Search results for: intervention

Authors: Srividya Sheshadri, Christopher Coley, Roa. R. Bhavani

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India currently accounts for 60 percent of the open defecation that is practiced globally. While research in the domain of sanitation development makes it apparent that girls and women living in rural India are disproportionately affected, interventions to address this dilemma are lacking. An important but relatively unexplored connection with poor sanitation is that women living in rural India are not only the largest marginalized group without access to adequate sanitation facilities, they also represent a majority of India’s unskilled workers. By training women to build their own toilets, through an approach that has demonstrated success in empowering marginalized communities through technical and vocational education and training (TVET), a collaborative dynamic emerges that can engage entire communities in the movement towards total sanitation. Designed and implemented by Amrita University, this technology-enhanced, community-based approach to skill development, known as Amrita computerized Vocational Education and Training (or Amrita cVET), has begun to show promise in addressing the struggle to end open defecation, and raise sanitation awareness, as well as strengthen personal and community development among women living in rural India. While Amrita cVET project, known as Women Empowerment: Sanitation, is currently in implementation in seven states throughout India, this paper will discuss early stages of the intervention in rural villages within the Indian states of: Karnataka and Goa, where previous sanitation efforts have failed to take hold.

Keywords: community based development, empowerment studies, sanitation in India, computerized vocational training

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Authors: Yeaji Seok, Myung Kyung Lee

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Background: Even if patients survive after a stroke, stroke patients may experience disability in mobility, sensation, cognition, and speech and language. Stroke patients require rehabilitation for functional recovery and daily life for a considerable time. During rehabilitation, the role of caregivers is important. However, the stroke patients’ quality of life may deteriorate due to family caregivers’ non-preparedness and increased role burden. Purpose: To investigate the prediction of caregivers' preparedness and role burden on stroke patients’ quality of life. Methods: The target population was stroke patients who were hospitalized for rehabilitation and their family care providers. A total of 153 patient-family caregiver dyads were recruited from June to August 2021. Data were collected from self-reported questionnaires and analyzed using descriptive statistics, t-tests, chi-squared test, one-way analysis of variance, Pearson’s correlation coefficients, and multiple regression with SPSS statistics 28 programs. Results: Family caregivers’ preparedness affected stroke patients’ mobility (β = .20, p < 0.05) and character (β = -.084, p < 0.05) and production activities (β = -.197, p < 0.05) in quality of life. The role burden of family caregivers affected language skills (β = .310, p<0.05), visual functions (β=-.357, p < 0.05), thinking skills (β = 0.443, p = 0.05), mood conditions (β = 0.565, p < 0.001), family roles (β = -0.361, p < 0.001), and social roles (β = -0.304, p < 0.001), while the caregivers’ burden of performing self-protection negatively affected patients’ social roles (β = .180, p=.048). In addition, caregivers’ role burden of personal life sacrifice affected patients’ mobility (β = .311, p < 0.05), self-care (β =.232, p < 0.05) and energy (β = .239, p < 0.05). Conclusion: This study indicated that family caregivers' preparedness and role burden affected stroke patients’ quality of life. The results of this study suggested that intervention to improve family caregivers’ preparedness and to reduce role burden should be required for quality of life in stroke patients.

Keywords: quality of life, preparedness, role burden, caregivers, stroke

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Authors: Amena Omer Syeda, Harita Shyam

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Background: Anorexia a common symptom among patients with prolonged illness leading to anorexia-cachexia syndrome with a prevalence rate of 70%. In order to provide effective health care and better response to treatment, appetite should be assessed on admission and then periodically for earlier nutrition intervention. Functional Assessment of Anorexia/Cachexia Therapy (FAACT) appetite scale is 12 questions, patient-rated, symptom specific measure for appetite, and distress from anorexia. It assigns a score ranging from 0 (worst response) to 4 (best response). Therefore, proposing a total score of ≤24 may be sufficient to make a diagnosis of anorexia. Objectives: To assess the FAACT scale by co-relating the scores with the Nutritional intake and BMI of Cancer Patients. Methods: The FAACT scores of 100 cancer in-patients receiving chemotherapy or radiation as treatment, their 24-hour calorie and protein intake and BMI were recorded. The data was then statistically analyzed. Results: The calorie and protein intake and FAACT scores both showed a significant positive co-relation (p<0.001), inferring that the patients with a FAACT score of ≤24 where not meeting their calorie as well as protein requirements, hence rightly categorizing them as anorexic. The co-relation between BMI and FAACT scores showed a weak co-relation and was not statistically significant (p > 0.05).The FAACT scale thus is not sensitive to distinguish patients being under-weight, normal weight or obese. Conclusion: The FAACT scale helps in providing better palliative and nutritional care as it correctly assessed anorexia /cachexia in cancer patients and co-related significantly with their nutrient intake.

Keywords: appetite, cachexia, cancer, malnutrition

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Authors: Balakrishna Valluru, Ruth Suckling

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A 16 year old male was found collapsed on the road following stab injuries to the chest and abdomen and was transported to the emergency department by ambulance. On arrival in the emergency department the patient was breathless and appeared pale. He was maintaining his airway with spontaneous breathing and had a heart rate of 122 beats per minute with a blood pressure of 83/63 mmHg. He was resuscitated initially with three units of packed red cells. Clinical examination identified three incisional wounds each measuring 2 cm. These were in the left para-sternal region, right infra-scapular region and left upper quadrant of the abdomen. The chest wound over the left parasternal area at the level of 4tth intercostal space was bleeding intermittently on leaning forwards and was relieving his breathlessness intermittently. CT imaging was performed to characterize his injuries and determine his management. CT scan of chest and abdomen showed moderate size haemopericardium with left sided haemopneumothorax. The patient underwent urgent surgical repair of the left ventricle and left anterior descending artery. He recovered without complications and was discharged from the hospital. This case highlights the fact that the potential to develop a life threatening cardiac tamponade was mitigated by the left parasternal stab wound. This injury fortuitously provided a pericardial window through which the bleeding from the injured left ventricle and left anterior descending artery could drain into the left hemithorax providing an opportunity for timely surgical intervention to repair the cardiac injuries.

Keywords: stab, incisional, haemo-pericardium, haemo-pneumothorax

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Authors: Iftekhar Hassan, Sayedil Morsalin, Easir A Khan

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Accidents involving fire occur frequently in recent times and their causes showing a great deal of variety which require intervention methods and risk assessment strategies are unique in each case. On September 4, 2020, a fire and explosion occurred in a confined space caused by a methane gas leak from an underground pipeline in Baitus Salat Jame mosque during Night (Esha) prayer in Narayanganj District, Bangladesh that killed 34 people. In this research, this incident is simulated using Fire Dynamics Simulator (FDS) software to analyze and understand the nature of the accident and associated consequences. FDS is an advanced computational fluid dynamics (CFD) system of fire-driven fluid flow which solves numerically a large eddy simulation form of the Navier–Stokes’s equations for simulation of the fire and smoke spread and prediction of thermal radiation, toxic substances concentrations and other relevant parameters of fire. This study focuses on understanding the nature of the fire and consequence evaluation due to thermal radiation caused by vapor cloud explosion. An evacuation modeling was constructed to visualize the effect of evacuation time and fractional effective dose (FED) for different types of agents. The results were presented by 3D animation, sliced pictures and graphical representation to understand fire hazards caused by thermal radiation or smoke due to vapor cloud explosion. This study will help to design and develop appropriate respond strategy for preventing similar accidents.

Keywords: consequence modeling, fire and explosion, fire dynamics simulation (FDS), thermal radiation

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Authors: Huimin Zhao, Xiaoquan Liu, Haochen Liu

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The major challenge facing Alzheimer's Disease (AD) drug development is how to effectively improve cognitive function in clinical practice. Growing evidence indicates that stimulating hippocampal neurogenesis is a strategy for restoring cognition in animal models of AD. The mitogen-activated protein kinase (MAPK) pathway is a crucial factor in neurogenesis, which is negatively regulated by Dual-specificity phosphatase 16 (DUSP16). Transcriptome analysis of post-mortem brain tissue revealed up-regulation of DUSP16 expression in AD patients. Additionally, DUSP16 was involved in regulating the proliferation and neural differentiation of neural progenitor cells (NPCs). Nevertheless, whether the effect of DUSP16 on ameliorating cognitive disorders by influencing NPCs differentiation in AD mice remains unclear. Our study demonstrates an association between DUSP16 SNPs and clinical progression in individuals with mild cognitive impairment (MCI). Besides, we found that increased DUSP16 expression in both 3×Tg and SAMP8 models of AD led to NPC differentiation impairments. By silencing DUSP16, cognitive benefits, the induction of AHN and synaptic plasticity, were observed in AD mice. Furthermore, we found that DUSP16 is involved in the process of NPC differentiation by regulating c-Jun N-terminal kinase (JNK) phosphorylation. Moreover, the increased DUSP16 may be regulated by the ETS transcription factor (ELK1), which binds to the promoter region of DUSP16. Loss of ELK1 resulted in decreased DUSP16 mRNA and protein levels. Our data uncover a potential regulatory role for DUSP16 in adult hippocampal neurogenesis and provide a possibility to find the target of AD intervention.

Keywords: alzheimer's disease, cognitive function, DUSP16, hippocampal neurogenesis

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Authors: Mahboubeh Varmaziar

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Depression is a significant public health concern affecting people of all ages and genders. Physical activity has been shown to have a positive effect on mental health, particularly in alleviating symptoms of depression. This study aims to explore the impact of continuous exercise on depression levels among young female athletes in Hamadan Province, Iran. In this randomized controlled trial, 72 women aged 20 to 35 years attending sports centers in Hamadan Province were selected through convenient sampling and randomly assigned to either the control or experimental group. The experimental group participated in a continuous exercise program consisting of 20 sessions over six weeks, with each session lasting 30 minutes. In contrast, the control group maintained their usual daily activities at the sports center. Both groups completed demographic and Beck Depression Inventory questionnaires. Data were analyzed using descriptive and inferential statistics, including two-way ANOVA. The results of the two-way ANOVA, after controlling for the pre-test effect, revealed a significant difference in the mean depression scores between the control and experimental groups (p < 0.001). This suggests that the continuous exercise program significantly reduced depression levels in the young female athletes. The findings suggest that continuous exercise is an effective non-pharmacological intervention for reducing depression in young female athletes. Incorporating regular physical activity into treatment plans may serve as a complementary therapy alongside conventional treatments, offering a low-risk and beneficial approach to managing depression.

Keywords: depression, exercise, female athletes, yong women

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Authors: Siwarak Kitchanapaibul, Warren Gillibrand, Rob Burton

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The prevalence of diabetes mellitus has been rising all over the world. Self-management is required for diabetes mellitus patients. The objective of this study is to explore the self-management among the ethnic groups with type 2 diabetes mellitus in Thailand, an upper middle-income country which is located in South East Asia. The ethnic groups in Thailand are a minority group which has limited education and a different culture, language, costume and lifestyle from Thai people. The qualitative exploratory study was used in this study. In-depth interviews with semi-structured open questions were conducted by 20 participants from purposive sampling. These participants were the ethnic groups who have type 2 diabetes mellitus, received the services from a region hospital, understood Thai and were willing to participate. Content analysis was adopted for the study. The results showed that all of the participants controlled their diet before the appointment day and never miss their appointment. Only 3 participants did their exercise while 2 participants stated that they occasionally forgot to take medicine. 10 participants use the herbs for reducing the sugar level. 12 participants drank a lot of water after a lapse in the diet because they believed that water could dilute the sugar. The findings identified 5 themes; ‘controlling diet before appointment day’; ‘drinking water after a lapse in diet’; ‘medication being a vital importance’; ‘exercise is unimportant’; and ‘taking herbs for sugar reduction’. The results of this study are important to the health professionals to understand the self-management of Ethnic groups and use the data to create the appropriate intervention for promoting health among the ethnic groups with type 2 diabetes mellitus in Thailand. The findings will lead to the revision of health policy and the procedure for promoting health in this special ethnic groups.

Keywords: self-management, diabetes, ethnic groups, Thailand

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Authors: Syed Toqueer Akhter, Hussain Hamid

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Over the last few decades an upward trend has been observed in the case of labor migration from Pakistan. The emigrants are not just economically motivated and in search of a safe living environment towards more developed countries in Europe, North America and Middle East. The opportunity cost of migration comes in the form of brain drain that is the loss of qualified and skilled human capital. Throughout the history of Pakistan, situations of political instability have emerged ranging from violation of political rights, political disappearances to political assassinations. Providing security to the citizens is a major issue faced in Pakistan due to increase in crime and terrorist activities. The aim of the study is to test the impact of political instability, appearing in the form of political terror, violation of political rights and civil liberty on skilled migration of labor. Three proxies are used to measure the political instability; political terror scale (based on a scale of 1-5, the political terror and violence that a country encounters in a particular year), political rights (a rating of 1-7, that describes political rights as the ability for the people to participate without restraint in political process) and civil liberty (a rating of 1-7, civil liberty is defined as the freedom of expression and rights without government intervention). Using time series data from 1980-2011, the distributed lag models were used for estimation because migration is not a onetime process, previous events and migration can lead to more migration. Our research clearly shows that political instability appearing in the form of political terror, political rights and civil liberty all appeared significant in explaining the extent of skilled migration of Pakistan.

Keywords: skilled labor migration, political terror, political rights, civil liberty, distributed lag model

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Authors: Lauren McGillivray, Michelle Torok, Alison Calear

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Suicide is the leading cause of death for Australians aged 15-24 years, with rates increasing over the past decade. As young people can be particularly vulnerable to mental health problems and suicidal behavior, they are an essential and obvious target for suicide prevention efforts. This study investigates the effectiveness of the universal mental health promotion and suicide prevention program, Youth Aware of Mental Health (YAM), to reduce suicidal ideation and attempts and increase help-seeking in young people. This trial took place in Australian schools across four regions in New South Wales that form part of LifeSpan, a larger multilevel suicide prevention research trial. The YAM program was delivered to Year 9 students in up to 78 schools over two years (from January 2017 to December 2019). All schools were invited to participate in YAM's evaluation, which included completing a student questionnaire at three time-points: baseline, 3-month post-intervention, and 6-month follow-up. The primary outcome is suicidal ideation severity. Secondary outcomes are new reports of suicide attempts, stigma towards suicide, knowledge about suicide, help-seeking intentions and behaviors, and depressive symptoms. Results from pre-post and follow-up data will be presented. These research findings are promising and will contribute to the evidence-based for YAM and suicide prevention programs in Australian schools. These findings are also expected to promote YAM's value and sustainability to be more widely delivered in Australian secondary schools.

Keywords: adolescent mental health, suicidal ideation, suicide prevention, universal program

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Authors: Yong Li

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Major cities in China has experienced a shift from production based on manufacturing industry to tertiary industry. How to make a better use of existing obsolete industrial land within urban cores has become a difficult problem for many policymakers. City governments regard old manufacturing industrial land as an important source of land to facilitate the development of the cities. Despite the announcement of policies in promoting that, a large portion of industrial land is still not properly redeveloped and most of them became obsolete. The study uses the project of Xinyi International Club as a case to examine the process of adaptive reuse of obsolete industrial space in Guangzhou, China. It attempts to elucidate the underlying mechanisms by identifying the key forces from both the government and the private sectors in influencing the process. The study found that market forces in transforming industrial space are exerting a strong impact on the existing land use planning system in Chinese cities. Pragmatic relaxation of the formal land use the regulatory framework and government supportive land-use intervention have also been crucial towards achieving successful implementation of the restructuring project and making it a showcase. This study questions whether these extraordinary measures, in particular, the use of temporary land use permit, are sustainable in facilitating the transformation of derelict industrial land, and in informing future industrial land-use restructuring policies. It concludes that, while the land use regulatory system in China is becoming increasingly dynamic and flexible, it remains ill-equipped in responding positively to the market, which is characterized by an increasing bargaining power of the private sector. A comprehensive appraisal of the overall impacts of these adaptive re-uses on society is wanting.

Keywords: China, land alteration, obsolete industrial properties, urban planning

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Authors: P. Gil Del Álamo, J. García Pereda, A. Castañeda De La Paz, D. Arazola Lopez, M. D. Cubiles De La Vega, A. Enguíx González, J. M. Muñoz Pichardo

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In the last decades, obesity has more than doubled and is, with overweight, the second leading cause of preventable death. Despite multiple strategies against obesity, no country to date has reduced the number of obese people. To achieve World Health Organization’s target to reverse this tendency we need dramatic and different actions to engage the civil society in creating demand for a healthy style of life. The objective of this study is to demonstrate that a social media as the television can be used to convince the civil society that a healthy nutrition and physical activity are affordable, effective and necessary to prevent and to treat the obesity. Methodology: 61 individuals (34 women and 27 men) with obesity (mean BMI 45,51) were recruited to follow during 22 weeks an intensive lifestyle intervention in order to lose weight in a healthy manner. They were not isolated or moved from their usual environment. This program included endocrinological and nutritional assessment, promotion of physical activity and psychological support. BMI was measured every week. Time to leave obesity between men and women was analyzed with a survival analysis. Results: BMI decreased in all the cases. Analysing Time to leave obesity, around the week 30, 25% of men leave the obesity and around the week 39, 25% of women leave the obesity too. Conclusion: We demonstrate the audience that improving the quality of the diet and increasing the physical activity is a realistic way to lose weight. This evidence can encourage the people to act in their own self-interest changing their style of life in order to prevent or to reduce their overweight.

Keywords: obesity epidemic, obesity prevention, obesity strategies, social media

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Authors: Francesco Ruscio, Paolo Paoletti, Jens Thomas, Paul Myers, Sebastiano Fichera

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This paper presents the development of a low-cost monitoring system for a hydroponic urban vertical farm, enabling its automation and a quantitative assessment of the farm performance. Urban farming has seen increasing interest in the last decade thanks to the development of energy efficient and affordable LED lights; however, the optimal configuration of such systems (i.e. amount of nutrients, light-on time, ambient temperature etc.) is mostly based on the farmers’ experience and empirical guidelines. Moreover, even if simple, the maintenance of such systems is labor intensive as it requires water to be topped-up periodically, mixing of the nutrients etc. To unlock the full potential of urban farming, a quantitative understanding of the role that each variable plays in the growth of the plants is needed, together with a higher degree of automation. The low-cost monitoring system proposed in this paper is a step toward filling this knowledge and technological gap, as it enables collection of sensor data related to water and air temperature, water level, humidity, pressure, light intensity, pH and electric conductivity without requiring any human intervention. More sensors and actuators can also easily be added thanks to the modular design of the proposed platform. Data can be accessed remotely via a simple web interface. The proposed platform can be used both for quantitatively optimizing the setup of the farms and for automating some of the most labor-intensive maintenance activities. Moreover, such monitoring system can also potentially be used for high-level decision making, once enough data are collected.

Keywords: automation, hydroponics, internet of things, monitoring system, urban farming

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Authors: Raphael M. Ritti-Dias, Marilia A. Correia, Wagner J. R. Domingues, Aline C. Palmeira, Paulo Longano, Nelson Wolosker, Lauro C. Vianna, Gabriel G. Cucato

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Patients with peripheral arterial disease (PAD) have a high prevalence of hypertension, which contributes to a high risk of acute cardiovascular events and cardiovascular mortality. Strategies to reduce cardiovascular risk of these patients are needed. Meta-analysis studies have shown that isometric handgrip training promotes reductions in clinical blood pressure in normotensive, pre-hypertensive and hypertensive individuals. However, the effect of this exercise training on other cardiovascular function indicators in PAD patients remains unknown. Thus, the aim of this study was to analyze the effects of isometric handgrip training on blood pressure in patients with PAD. In this clinical trial, 28 patients were randomly allocated into two groups: isometric handgrip training (HG) and control (CG). The HG conducted the unilateral handgrip training three days per week (four sets of two minutes, with 30% of maximum voluntary contraction with an interval of four minutes between sets). CG was encouraged to increase their physical activity levels. At baseline and after eight weeks blood pressure and heart rate were obtained. ANOVA two-way for repeated measures with the group (GH and GC) and time (pre- and post-intervention) as factors was performed. After 8 weeks of training there were no significant changes in systolic blood pressure (HG pre 141 ± 24.0 mmHg vs. HG post 142 ± 22.0 mmHg; CG pre 140 ± 22.1 mmHg vs. CG post 146 ± 16.2 mmHg; P=0.18), diastolic blood pressure (HG pre 74 ± 10.4 mmHg vs. HG post 74 ± 11.9 mmHg; CG pre 72 ± 6.9 mmHg vs. CG post 74 ± 8.0 mmHg; P=0.22) and heart rate (HG pre 61 ± 10.5 bpm vs. HG post 62 ± 8.0 bpm; CG pre 64 ± 11.8 bpm vs. CG post 65 ± 13.6 bpm; P=0.81). In conclusion, our preliminary data indicate that isometric handgrip training did not modify blood pressure and heart rate in patients with PAD.

Keywords: blood pressure, exercise, isometric, peripheral artery disease

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Authors: Jamil Ahmed, Li P. Wong, Yan P. Chua

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The United Nation's sustainable development goals include the target to ensure access to water and sanitation for all; however, very few studies have assessed school-based drinking water in Pakistan. The purpose of this study was to characterize water quality in primary schools of Pakistan and to characterize how recent WASH interventions were associated with school water quality. We conducted a representative cross-sectional study of primary schools in the Sindh province of Pakistan. We used structured observations and structured interviews to ascertain the school’s WASH conditions. Our primary exposures of interest were the implementation of previous WASH interventions in the school and the water source type. Outcomes of interest included water quality (measured by various chemical and microbiological indicators) and water availability at the school’s primary drinking water source. We used log-binomial regression to characterize how WASH exposures were associated with water quality outcomes. We collected data from 256 schools. Groundwater was the primary drinking water source at most schools (87%). Water testing showed that 14% of the school’s water had arsenic above the WHO recommendations, and over 50% of the water samples exceeded recommendations for both lead and cadmium. A majority of the water sources (52%) had fecal coliform contamination. None of the schools had nitrate contamination (0%), and few had fluoride contamination (5%). Regression results indicated that having a recent WASH intervention at the school was not associated with either arsenic contamination (prevalence ratio=0.97; 95% CI: 0.46-2.1) or with fecal coliform contamination (PR=0.88; 95% CI: 0.67-1.17). Our assessment unveiled several water quality gaps that exist, including high heavy metal and fecal contamination. Our findings will help various stakeholders to take suitable action to improve water quality in Pakistani schools.

Keywords: WASH interventions, water quality, primary school children, heavy metals

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Authors: Berna Yaylalı, Isin Can Traunmüller

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This paper explores the emergent bottom-up practices in the fields of architecture and urban design within comparative perspectives of two cities. As a temporary, easily affordable intervention that gives the possibility of transforming neglected spaces into vibrant public spaces, tactical urbanism, together with creative place-making strategies, presents alternative ways of creating sustainable developments in derelict and underused areas. This study examines the potential of social and physical developments through a reading of case studies of two creative spatial practices: a pop-up garden transformed from an unused derelict space in Favoriten, Vienna, and an urban community garden in Kuzguncuk, Istanbul. Two cities are chosen according to their multicultural population and diversity. Istanbul was selected as a design city by UNESCO Creative Cities Network in 2017, and Vienna was declared an open and livable city by its local government. This research will use media archives and reports, interviews with locals and local governments, site observations, and visual recordings as methods to provide a critical reading on creative public spaces from the view of local users in these neighborhoods. Reflecting on these emergent ways, this study aims at discussing the production process of tactile urbanism with the practices of locals and the decision-making process with cases from İstanbul and Vienna. The comparison between their place-making strategies in tactical urbanism will give important insights for future developments.

Keywords: creative city, tactical urbanism, neglected area, public space

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Authors: Anthony Idowu Ajayi, Ezebunwa Ethelbert Nwokocha, Wilson Akpan, Oladele Vincent Adeniyi

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Studies on emergency contraception (EC) mostly utilise quantitative methods and focus on medically approved drugs for the prevention of unwanted pregnancies. This methodological bias necessarily obscures insider perspectives on sexual behaviour, particularly on why specific methods are utilized by women who seek to prevent unplanned pregnancies. In order to privilege this perspective, with a view to further enriching the discourse and policy on the prevention and management of unplanned pregnancies, this paper brings together the findings from several focus groups and in-depth interviews conducted amongst unmarried female undergraduate students in two Nigerian universities. The study found that while the research participants had good knowledge of the consequences of unprotected sexual intercourses - with abstinence and condom widely used - participants’ willingness to rely only on medically sound measures to prevent unwanted pregnancies was not always mediated by such knowledge. Some of the methods favored by participants appeared to be those commonly associated with people of low socio-economic status in the society where the study was conducted. Medically unsafe concoctions, some outright dangerous, were widely believed to be efficacious in preventing unwanted pregnancy. Furthermore, respondents’ narratives about their sexual behaviour revealed that inadequate sex education, socio-economic pressures, and misconceptions about the efficacy of “crude” emergency contraception methods were all interrelated. The paper therefore suggests that these different facets of the unplanned pregnancy problem should be the focus of intervention.

Keywords: unplanned pregnancy, unsafe abortion, emergency contraception, concoctions

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Authors: Alexandre H. Okano, Pedro M. D. Agrícola, Daniel G. Da S. Machado, Luiz I. Do N. Neto, Luiz F. Farias Junior, Paulo H. D. Nascimento, Rickson C. Mesquita, John F. Araujo, Eduardo B. Fontes, Hassan M. Elsangedy, Shinsuke Shimojo, Li M. Li

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The prefrontal cortex is involved in the reward system and the insular cortex integrates the afferent inputs arriving from the body’ systems and turns into feelings. Therefore, modulating neuronal activity in these regions may change individuals’ perception in a given situation such as exercise. We tested whether transcranial direct current stimulation (tDCS) change cerebral oxygenation and pleasure during exercise. Fourteen volunteer healthy adult men were assessed into five different sessions. First, subjects underwent to a maximum incremental test on a cycle ergometer. Then, subjects were randomly assigned to a transcranial direct current stimulation (2mA for 15 min) intervention in a cross over design in four different conditions: anode and cathode electrodes on T3 and Fp2 targeting the insular cortex, and Fpz and F4 targeting prefrontal cortex, respectively; and their respective sham. These sessions were followed by 30 min of moderate intensity exercise. Brain oxygenation was measured in prefrontal cortex with a near infrared spectroscopy. Perceived exertion and pleasure were also measured during exercise. The asymmetry in prefrontal cortex oxygenation before the stimulation decreased only when it was applied over this region which did not occur after insular cortex or sham stimulation. Furthermore, pleasure was maintained during exercise only after prefrontal cortex stimulation (P > 0.7), while there was a decrease throughout exercise (P < 0.03) during the other conditions. We conclude that tDCS over the prefrontal cortex changes brain oxygenation in ventromedial prefrontal cortex and maintains perceived pleasure during exercise. Therefore, this technique might be used to enhance effective responses related to exercise.

Keywords: affect, brain stimulation, dopamine neuromodulation, pleasure, reward, transcranial direct current stimulation

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Authors: Masoumeh Khailghi Sikaroudi, Mohsen Masoodi, Fazad Shidfar, Meghdad Sedaghat

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Background: The hypertonicity of internal anal sphincter resting pressure is one of the main reasons for chronic anal fissures. The aim of this study is to assess the effect of oral administration of L-arginine on anal fissure symptom improvement by relaxation of the internal anal sphincter. Method: Seventy-six chronic anal fissure patients (age: 18-65 years) took part in this randomized, double-blind, placebo-controlled trial study from February 2019 to October 2020 at Rasoul-e-Akram Hospital, Tehran, Iran. Participants were allocated into treatment (L-arginine) or placebo groups. They took a 1000 mg capsule three times a day for one month and were followed up at the end of the first and third months after receiving the intervention. Clinical symptoms, anal sphincter resting pressure, and quality of life (QoL) were completed at baseline and the end of the study. Result: The analysis of data was shown significant improvement in bleeding, fissure size, and pain within each group; however, this effect was more seen in the arginine group compared to the control group at the end of the study (P-values<0.001). Following that, a significant increase in QoL was seen just in patients who were treated with arginine (P-value=0.006). Also, the comparison of anal pressures to baseline and between groups at the end of the study showed a significant reduction in sphincter pressure in treated patients (P-value<0.001, =0.049; respectively). Conclusion: Oral administration of 3000 mg L-arginine can heal chronic anal fissures by reducing anal internal sphincter pressure with fewer side effects. However, a long-term study with more follow-up is recommended.

Keywords: L-arginine, anal fissure, sphincter pressure, clinical symptoms, quality of life

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Authors: Daofan Guo, Dong Yang

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For decades, well logging with coiled tubing has relied solely on surface data such as pump pressure, wellhead pressure, depth counter, and weight indicator readings. While this data serves the oil industry well, modern smart logging utilizes real-time downhole information, which automatically increases operational efficiency and optimizes intervention qualities. For example, downhole pressure, temperature, and depth measurement data can be transmitted through the electro-optical hybrid cable in the coiled tubing to surface operators on a real-time base. This paper mainly introduces the unique structural features and various applications of the electro-optical hybrid cables which were deployed into downhole with the help of coiled tubing technology. Fiber optic elements in the cable enable optical communications and distributed measurements, such as distributed temperature and acoustic sensing. The electrical elements provide continuous surface power for downhole tools, eliminating the limitations of traditional batteries, such as temperature, operating time, and safety concerns. The electrical elements also enable cable telemetry operation of cable tools. Both power supply and signal transmission were integrated into an electro-optical hybrid cable, and the downhole information can be captured by downhole electrical sensors and distributed optical sensing technologies, then travels up through an optical fiber to the surface, which greatly improves the accuracy of measurement data transmission.

Keywords: electro-optical hybrid cable, underground photoelectric composite cable, seismic cable, coiled tubing, real-time monitoring

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Authors: Z. Abram, V. Nadasan, J. Balint, J. L. Ferencz

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Introduction: Online smoking prevention programs became popular in the last time. In order to extend the use of such programs, existing applications can be adapted and translated in the native languages of the target groups. It is the first time that in Romania such a software was implemented. Our goal was to provide a computer-aided intervention with attractive content targeting high school students who are familiar with information and communication technology. Material and methods: ASPIRA is the Romanian/Hungarian adapted version of a smoking prevention program created in USA. Prior to apply the questionnaire and ASPIRA online program which contains five modules that include tests, videos and interactive games, the program was tested in some IT laboratories on a group of schoolchildren and students. The pilot study questionnaires were completed considering the opinions of young people and the functionality of the software. Results: Above 90% of participants reported a good or very good impression about the ASPIRA program. Only a small minority found that the program included some parts which were too long or reported the existence of any technical problems regarding the functionality of the software. 76% of the participants had little or very little difficulty in understanding the messages presented by the English speaking characters. Only 7.5% of the participants thought that the program included content that was not appropriate for the local culture. Conclusions: The vast majority of students reported favorite impressions about ASPIRA online program. High school students and boys were more critical. Language and cultural barriers did not have the potential to reduce in a significant manner the effectiveness of the tested program.

Keywords: smoking prevention, ASPIRA online program, youth opinions, language/cultural barriers

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Authors: Teresa Caswell

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Throughout the United States and within a myriad of demographic contexts, students of color experience the results of systemic inequities as an academic outcome. These disparities continue despite the increased resources provided to students and ongoing instruction-focused professional learning received by teachers. The researcher postulated that lower levels of educator cultural competency are an underlying factor of why resource and instructional interventions are less effective than desired. Before implementing any type of intervention, however, cultural competency needed to be confirmed as a factor in schools demonstrating academic disparities between racial subgroups. A needs assessment was designed to measure levels of individual beliefs, including cultural competency, in both principals and teachers at three neighboring schools verified to have academic disparities. The resulting mixed method study utilized the Optimal Theory Applied to Identity Development (OTAID) model to measure cultural competency quantitatively, through self-identity inventory survey items, with teachers and qualitatively, through one-on-one interviews, with each school’s principal. A joint display was utilized to see combined data within and across school contexts. Each school was confirmed to have misalignments between principal and teacher levels of cultural competency beliefs while also indicating that a number of participants in the self-identity inventory survey may have intentionally skipped items referencing the term oppression. Additional use of the OTAID model and self-identity inventory in future research and across contexts is needed to determine transferability and dependability as cultural competency measures.

Keywords: cultural competency, identity development, mixed-method analysis, needs assessment

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Authors: Samantha Meyr, Eman Mirdamadi, Martha Wang, Tao Lowe, Ryan Smith, Quinn Burke

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Critical-sized bone defects (CSD) treatment options remain a major clinical orthopedic challenge. They are uniquely contoured diseased or damaged bones and can be defined as those that will not heal spontaneously and require surgical intervention. Autografts are the current gold standard CSD treatment, which are histocompatible and provoke a minimal immunogenic response; however, they can cause donor site morbidity and will not suffice for the size required for replacement. As an alternative to traditional surgical methods, bone tissue engineering will be implemented via 3D printing methods. A freeze-dried bone matrix (FDBM) is a type of graft material available but will only function as desired when in the presence of bone growth factors. Polycaprolactone (PCL) is a known biodegradable material with good biocompatibility that has been proven manageable in 3D printing as a medical device. A 3D-extrusion printing strategy is introduced to print these materials into scaffolds for bone grafting purposes, which could be more accessible and rapid than the current standard. Mechanical, thermal, cytotoxic, and physical properties were investigated throughout a degradation period of 6 months using fibroblasts and dental pulp stem cells. PCL-FDBM scaffolds were successfully printed with high print fidelity in their respective pore sizes and allograft content. Additionally, we have created a method for evaluating PCL using differential scanning calorimetry (DSC) and have evaluated PCL degradation over roughly 6 months.

Keywords: 3D printing, bone tissue engineering, cytotoxicity, degradation, scaffolds

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Authors: S. Nikpour, S. Vahidi, H. Haghani

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Introduction: Exercise has mental and physical health benefits for patients with advanced stage cancer who actively receive chemotherapy, yet little is known about patients’ levels of interest in becoming more active or their confidence in increasing their activity level. Methods and materials: A convenience sample of 200 patients with advanced-stage cancer who were receiving chemotherapy completed self-report measures assessing physical activity level, mood, and quality-of-life variables. Qualitative data on patient-perceived benefits of, and barriers to, physical activity also were collected, coded by independent raters, and organized by predominant themes. Results: Current physical activity level, physical activity outcome expectations, and positive mood were significantly associated with self-efficacy. Fatigue was the most frequently listed barrier to physical activity; improved physical strength and health were the most commonly listed benefits. Participants identified benefits related to both general health and cancer-symptom management that were related to exercise. 59.5% of participants reported that they were seriously planning to increase or maintain their physical activity level, and over 40% reported having interest in receiving an intervention to become more active. Conclusion: These results suggested that many advanced-stage cancer patients who receive chemotherapy are interested in maintaining or increasing their physical activity level and in receiving professional support for exercise. In addition, these individuals identified general health and cancer-specific benefits of, and barriers to, physical activity. Future research will investigate how these findings may be incorporated into physical activity interventions for advanced-stage oncology patients receiving medical treatment.

Keywords: physical activity, cancer, self-efficacy

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Authors: Julianne Macmullen

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Due to advances in technology and early detection and treatment of cancer, many cancer patients are surviving longer than five years post-diagnosis. Most cancer patients suffer from depression, anxiety, and post-traumatic stress disorder (PTSD) at some point during diagnosis, treatment, and survivorship. A subgroup of patients will continue to suffer from depression and PTSD and require early intervention. Support groups provide patients with the emotional and informational support they require while also giving survivors a sense of community, friendship, and purpose. This type of support is recognized by researchers to improve the quality of life while also decreasing depression and PTSD symptoms. The gaps in the literature include cultural diversity, minorities, and support groups involving cancer types other than breast cancer. Another gap in the literature includes the perceptions of cancer patients as well as longitudinal studies to determine the relationships between support groups and decreased depression and PTSD rates over time. Future research is required to fill the gaps in the literature mentioned previously. Future research is also needed to analyze the difference in age groups and different types of support groups such as professionally-led, peer-led, and online. Implications for practice involve providers assessing for the symptoms of depression and PTSD in order to offer prompt treatment and support services to those patients. In conclusion, social support by way of support groups improves the quality of life, gives survivors a sense of purpose to help others while also gaining the support they need, and reduces the rate of depressive episodes related to PTSD.

Keywords: cancer survivor, survivorship, post-traumatic stress disorder (PTSD), depression, support groups

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Authors: Diobein C. Flores

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The populace in Municipality of Talaingod is composed of Ata-Manobo. The said lumads enrich their culture, orientation and self because the place is a hive of their tribe. In lieu, the study would analyze the participation of the Ata-Manobo in the making of school improvement plan (SIP). Thus, it recommends alternative policy options that would help strengthen their involvement. The school stakeholders-Ata Manobo representatives from students, parent-teacher association, alumni, basic sector, municipal/barangay government unit, civic/social organizations and other government various agencies are the key participants in this study. The research used descriptive design. The responses of the representatives were analyzed through the criteria involved in employing Rational Model. The technical dimension, administrative, political acceptability and economic are the criteria in revealing decision. The policy alternative option 3- recommends to formulate policy for the purpose of capacitating stakeholders or governing council members in the making of SIP was pointed out as the most preferred option. This could strengthen the participation among Ata-Manobo as stakeholders in planning. Hence, the formulation alternative policy- capacitating stakeholders in the crafting of school improvement plan is recommended. The suggested initiative would assist the Department of Education in forging consensus across neighborhoods during the making of SIP. The appropriation of the definite budget to be used during the conduct of capability building activities is also suggested. Training-workshops are identified as possible intervention to ensure that the stakeholders are equipped with necessary knowledge and skills needed in the making of SIP. Indeed, the equal opportunities for all stakeholders regardless of their life circumstances must be noted. With the belief, people must be empowered to take advantage and spearhead progress in the making of SIP.

Keywords: Ata-Manobo Tribe, stakeholders, school improvement plan, Municipality of Talaingod, Philippines

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Authors: Faith Samkange, Juliet Chipumuro, Henry Wanyama

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Business development and entrepreneurship constitute a major part of economic and human development for many countries within the Southern Africa Development Communities (SADC). While a marked increase in entrepreneurship activity has been registered, more than 70% of these business enterprises are still failing particularly in their conceptual years. One of the major reasons for this failure is that project process trends have tended to be fragmented and linear in approach while focusing primarily on isolated articulation of development aspects such as marketing, operations, accounting and human resources management with limited integration. Given the complexity of environmental, economic and human development issues in the SADC region, a multi-disciplinary, transformative, systematic and coordinated approach towards entrepreneurship development may be a more useful approach. This paper develops a proposed conceptual framework for an innovative and sustainable food production and food consumption Agritech entrepreneurship project in the Eastern Cape Province of South Africa based on a systematic review of existing literature. A thematic analysis of the literature reviewed is applied to develop this theoretical contribution to knowledge. The conceptual framework will be tested in a research driven intervention project designed to improve the quality of life for marginalized indigenous African communities by addressing poverty alleviation, unemployment and gender inequality as stipulated in the global sustainable development goals by the United Nations in 2018.

Keywords: innovative entrepreneurship, sustainability, food production and consumption, marginalised communities, poverty alleviation

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Authors: Lalit Tejwani, Reetika Sharma, Arun Singhvi, Himanshu Shekhar

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Purpose: To assess the efficacy of collagen matrix implant (Ologen) in phacotrabeculectomy augmented with mitomycin C (MMC). Methods: A biodegradable collagen matrix (Ologen) was placed in the subconjunctival and subscleral space in twenty-two eyes of 22 patients with glaucoma and cataract who underwent combined phacoemulsification and trabeculectomy augmented with MMC. All of them were examined preoperatively and on the first postoperative day. They were followed for twelve months after surgery. Any intervention needed in follow-up period was noted. Any complication was recorded. The primary outcome measure was postoperative intraocular pressure at one year follow-up. Any additional postoperative treatments needed and adverse events were noted. Results: The mean age of patients included in the study was 57.77 ± 9.68 years (range=36 to 70 years). All the patients were followed for at least one year. Three patients had history of failed trabeculectomy. Fifteen patients had chronic angle closure glaucoma with cataract, five had primary open angle glaucoma with cataract, one had uveitic glaucoma with cataract, and one had juvenile open angle glaucoma with cataract. Mean preoperative IOP was 32.63 ± 8.29 mm Hg, eighteen patients were on oral antiglaucoma medicines. The mean postoperative IOP was 10.09 ± 2.65 mm Hg at three months, 10.36 ± 2.19 mm Hg at six months and 11.36 ± 2.72 mm Hg at one year follow up. No adverse effect related to Ologen was seen. Anterior chamber reformation was done in five patients, and three needed needling of bleb. Four patients needed additional antiglaucoma medications in the follow-up period. Conclusions: Combined phacotrabeculectomy with MMC with Ologen implantation appears to be a safe and effective option in glaucoma patients needing trabeculectomy with significant cataract. Comparative studies with longer duration of follow-up in larger number of patients are needed.

Keywords: combined surgery, ologen, phacotrabeculectomy, success

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Authors: Papai Barman, Harihar Sahoo

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With increasing life expectancy, urbanization, and adult out migration, elder people live without adult child and most of time responsible for grandchild caring while the care is needed for them. On this line, the current study examined the association between grandchild caring (GCC) with different household structures and depression among elderly (60+) grandparents (GP) living in India using Longitudinal Aging Study in India (LASI), 2017-18. HH structure was defined as the skipped-generation household (SGH) where GP and GC lived together without middle generation and the multi-generation household (MGH) where more than two generations lived together. GCC was defined by two categories, compulsive and non-compulsive caring. CES-D depression scale was utilized to measure GP’s mental health. Socio-economic characteristics, chronic diseases, and health behavior were controlled to get the effect of HH structure and GCC considered key explanatory variables. Bivariate analyses showed that the prevalence of elderly lived in SGH in India (2.5%). Prevalence of compulsive caring was found 16.3% in MGH and 51.1% in SGH. Prevalence of depressions was found nearly 37.1 and 49.5% among the GPs responsible for GCC in MGH and SGH, respectively. Using Biprobit and margins results, GPs lived in SGH were 0.40 times (dy/dx=0.40, p<0.001) more likely to report depression than GPs lived in MGH, given the condition on compulsive caring. Ensuring SDG goal-3, health aging, and giving more social security to the elder people responsible for caring while they are needed care at later life, the current study may improve the existing knowledge and help policy makers to make an intervention on this most vulnerable people, especially for the elderly people living in SGH and responsible for caring.

Keywords: household structure, grandchild caring, skipped-generation household, multi-generation household, depression, mental health, India

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Authors: A. A. Adedini, B. A. Aina, P. U. Ogbo

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Child obesity is on the rise globally. According to the World Health Organization, the number of obese children would increase to 70 million by 2025 if no intervention is made. An increase in the prevalence of overweight and obesity amongst school children in Lagos State, Nigeria has been established but specific factors promoting its prevalence are unknown. This aim of this study is to identify the commonly expressed factor(s) responsible for the rise in prevalence of child overweight and obesity in Lagos, Nigeria. Five focus group discussions were conducted with different groups of stake-holders involved in child care, namely: parents, teachers and health workers. Participants were recruited using a purposive sampling method; a validated question guide was employed for the discussion sessions. The discussions were recorded, collated, analysed using Grounded theory to extract themes. Six themes emerged from the discussions as follows: Civilization and lifestyle imbalance resulting from busy work schedules of young mothers leading to adoption of westernized culture promoting preference for processed and fast food meals; insecurity and congestion of the state which discourages out-door activities; ignorance of the populace on the prevalence of child obesity in the state; inadequate educative and enlightenment programmes in schools and by the Nigerian government; myths on child care and body physique and societal perceptions of the children born into affluent homes. Some of the factors responsible for the rise in the prevalence of child obesity in Lagos, Nigeria have been identified. Preventive strategies to control the prevalence of obesity in children residing in Lagos state is considered for further studies.

Keywords: Childhood Obesity, factors, lagos state, stakeholders

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