in the first hour post-birth can decrease neonatal morbidity and mortality. Disease prevention and health outcomes differ immensely between newborns who receive human milk and those who do not. Rwanda has high breastfeeding rates, though factors associated with early initiation of breastfeeding (EIBF) are unknown. Objective: To assess factors associated with EIBF among mothers in immediate postpartum units at two hospitals. Methods: A cross-sectional study design and a convenience sample of 187 mothers were used. An interviewer-administered questionnaire was used for data collection. A Chi-square test showed the relationship between EIBF and sociodemographic factors. Results: The findings showed less than one quarter (20.5%) breastfed within the first hour after birth. The majority was < 25 years (52.4%), had some primary education (27.7%) employed (66.7%), urban dweller (58.1%), attendance of one ANC visit or more (81.3%), vaginal birth (58.8%), and did not receive EIBF health education (92.0%). The majority (78.5%) was too tired to initiate breastfeeding, and many supplemented (41.9%) due to perceived insufficient breastmilk. Conclusion: Most mothers did not initiate breastfeeding within the first hour after birth. Sociodemographic factors were associated with EIBF. A program to promote, protect, and support EIBF is urgently needed the community.

Keywords: breastfeeding, early initiation, neonates, morbidity, mortality, sub-Saharan Africa

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Authors: Zahra Zamanian, Alireza Zamanian, Jafar Hasanzadeh

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Background: Unwanted sound, as one of the most important physical factors in the majority of production units, imposes a great number of problems on the industrial workers. Sound is one of the environmental factors which can cause physical as well as psychological damages and also affects the individuals’ performance and productivity. Therefore, the present study aimed to determine the effect of noise exposure on human performance. Methods: The present study assessed the effect of noise on the performance of 50 students of Shiraz University of Medical Sciences (25 males and 25 females) at the sound pressures of 70, 90, and 110 dB by using two factors of physical features and the creation of different conditions of sound pressure source as well as applying Two-Arm coordination Test. Results: The results of the present study revealed no significant difference between male and female subjects as well as different conditions of creating sound pressure regarding the length of performance (p> 0.05). In addition, as the sound pressure increased, the length of performance increased, as well. According to the results, no significant difference was found between the performance at 70 and 90 dB. On the other hand, the performance at 110 dB was significantly different from the performance at 70 and 90 dB (p<0.05 and p<0.001). Conclusion: In general, as the sound pressure increases, the performance decreases which results in a considerable increase in the individuals’ rate of error.

Keywords: physical factors, two-arm coordination test, Shiraz University of Medical Sciences, noise

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Authors: Yafa Haron, Hanna Adami

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Background: World Health Organization emphasizes the contribution of nurses in planning and implementing health policies and reforms. Aim: To evaluate nursing students’ attitudes towards nurses’ involvement in health policy issues. Methods: Mixed-methods; qualitative and quantitative – a descriptive study. Participants - nursing students who were enrolled in their last year in the undergraduate program (BSN). Qualitative data included two open-ended questions: What is health policy and what is the importance of studying health policy, and 18 statements on the Likert Scale range 1-5. Results: Qualitativeanalysisrevealed that the majority of students defined health policy as a set of rules and regulations that defined procedures, borders, and proper conduct. 73% of students responded that nurses should be active in policymaking, but only 22% thought that nurses were currently involved in political issues. 28% thought that nurses do not have the knowledge and the time needed (60%) for political activity. 77% thought that the work environment did not encourage nurses to be politically active. Nursing students are aware of the importance towards nurses’ involvement in health policy issues, however, they do not have role models based on their low evaluation regarding nurses’ involvement in the health policy decision making process at the local or national level. Conclusions: Results emphasize the importance and the need of implementation the recommendation to include “advance policy changes” as core competency in nursing education and practice.

Keywords: health policy, nursing education, health systems, student perceptions

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Authors: Saad Khalid Niaz, Arif Mahmood Siddiqui, Afzal Haqi

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Background: Estimated prevalence of Hepatitis C in Pakistan is 5% of which 78 % are Genotype 3, in which Response to conventional interferon is reported to be 70%. Objective: To determine the efficacy of pegylated interferon 20 kDa (Unipeg) plus ribavirin (Ribazole) in HCV genotype 3 patients who relapsed to conventional interferon. Methods: This is an ongoing study of 20 enrolled patients. Pegylated interferon alfa-2a 20 kDa 180 mcg weekly with ribavirin, were administered for a period of 24 weeks. Virological Responses were measured by Qualitative HCV RNA at weeks 4, 12, 24 and 48 to determine Rapid Virological Response (RVR), Early Virological Response (EVR), End of Treatment (ETR) and Sustained Virological Response (SVR), respectively. EVR was done for those who didn’t achieve RVR. Results: Males were 12 (60%) and mean age was 38.5 ±7.62 years. Out of 20 recruited patients, all completed 4 weeks therapy; RVR was achieved in 8 (40%) patients. One patient was lost to follow up and one yet to visit at 12 weeks. From 10 patients, 8 (80%) patients achieved EVR. Out of intent-to-treat patients, 15 completed 24 weeks therapy, ETR was achieved in 14 (93%) patients and 9 patients completed post therapy follow-up, of which, 8 (89%) patients achieved SVR. Conclusion: Our interim data demonstrates that Pegylated Interferon alfa-2a 20 kDa 180 mcg (Unipeg) in combination with Ribavirin (Ribazole) has shown promising results in treating HCV Genotype 3 patients who relapsed to conventional interferon. We recommend use of Pegylated Interferon in Relapsers with Genotype 3 when financial constraints limit the use of oral antivirals.

Keywords: pegylated interferon (unipeg), hepatitis c, relapsers, Pakistan

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Authors: Neeraj Malhotra

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Background: Bioreactors in tissue engineering are used as devices that apply mechanical means to influence biological processes. They are commonly employed for stem cell culturing, growth and expansion as well as in 3D tissue culture. Contemporarily there use is well established and is tested extensively in the medical sciences, for tissue-regeneration and tissue engineering of organs like bone, cartilage, blood vessels, skin grafts, cardiac muscle etc. Methodology: Literature search, both electronic and hand search, was done using the following MeSH and keywords: bioreactors, bioreactors and dentistry, bioreactors & dental tissue engineering, bioreactors and regenerative dentistry. Articles published only in English language were included for review. Results: Bioreactors like, spinner flask-, rotating wall-, flow perfusion-, and micro-bioreactors and in-vivo bioreactor have been employed and tested for the regeneration of dental and like-tissues. These include gingival tissue, periodontal ligament, alveolar bone, mucosa, cementum and blood vessels. Based on their working dynamics they can be customized in future for regeneration of pulp tissue and whole tooth regeneration. Apart from this, they have been successfully used in testing the clinical efficacy and biological safety of dental biomaterials. Conclusion: Bioreactors have potential use in testing dental biomaterials and tissue engineering approaches aimed at regenerative dentistry.

Keywords: bioreactors, biological process, mechanical stimulation, regenerative dentistry, stem cells

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Authors: Tiffany Gallagher, Sheila Bennett

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Based on data from a larger study, this research is based in a small school district in Ontario, Canada, that has made a transition from self-contained classes for students with exceptionalities to inclusive classroom placements for all students with their age-appropriate peers. The school board aided this transition by hiring Inclusion Coaches with a background in special education to work alongside teachers as partners and inform their inclusive practice. Based on qualitative data from four focus groups conducted with Inclusion Coaches, as well as four blog-style reflections collected at various points over two years, six principles of inclusive practice were identified for coaches. The six principles form a model during transition: pre-requisite, process, precipice, promotion, proof, and promise. These principles are encapsulated in a visual model of a spiraling staircase displaying the conditions that exist prior to coaching, during coaching interactions and considerations for the sustainability of coaching. These six principles are re-iterative and should be re-visited each time a coaching interaction is initiated. Exploring inclusion coaching as a model emulates coaching in other contexts and allows us to examine an established process through a new lens. This research becomes increasingly important as more school boards transition toward inclusive classrooms, The Six ‘P’ Model: Principles of Inclusive Practice for Inclusion Coaches allows for a unique look into a scaffolding model of building educator capacity in an inclusive setting.

Keywords: capacity building, coaching, inclusion, special education

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Authors: Guenther Schuh, Christina Koenig, Nico Schoen, Markus Wellensiek

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Identification and selection of appropriate product and manufacturing technologies are key factors for competitiveness and market success of technology-based companies. Therefore many companies perform technology intelligence (TI) activities to ensure the identification of evolving technologies at the right time. Technology monitoring is one of the three base activities of TI, besides scanning and scouting. As the technological progress is accelerating, more and more technologies are being developed. Against the background of limited resources it is therefore necessary to focus TI activities. In this paper, we propose a concept for defining appropriate search fields for technology monitoring. This limitation of search space leads to more concentrated monitoring activities. The concept will be introduced and demonstrated through an anonymized case study conducted within an industry project at the Fraunhofer Institute for Production Technology. The described concept provides a customized monitoring approach, which is suitable for use in technology-oriented companies especially those that have not yet defined an explicit technology strategy. It is shown in this paper that the definition of search fields and search tasks are suitable methods to define topics of interest and thus to direct monitoring activities. Current as well as planned product, production and material technologies as well as existing skills, capabilities and resources form the basis of the described derivation of relevant search areas. To further improve the concept of technology monitoring the proposed concept should be extended during future research e.g. by the definition of relevant monitoring parameters.

Keywords: monitoring radar, search field, technology intelligence, technology monitoring

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Authors: Mohammad Javad Behzadnia, Hamidreza Javadzadeh

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Background: Pain management is essential to surmounting multi-injured people in an overcrowded emergency setting. Its role would be more apparent when the physician encounters a mass casualty in a war zone or even a military prehospital. Having sedative and analgesic properties, rapid onset and offset effects, and maintaining the cardiovascular and respiratory contain are the main reason for selecting Ketamine as a good choice in the war zone. Methods: In a prospective interventional study in a war zone, we have selected and followed two groups of casualties for pain management. All were men with an average age of 26.6±8 y/o and 27.5 ±7 y/o in A and B groups, respectively. Group A received only Ketamine and Group B received Ketamine and diazepam. Results: This study showed that all of the injured patients who received Ketamine had experienced some agitation, and they may finally need benzodiazepines for sedation, but in group B that received benzodiazepine before or simultaneous with Ketamine, the agitation was significantly reduced. (P Value ≤0.05) Conclusion: Various factors may affect pain score and perception; patients' culture, mental health, previous drug usage, and addiction could alter the pain score in similar situations. It seems that the significant agitation is due to catecholamine release in stressful Moments of the battlefield. Accordingly, this situation could be exacerbated due to ketamine properties. Nonetheless, as a good choice in the war zone, Ketamine is now recommended to combine with benzodiazepines for procedural sedation and analgesia (PSA).

Keywords: battlefield, ketamine, benzodiazepine, pain control

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Authors: Kaili Wang, Botao Zhang, Enming Zhang

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Background: Low back pain (LBP) is a common problem affecting athletes' training and competition. Although the association between a limited hip range of motion and prevalence of low back pain has been studied extensively, it has not been studied in table tennis. Aim: The main purposes of this study in table tennis players were (1) to investigate if there is a difference in hip internal rotation (HIR) and external rotation (HER) range of motion (ROM) between players with LBP and players without LBP and (2) to analyze the association between HIR and HER ROM and LBP. Methods: Forty-six table tennis players from the Chinese table tennis team were evaluated for passive maximum HIR and HER ROM. LBP was retrospectively recorded for the last 12 months before the date of ROM assessment by a physical therapist. The data were analyzed the difference in HIR and HER ROM between players with LBP and players without LBP by Mann-Whitney U test, and the association between the difference in HIR and HER ROM and LBP was analyzed via a binary logistic regression. Results: The 54% of players had developed LBP during the retrospective study period. Significant difference between LBP group and the asymptomatic group for HIR ROM (z=4.007, p<0.001) was observed. Difference between LBP group and asymptomatic group for HER ROM (z=1.117, p=0.264) was not significant. Players who had HIR ROM deficit had an increased risk of LBP compared with players without HIR ROM deficit (OR=5.344, 95%CI: 1.006-28.395, P=0.049). Conclusion: HIR ROM of a table tennis player with LBP was less than a table tennis player without LBP. Compared with player whose HIR ROM was normal, player who had HIR ROM deficit appeared to have a higher risk for LBP.

Keywords: assessment, injury prevention, low back pain, table tennis players

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Authors: Zakieh Rostamzadeh , Nariman Sepehrvand-Zahra Shirmohamadi

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Background: Cytomegalovirus (CMV) infection is one of the most common infectious problems following kidney transplantation. In this study, we are aimed to investigate the CMV infection in the setting of renal transplant recipients in Urmia-Iran, using both ELISA and polymerase chain reaction (PCR) methods. Methods: Ninety-six renal transplant recipients were selected randomly and enrolled in a cross-sectional study. Blood sampling was done via venipuncture, and all sera were investigated for anti-CMV IgM, and the seropositive cases in association with 14 randomly selected seronegative cases were investigated with PCR assay. Results: Thirty-three patients (34.3%) were seropositive for anti-CMV IgM, 3 patients (3.1%) were in borderline range, and 60 patients (62.5%) were seronegative. By considering the patients with borderline anti-CMV IgM levels as seropositive, 37.5% were seropositive for anti-CMV IgM. Among 36 seropositive cases, the CMV infection was confirmed in 19 (52.7%) of them using PCR. Age (P = 0.40), educational status (P = 0.77), history of pre-transplantation dialysis (0.52), history of blood transfusion (P = 0.52), and immunosuppressive regimen were not statistically different among recipients with positive versus negative CMV PCR study results. Conclusion: The seroprevalence of CMV infection was demonstrated to be high in renal transplant recipients of Urmia-Iran. The rate was higher compared to several previous reports in the literature. ELISA method has an appropriate sensitivity to screen the recipients for CMV infection but considering its relatively low specificity, the seropositive cases are better to be confirmed by further PCR study.

Keywords: cytomegalovirus, renal transplantation, ELISA, IgM, PCR

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Authors: Klaudia Tomala, Elzbieta Grochowska-Niedworok, Katarzyna Brukalo, Marek Kardas, Beata Calyniuk, Renata Polaniak

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Background. Nutrition plays an important role in the psychophysical growth of children and has effects on their health. Providing children with the appropriate supply of macro- and micro-nutrients requires dietary diversity across every food group. Meals in kindergartens should provide 70-75% of their daily food requirement. Aim. The aim of this study was to determine the vitamin content in the food rations of children attending kindergarten in the wider aspect of nutritional status. Material and Methods. Kindergarten menus from the spring and autumn seasons of 2015 were analyzed. In these meals, fat content and levels of water-soluble vitamins were estimated. The vitamin content was evaluated using the diet calculator “Aliant”. Statistical analysis was done in MS Office Excel 2007. Results. Vitamin content in the analyzed menus in many cases is too high with reference to dietary intake, with only vitamin D intake being insufficient. Vitamin E intake was closest to the dietary reference intake. Conclusion. The results show that vitamin intake is usually too high, and menus should, therefore, be modified. Also, nutrition education among kindergarten staff is needed. The identified errors in the composition of meals will affect the nutritional status of children and their proper composition in the body.

Keywords: children, nutrition status, vitamins, preschool

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Authors: S. Öcal, A. Erakgün, E. Yüksel, M. N. Deniz, E. Erhan, A. Çertuğ

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Background: Emergence agitation (EA) is defined as a dissociated state of consciousness during the early post-anesthesia period in which the child is inconsolable, irritable, uncompromising or uncooperative, typically thrashing, crying, moaning, or incoherent, and not recognizing or identifying familiar and known objects or people. Some studies found preoperative parental anxiety to be a predictor of EA. Methods: Seventy-four children, between the ages of 3-12 undergoing adenoidectomy/tonsillectomy at Ege University Hospital, were studied. Anesthesia was induced and maintained using 2% sevoflurane in 50% oxygen and 50% air following a premedicative dose of 0.5mg/kg oral midazolam. After the children were taken into the operating theater, the mothers were given the State-Trait Anxiety Inventory (STAI) questionnaire. To evaluate EA, Post Anesthetic Emergence Delirium (PAED) score of the children were noted every 10min during the first 30min of the postoperative period. EA was defined with a highest PAED score of ≥ 10, and non-EA with a highest PAED score of ≤ 9. Results: In this study, the incidence of postoperative EA was 31% (34% under the age of 6 and 19% over). Mothers of children with EA were found not to be significantly more anxious on STAI compared to mothers of non-EA children. Conclusions: Contrary to some earlier studies, we were unable to find an association between preoperative parental anxiety and postoperative EA.

Keywords: parental anxiety, emergence agittion, Post Anesthetic Emergence Delirium, anesthesia

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Authors: Bashar Al-Sabti, Jehad Harbali

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Background: Pyridine is a reactive base that might be used in preparing sitagliptin. International Agency for Research on Cancer classifies pyridine in group 2B; this classification means that pyridine is possibly carcinogenic to humans. Therefore, pyridine should be monitored at the allowed limit in sitagliptin pharmaceutical ingredients. Objective: The aim of this study was to develop a novel ultra high performance liquid chromatography mass spectrometry (UHPLC-MS) method to estimate the quantity of pyridine impurity in sitagliptin pharmaceutical ingredients. Methods: The separation was performed on C8 shim-pack (150 mm X 4.6 mm, 5 µm) in reversed phase mode using a mobile phase of water-methanol-acetonitrile containing 4 mM ammonium acetate in gradient mode. Pyridine was detected by mass spectrometer using selected ionization monitoring mode at m/z = 80. The flow rate of the method was 0.75 mL/min. Results: The method showed excellent sensitivity with a quantitation limit of 1.5 ppm of pyridine relative to sitagliptin. The linearity of the method was excellent at the range of 1.5-22.5 ppm with a correlation coefficient of 0.9996. Recoveries values were between 93.59-103.55%. Conclusions: The results showed good linearity, precision, accuracy, sensitivity, selectivity, and robustness. The studied method was applied to test three batches of sitagliptin raw materials. Highlights: This method is useful for monitoring pyridine in sitagliptin during its synthesis and testing sitagliptin raw materials before using them in the production of pharmaceutical products.

Keywords: genotoxic impurity, pyridine, sitagliptin, UHPLC -MS

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Authors: Priyanka Kalra

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Background: Complementary and alternative medicine (CAM) includes various practices like Ayurveda, Yoga & Meditation Acupressure Acupuncture and Reiki. These practices are frequently used by patients with spinal cord injury (SCI). They have shown effectiveness in the management of pain and stress consequently improving overall quality of life post injury. Objective: The goals of the present case series were to evaluate the feasibility of 1) Using of Ayurvedic herbal oil massages in shoulder pain management, 2) Using yoga & meditation on managing the stress in spinal cord injury. Methodology: 15 SCI cases with muscular pain around shoulder were treated with Ayurvedic herbal oil massage for 10 days in CAM Department. Each session consisted of 30 min oil massage followed by 10 min hot towel fomentation. The patients continued regular therapy medications along with CAM. Another 15 SCI cases were treated with yoga and meditation for 15 days 30 min yoga (20 min Asana+ 10 min Pranayam + 15 min Meditation) in isolated yoga room of CAM department. Results: On the VAS scale the patients reported a reduction in their pain score by 70 %. On the PSS scale, the patients reported a reduction in their stress score by 80 %. Conclusion: These case series may encourage more people to explore CAM therapies.

Keywords: spinal cord injury, Ayurveda, complementary and alternative medicine, yoga, meditation

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Authors: Olusegun Akinsiku, Olukayode Oyediran, Koleola Odusami

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A construction project is usually made up of a variety of stakeholders whose interests may positively or negatively impact on the outcome of the project execution. The variability of project stakeholders is apparent in their cultural differences, professional background and ethics, and differences in ideas. The need for the effectiveness of construction teams has been investigated as this is an important aspect to meeting client’s expectations in the construction industry. This study adopts a cross-sectional descriptive survey with the purpose of identifying the critical success factors (CSFs) associated with the team effectiveness of construction projects stakeholders, their relationship and the effects on construction project performance. The instrument for data collection was a designed questionnaire which was administered to construction professionals in the construction industry in Lagos State, Nigeria using proportionate stratified sampling. The highest ranked identified CSFs include “team trust”, “esprit de corps among members” and “team cohesiveness”. Using factor analysis and considering the effects of team cohesiveness on project performance, the identified CSFs were categorized into three groups namely cognitive attributes, behavior and processes attributes and affective attributes. All the three groups were observed to have a strong correlation with project performance. The findings of this study are useful in helping construction stakeholders benchmark the team effectiveness factors that will guarantee project success.

Keywords: construction, critical success factors, performance, stakeholders, team effectiveness

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Authors: Eser Bingül

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The leadership and leaders, also having been a privileged subject of scientific researches in the last century, have become influential in shaping the destiny of the states since the first examples of the warfare history. The issue of leadership, finding a place in the management science, can also be defined as an integration of function within the aspect of leader. In this description, the relationship has come to the foreground which is established between the development of leadership theories and the elements of function which are leader, followers, and condition. While one reason of this analysis in leadership is to keep a lens to the historical background, the main reason has been a questioning the traits and education of leaders who have still affected the nation’s and organization’s fate. The links and analysis established in the definition of leadership have put forward the necessity of solving the unpredictable structure of human nature and behaviors in the focus of leadership approach. On the other hand becoming a model that meets the today’s needs of any system has given a clue that the leaders should turn towards the people. Being aware of this necessity, human-oriented leadership approach aims to gain both followers and their abilities to the system with giving them a deserved esteem and create the team spirit based on mutual trust. Ultimately this approach, with the determined leadership qualities consisting of charisma, ability of communication and trust, will be able to produce the solutions to the instant and long-term problems and uncertainties, derived from the variables of function, for the sake of systems.

Keywords: human nature, leadership, human-oriented approach, social sciences and humanities

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Authors: Edmund Kwablah, Anthony Amoah

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The merits associated with Foreign Direct Investment (FDI) inflows to host countries in Sub-Saharan Africa cannot be overemphasized. Against this background, countries have sought to design and implement strategic policies geared towards enhacing FDI and promoting economic growth. In this study, we used the Fully Modified Ordinary Least Squares technique and a panel data for Sub-Saharan African (SSA) countries spanning from 1998 to 2016. We hypothesize that FDI’s effect on economic growth is contingent on some absorptive capacities (e.g., financial market development and economic freedom) of the host country. We used financial market data that accounts for market fragility as a measure of financial market development and economic freedom data which uses the overall score of all the freedom indicators as a measure of economic freedom. Our results suggest that FDI has a statistically positive effect on economic growth when we account for host country’s absorptive capacities. However, a negative relationship will ensue if these absorptive capacities are not accounted for. We recommend that a developing continent like SSA should focus on identifying and building the relevant absorptive capacities that can translate the effect of FDI into a positive growth. This is because an economy with sound absorptive capacities reduces business risk and spur economic growth.

Keywords: FDI, absorptive capacity, economic growth, FMOLS, Fully Modified Ordinary Least Squares, SSA

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Authors: Philippa Sambevski

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Breast cancer is the most common cancer diagnosed in Australian women. The incidence of breast cancer for Aboriginal and Torres Strait Islander (ATSI) women is lower than for non-indigenous women. However, the mortality rate for ATSI women is higher. The participation rate of ATSI women in BreastScreen Australia is below the general population. In this thematic literature review, the author collates viable strategies to increase breast screening rates among culturally and linguistically diverse individuals and provide culturally competent care. Barriers to accessing BreastScreen for ATSI women include language or communication limits, isolation, and a lack of culturally sensitive information. Culturally competent strategies require healthcare workers with an appropriate cultural and social background, clear messages, and the embedding of cultural respect within healthcare organisations. Cultural safety is determined by partnering with local indigenous groups, recognising the consumer experience, and allowing people to raise their concerns. The corresponding academic poster identifies strategies for healthcare workers to provide culturally competent care in a BreastScreen setting.

Keywords: breast screen, closing the gap, Australia, cultural safety, Aboriginal and Torres Strait Islander

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Authors: P. K. Raheemudheen, Vibha Sharma, C. B. Tripathi

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Background and Aim: Intimate relationships are one of the major sources of unhappiness for emerging adults(18-25 years) and the extent of worry from it is higher for them as compared to older adults. This increases their vulnerability to develop anxiety and depression. Current academic literature have highlighted adult attachment have a crucial role in determining the psycho social adjustment and psychopathology in Emerging Adulthood. In this context, present study is an attempt to explore patterns of adult attachment styles, availability of attachment figures and dimensions of intimate relationship among emerging adults. Method: The participants(n=30) were emerging adults diagnosed with anxiety or/and depression seeking treatment from IHBAS, Delhi. Relationship Style Questionnaire was used to assess the adult attachment styles and Multidimensional Relationship Questionnaire was used to assess dimensions of intimate relationship. Results& Discussion: Results showed that majority of the participants have insecure attachment styles. They perceived their attachment figure as insensitive and unavailable. Further, it was found that participants experience multiple difficulties to establish and maintain healthy intimate relationships. These findings highlight Adult attachment insecurities seem to contribute to anxiety and depression among emerging adults. It proved a conceptual foundation for planning interventions to deal with these attachment based correlate of anxiety and depression which may be more amenable to therapeutic change.

Keywords: emerging adult, adult attachment, intimate relationship, anxiety

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Authors: Aremu Abdulmujeeb Babatunde

Abstract:

Background: Low back pain was not only considered to be the most common reason for functional disability worldwide, but also estimated to have affected 90% of the universal population. This study aimed at determining the prevalence, consequences and socio-demographic factors associated with low back pain. Methods; A cross-sectional survey was employed and a total number of 150 self-structured questionnaire was distributed among healthcare workers and this was used to determine the prevalence of low back pain and work related absenteeism. Data was entered using Epi info soft-ware and analyzed using SPSS. Results; An overall response rate of 84% (n = 140) was achieved. The study established that majority (37%) of the respondents were in the age bracket of 20-39 years, 57% female (n=59) and 64% of them were married. the pint prevalence was 84%, 31% of the respondents took leave from work as a result of low back pain. There was high prevalence of sick leave among nursing staff 45.2%, Chi-square test shows that there was a statistically significant association between the respondents occupations and daily time spent during their work (P value 0.011 and 0.042) respectively. Socio-demographic factors like age, marital status and gender were not statistically significant at P<0.05. Conclusions; The medical and socio-professional consequences of low back pain among healthcare workers was as a result of their occupation designations and the daily time spent in carry out this occupations.

Keywords: low back pain, healthcare workers, prevalence, sick leave

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Authors: Zohreh Rostami, Arezoo Khosravi, Mohammad Nikpoor Aghdam, Mahmood Salesi

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Background: Cardiovascular mortality in chronic kidney disease (CKD) and end stage renal disease (ESRD) patients have a strong relationship with baseline or progressive left ventricular hypertrophy (LVH) meanwhile in hemodialysis patients 10% decrement in left ventricular mass was associated with 28% reduction in cardiovascular mortality risk. In consonance with these arguments, we designed a study to measure morphological and functional echocardiographic variations early after transplantation. Method: The patients with normal renal function underwent two advanced echocardiographic studies to examine the structural and functional changes in left ventricular mass before and 3-month after transplantation. Results: From a total of 23 participants 21(91.3%) presented with left ventricular hypertrophy, 60.9% in eccentric and 30.4% in concentric group. Diastolic dysfunction improved in concentric group after transplantation. Both in pre and post transplantation global longitudinal strain (GLS)- average in eccentric group was more than concentric (-17.45 ± 2.75 vs -14.3 ± 3.38 p=0.03) and (-18.08 ± 2.6 vs -16.1 ± 2.7 p= 0.04) respectively. Conclusion: Improvement and recovery of left ventricular function in concentric group was better and sooner than eccentric after kidney transplantation. Although fractional shortening and diastolic function and GLS-4C in pre-transplantation in concentric group was worse than eccentric, but therapeutic response to kidney transplantation in concentric was more and earlier than eccentric group.

Keywords: chronic kidney disease, end stage renal disease, left ventricular hypertrophy, global longitudinal strain

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Authors: Amjed Rasheed

Abstract:

Rebellions are driven by several incentives. They do not often occur because of historical grievances or political exclusion. They can be driven by the desire to control over natural resources, or by both. In the case of the Islamic State (ISIL), greed and grievance are both drive this radical group to operate in Iraq and Syria. This article aims to show that grievance was the trigger to the emergence of ISIL. It also aims to demonstrate that ISIL is using oil as a tool, to implements its political ends, than a purpose per se. In other words, the emergence of ISIL is based on socio-political conditions, which are domestically driven, and oil is not ISIL’s aim but a source of revenue to finance its activities. This paper applies conflict analysis methodology to analyse the conflict in Iraq and Syria, with a specific highlight to ISIL. By doing so, it gives ahistorical background on emergence of ISIL. It also provides an insightful explanation on the main dynamics and the tactics this organisation applies. It also delivers a sufficient explanation on how it recruits its members, both local and international. It concludes that tackling ISIL needs a more sophisticated approach than the one Obama administration has adopted. It is more a political issue to be tackled by political means, than a military one to be tackled by military means. The current war is an Intra-Sunni war, and therefore, Sunni states have to be on board to crackdown ISIL. Besides, the article finishes with the argument that democratisation is not necessarily the key answer to bring stability to the region, but a sort of governance that provides security and material needs to individuals.

Keywords: ISIL, Iraq, domestic politics, Islamic radicalisation

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Authors: Hyuk-Hoon Kim, Young Gi Min

Abstract:

Background: Acute poisoning is the common cause of morbidity and mortality. Characteristics of acute poisoning differ between countries. While other countries operate the database system for poisoning, Korea has not collected the database for acute poisoning. Distribution of incidence of acute poisoning depending on the types of materials have also not studied in Korea. Our aims are to evaluate the etiologic and demographic characteristics of acute poisoning cases and to obtain up-to-date information on acute poisonings. Method: We retrospectively recorded cases of acute poisoning from eight emergency departments of second level or university hospitals from different cities in Gyeonggi province in Korea from April 2006 and March 2015. The distributions of incidence of acute poisoning depending on the types of materials are mapped by geographic information system. Result: A total of 3,449 poisoned cases were analyzed. Mean estimated age of patients was 39.56 ± 22.40 years. Mean male to female ratio of patients was 1:1.4. Mean proportion of intentional poisoning was 57.9%. Common materials are benzodiazepine (16.6%), carbon monoxide (10.5%), pesticide (8.1%) and zolpidem (7.1%) Common route of exposure is ingestion (79.5%) and followed by inhalation (16.5%). Common treatment methods are gastric lavage (20%) and activated charcoal (30%). Most cases had uneventful recovery; 61.4% were treated as outpatients and 0.1% of the poisoning resulted in death in ER. Conclusion: Even though the cases enrolled in our study is not the overall cases of acute poisoning in Korea, our study could be the basis of countermeasures for analysis and prevention of acute poisoning in Korea.

Keywords: acute poisoning, emergency department, epidemiology, Korea

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