Search results for: Plug Setting Multiplier (PSM)
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2098

Search results for: Plug Setting Multiplier (PSM)

748 Indoor Air Pollution Effects on Physical Growth of Children under 5 Years from Solid Fuel Combustion

Authors: Nayomi Ranathunga, Priyantha Perera, Sumal Nandasena, Nalini Sathiakumar, Anuradhini Kasthuriratne, Rajitha Wikremasinghe

Abstract:

Solid fuel combustion is an important source of indoor air pollution (IAP) in developing countries that has adverse health impacts particularly in children. This study was conducted to determine the effect of IAP due to solid fuel combustion on physical growth of children under five in a Sri Lankan setting. A prospective study was conducted in a mixed population comprising urban and semi urban residents. The study included 240 children under 5 who were permanent residents of the area. Physical growth was assessed by measuring anthropometric indices based on the World Health Organization (WHO) guidelines and standards. Exposure levels were defined according to the main type of fuel used for cooking at home: children residing in households using biomass fuel or kerosene as the main type of fuel for cooking were classified as the “high exposure” group and children resident in households using liquefied petroleum gas (LPG) or electricity for cooking were classified as the “low exposure” group. Sixty percent of the children were classified as from the “high” exposure group and 40% of the children were classified as from the “low” exposure group; 54% of the children were male. At baseline, the prevalence of wasting was 17.1% and the prevalence of stunting was 10.4%; the mean z-score for weight for height was - 0.85, weight for age was - 0.46 and height for age was -0.38. At baseline, children from the “high” exposure group had a significantly lower mean weight for height z-score (p=0.02) and a mean height for age z-score (p=0.001) as compared to children from the “low” exposure group after adjusting for confounding factors such as father’s education, mother’s education and family income. Poor maternal education was significantly associated with lower height for age z-scores (p=0.04) after adjusting for exposure status. IAP due to combustion of biomass fuel leads to chronic malnutrition.

Keywords: children, growth, indoor air pollution, solid fuel

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747 A Comparative Legal Enquiry on the Concept of Invention

Authors: Giovanna Carugno

Abstract:

The concept of invention is rarely scrutinized by legal scholars since it is a slippery one, full of nuances and difficult to be defined. When does an idea become relevant for the patent law? When is it simply possible to talk of what an invention is? It is the first question to be answered to obtain a patent, but it is sometimes neglected by treaties or reduced to very simple and automatically re-cited definitions. Maybe, also because it is more a transnational and cultural concept than a mere institution of law. Tautology is used to avoid the challenge (in the United States patent regulation, the inventor is the one who contributed to have a patentable invention); in other case, a clear definition is surprisingly not even provided (see, e.g., the European Patent Convention). In Europe, the issue is still more complicated because there are several different solutions elaborate inorganically be national systems of courts varying one to the other only with the aim of solving different IP cases. Also a neighbor domain, like copyright law, is not assisting us in the research, since an author in this field is entitles to be the 'inventor' or the 'author' and to protect as far as he produces something new. Novelty is not enough in patent law. A simple distinction between mere improvement that can be achieved by a man skilled in the art (a sort of reasonable man, in other sectors) or a change that is not obvious rising to the dignity of protection seems not going too far. It is not still defining this concept; it is rigid and not fruitful. So, setting aside for the moment the issue related to the definition of the invention/inventor, our proposal is to scrutinize the possible self-sufficiency of a system in which the inventor or the improver should be awarded of royalties or similar compensation according to the economic improvement he was able to bring. The law, in this case, is in the penumbras of misleading concepts, divided between facts that are obscure and technical, and not involving necessarily legal issues. The aim of this paper is to find out a single definition (or, at least, the minimum elements common in the different legal systems) of what is (legally) an invention and what can be the hints to practically identify an authentic invention. In conclusion, it will propose an alternative system in which the invention is not considered anymore and the only thing that matters are the revenues generated by technological improvement, caused by the worker's activity.

Keywords: comparative law, intellectual property, invention, patents

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746 Reduction of Transient Receptor Potential Vanilloid 1 for Chronic Pain and Depression Co-Morbidity through Electroacupuncture and Gene Deletion in Mice Brain

Authors: Bernice Lottering, Yi-Wen Lin

Abstract:

Chronic pain and depression have an estimated 80% rate of comorbidity with unsatisfactory treatment interventions signifying the importance of developing effective therapeutic interventions for a serious chronic condition affecting a large majority of the global population. Chronic pain is defined as persistent pain presenting for over 3 months. This disease state increases the risk of developing depression in comparison to healthy individuals. In the current study, complete Freund’s adjuvant (CFA) was used to induce cell-mediated chronic inflammatory pain in a murine model. Significant mechanical and thermal hyperalgesia was induced, alongside observable depression-like behaviors. These conditions were attenuated through the use of electroacupuncture (EA). Similarly, these effects were also investigated with respect to the transient receptor potential vanilloid 1 (TRPV1), by analyzing the effects of TRPV1 gene deletion on the comorbidity of chronic pain and depression. The expression of the TRPV1 inflammatory response, and related downstream molecules, including protein kinases (PKs), mitogen-activated protein kinase (MAPKs), and transcriptional factors, were significantly reduced in the thalamus, prefrontal cortex (PFC), hippocampus, and periaqueductal gray (PAG) of CFA-treated mice. In addition, phosphorylated N-methyl-D-aspartate (NMDA) receptor 1 was also found to be reduced in the aforementioned areas, suggesting potential application and validity in a clinical setting. Our study determined the prospective therapeutic effects of EA in the treatment of chronic inflammatory pain and depression comorbidity and provides a novel and detailed mechanism underlying EA-mediated analgesia. These findings may be relevant in the utilization of clinical intervention approaches related to chronic pain and depression comorbidity.

Keywords: chronic pain, depression, NMDA, prefrontal cortex, TRPV1

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745 Effects of Tenefovir Disiproxil Fumarate on the Renal Sufficiency of HIV Positive Patients

Authors: Londeka Ntuli, Frasia Oosthuizen

Abstract:

Background: Tenefovir disiproxil fumarate (TDF) is a nephrotoxic drug and has been proven to contribute to renal insufficiency necessitating intensive monitoring and management of adverse effects arising from prolonged exposure to the drug. TDF is one of the preferred first-line drugs used in combination therapy in most regions. There are estimated 300 000 patients being initiated on the Efavirenz/TDF/Emtricitabine first-line regimen annually in South Africa. It is against this background that this study aims to investigate the effects of TDF on renal sufficiency of HIV positive patients. Methodology: A retrospective quantitative study was conducted, analysing clinical charts of HIV positive patient’s older than 18 years of age and on a TDF-containing regimen for more than 1 year. Data were obtained from the analysis of patient files and was transcribed into Microsoft® Excel® spreadsheet. Extracted data were coded, categorised and analysed using STATA®. Results: A total of 275 patient files were included in this study. Renal function started decreasing after 3 months of treatment (with 93.5% patients having a normal EGFR), and kept on decreasing as time progressed with only 39.6% normal renal function at year 4. Additional risk factors for renal insufficiency included age below 25, female gender, and additional medication. Conclusion: It is clear from this study that the use of TDF necessitates intensive monitoring and management of adverse effects arising from prolonged exposure to the drug. The findings from this study generated pertinent information on the safety profile of the drug TDF in a resource-limited setting of a public health institution. The appropriate management is of tremendous importance in the South African context where the majority of HIV positive individuals are on the TDF containing regimen; thus it is beneficial to ascertain the possible level of toxicities these patients may be experiencing.

Keywords: renal insufficiency, tenefovir, HIV, risk factors

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744 Mental Contrasting with Implementation Intentions: A Metacognitive Strategy on Educational Context

Authors: Paula Paulino, Alzira Matias, Ana Margarida Veiga Simão

Abstract:

Self-regulated learning (SRL) directs students in analyzing proposed tasks, setting goals and designing plans to achieve those goals. The literature has suggested a metacognitive strategy for goal attainment known as Mental Contrasting with Implementation Intentions (MCII). This strategy involves Mental Contrasting (MC), in which a significant goal and an obstacle are identified, and Implementation Intentions (II), in which an "if... then…" plan is conceived and operationalized to overcome that obstacle. The present study proposes to assess the MCII process and whether it promotes students’ commitment towards learning goals during school tasks in sciences subjects. In this investigation, we intended to study the MCII strategy in a systemic context of the classroom. Fifty-six students from middle school and secondary education attending a public school in Lisbon (Portugal) participated in the study. The MCII strategy was explicitly taught in a procedure that included metacognitive modeling, guided practice and autonomous practice of strategy. A mental contrast between a goal they wanted to achieve and a possible obstacle to achieving that desire was instructed, and then the formulation of plans in order to overcome the obstacle identified previously. The preliminary results suggest that the MCII metacognitive strategy, applied to the school context, leads to more sophisticated reflections, the promotion of learning goals and the elaboration of more complex and specific self-regulated plans. Further, students achieve better results on school tests and worksheets after strategy practice. This study presents important implications since the MCII has been related to improved outcomes and increased attendance. Additionally, MCII seems to be an innovative process that captures students’ efforts to learn and enhances self-efficacy beliefs during learning tasks.

Keywords: implementation intentions, learning goals, mental contrasting, metacognitive strategy, self-regulated learning

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743 Effect of Zidovudine on Hematological and Virologic Parameters among Female Sex Workers Receiving Antiretroviral Therapy (ART) in North-Western Nigeria

Authors: N. M. Sani, E. D. Jatau, O. S. Olonitola, M. Y. Gwarzo, P. Moodley, N. S. Mujahid

Abstract:

Haemoglobin (HB) indicates anaemia level and by extension may reflect the nutritional level and perhaps the immunity of an individual. Some antiretroviral drugs like zidovudine are known to cause anaemia in People living with HIV/AIDS (PLWHA). A cross-sectional study using demographic data and blood specimen from 218 female commercial sex workers attending antiretroviral therapy (ART) clinics was conducted between December 2009 and July 2011 to assess the effect of zidovudine on haematologic and RNA viral load of female sex workers receiving antiretroviral treatment in north-western Nigeria. Anaemia is a common and serious complication of both HIV infection and its treatment. In the setting of HIV infection, anaemia has been associated with decreased quality of life, functional status, and survival. Antiretroviral therapy, particularly the highly active antiretroviral therapy (HAART), has been associated with a decrease in the incidence and severity of anaemia in HIV-infected patients who have received a HAART regimen for at least 1 year. In this study, result has shown that out of 218 patients, 26 with haemoglobin count between 5.1–10 g/dl were observed to have the highest viral load count of 300,000–350,000 copies/ml. It was also observed that most patients (190) with HB of 10.1–15.0 g/dl had viral load count of 200,000–250,000 copies/ml. An inverse relationship therefore exists, i.e. the lower the haemoglobin level, the higher the viral load count, even though the test statistics did not show any significance between the two (P=0.206). This shows that multivariate logistic regression analysis demonstrated that anaemia was associated with a CD4+ cell count below 50/µL in female sex workers with a viral load above 100,000 copies/mL who use zidovudine. Severe anaemia was less prevalent in this study population than in historical comparators; however, mild to moderate anaemia rates remain high. The study, therefore, recommends that hematological and virologic parameters be monitored closely in patients receiving first line ART regimen.

Keywords: anaemia, female sex worker, haemoglobin, Zidovudine

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742 Exploring the Effectiveness of End-Of-Life Patient Decision Add in the ICU

Authors: Ru-Yu Lien, Shih-Hsin Hung, Shu-Fen Lu, Ju-Jen Shie, Wen-Ju Yang, Yuann-Meei Tzeng, Chien-Ying Wang

Abstract:

Background: The quality of care in intensive care units (ICUs) is crucial, especially for terminally ill patients. Shared decision-making (SDM) with families is essential to ensure appropriate care and reduce suffering. Aim: This study explores the effectiveness of an end-of-life decision support Patient Decision Aid (PDA) in an ICU setting. Methods: This study employed a cross-sectional research design conducted in an ICU from August 2020 to June 2023. Participants included family members of end-of-life patients aged 20 or older. A total of 319 participants. Family members of end-of-life patients received the PDA, and data were collected after they made medical decisions. Data collection involved providing family members with a PDA during family meetings. A post-PDA questionnaire with 17 questions assessed PDA effectiveness and anxiety levels. Statistical analysis was performed using SPSS 22.0. Results: The PDA significantly reduced anxiety levels among family members (p < 0.001). It helped them organize their thoughts, prepare for discussions with doctors, and understand critical decision factors. Most importantly, it influenced decision outcomes, with a shift towards palliative care and withdrawal of life-sustaining treatment. Conclusion: This study highlights the importance of family-centered end-of-life care in ICUs. PDAs promote informed decision-making, reduce conflicts, and enhance patient and family involvement. These tools align patient values and goals with medical recommendations, ultimately leading to decisions that prioritize comfort and quality of life. Implementing PDAs in healthcare systems can ensure that patients' care aligns with their values.

Keywords: shared decision-making, patient decision aid, end-of-life care, intensive care unit, family-centered care

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741 Indian Bankruptcy Code 2016: Impact On Cross-Border Insolvency, an Analysis

Authors: Astha Sinha, Anjali Kanagali

Abstract:

India has been tackling with less than sophisticated legislations when it comes to recovery of debt and bankruptcy situations for a while now. There were multiple overlapping laws and adjudication forums dealing with financial failures and insolvency of companies/individuals in India without really aiding the timely recover of defaulted assets. It remained dicey for businesses to invest in India since there was a lack of legal and institutional machinery for dealing with debt defaults as per the global standards. After much deliberation, the Indian Draft Insolvency code received the presidential assent on May 28, 2016 bringing the Bankruptcy and Insolvency Code, 2016 into existence. The Code is expected to bring about great progress for the country and specifically has the two standout developments. The first is that it calls for resolution of corporate insolvency within a period of 180 days extendable by 90 days hence bringing about security in the minds of investors. Second is that it calls for the creation of a new class of insolvency professionals whose primary function shall be helping sick companies and banks with their takeovers, provides for setting up an Insolvency and Bankruptcy Board to regulate the same and provides for a two stage process of liquidation. The Code is estimated to help India move up its ranking on the World Bank’s ease of doing business index. It is currently ranked at the 130th position lower than some of the sub-saharan African countries. Besides this, however, there are various areas in which the Code falls short such as lack of provisions for aiding the issue of cross-border insolvency, impact on Medium and Small Enterprises in India etc. This paper aims to analyze the provisions of the new Bankruptcy and Insolvency Code, 2016 and its contribution in making India a more desirable location for doing business. It shall also emphasize on the cross-border insolvency issues, practices followed by other countries to resolve the same and the way forward for India to strengthen its Bankruptcy and Insolvency framework.

Keywords: bankruptcy and insolvency code 2016, cross-border insolvency provisions in the 2016 code, Ease of doing business and bankruptcy code, highlights of the new Indian bankruptcy code 2016

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740 Life Stories: High Quality of Life until the End with the Narrative Medicine and the Storytelling

Authors: Danila Zuffetti, Lorenzo Chiesa

Abstract:

Background: A hospice narrative interview aims at putting the sick at the core of disease and treatment allowing them to explore their most intimate facets. The aim of this work is to favor authentic narration by leading towards awareness and acceptance of terminality and to face death with serenity. Narration in palliative care aims at helping to reduce the chaos generated by the disease and to elaborate interpretations on the course of reality, besides, the narration delivered to the doctor is fundamental and communicates the meaning given to symptoms. Methods: The narrative interview has become a regular activity in the Castellini Foundation since 2017. Patients take part every week, and for more days, in one hour sessions, in a welcoming and empathic setting and the interaction with the operator leads to a gradual awareness of their terminality. Patients are submitted with free answer questions with the purpose of facilitating and stimulating self-narration. Narration has not always been linear, but patients are left free to shift in time to revisit their disease process by making use of different tools, such as digital storytelling. Results: The answers provided by the patients show to which extent the narrative interview is an instrument allowing the analysis of the stories and gives the possibility to better understand and deepen the different implications of patient and caregiver’s background. Conclusion: The narration work in the hospice demonstrates that narrative medicine is an added value. This instrument has proven useful not only in the support of patients but also for the palliative doctor to identify wishes for accompanying them to the end with dignity and serenity. The narrative interview favors the construction of an authentic therapeutic relationship. The sick are taken wholly in charge, and they are guaranteed a high quality of life until their very last instant.

Keywords: construction of an authentic therapy relationship, gradual awareness of their terminality, narrative interview, reduce the chaos generated by the desease

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739 Promoting Early Learning of Children under Five Years in an Economically Disadvantaged Community in Sri Lanka through Health Promotion Approach

Authors: Najith Duminda Galmangoda Guruge, Nadeeka Rathnayake, Vinodani Wimalasena, Dinesha Wijesooriya

Abstract:

Investing in Early Learning can improve children’ interests for education and makes them ready for school. Children in economically disadvantaged communities may have reduced readiness for schools. Health Promotion approach enables communities including disadvantaged to control over their health. Mothers of children under the age five in ‘Alapathwewa’ community (n=40) were selected as the sample with the aim to promote early learning of children to improve their school readiness. Mothers in ‘Morakeewa’ community (n=40) were the control. Interventions were for a period of 2 years and children of these mothers were followed up to school entry. Importance of early learning and possibility of providing quality learning environments for children at a low cost was discussed with mothers in an experimental setting by facilitators. Mothers were enabled to make age-appropriate baby rooms which provide learning opportunities. Collective community playhouses and play areas were developed by mothers to provide opportunities for children to interact and learn with each other. Mothers started discussing with each other and sharing experiences. The progress was monitored by mothers at regular intervals. Data regarding school competencies of children were obtained from school teachers. School teachers measured thirteen competencies of children on a scale of ‘very good, good, moderate and weak’. All children in the experimental group were in ‘very good’ level in two competencies, ‘communicate friendly with others’ and ‘express ideas well’. Children in the experimental group reported a significantly higher achievement of all thirteen competencies (p < .05) than children in control. Providing quality early learning environments for children even in economically disadvantaged settings makes them ready for schools. Through a Health Promotion approach, early learning experiences for children can be provided at a low cost.

Keywords: disadvantaged, early learning, economically, health promotion

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738 Sildenafil Citrate (Viagra) Suppositories Are Promising Approach for Treatment of Unexplained Infertility

Authors: Shahinaz El-Shourbagy El-Shourbagy, Ahmed M. E Ossman Ossman, Ashraf El-Mohamady El-Mohamady

Abstract:

Objective: To investigate if there is a role of sildenafil citrate (Viagra) in the treatment of infertile couples for idiopathic cause. Design: An observational study. Setting: Infertility outpatient clinic of Tanta University Hospital Egypt. Patient(s): 50 unexplained infertility women {endometrial thickness (EM) and the mean resistance index (RI)} compared to 50 fertile control group attended for check-up in the same period and receiving no treatment. Intervention(s): unexplained infertility women were given 25 mg of sildenafil citrate suppositories four times per day for seven days starting from the 5th day of the menstrual cycle for three cycles. Main Outcome Measures: EM and RI of endometrial spiral artery were assessed by transvaginal color-pulsed Doppler ultrasound in unexplained infertility women before and after sildenafil citrate treatment and compared with control. The conception rate and pregnancy outcome were recorded in the two groups. Result(s): Women with unexplained infertility had significantly thinner endometrium and a higher spiral artery resistance index, meaning lower peri-implantation blood flow than the fertile controls. Sildenafil citrate treated women showed a statistically significant increase in endometrial thickness (p < 0.001) and a significant decrease in the mean spiral artery resistance index (p < 0.001) giving a better conception rate. Conclusion: Sildenafil citrate suppositories treatment enhance the endometrial blood flow through decreasing spiral artery resistance index 'RI' and consequently improve endometrial growth and receptivity in cases of unexplained infertility thus giving a better conception rate.

Keywords: Unexplained infertility, endometrial blood flow, endome¬trial receptivity, color-pulsed Doppler ultrasound; RI (resis¬tance index, Sildenafil citrate (Viagra)

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737 A Prospective Study on the Evaluation of Statins Usage on HbA1c Control among Type 2 Diabetes Mellitus in an Outpatients Setting

Authors: Mohamed A. Hammad, Dzul Azri Mohamed Noor, Syed Azhar Syed Sulaiman, Abeer Kharshid, Nor Azizah Aziz, Tarek M. Elsayed

Abstract:

Medication safety is always an issue. In 2015, the National Pharmaceutical Control Bureau released a statement requesting all statins manufacturers in Malaysia to include the risk of diabetes information in the drug information leaflet in response to United States Food and Drug Administration (U.S. FDA) report. However, the data regarding this warning label in Malaysia is limited, so there is still some uncertainty whether such risk can also be observed in the Malaysian population or not. The study aims to determine the effect of statins on HbA1c% in type 2 diabetic outpatients in endocrine clinics at Hospital Pulau Pinang between June 2015 and May 2016 in Malaysia. In a prospective cohort study, records of 400 type 2 diabetic patients (control group 104 patients not using statin and treatment group 296 patients using statin) were reviewed to identify demographic criteria and lab tests. The prevalence of glycemic control (Glycated hemoglobin, HbA1C ≤ 7% for patient < 65 years, and < 8% for patient ≥ 65 years) was estimated, according to American Diabetes Association guidelines 2015. The results were presented as descriptive statistics. From 296 patients with Type 2 diabetes using statins cohort with a mean age of 57.52 ± 12.2 years, only 81 (27.4%) cases had controlled glycemia, and 215 (72.6%) had uncontrolled glycemia, CI: 95% (6.3–11.1). While the control group 104 diabetic patients had a mean age 46.1 ± 18 years and distributed among 59 (56.7%) patients with controlled diabetes and 45 (43.3%) cases, had uncontrolled glycemia, CI: 95% (5.2–10.3). The relative risk (RR) of uncontrolled glycemia in diabetic patients used statins was 1.68, and the excessive relative risk (ERR) was 68%. The absolute risk (AR) was 29.3%, and the number needed to harm (NNH) was 4. Diabetic patients using statins have more risk of uncontrolled glycemia than the patients with Type 2 diabetes non-using statins.

Keywords: diabetes mellitus, HbA1c, Malaysia, outpatients, statin, type 2, uncontrolled glycemia

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736 Late Neolithic Cemeteries Funerary and Their Indications of Societies Changes and Religion Emergences of Sudan: Qalaat Shanan Site Case Study

Authors: Ahmed Hamid Nassr

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The significant of the old stone ages in the Sudan, seems from the longest times and the large differentiation in antiquities, so many Neolithic cemeteries have been discovered in the Sudan, which the studies revealed costumes’ funerary from the Form of grave and the contents has been contrasted in some elements and constant in the others. Many interpretations of the late Neolithic cemeteries tradition written from the earlier studies, most of them focus of the development and change in the burial from society’s development and ideas of afterlife beginnings. Another emphasis undertaken is the relationship between societies cultural aspects and the environmental conditions of the period; it has been considered that it hyper-affected the development of farming in one way or another. The site of Qalaat Shanan noted in earlier 1990 and excavated by the Author from 2011-2013, the site located north of Khartoum about 170 km in Shendi town. Site setting lies amongst a group of Neolithic sites in the Shendi area, it reflected a succession of various Neolithic activities from the early to the late horizons. Excavation revealed many late Neolithic graves, the adult and child graves show large funerary content, different in quality and quantity, which indicates of societies development and related to religion and ideas about the afterlife. This presentation discusses the variations of the Late Neolithic cemeteries in Galaat Shanan site from the grave form, content and differentiation of the sex and age and compared with other late Neolithic discoveries in Sudan and the Nile valley. The study shows many changes in the graves related to the societies changes in late Neolithic in Sudan, climate and economic subsistence's are well reasons, but also the idea change is the main reason for the changes. That is clear from the variations of grave shape and content in age and sex and might be society’s status and levels.

Keywords: Sudan, Shendi town, Qalaat Shanan, late neolithic, cemeteries, funerary, tradition

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735 Community Perceptions on Honey Quality in Tobacco Growing Areas in Kigoma Region, Tanzania

Authors: Pilly Kagosi, Cherestino Balama

Abstract:

Beekeeping plays major role in improving biodiversity, increasing household income, and crop production through pollination. Tobacco farming is also the main source of household income for smallholder farmers. In Kigoma, production of Tobacco has increased and is perceived to threaten honey quality. The study explored the perception of the community on quality of honey in tobacco and non tobacco growing areas. The study was conducted in Kigoma Region, Tanzania. District and Villages were purposively sampled based on large numbers of people dealing with beekeeping activities and tobacco farming. Socioeconomic data were collected and analysed using Statistical Package for Social Sciences and content analysis. The perception of stakeholders on honey quality was analysed using Likert scale. Majority of the respondents agreed that tobacco farming greatly affects honey quality because honey from beehives near tobacco farms test bitter and sometimes irritating, which was associated with nicotine content and agrochemicals applied to tobacco crops. Though they cannot differentiate honey bitterness from agrochemicals and bee fodders. Furthermore, it was revealed that chemicals applied to tobacco and vegetables have negative effect on the bees and honey quality. Respondents believe that setting bee hives near tobacco farms might contaminate honey and therefore affect its quality. Beekeepers are not aware of the nicotine content from other bee fodders like miombo of which do not have any effect on human beings. Actually, tobacco farming does not affect beekeeping activities in issue of quality when farmers follow proper management of tobacco flowers and proper handling of honey. Though, big challenge in tobacco farming is chemically applied to the crops and harvest bee fodders for curing tobacco. The study recommends training to community on proper management of tobacco and proper handling of bee products.

Keywords: community, honey, perceptions, tobacco

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734 Applications of the Morphological Variability in River Management: A Study of West Rapti River

Authors: Partha Sarathi Mondal, Srabani Sanyal

Abstract:

Different geomorphic agents produce a different landforms pattern. Similarly rivers also have a distinct and diverse landforms pattern. And even, within a river course different and distinct assemblage of landforms i.e. morphological variability are seen. These morphological variability are produced by different river processes. Channel and floodplain morphology helps to interpret river processes. Consequently morphological variability can be used as an important tool for assessing river processes, hydrological connectivity and river health, which will help us to draw inference about river processes and therefore, management of river health. The present study is documented on West Rapti river, a trans-boundary river flowing through Nepal and India, from its source to confluence with Ghaghra river in India. The river shows a significant morphological variability throughout its course. The present study tries to find out factors and processes responsible for the morphological variability of the river and in which way it can be applied in river management practices. For this purpose channel and floodplain morphology of West Rapti river was mapped as accurately as possible and then on the basis of process-form interactions, inferences are drawn to understand factors of morphological variability. The study shows that the valley setting of West Rapti river, in the Himalayan region, is confined and somewhere partly confined whereas, channel of the West Rapti river is single thread in most part of Himalayan region and braided in valley region. In the foothill region valley is unconfined and channel is braided, in middle part channel is meandering and valley is unconfined, whereas, channel is anthropogenically altered in the lower part of the course. Due to this the morphology of West Rapti river is highly diverse. These morphological variability are produced by different geomorphic processes. Therefore, for any river management it is essential to sustain these morphological variability so that the river could not cross the geomorphic threshold and environmental flow of the river along with the biodiversity of riparian region is maintained.

Keywords: channel morphology, environmental flow, floodplain morphology, geomorphic threshold

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733 Gender Discrimination and Wellbeing in Family Sphere Due to Male Migration and Remittances: A Study of Doaba Region of Punjab

Authors: Atinder Pal Kaur

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A central characteristic of people is their apparent movement from one station to other for their sustenance. Human migration has become one of the most challenging issues faced by the world today. Migration represents an important dimension in world-wide setting; and remittances received by families constitute a major agent in integrating societies in the all over the world, both economically and socially. This paper is an attempt to explore the impact of male migration and remittances upon the family system. This paper brings out how the women play the role of head of the household and take all the economic decisions, but still faces discrimination in the family, that bring loneliness and emotional breakdown on their personal front. For the purpose of this study, data was collected using 30 interviews and 10 case studies in the Doaba region of Punjab. The respondents were classified into two age groups 20-35 years and above 40 years aged women whose husbands migrated abroad. The findings of this study revealed that even though the women were taking some of the economic decisions, but in majority of the cases the patriarchal structure still existed and power remained in the hands of their husbands or in-laws. It was found that women of different age groups reported differently in terms of authority that they have regarding remittances and its consequences in their emotional well-being. The distinction related to their participation in public and private spheres still exists and public spheres are mostly dominated by male members of the family. It can be concluded that freedom of women to take decision on their own is still restricted and they are subjugated to follow their husband or in-law’s opinion in matters related to both public and private spheres. However, old age group women enjoyed more independence and freedom to take decision in comparison to young age women. Loneliness and depression were more common in the young age respondent’s group than in old age women.

Keywords: gender discrimination, migration, patriarchal structure, remittances

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732 Quality Assessment of New Zealand Mānuka Honeys Using Hyperspectral Imaging Combined with Deep 1D-Convolutional Neural Networks

Authors: Hien Thi Dieu Truong, Mahmoud Al-Sarayreh, Pullanagari Reddy, Marlon M. Reis, Richard Archer

Abstract:

New Zealand mānuka honey is a honeybee product derived mainly from Leptospermum scoparium nectar. The potent antibacterial activity of mānuka honey derives principally from methylglyoxal (MGO), in addition to the hydrogen peroxide and other lesser activities present in all honey. MGO is formed from dihydroxyacetone (DHA) unique to L. scoparium nectar. Mānuka honey also has an idiosyncratic phenolic profile that is useful as a chemical maker. Authentic mānuka honey is highly valuable, but almost all honey is formed from natural mixtures of nectars harvested by a hive over a time period. Once diluted by other nectars, mānuka honey irrevocably loses value. We aimed to apply hyperspectral imaging to honey frames before bulk extraction to minimise the dilution of genuine mānuka by other honey and ensure authenticity at the source. This technology is non-destructive and suitable for an industrial setting. Chemometrics using linear Partial Least Squares (PLS) and Support Vector Machine (SVM) showed limited efficacy in interpreting chemical footprints due to large non-linear relationships between predictor and predictand in a large sample set, likely due to honey quality variability across geographic regions. Therefore, an advanced modelling approach, one-dimensional convolutional neural networks (1D-CNN), was investigated for analysing hyperspectral data for extraction of biochemical information from honey. The 1D-CNN model showed superior prediction of honey quality (R² = 0.73, RMSE = 2.346, RPD= 2.56) to PLS (R² = 0.66, RMSE = 2.607, RPD= 1.91) and SVM (R² = 0.67, RMSE = 2.559, RPD=1.98). Classification of mono-floral manuka honey from multi-floral and non-manuka honey exceeded 90% accuracy for all models tried. Overall, this study reveals the potential of HSI and deep learning modelling for automating the evaluation of honey quality in frames.

Keywords: mānuka honey, quality, purity, potency, deep learning, 1D-CNN, chemometrics

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731 The Effect of Attention-Deficit/Hyperactivity Disorder on Additional Language Learning: Voices of English as a Foreign Language Teachers in Poland

Authors: Agnieszka Kałdonek-Crnjaković

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Research on Attention-Deficit/Hyperactivity Disorder (ADHD) is abundant but not in the field of applied linguistics and foreign or second language education. To fill this research gap, the present study aimed to investigate the effect of ADHD on skills and systems development in a second and foreign language from the teacher's perspective. The participants were 51 English as a foreign language (EFL) teachers in Poland working in state pre-, primary, and high schools. Research questions were as follows: Do ADHD-type behaviors affect EFL learning of the individual with the condition and their classmates to the same extent considering different educational settings and specific skills and systems? And To what extent do ADHD-type behaviors affect ESL/EFL skills and systems considering different ADHD presentations? Data were collected by means of a questionnaire distributed via a Google form. It contained 14 statements on a six-point Likert scale related to the effect of ADHD on specific language skills and systems in the context of an individual with the condition and their classmates and situations related to inattention and hyperactivity/impulsivity presentations of the condition, where the participants needed to identify skills and systems affected by the given ADHD manifestation. The results show that ADHD affects all language skills and systems development in both the individual with the condition and their classmates, but this effect is more significant in the latter. However, ADHD affected skills and systems to a different degree; writing skills were reported as the most affected by this disorder. Also, the effect of ADHD differed depending on the educational setting, being the highest in high school and lowest in the first three grades of primary school. These findings will be discussed in the context of foreign/second language teaching in the school context, considering different phases of education as well as future research on ADHD and language learning and teaching.

Keywords: ADHD, EFL teachers, foreign/second language learning, language skills and systems development

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730 Effects of Changes in LULC on Hydrological Response in Upper Indus Basin

Authors: Ahmad Ammar, Umar Khan Khattak, Muhammad Majid

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Empirically based lumped hydrologic models have an extensive track record of use for various watershed managements and flood related studies. This study focuses on the impacts of LULC change for 10 year period on the discharge in watershed using lumped model HEC-HMS. The Indus above Tarbela region acts as a source of the main flood events in the middle and lower portions of Indus because of the amount of rainfall and topographic setting of the region. The discharge pattern of the region is influenced by the LULC associated with it. In this study the Landsat TM images were used to do LULC analysis of the watershed. Satellite daily precipitation TRMM data was used as input rainfall. The input variables for model building in HEC-HMS were then calculated based on the GIS data collected and pre-processed in HEC-GeoHMS. SCS-CN was used as transform model, SCS unit hydrograph method was used as loss model and Muskingum was used as routing model. For discharge simulation years 2000 and 2010 were taken. HEC-HMS was calibrated for the year 2000 and then validated for 2010.The performance of the model was assessed through calibration and validation process and resulted R2=0.92 during calibration and validation. Relative Bias for the years 2000 was -9% and for2010 was -14%. The result shows that in 10 years the impact of LULC change on discharge has been negligible in the study area overall. One reason is that, the proportion of built-up area in the watershed, which is the main causative factor of change in discharge, is less than 1% of the total area. However, locally, the impact of development was found significant in built up area of Mansehra city. The analysis was done on Mansehra city sub-watershed with an area of about 16 km2 and has more than 13% built up area in 2010. The results showed that with an increase of 40% built-up area in the city from 2000 to 2010 the discharge values increased about 33 percent, indicating the impact of LULC change on discharge value.

Keywords: LULC change, HEC-HMS, Indus Above Tarbela, SCS-CN

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729 Remote Vital Signs Monitoring in Neonatal Intensive Care Unit Using a Digital Camera

Authors: Fatema-Tuz-Zohra Khanam, Ali Al-Naji, Asanka G. Perera, Kim Gibson, Javaan Chahl

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Conventional contact-based vital signs monitoring sensors such as pulse oximeters or electrocardiogram (ECG) may cause discomfort, skin damage, and infections, particularly in neonates with fragile, sensitive skin. Therefore, remote monitoring of the vital sign is desired in both clinical and non-clinical settings to overcome these issues. Camera-based vital signs monitoring is a recent technology for these applications with many positive attributes. However, there are still limited camera-based studies on neonates in a clinical setting. In this study, the heart rate (HR) and respiratory rate (RR) of eight infants at the Neonatal Intensive Care Unit (NICU) in Flinders Medical Centre were remotely monitored using a digital camera applying color and motion-based computational methods. The region-of-interest (ROI) was efficiently selected by incorporating an image decomposition method. Furthermore, spatial averaging, spectral analysis, band-pass filtering, and peak detection were also used to extract both HR and RR. The experimental results were validated with the ground truth data obtained from an ECG monitor and showed a strong correlation using the Pearson correlation coefficient (PCC) 0.9794 and 0.9412 for HR and RR, respectively. The RMSE between camera-based data and ECG data for HR and RR were 2.84 beats/min and 2.91 breaths/min, respectively. A Bland Altman analysis of the data also showed a close correlation between both data sets with a mean bias of 0.60 beats/min and 1 breath/min, and the lower and upper limit of agreement -4.9 to + 6.1 beats/min and -4.4 to +6.4 breaths/min for both HR and RR, respectively. Therefore, video camera imaging may replace conventional contact-based monitoring in NICU and has potential applications in other contexts such as home health monitoring.

Keywords: neonates, NICU, digital camera, heart rate, respiratory rate, image decomposition

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728 Taguchi Robust Design for Optimal Setting of Process Wastes Parameters in an Automotive Parts Manufacturing Company

Authors: Charles Chikwendu Okpala, Christopher Chukwutoo Ihueze

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As a technique that reduces variation in a product by lessening the sensitivity of the design to sources of variation, rather than by controlling their sources, Taguchi Robust Design entails the designing of ideal goods, by developing a product that has minimal variance in its characteristics and also meets the desired exact performance. This paper examined the concept of the manufacturing approach and its application to brake pad product of an automotive parts manufacturing company. Although the firm claimed that only defects, excess inventory, and over-production were the few wastes that grossly affect their productivity and profitability, a careful study and analysis of their manufacturing processes with the application of Single Minute Exchange of Dies (SMED) tool showed that the waste of waiting is the fourth waste that bedevils the firm. The selection of the Taguchi L9 orthogonal array which is based on the four parameters and the three levels of variation for each parameter revealed that with a range of 2.17, that waiting is the major waste that the company must reduce in order to continue to be viable. Also, to enhance the company’s throughput and profitability, the wastes of over-production, excess inventory, and defects with ranges of 2.01, 1.46, and 0.82, ranking second, third, and fourth respectively must also be reduced to the barest minimum. After proposing -33.84 as the highest optimum Signal-to-Noise ratio to be maintained for the waste of waiting, the paper advocated for the adoption of all the tools and techniques of Lean Production System (LPS), and Continuous Improvement (CI), and concluded by recommending SMED in order to drastically reduce set up time which leads to unnecessary waiting.

Keywords: lean production system, single minute exchange of dies, signal to noise ratio, Taguchi robust design, waste

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727 An Atomistic Approach to Define Continuum Mechanical Quantities in One Dimensional Nanostructures at Finite Temperature

Authors: Smriti, Ajeet Kumar

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We present a variant of the Irving-Kirkwood procedure to obtain the microscopic expressions of the cross-section averaged continuum fields such as internal force and moment in one-dimensional nanostructures in the non-equilibrium setting. In one-dimensional continuum theories for slender bodies, we deal with quantities such as mass, linear momentum, angular momentum, and strain energy densities, all defined per unit length. These quantities are obtained by integrating the corresponding pointwise (per unit volume) quantities over the cross-section of the slender body. However, no well-defined cross-section exists for these nanostructures at finite temperature. We thus define the cross-section of a nanorod to be an infinite plane which is fixed in space even when time progresses and defines the above continuum quantities by integrating the pointwise microscopic quantities over this infinite plane. The method yields explicit expressions of both the potential and kinetic parts of the above quantities. We further specialize in these expressions for helically repeating one-dimensional nanostructures in order to use them in molecular dynamics study of extension, torsion, and bending of such nanostructures. As, the Irving-Kirkwood procedure does not yield expressions of stiffnesses, we resort to a thermodynamic equilibrium approach to obtain the expressions of axial force, twisting moment, bending moment, and the associated stiffnesses by taking the first and second derivatives of the Helmholtz free energy with respect to conjugate strain measures. The equilibrium approach yields expressions independent of kinetic terms. We then establish the equivalence of the expressions obtained using the two approaches. The derived expressions are used to understand the extension, torsion, and bending of single-walled carbon nanotubes at non-zero temperatures.

Keywords: thermoelasticity, molecular dynamics, one dimensional nanostructures, nanotube buckling

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726 Impact of Water Storage Structures on Groundwater Recharge in Jeloula Basin, Central Tunisia

Authors: I. Farid, K. Zouari

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An attempt has been made to examine the effect of water storage structures on groundwater recharge in a semi-arid agroclimatic setting in Jeloula Basin (Central Tunisia). In this area, surface water in rivers is seasonal, and therefore groundwater is the perennial source of water supply for domestic and agricultural purposes. Three pumped storage water power plants (PSWPP) have been built to increase the overall water availability in the basin and support agricultural livelihoods of rural smallholders. The scale and geographical dispersion of these multiple lakes restrict the understanding of these coupled human-water systems and the identification of adequate strategies to support riparian farmers. In the present review, hydrochemistry and isotopic tools were combined to get an insight into the processes controlling mineralization and recharge conditions in the investigated aquifer system. This study showed a slight increase in the groundwater level, especially after the artificial recharge operations and a decline when the water volume moves down during drought periods. Chemical data indicate that the main sources of salinity in the waters are related to water-rock interactions. Data inferred from stable isotopes in groundwater samples indicated recharge with modern rainfall. The investigated surface water samples collected from the PSWPP are affected by a significant evaporation and reveal large seasonal variations, which could be controlled by the water volume changes in the open surface reservoirs and the meteorological conditions during evaporation, condensation, and precipitation. The geochemical information is comparable to the isotopic results and illustrates that the chemical and isotopic signatures of reservoir waters differ clearly from those of groundwaters. These data confirm that the contribution of the artificial recharge operations from the PSWPP is very limited.

Keywords: Jeloula basin, recharge, hydrochemistry, isotopes

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725 Experimenting the Influence of Input Modality on Involvement Load Hypothesis

Authors: Mohammad Hassanzadeh

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As far as incidental vocabulary learning is concerned, the basic contention of the Involvement Load Hypothesis (ILH) is that retention of unfamiliar words is, generally, conditional upon the degree of involvement in processing them. This study examined input modality and incidental vocabulary uptake in a task-induced setting whereby three variously loaded task types (marginal glosses, fill-in-task, and sentence-writing) were alternately assigned to one group of students at Allameh Tabataba’i University (n=2l) during six classroom sessions. While one round of exposure was comprised of the audiovisual medium (TV talk shows), the second round consisted of textual materials with approximately similar subject matter (reading texts). In both conditions, however, the tasks were equivalent to one another. Taken together, the study pursued the dual objectives of establishing a litmus test for the ILH and its proposed values of ‘need’, ‘search’ and ‘evaluation’ in the first place. Secondly, it sought to bring to light the superiority issue of exposure to audiovisual input versus the written input as far as the incorporation of tasks is concerned. At the end of each treatment session, a vocabulary active recall test was administered to measure their incidental gains. Running a one-way analysis of variance revealed that the audiovisual intervention yielded higher gains than the written version even when differing tasks were included. Meanwhile, task 'three' (sentence-writing) turned out the most efficient in tapping learners' active recall of the target vocabulary items. In addition to shedding light on the superiority of audiovisual input over the written input when circumstances are relatively held constant, this study for the most part, did support the underlying tenets of ILH.

Keywords: Keywords— Evaluation, incidental vocabulary learning, input mode, Involvement Load Hypothesis, need, search.

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724 CO₂ Storage Capacity Assessment of Deep Saline Aquifers in Malaysia

Authors: Radzuan Junin, Dayang Zulaika A. Hasbollah

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The increasing amount of greenhouse gasses in the atmosphere recently has become one of the discussed topics in relation with world’s concern on climate change. Developing countries’ emissions (such as Malaysia) are now seen to surpass developed country’s emissions due to rapid economic development growth in recent decades. This paper presents the potential storage sites suitability and storage capacity assessment for CO2 sequestration in sedimentary basins of Malaysia. This study is the first of its kind that made an identification of potential storage sites and assessment of CO2 storage capacity within the deep saline aquifers in the country. The CO2 storage capacity in saline formation assessment was conducted based on the method for quick assessment of CO2 storage capacity in closed, and semi-closed saline formations modified to suit the geology setting of Malaysia. Then, an integrated approach that involved geographic information systems (GIS) analysis and field data assessment was adopted to provide the potential storage sites and its capacity for CO2 sequestration. This study concentrated on the assessment of major sedimentary basins in Malaysia both onshore and offshore where potential geological formations which CO2 could be stored exist below 800 meters and where suitable sealing formations are present. Based on regional study and amount of data available, there are 14 sedimentary basins all around Malaysia that has been identified as potential CO2 storage. Meanwhile, from the screening and ranking exercises, it is obvious that Malay Basin, Central Luconia Province, West Baram Delta and Balingian Province are respectively ranked as the top four in the ranking system for CO2 storage. 27% of sedimentary basins in Malaysia were evaluated as high potential area for CO2 storage. This study should provide a basis for further work to reduce the uncertainty in these estimates and also provide support to policy makers on future planning of carbon capture and sequestration (CCS) projects in Malaysia.

Keywords: CO₂ storage, deep saline aquifer, GIS, sedimentary basin

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723 Alternative Water Resources and Brominated Byproducts

Authors: Nora Kuiper, Candace Rowell, Hugues Preud'Homme, Basem Shomar

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As the global dependence on seawater desalination as a primary drinking water resource increases, a unique class of secondary pollutants is emerging. The presence of bromide salts in seawater may result in increased levels of bromine and brominated byproducts in drinking water. The State of Qatar offers a unique setting to study these pollutants and their impacts on consumers as the country is 100% dependent on seawater desalination to supply municipal tap water and locally produced bottled water. Tap water (n=115) and bottled water (n=62) samples were collected throughout the State of Qatar and analyzed for a suite of inorganic and organic compounds, including 54 volatile organic compounds (VOCs), with an emphasis on brominated byproducts. All VOC identification and quantification was completed using a Bruker Scion GCMSMS with static headspace technologies. A risk survey tool was used to collect information regarding local consumption habits, health outcomes and perception of water sources for adults and children. This study is the first of its kind in the country. Dibromomethane, bromoform, and bromobenzene were detected in 61%, 88% and 2%, of the drinking water samples analyzed. The levels of dibromomethane ranged from approximately 100-500 ng/L and the concentrations of bromoform ranged from approximately 5-50 µg/L. Additionally, bromobenzene concentrations were 60 ng/L. The presence of brominated compounds in drinking water is a public health concern specific to populations using seawater as a feed water source and may pose unique risks that have not been previously studied. Risk assessments are ongoing to quantify the risks associated with prolonged consumption of disinfection byproducts; specifically the risks of brominated trihalomethanes as the levels of bromoform found in Qatar’s drinking water reach more than 60% of the US EPA’s Maximum Contaminant Level of all THMs.

Keywords: brominated byproducts, desalination, trihalomethanes, risk assessment

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722 Exploring Content of Home-Based Care Education After Caesarean Section Provided by Nurse Midwives in Maternity Units

Authors: Mdoe Mwajuma Bakari, Mselle Lilian Teddy, Kibusi Stephen Mathew

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Background: Due to the increase of caesarean section (CS), many women are discharge early to their home. Women should be aware on how to take care of themselves at home after CS. Evidence shows non-uniform health education on home care after CS are provided to post CS mothers because of lack of standard home care guideline on home after CS; as existing guidelines explore only care of women in hospital setting, for health care workers. There is a need to develop post CS home care guide; exploring contents of home based care education after CS provided by nurse midwives will inform the development of the guide. Objective: To explore the content of health education provided by nurse midwives to post CS mother about home care after hospital discharge in Dodoma, Tanzania. Methodology: An exploratory qualitative study using in-depth interview was conducted in this study using triangulation of data collection method; where 14 nurse midwives working in maternity unit and 11 post CS mother attending their post-natal clinic were recruited. Content analysis was used to generate themes that describe health education information provided by nurse midwives to post CS mother about home care after hospital discharge. Results: The study found that, nutrition health education, maternal and newborn hygiene care of caesarean wound at home were the component of health education provided to post CS mothers by nurse midwives. Contradicting instruction were found to be provided to post CS mothers. Conclusion: This study reported non-uniform health education provided by the nurse midwives on home care after CS. Despite of the fact that nurse midwives recognizes the need to provide health education to the post CS mothers, there is a need to develop home care guideline as a reference for their education to ensure uniform package of education is provided to post CS mothers in order to improve recovery of post CS mothers from CS.

Keywords: caesarean section, home care, discharge education, homecare after caesarean section

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721 Psychological Capital: Convergent and Discriminant Validity of a Reconfigured Measure

Authors: Anton Grobler

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Background: Psychological capital (PsyCap), consisting of Hope, Optimism, Resilience, and Self-efficacy, is a popular positive organisational behaviour construct utilised in the studying employee work and behavioral attitudes. Various scholars believe however that further validity research should be conducted on the PsyCap questionnaire (PCQ), outside of the founding research team and in more diverse settings, for the purpose of this paper, within the diverse South African (SA) context. Aim: The purpose of this study was to investigate the construct validity of the PCQ with specific reference to its psychometric properties within the diverse SA context. Setting: The sample includes a total of 1 749 respondents, ± 60 each from 30 organisations in South Africa. Method: This study utilised a cross-sectional design and quantitative analysis. The sample is relatively representative (in terms of race, gender) of the South African workforce. A multi-factorial model was statistically explored and confirmed (with exploratory factor analysis [EFA] and confirmatory factor analysis [CFA] respectively). Results: The study yielded a three-factor solution, with Hope and Optimism as a combined factor and Resilience and Self-efficacy made up of a reconfigured set of substantively justifiable items. Three items of the original 24 items were found not to be suitable. The three factors showed good psychometric properties, good fit (in support of construct validity) and acceptable levels of convergent and discriminant validity. Conclusion: The results support the original conceptualisation of PsyCap, although with a unique structural configuration. This resonates with the notion of scholars that further research should be conducted within diverse settings. This is necessary to ensure the valid measurement of the construct, which is considered to be one of the four criteria for a construct to be categorised as a positive organisational behaviour construct.

Keywords: positive organisational behaviour, psychological capital, hope, optimism, resilience, self-efficacy, construct validity

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720 Prophylactic Replacement of Voice Prosthesis: A Study to Predict Prosthesis Lifetime

Authors: Anne Heirman, Vincent van der Noort, Rob van Son, Marije Petersen, Lisette van der Molen, Gyorgy Halmos, Richard Dirven, Michiel van den Brekel

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Objective: Voice prosthesis leakage significantly impacts laryngectomies patients' quality of life, causing insecurity and frequent unplanned hospital visits and costs. In this study, the concept of prophylactic voice prosthesis replacement was explored to prevent leakages. Study Design: A retrospective cohort study. Setting: Tertiary hospital. Methods: Device lifetimes and voice prosthesis replacements of a retrospective cohort, including all patients with laryngectomies between 2000 and 2012 in the Netherlands Cancer Institute, were used to calculate the number of needed voice prostheses per patient per year when preventing 70% of the leakages by prophylactic replacement. Various strategies for the timing of prophylactic replacement were considered: Adaptive strategies based on the individual patient’s history of replacement and fixed strategies based on the results of patients with similar voice prosthesis or treatment characteristics. Results: Patients used a median of 3.4 voice prostheses per year (range 0.1-48.1). We found a high inter-and intrapatient variability in device lifetime. When applying prophylactic replacement, this would become a median of 9.4 voice prostheses per year, which means replacement every 38 days, implying more than six additional voice prostheses per patient per year. The individual adaptive model showed that preventing 70% of the leakages was impossible for most patients, and only a median of 25% can be prevented. Monte-Carlo simulations showed that prophylactic replacement is not feasible due to the high Coefficient of Variation (Standard Deviation/Mean) in device lifetime. Conclusion: Based on our simulations, prophylactic replacement of voice prostheses is not feasible due to high inter-and intrapatient variation in device lifetime.

Keywords: voice prosthesis, voice rehabilitation, total laryngectomy, prosthetic leakage, device lifetime

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719 Teacher Education: Teacher Development and Support

Authors: Khadem Hichem

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With the new technology challenges, dynamics and challenges of the contemporary world, most teachers are struggling to maintain effective and successful teaching /learning environment for learners. Teachers as a key to the success of reforms in the educational setting, they must improve their competencies to teach effectively. Many researchers emphasis on the ongoing professional development of the teacher by enhancing their experiences and encouraging their responsibility for learning, and thus promoting self-reliance, collaboration, and reflection. In short, teachers are considered as learners and they need to learn together. The educational system must support, both conceptually and financially, the teachers’ development as lifelong learners Teachers need opportunities to grow in language proficiency and in knowledge. Changing nature of language and culture in the world, all teachers must have opportunities to update their knowledge and practices. Many researchers in the field of foreign or additional languages indicate that teachers keep side by side of effective instructional practices and they need special support with the challenging task of developing and administering proficiency tests to their students. For significant change to occur, each individual teacher’s needs must be addressed. The teacher must be involved experientially in the process of development, since, by itself, knowledge of how to change does not mean change will be initiated. For improvement to occur, new skills have to be guided, practiced, and reflected upon in collaboration with colleagues. Clearly, teachers are at different places developmentally; therefore, allowances for various entry levels and individual differences need to be built into the professional development structure. Objectives must be meaningful to the participant and teacher improvement must be stated terms of student knowledge, student performance, and motivation. The most successful professional development process acknowledges the student-centered nature of good teaching. This paper highlights the importance of teacher professional development process and institutional supports as way to enhance good teaching and learning environment.

Keywords: teacher professional development, teacher competencies, institutional support, teacher education

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