Search results for: HIV/AIDS interventions

Authors: Flex Anim

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The financial system is a decentralized studies system that was put into place in Ghana as a grassroots financial studies approach. Its main goal is to give people the precise knowledge, abilities, and training required for a given trade, business, profession, or occupation. In this essay, the question of how the financial studies system's devolution to local businesses results in responsible and responsive representation as well as long-term company learning is raised. It centers on two case studies, Asekwa Municipal and Oforikrom. The next question posed by the study is how senior high school students are rebuilding their livelihoods and socioeconomic well-being by creating new curriculum and social practices related to the finance and business studies system. The paper here concentrates on Kumasi District and makes inferences for the other two examples. The paper demonstrates how the financial studies system's establishment of representative groups creates the democratic space required for the successful representation of community goals. Nonetheless, the interests of a privileged few are advanced as a result of elite capture. The state's financial and business training programs do not adhere to the financial studies system's established policy procedures and do not transfer pertinent and discretionary resources to local educators. As a result, local educators are unable to encourage representation that is accountable and responsive. The financial studies system continues to pique the interest of rural areas, but this desire is skewed toward getting access to financial or business training institutions for higher education. Since the locals are not actively involved in financial education, the financial studies system serves just to advance the interests of specific populations. This article explains how rhetoric and personal benefits can be supported by the public even in the case of "failed" interventions.

Keywords: financial studies system, financial studies' devolution, local government, senior high schools and financial education, as well as community goals and representation

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Authors: Loyce Nahwera, Joy Wachira, Edwin Kiptolo, Constance Nsibambi, Mshilla Maghanga, Timothy Makubuya

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Introduction: Hypertension is one of the most prominent risk factors for cardiovascular diseases globally, and it can be modified through lifestyle interventions such as exercise. The objective of this study was to investigate the effects of a 12-week aerobic dance programme on systolic blood pressure (SBP) in stage 1 hypertensive individuals. Methods: This study employed an experimental research design. A total of 36 stage 1 hypertensive individuals who were randomly assigned into experimental and control groups completed the study. Systolic BP was measured using a mercury sphygmomanometer at baseline, mid-point and after the program. The experimental group participants trained 3 days a week, 45 minutes per session, at a moderate intensity of 40-60% of maximum oxygen consumption (VO2max) monitored by Garmin heart rate monitors. Data were analyzed using SPSS version 20. The significance level was set at p<0.05. A paired sample t-test was used to compare mean differences within the groups. Results: Data from the 36 participants (22 males and 14 females) (experimental; n=18, control; n=18) show that the experimental group had a mean SBP of 143.83±6.382 mmHg at baseline while the control had a mean of 137.61±6.400 mmHg. Following the end of a 6-week aerobic dance, the mean SBP of the experimental group reduced to 138.06±9.539 mmHg while that of the control marginally decreased to 137.00±8.073 mmHg. At the completion of a 12-week program, the mean SBP of the experimental group reduced to 136.33±9.191 mmHg, while that of the control marginally increased to 139.56±9.954 mmHg. This implies that both the 6-week and 12-week aerobic dance program reduced the SBP of the experimental group by 5.77±7.133 mmHg and 7.50±8.487 mmHg, respectively, while the control group fast reduced marginally by 0.61 before ultimately increasing by 1.95±7.974 mmHg at 12-weeks. The changes were statistically significant (p<0.05) at both 6 and 12 weeks of an aerobic dance program. Conclusion: The study concluded that aerobic dance is an effective non-pharmacological method for managing SBP of stage 1 hypertensive individuals both in the short-term (6 weeks) and long-term (12 weeks).

Keywords: aerobic dance, blood pressure, stage 1 hypertension, systolic blood pressure.

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Authors: Lydia Murugi Mugendi

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The promotion of tree growing as a lucrative enterprise is the focus of this paper as management practices have shifted focus from protection of natural forest resources to community/government partnerships with the aim of resource conservation, management and increase of on-farm tree growing. Using KEFRI as (the source) of information pertaining Melia volkensii (the medium or message) being transferred, this paper investigates the current perception towards forestry and the behavioural attitudes of recipients of forest intervention activities. The two objectives explored in this paper are to find out the level of adoption of Mukau in Kitui, Kibwezi and Samburu/Taru and secondly, to find out the characteristics of the adoption process between Kitui, Kibwezi and Samburu/Taru. The methodologies used during data collection were participatory rural appraisal tools in conjunction with the social survey questionnaires. Simple random sampling and snowball sampling were used to identify respondents within the three target sites and analysis was done using SPSS. Results of the study of indicating that adoption rates of the Mukau in Samburu/Taru, where forestry-related activities were introduced within the past one decade had significantly increase despite initial resistance. The other areas, which had benefited from numerous decades of intense forestry extension projects and activities, indicated a decline in re-adoption rates of Mukau as an enterprise. This study has brought out the reality of adoption trends and state of Mukau population within the three counties while providing a glimpse towards the communities’ perception in regards to adoption of forestry and other environmental innovations. The outcome of the study is to provide a guideline for extension/ dissemination officers in KEFRI and related stakeholders to promote seamless cohesive interaction between the recipient communities of the proposed interventions.

Keywords: adoption, innovation, enterprise, extension, DOI Theory

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Authors: Jiajia Peng, Jianqing Qiu, Jianjun Ren, Yu Zhao

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Background: Insufficient sleep has been focused on as a public health epidemic. However, a comprehensive analysis of disease trajectory associated with unhealthy sleep habits is still unclear currently. Objective: This study sought to comprehensively clarify the disease's trajectory in relation to the overall poor sleep pattern and unhealthy sleep behaviors separately. Methods: 410,682 participants with available information on sleep behaviors were collected from the UK Biobank at the baseline visit (2006-2010). These participants were classified as having high- and low risk of each sleep behavior and were followed from 2006 to 2020 to identify the increased risks of diseases. We used Cox regression to estimate the associations of high-risk sleep behaviors with the elevated risks of diseases, and further established diseases trajectory using significant diseases. The low-risk unhealthy sleep behaviors were defined as the reference. Thereafter, we also examined the trajectory of diseases linked with the overall poor sleep pattern by combining all of these unhealthy sleep behaviors. To visualize the disease's trajectory, network analysis was used for presenting these trajectories. Results: During a median follow-up of 12.2 years, we noted 12 medical conditions in relation to unhealthy sleep behaviors and the overall poor sleep pattern among 410,682 participants with a median age of 58.0 years. The majority of participants had unhealthy sleep behaviors; in particular, 75.62% with frequent sleeplessness, and 72.12% had abnormal sleep durations. Besides, a total of 16,032 individuals with an overall poor sleep pattern were identified. In general, three major disease clusters were associated with overall poor sleep status and unhealthy sleep behaviors according to the disease trajectory and network analysis, mainly in the digestive, musculoskeletal and connective tissue, and cardiometabolic systems. Of note, two circularity disease pairs (I25→I20 and I48→I50) showed the highest risks following these unhealthy sleep habits. Additionally, significant differences in disease trajectories were observed in relation to sex and sleep medication among individuals with poor sleep status. Conclusions: We identified the major disease clusters and high-risk diseases following participants with overall poor sleep health and unhealthy sleep behaviors, respectively. It may suggest the need to investigate the potential interventions targeting these key pathways.

Keywords: sleep, poor sleep, unhealthy sleep behaviors, disease trajectory, UK Biobank

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Authors: Kelly E. Tow, Peter Caputi, Claudia Rogge, Thomas Lee, Simon R. Knowles

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Inflammatory Bowel Disease (IBD) is a serious chronic health condition, characterised by inflammation of the gastrointestinal tract. Individuals with active IBD experience severe abdominal symptoms, which can adversely impact their physical and mental health, as well as their quality of life (QoL). Given that stress may exacerbate IBD symptoms and is frequently highlighted as a contributing factor for the development of psychological difficulties and poorer QoL, it is vital to investigate stress-management strategies aimed at improving the lives of those with IBD. The present study extends on the limited research in IBD cohorts by exploring the role of dispositional mindfulness and its impact on psychological well-being and QoL. The study examined how disease activity and dispositional mindfulness were related to psychological distress and QoL in a cohort of IBD patients. The potential role of dispositional mindfulness as a moderator between stress and anxiety, depression and QoL in these individuals was also examined. Participants included 47 patients with a clinical diagnosis of IBD. Each patient completed a series of psychological questionnaires and was assessed by a gastroenterologist to determine their disease activity levels. Correlation analyses indicated that disease activity was not significantly related to psychological distress or QoL in the sample of IBD patients. However, dispositional mindfulness was inversely related to psychological distress and positively related to QoL. Furthermore, moderation analyses demonstrated a significant interaction between stress and dispositional mindfulness on anxiety. These findings demonstrate that increased levels of dispositional mindfulness may be beneficial for individuals with IBD. Specifically, the results indicate positive links between dispositional mindfulness, general psychological well-being and QoL, and suggest that dispositional mindfulness may attenuate the negative impacts of stress on levels of anxiety in IBD patients. While further research is required to validate and expand on these findings, the current study highlights the importance of addressing psychological factors in IBD and indicates support for the use of mindfulness-based interventions for patients with the disease.

Keywords: anxiety, depression, dispositional mindfulness, inflammatory bowel disease, quality of life, stress

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Authors: Michael Ryan, Rosemary E. Borgerding, Kimberly L. Oliver

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The objective of this study was to assess the effectiveness of a sports nutrition intervention on body composition in high-school athletes. The study aimed to improve the food and water intake of high-school athletes, evaluate the cost-effectiveness of the intervention, and assess changes in body fat. Data were collected through observations, questionnaires, and interviews. Additionally, bioelectrical impedance analysis was performed to assess the body composition of athletes both before and after the intervention. Athletes (n=25) participated in researcher-monitored training sessions three times a week over the course of 12 weeks. During these sessions, in addition to completing their auxiliary sports training, participants were exposed to educational interventions aimed at improving their nutrition. These included discussions regarding current eating habits, nutritional guidelines for athletes, and individualized recommendations. Food was also made available to athletes for consumption before and after practice. Meals of balanced macronutrient composition were prepared and provided to athletes on four separate occasions throughout the intervention, either prior to or following a competitive event such as a tournament or game. A paired t-test was used to determine the statistical significance of the changes in body fat percentage. The results showed that there was a statistically significant difference between pre and post-intervention body fat percentage (p= .006). Cohen's d of 0.603 was calculated, indicating a moderate effect size. In conclusion, this study provides evidence that a sports nutrition intervention that combines food availability, explicit prescription, and education can be effective in improving the body composition of high-school athletes. However, it's worth noting that this study had a small sample size, and the conclusions cannot be generalized to a larger population. Further research is needed to assess the scalability of this study. This preliminary study demonstrated the feasibility of this type of nutritional intervention and laid the groundwork for a larger, more extensive study to be conducted in the future.

Keywords: bioelectrical impedance, body composition, high-school athletes, sports nutrition, sports pedagogy

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Authors: Kalimah Ibrahiim, Israa Elmousa

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This study employed the world café method alongside semi-structured interviews within a 'conversation café' setting to engage stakeholders from the public health and primary care sectors. The objective was to collaboratively explore strategies to improve outcomes for young people not in education, employment, or training (NEET). The discussions were aimed at identifying the underlying causes of disparities faced by NEET individuals, exchanging experiences, and formulating community-driven solutions to bolster preventive efforts and shape policy initiatives. A thematic analysis of the qualitative data gathered emphasized the importance of community problem-solving through the exchange of ideas and reflective discussions. Healthcare professionals reflected on their potential roles, pinpointing a significant gap in understanding the specific needs of the NEET population and the unclear distribution of responsibilities among stakeholders. The results underscore the necessity for a unified approach in primary care and the fostering of multi-agency collaborations that focus on addressing social determinants of health. Such strategies are critical not only for the immediate improvement of health outcomes for NEET individuals but also for informing broader policy decisions that can have long-term benefits. Further research is ongoing, delving deeper into the unique challenges faced by this demographic and striving to develop more effective interventions. The study advocates for continued efforts to integrate insights from various sectors to create a more holistic and effective response to the needs of the NEET population, ensuring that future strategies are informed by a comprehensive understanding of their circumstances and challenges.

Keywords: multi-agency working, primary care, public health, social inequalities

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Authors: M. A. Barros, M. V. Barros

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The aim of this work is to analyze the discursive dynamics of preservice teachers during the implementation of a didactic sequence on topics of Quantum Mechanics for High School. Our research methodology was qualitative, case study type, in which we selected two prospective teachers on the Physics Teacher Training Course of the Sao Carlos Institute of Physics, at the University of Sao Paulo/Brazil. The set of modes of communication analyzed were the intentions and interventions of the teachers, the established communicative approach, the patterns and the contents of the interactions between teachers and students. Data were collected through video recording, interviews and questionnaires conducted before and after an 8 hour mini-course, which was offered to a group of 20 secondary students. As teaching strategy we used an active learning methodology, called: Peer Instruction. The episodes pointed out that both future teachers used interactive dialogic and authoritative communicative approaches to mediate the discussion between peers. In the interactive dialogic dimension the communication pattern was predominantly I-R-F (initiation-response-feedback), in which the future teachers assisted the students in the discussion by providing feedback to their initiations and contributing to the progress of the discussions between peers. Although the interactive dialogic dimension has been preferential during the use of the Peer Instruction method the authoritative communicative approach was also employed. In the authoritative dimension, future teachers used predominantly the type I-R-E (initiation-response-evaluation) communication pattern by asking the students several questions and leading them to the correct answer. Among the main implications the work contributes to the improvement of the practices of future teachers involved in applying active learning methodologies in classroom by identifying the types of communicative approaches and communication patterns used, as well as researches on curriculum innovation in physics in high school.

Keywords: curricular innovation, high school, physics teaching, discursive dynamics

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Authors: Josephine Emebiziogo Anene-Okeakwa

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This study investigates the challenges and opportunities for gender equality in vocational education in Awka South, Anambra State, Nigeria. Recognizing the critical role of vocational education in economic development, the research aims to evaluate the current state of gender equality, identify key barriers faced by female students, assess the impact of government policies, and explore opportunities for enhancing gender equality in this sector. Ten vocational schools within Awka South were randomly selected, and a total of 1,000 questionnaires were distributed among students, with 991 completed and returned, yielding a high response rate of 99.1%, and the retrieved data were analyzed using SPSS. The findings indicate significant gender disparities in vocational education enrollment and participation, with male students overwhelmingly outnumbering female students in most technical and engineering-related programs. Key barriers identified include cultural norms discouraging females from pursuing technical fields, economic constraints, lack of female role models, and social stereotypes regarding gender roles. Despite various government policies aimed at promoting gender equality, their implementation and effectiveness remain inadequate, as reflected in persistent gender disparities. However, opportunities for improving gender equality were identified, such as implementing gender-sensitive curricula, expanding mentorship programs for female students, and adopting best practices from other countries. The study recommends enhancing access to vocational training resources, implementing gender-sensitive curricula, expanding mentorship programs, and strengthening the implementation and monitoring of government policies. Addressing these challenges through targeted interventions is essential for achieving gender parity in vocational education, thereby empowering female students and contributing to Nigeria's socio-economic development.

Keywords: vocational education, gender equality, barriers, government policies

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Authors: Cristina Cirone, Katrina Cirone, Monali S. Malvankar-Mehta

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Purpose: An increased risk of visual impairment has been observed in individuals lacking a balanced diet. The purpose of this paper is to characterize the relationship between plant-based diets and specific ocular outcomes among adults. Design: Systematic review and meta-analysis. Methods: This systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines. The databases MEDLINE, EMBASE, Cochrane, and PubMed, were systematically searched up until May 27, 2021. Of the 503 articles independently screened by two reviewers, 21 were included in this review. Quality assessment and data extraction were performed by both reviewers. Meta-analysis was conducted using STATA 15.0. Fixed-effect and random-effect models were computed based on heterogeneity. Results: A total of 503 studies were identified which then underwent duplicate removal and a title and abstract screen. The remaining 61 studies underwent a full-text screen, 21 progressed to data extraction and fifteen were included in the quantitative analysis. Meta-analysis indicated that regular consumption of fish (OR = 0.70; CI: [0.62-0.79]) and skim milk, poultry, and non-meat animal products (OR = 0.70; CI: [0.61-0.79]) is positively correlated with a reduced risk of visual impairment (age-related macular degeneration, age-related maculopathy, cataract development, and central geographic atrophy) among adults. Consumption of red meat [OR = 1.41; CI: [1.07-1.86]) is associated with an increased risk of visual impairment. Conclusion: Overall, a pescatarian diet is associated with the most favorable visual outcomes among adults, while the consumption of red meat appears to negatively impact vision. Results suggest a need for more local and government-led interventions promoting a healthy and balanced diet.

Keywords: plant-based diet, pescatarian diet, visual impairment, systematic review, meta-analysis

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Authors: Inbal Zuriely, Yonit Weiss, Hilla Zaharoni, Hadas Lewkowicz, Tatiana Vander, Tarif Bader

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early active movement, along with adjusting optimal nutrition, prevents aggravation of muscle degeneracy and functional decline. Eating is a basic activity of daily life, which reflects the patient's independence. When eating and feeding are experienced successfully, they lead to a sense of pleasure and satisfaction. However, when they are experienced as a difficulty, they might evoke feelings of helplessness and frustration. This stresses the essential process of gradual weaning off the enteral feeding tube. the work describes the collaboration of a dietitian, determining the nutritional needs of patients undergoing enteral tube weaning as part of the rehabilitation process, with the suited treatment of an occupational therapist. Occupational therapy intervention regarding eating capabilities focuses on improving the required motor and cognitive components, along with environmental adjustments and aids, imparting eating strategies and training to patients and their families. The project was conducted in the long-term, ventilated patients’ department at the Herzfeld Rehabilitation Geriatric Medical Center on patients undergoing enteral tube weaning with the staff’s assistance. Establishing continuous collaboration between the dietician and the occupational therapist, starting from the beginning of the feeding-tube weaning process: 1.The dietician updates the occupational therapist about the start of the process and the approved diet. 2.The occupational therapist performs cognitive, motor, and functional assessments and treatments regarding the patient’s eating capabilities and recommends the required adjustments for independent eating according to the FIM (Functional Independence Measure) scale. 3.The occupational therapist closely follows up on the patient’s degree of independence in eating and provides a repeated update to the dietician. 4.The dietician accordingly guides the ward staff on whether and how to feed the patient or allow independent eating. The project aimed to promote patients toward independent feeding, which leads to a sense of empowerment, enjoyment of the eating experience, and progress of functional ability, along with performing active movements that will motivate mobilization. From the beginning of 2022, 26 patients participated in the project. 79% of all patients who started the weaning process from tube feeding achieved different levels of independence in feeding (independence levels ranged from supervision (FIM-5) to complete independence (FIM-7). The integration of occupational therapy and dietary treatment is based on a patient-centered approach while considering the patient’s personal needs, preferences, and goals. This interdisciplinary partnership is essential for meeting the complex needs of prolonged mechanically ventilated patients and promotes independent functioning and quality of life.

Keywords: dietary, mechanical ventilation, occupational therapy, tube feeding weaning

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Authors: Naif A. Haddad

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Greek, Hellenistic and Roman theatre heritage are exposed to multiple risks at varied times or simultaneously. There is no single reason why a theatre building becomes ‘at risk’, as each case has different circumstances which have led to the theatre building decay. There are complicated processes of destruction and distress that show divergence in theatre building materials' decay. Theatre modern use for cultural performances causes much of the risks concerning the physical structure and authenticity of theatre sites. In addition, there are some deterioration and deformations due to previous poor quality restorations and interventions through related excavation and conservation programmes as also risks to authenticity due to new additions. For preventive conservation, theatre natural and anthropogenic risks management can provide a framework for decision making. These risks to ancient theatre heritage may stem from exposure to one or more risk or synergy of many factors. We, therefore, need to link the theatre natural risks to the risks that come from anthropogenic factors associated with social and economic development. However, this requires a holistic approach, and systematic methodology for understanding these risks from various sources while incorporating specific actions, planning and strategies for each specific risk. Elaborating on recent relevant studies, and ERATO and ATHENA EU projects for ancient theaters and odea and general surveys, this paper attempts to discuss the main aspects of the ancient Greek, Hellenistic and Roman theatres risk related issues. Relevant case studies shall also be discussed and investigated to examine frameworks for risk mitigation, and related guidelines and recommendations that provide a systematic approach for sustainable management and planning in relation mainly to ‘compatible use’ of theatre sites.

Keywords: cultural heritage management, European ancient theatres projects, Anthropogenic risks mitigation, sustainable management and planning, preventive conservation, modern use, compatible use

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Authors: Kiran Sharma, Viktor Kunder, Zerha Rizvi, Ricardo Soubelet

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Platelet rich plasma (PRP) has been recognized as a method of treatment in medicine since the 1980s. It primarily functions by releasing cytokines and growth factors that promote wound healing; these growth promoting factors released by PRP enact new processes such as angiogenesis, collagen deposition, and tissue formation that can change wound healing outcomes. Many studies recognize that PRP aids in chronic wound healing, which is advantageous for patients who suffer from chronic diabetic foot ulcers (DFUs). This scoping review aims to examine literature to identify the efficacy of PRP use in the healing of DFUs. Following PRISMA guidelines, we searched randomized-controlled trials involving PRP use in diabetic patients with foot ulcers using PubMed, Medline, CINAHL Complete, and Cochrane Database of Systematic Reviews. We restricted the search to articles published during 2005-2022, full texts in the English language, articles involving patients aged 19 years or older, articles that used PRP on specifically DFUs, articles that included a control group, articles on human subjects. The initial search yielded 119 articles after removing duplicates. Final analysis for relevance yielded 8 articles. In all cases except one, the PRP group showed either faster healing, more complete healing, or a larger percentage of healed participants. There were no situations in the included studies where the control group had a higher rate of healing or decreased wound size as compared to a group with isolated PRP-only use. Only one study did not show conclusive evidence that PRP caused accelerated healing in DFUs, and this study did not have an isolated PRP variable group. Application styles of PRP for treatment were shown to influence the level of healing in patients, with injected PRP appearing to achieve the best results as compared to topical PRP application. However, this was not conclusive due to the involvement of several other variables. Two studies additionally found PRP to be useful in healing refractory DFUs, and one study found that PRP use in patients with additional comorbidities was still more effective in healing DFUs than the standard control groups. The findings of this review suggest that PRP is a useful tool in reducing healing times and improving rates of complete wound healing in DFUs. There is room for further research in the application styles of PRP before conclusive statements can be made on the efficacy of injected versus topical PRP healing based on the findings in this study. The results of this review provide a baseline for further research in PRP use in diabetic patients and can be used by both physicians and public health experts to guide future treatment options for DFUs.

Keywords: diabetic foot ulcer, DFU, platelet rich plasma, PRP

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Authors: Santosh Sharma

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Background: Drug abuse, needle sharing, and risky sexual behaviour are often compounded to increase the risk of HIV transmission. Injecting Drug Users are at the duel risk of needle sharing and risky sexual Behaviour, becoming more vulnerable to STI and HIV. Thus, studying the interface of injecting drug use and risky sexual behaviour is important to curb the pace of HIV epidemic among IDUs. The aim of this study is to determine the factor associated with HIV among injecting drug users in three states of India. Materials and methods: This paper analyzes covariates of multiplicity of risk behavior among injecting drug users. Findings are based on data from Integrated Behavioral and Biological Assessment (IBBA) round 2, 2010. IBBA collects the information of IDUs from the six districts. IDUs were selected on the criteria of those who were 18 years or older, who injected addictive substances/drugs for non-medical purposes at least once in past six month. A total of 1,979 in round 2 were interviewed in the IBBA. The study employs quantitative techniques using standard statistical tools to achieve the above objectives. All results presented in this paper are unweighted univariate measures. Results: Among IDUs, average duration of injecting drugs is 5.2 years. Mean duration between first drug use to first injecting drugs among younger IDUs, belongs to 18-24 years is 2.6 years Needle cleaning practices is common with above two-fifths reporting its every time cleaning. Needle sharing is quite prevalent especially among younger IDUs. Further, IDUs practicing needle sharing exhibit pervasive multi-partner behavior. Condom use with commercial partners is almost 81 %, whereas with intimate partner it is 39 %. Coexistence of needle sharing and unprotected sex enhances STI prevalence (6.8 %), which is further pronounced among divorced/separated/widowed (9.4 %). Conclusion: Working towards risk reduction for IDUs must deal with multiplicity of risk. Interventions should deal with covariates of risk, addressing youth, and risky sexual behavior.

Keywords: IDUs, HIV, STI, behaviour

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Authors: Nuo Xu, Sijing Chen

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Background: Childbirth is considered a critical traumatic event throughout our lives, positively or negatively impacting the mother's physiology, psychology, and even the whole family. Adverse birth experiences, such as labor pain, anxiety, and fear can negatively impact the mother. Studies had shown that the immersive nature of VR can distract attention from pain and increase focus on interventions for pain relief. However, the existing studies that applied VR to maternal delivery were still in their infancy and showed disparate results, and the small sample size is not representative, so this review analyzed the effects of VR in labor, such as on maternal pain and anxiety, with a view to providing a basis for future applications. Search strategy: We searched Pubmed, Embase, Web of Science, the Cochrane Library, CINAHL, China National Knowledge Infrastructure, Wan-Fang database from the building to November 17, 2021. Selection Criteria: Randomized controlled trials (RCTs) that intervened the pregnant women aged 18-35 years with gestational >34 weeks and without complications with VR technology were contained within this review. Data Collection and Analysis: Two researchers completed the study selection, data extraction, and assessment of study quality. For quantitative data we used MD or SMD, and RR (risk ratio) for qualitative data. Random-effects model and 95% confidence interval (95% CI) were used. Main Results: 12 studies were included. Using VR could relieve pain during labor (MD=-1.81, 95% CI (-2.04, -1.57), P< 0.00001) and active period (SMD=-0.41, 95% CI (-0.68, -0.14), P= 0.003), reduce anxiety (SMD=-1.39, 95% CI (-1.99, -0.78), P< 0.00001) and improve satisfaction (RR = 1.32; 95% CI (1.10, 1.59); P = 0.003), but the effect on the duration of first (SMD=-1.12, 95% CI (-2.38, 0.13), P=0.08) and second (SMD=-0.22, 95% CI (-0.67, 0.24), P=0.35) stage of labor was not statistically significant. Conclusions: Compared with conventional care, VR technology can relieve labor pain and anxiety and improve satisfaction. However, extensive experimental validation is still needed.

Keywords: virtual reality, delivery, labor pain, anxiety, meta-analysis, systematic review

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Authors: Anetta Caplanova, Eva Sirakovova, Estera Szakadatova

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Non-payment of taxes and fees represents a problem, which occurs at national and local government levels in many countries. An effective tax collection is key for generating government and local government budget revenues to finance public services and infrastructure; thus, there is the need to address this problem. The standard approach considers as a solution raising taxes/fees to boost public revenues, which may be politically challenging and time-consuming to implement. An alternative approach is related to using behavioral interventions. These can be usually implemented relatively quickly, and in most cases, they are associated with low cost. In the paper, we present the results of the behavioral experiment focused on raising the level of compliance with the payment of garbage collection fees in a selected municipality in the Slovak Republic. The experiment was implemented using the leaflets sent to residential households together with the invoice for the garbage collection in the municipality Hlohovec, Western Slovakia, in Spring 2021. The sample of about 10000 households was divided into three random groups, a control group and two intervention groups. Households in intervention group 1 were sent a leaflet using the social norm nudge, while households in intervention group 2 were sent a leaflet using the deterrence nudge. The social norm framing leaflet pointed out that in the municipality, the prevailing majority of people paid the garbage collection fee and encouraged recipients to join this majority. The deterrent leaflet reminded the recipients that if they did not pay the fee on time, enforcement proceedings would follow. This was aimed to increase the subjective perception of citizens of the enforcement proceedings in case of noncompliance. In the paper, we present and discuss the results from the experiment and formulate relevant generalizations for other municipalities.

Keywords: municipal governments, garbage fee collection, behavioural intervention, social norm, deterrence nudge

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Authors: Min L. Stewart, Patrick Johnston

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Predictive coding has been proposed as a general explanatory framework for understanding the neural mechanisms of perception. As such, an underweighting of perceptual priors has been hypothesised to underpin a range of differences in inferential and sensory processing in autism spectrum disorders. However, empirical evidence to support this has not been well established. The present study uses an electroencephalography paradigm involving changes of facial identity and person category (actors etc.) to explore how levels of autistic traits (AT) affect predictive coding at multiple stages in the visual processing hierarchy. The study uses a rapid serial presentation of faces, with hierarchically structured sequences involving both periodic and aperiodic repetitions of different stimulus attributes (i.e., person identity and person category) in order to induce contextual expectations relating to these attributes. It investigates two main predictions: (1) significantly larger and late neural responses to change of expected visual sequences in high-relative to low-AT, and (2) significantly reduced neural responses to violations of contextually induced expectation in high- relative to low-AT. Preliminary frequency analysis data comparing high and low-AT show greater and later event-related-potentials (ERPs) in occipitotemporal areas and prefrontal areas in high-AT than in low-AT for periodic changes of facial identity and person category but smaller ERPs over the same areas in response to aperiodic changes of identity and category. The research advances our understanding of how abnormalities in predictive coding might underpin aberrant perceptual experience in autism spectrum. This is the first stage of a research project that will inform clinical practitioners in developing better diagnostic tests and interventions for people with autism.

Keywords: hierarchical visual processing, face processing, perceptual hierarchy, prediction error, predictive coding

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Authors: Aldona Kluczek

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In recent years, manufacturing processes have interacted with sustainability issues realized in the cost-effective ways that minimalize energy, decrease negative impacts on the environment and are safe for society. However, the attention has been on separate sustainability assessment methods considering energy and material flow, energy consumption, and emission release or process control. In this paper, the energy-led sustainability assessment approach combining the methods: energy Life Cycle Assessment to assess environmental impact, Life Cycle Cost to analyze costs, and Social Life Cycle Assessment through ‘energy LCA-based value stream map’, is used to assess the energy sustainability of the hardwood lumber manufacturing process in terms of technologies. The approach integrating environmental, economic and social issues can be visualized in the considered energy-efficient technologies on the map of an energy LCA-related (input and output) inventory data. It will enable the identification of efficient technology of a given process to be reached, through the effective analysis of energy flow. It is also indicated that interventions in the considered technology should focus on environmental, economic improvements to achieve energy sustainability. The results have indicated that the most intense energy losses are caused by a cogeneration technology. The environmental impact analysis shows that a substantial reduction by 34% can be achieved with the improvement of it. From the LCC point of view, the result seems to be cost-effective, when done at that plant where the improvement is used. By demonstrating the social dimension, every component of the energy of plant labor use in the life-cycle process of the lumber production has positive energy benefits. The energy required to install the energy-efficient technology amounts to 30.32 kJ compared to others components of the energy of plant labor and it has the highest value in terms of energy-related social indicators. The paper depicts an example of hardwood lumber production in order to prove the applicability of a sustainability assessment method.

Keywords: energy efficiency, energy life cycle assessment, life cycle cost, social life cycle analysis, manufacturing process, sustainability assessment

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Authors: Briony Gray, Glenn Simpson, Hajira Dambha-Miller, Andrew Farmer

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Multimorbidity may be strongly affected by a variety of conditions, factors, and variables requiring higher demands on health and social care services, infrastructure, and expenses. Holding one or more conditions increases one’s risk for development of future conditions; with patients over 65 years old at highest risk. Psychosocial factors such as anxiety and depression are rising exponentially globally, which has been amplified by the COVID19 pandemic. These are highly correlated and predict poorer outcomes when held in coexistence and increase the likelihood of comorbid physical health conditions. While possible future reform of social and healthcare systems may help to alleviate some of these mounting pressures, there remains an urgent need to better understand the potential role health behaviours and psychosocial conditions - such as anxiety and depression – may have on aging populations. Using the UK healthcare scene as a lens for analysis, this study uses big data collected in the UK Longitudinal Study of Aging (ELSA) to examine the role of anxiety and depression in ageing populations (65yrs+). Using logistic regression modelling, results identify the 10 most significant variables correlated with both anxiety and depression from data categorised into the areas of health behaviour, psychosocial, socioeconomic, and life satisfaction (each demonstrated through literature review to be of significance). These are compared with wider global research findings with the aim of better understanding the areas in which social and healthcare reform can support multimorbidity interventions, making suggestions for improved patient-centred care. Scope of future research is outlined, which includes analysis of 59 total multimorbidity variables from the ELSA dataset, going beyond anxiety and depression.

Keywords: multimorbidity, health behaviours, patient centred care, psychosocial factors

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Authors: Abraham Ampong

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BACKGROUND AND SIGNIFICANCE OF THE STUDY: The development of information technology and its influence today is inevitable in the world of education. The development of information technology and communication (ICT) has an impact on the use of teaching aids such as computers and the Internet, for example, E-learning. E-learning is a learning process attained through electronic means. But learning is not merely technology because learning is essentially more about the process of interaction between teacher, student, and source study. The main purpose of the study is to investigate learners’ online learning experiences in a blended learning approach, evaluate how learners’ experience of an online learning environment affects the blended learning approach and examine the future of online learning in a blended learning environment. Blended learning pedagogies have been recognized as a path to improve teacher’s instructional strategies for teaching using technology. Blended learning is perceived to have many advantages for teachers and students, including any-time learning, anywhere access, self-paced learning, inquiry-led learning and collaborative learning; this helps institutions to create desired instructional skills such as critical thinking in the process of learning. Blended learning as an approach to learning has gained momentum because of its widespread integration into educational organizations. METHODOLOGY: Based on the research objectives and questions of the study, the study will make use of the qualitative research approach. The rationale behind the selection of this research approach is that participants are able to make sense of their situations and appreciate their construction of knowledge and understanding because the methods focus on how people understand and interpret their experiences. A case study research design is adopted to explore the situation under investigation. The target population for the study will consist of selected students from selected universities. A simple random sampling technique will be used to select the targeted population. The data collection instrument that will be adopted for this study will be questions that will serve as an interview guide. An interview guide is a set of questions that an interviewer asks when interviewing respondents. Responses from the in-depth interview will be transcribed into word and analyzed under themes. Ethical issues to be catered for in this study include the right to privacy, voluntary participation, and no harm to participants, and confidentiality. INDICATORS OF THE MAJOR FINDINGS: It is suitable for the study to find out that online learning encourages timely feedback from teachers or that online learning tools are okay to use without issues. Most of the communication with the teacher can be done through emails and text messages. It is again suitable for sampled respondents to prefer online learning because there are few or no distractions. Learners can have access to technology to do other activities to support their learning”. There are, again, enough and enhanced learning materials available online. CONCLUSION: Unlike the previous research works focusing on the strengths and weaknesses of blended learning, the present study aims at the respective roles of its two modalities, as well as their interdependencies.

Keywords: online learning, blended learning, technologies, teaching methods

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Authors: C. John Thomas, Sabitha Jannet

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The review concentrates on mental health wellbeing at workplace to create a safe work environment. The purpose of the study is to find the existing gaps in occupational health in the manufacturing sector. Mental wellbeing is important because it is an essential component of human life and influences our emotions, attitudes, and feelings. In the workplace, mental wellbeing can encourage a culture of safety and avoid accidents. An environment where individuals are comfortable voicing themselves and being themselves. More technically, when individuals have psychological protection at work, without regard for humiliation or punishment, they feel relaxed expressing complaints and errors. They are sure they are going to speak up and not humiliate, neglect, or accuse them. Once they are uncertain about something, they know they are going to ask questions. They are inclined to trust their colleagues and respect them. The reviews were considered through keywords and health-related topics. There are different characteristics of mental wellbeing in the literature and how it impacts the workplace. There is also a possibility that their personal lives will have an impact. In every occupation, however, there is widespread acknowledgment that psychosocial hazards are an important health risk for workers, yet in many workplaces, the focus remains on physical hazards. It is alleged that the understating of workplace psychosocial hazards is primarily due to the perception that they present a more difficult and complex challenge when compared to other health and safety issues. Others, however, allege it is the paucity of awareness about psychosocial hazards and their alleviation that explains their relative neglect. The other researchers focused that following global trends, it is believed that psychosocial hazards must be minimized within our workplaces and that there is a requirement for workplace interventions to reduce psychological harm and promote mental health for all the workman employees to achieve zero harm. In common, this literature review compares various results of the individual studies on their research methods and finding to fill gaps.

Keywords: mental health wellbeing, occupational health, psychosocial hazards, safety culture, safety management systems, workman employee, workplace safety

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Authors: Beaudoin Marie-Joelle, Poirier Nathalie

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Introduction: Children with autism spectrum disorder (ASD) tend to lack socio-emotional skills (e.g., emotional regulation and theory of mind). Eisenberg’s theoretical model on emotion-related socialization behaviors suggests that mothers of children with ASD could play a central role in fostering the acquisition of socio-emotional skills by engaging in frequent educational conversations about emotions. Although, mothers’ perceptions of their own emotional skills and their child’s personality traits and social deficits could mitigate the benefit of their educative role. Objective: Our study aims to explore the association between mother-child conversations about emotions and the socio-emotional skills of their children when accounting for the moderating role of the mothers’ perceptions. Forty-nine mothers completed five questionnaires about emotionally related conversations, self-openness to emotions, and perceptions of personality and socio-emotional skills of their children with ASD. Results: Regression analyses showed that frequent mother-child conversations about emotions predicted better emotional regulation and theory of mind skills in children with ASD (p < 0.01). The children’s theory of mind was moderated by mothers’ perceptions of their own emotional openness (p < 0.05) and their perceptions of their children’s openness to experience (p < 0.01) and conscientiousness (p < 0.05). Conclusion: Mothers likely play an important role in the socio-emotional education of children with ASD. Further, mothers may be most helpful when they perceive that their interventions improve their child’s behaviors. Our findings corroborate those of the Eisenberg model, which claims that mother-child conversations about emotions predict socio-emotional development skills in children with ASD. Our results also help clarify the moderating role of mothers’ perceptions, which could mitigate their willingness to engage in educational conversations about emotions with their children. Therefore, in special needs' children education, school professionals could collaborate with mothers to increase the frequency of emotion-related conversations in ASD's students with emotion dysregulation or theory of mind problems.

Keywords: autism, parental socialization of emotion, emotional regulation, theory of mind

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Authors: Marriette Sakah, Samuel Gyamfi, Morkporkpor Delight Sedzro, Christoph Kuhn

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Ghana is experiencing rapid economic development and its cities command an increasingly dominant role as centers of both production and consumption. Cities run on energy and are extremely vulnerable to energy scarcity, energy price escalations and health impacts of very poor air quality. The overriding concern in Ghana and other West African states is bridging the gap between energy demand and supply. Energy efficiency presents a cost-effective solution for supply challenges by enabling more coverage with current power supply levels and reducing the need for investment in additional generation capacity and grid infrastructure. In Ghana, major issues for energy policy formulation in residential applications include lack of disaggregated electrical energy consumption data and lack of thorough understanding with regards to socio-economic influences on energy efficiency investment. This study uses a bottom up approach to estimate baseline electricity end-use as well as the energy consumption of best available technologies to enable estimation of energy-efficiency resource in terms of relative reduction in total energy use for Tema city, Ghana. A ground survey was conducted to assess the probable consumer behavior in response to energy efficiency initiatives to enable estimation of the amount of savings that would occur in response to specific policy interventions with regards to funding and incentives provision targeted at households. Results show that 16% - 54% reduction in annual electricity consumption is reasonably achievable depending on the level of incentives provision. The saved energy could supply 10000 - 34000 additional households if the added households use only best available technology. Political support and consumer awareness are necessary to translate energy efficiency resources into real energy savings.

Keywords: achievable energy savings, energy efficiency, Ghana, household appliances

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Authors: Ingrid Van Der Heijden, Naeemah Abrahams, Jane Harries

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Background: Women with disabilities are largely missing from global research on violence prevention, yet research shows that women with disabilities are a particularly marginalised group who experience heightened levels and unique forms of violence than men with disabilities, and women without disabilities. They face heightened stigma, discrimination, and violence due to their gender and their disability. Including women with disabilities in violence, research helps inform policy and prevention interventions that are relevant and inclusive. To ensure their inclusion in violence research, we need ethical guidelines that are sensitive to their heightened risk and vulnerability, that recognize the diversity in the disabled population, but that also promote disabled people’s agency in defining their own violence prevention needs and agendas. Objective: To highlight pertinent ethical issues around women with disabilities’ inclusion and participation in violence research. Methodology: Considering the lack of formalized guidelines for research of people with disabilities, we draw from the literature on international ethics guidelines for researching violence against women, and the Emancipatory Disability Research paradigm, as well as drawing from our own experiences from the field in applying the guidelines when doing research with disabled women. Findings: Following the guiding ethical principles of respect, benefit, justice, and do no harm, we argue that reasonable accommodation, capacity, and equal participation need to be considered in conceptualizing and conducting ethical violence research with women with disabilities. We conclude that disability research in the area of violence is highly politicized and must be carefully scrutinized to ensure justice and the contribution of women with disabilities to their own welfare. Implications: We suggest that these issues are practically applied in the field and tested and critiqued to enhance best practice for undertaking ethical research with this particular group. It is important that not only researchers and ethics committees, but also disabled women and disabled organizations, are involved in enhancing and formalizing ethical research guidelines for marginalized populations.

Keywords: capacity, emancipatory disability research paradigm equal participation, reasonable accommodation, research ethics, violence against women with disabilities

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Authors: Asghar Arif

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Lung cancer has been recognized as one of the greatest common cancers, causing the annual mortality rate of about 1.2 million people in the world. Lung cancer is the most prevalent cancer in men and the third-most common cancer among women (after breast and digestive cancers).Recent evidences have shown the inflammatory process as one of the potential factors of cancer. Tuberculosis (TB), pneumonia, and chronic bronchitis are among the most important inflammation-inducing factors in the lungs, among which TB has a more profound role in the emergence of cancer.TB is one of the important mortality factors throughout the world, and 205,000 death cases are reported annually due to this disease. Chronic inflammation and fibrosis due to TB can induce genetic mutation and alternations. Parenchyma tissue of lung is involved in both diseases of TB and lung cancer, and continuous cough in lung cancer, morphological vascular variations, lymphocytosis processes, and generation of immune system mediators such as interleukins, are all among the factors leading to the hypothesis regarding the role of TB in lung cancer Some reports have shown that the induction of necrosis and apoptosis or TB reactivation, especially in patients with immune-deficiency, may result in increasing IL-17 and TNF_α, which will either decrease P53 activity or increase the expression of Bcl-2, decrease Bax-T, and cause the inhibition of caspase-3 expression due to decreasing the expression of mitochondria cytochrome oxidase. It has been also indicated that following the injection of BCG vaccine, the host immune system will be reinforced, and in particular, the rates of gamma interferon, nitric oxide, and interleukin-2 are increased. Therefore, CD4 + lymphocyte function will be improved, and the person will be immune against cancer.Numerous prospective studies have so far been conducted on the role of TB in lung cancer, and it seems that this disease is effective in that particular cancer.One of the main challenges of lung cancer is its correct and timely diagnosis. Unfortunately, clinical symptoms (such as continuous cough, hemoptysis, weight loss, fever, chest pain, dyspnea, and loss of appetite) and radiological images are similar in TB and lung cancer. Therefore, anti-TB drugs are routinely prescribed for the patients in the countries with high prevalence of TB, like Pakistan. Regarding the similarity in clinical symptoms and radiological findings of lung cancer, proper diagnosis is necessary for TB and respiratory infections due to nontuberculousmycobacteria (NTM). Some of the drug resistive TB cases are, in fact, lung cancer or NTM lung infections. Acid-fast staining and histological study of phlegm and bronchial washing, culturing and polymerase chain reaction TB are among the most important solutions for differential diagnosis of these diseases. Briefly, it is assumed that TB is one of the risk factors for cancer. Numerous studies have been conducted in this regard throughout the world, and it has been observed that there is a significant relationship between previous TB infection and lung cancer. However, to prove this hypothesis, further and more extensive studies are required. In addition, as the clinical symptoms and radiological findings of TB, lung cancer, and non-TB mycobacteria lung infections are similar, they can be misdiagnosed as TB.

Keywords: TB and lung cancer, TB people, TB servivers, TB and HIV aids

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Authors: Yeo Ryeong Jeon, Pyong Kon Cho, Eun Ok Han, Hyon Chul Jang, Yong Min Kim

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This study surveyed on recognition related to radiation safety for radiation safety managers and workers those who have been worked in Republic of Korea education and research institution. At present, South Korea has no guideline and manual of radiation safety for education and research institution. Therefore, we tried to find an educational basis for development of radiation safety guideline and manual. To check the level of knowledge, attitude, and behavior about radiation safety, we used the questionnaire that consisted of 29 questions against knowledge, attitude and behavior, 4 questions against self-efficacy and expectation based on four factors (radiation source, human, organizational and physical environment) of the Haddon's matrix. Responses were collected between May 4 and June 30, 2015. We analyzed questionnaire by means of IBM SPSS/WIN 15 which well known as statistical package for social science. The data were compared with mean, standard deviation, Pearson's correlation, ANOVA (analysis of variance) and regression analysis. 180 copies of the questionnaire were returned from 60 workplaces. The overall mean results for behavior level was relatively lower than knowledge and attitude level. In particular, organizational environment factor on the radiation safety management indicated the lowest behavior level. Most of the factors were correlated in Pearson’s correlation analysis, especially between knowledge of human factors and behavior of human factors (Pearson’s correlation coefficient 0.809, P<.01). When analysis performed in line with the main radiation source type, institutions where have been used only opened RI (radioisotope) behavior level was the lowest among all subjects. Finally, knowledge of radiation source factor (β=0.556, P<.001) and human factor(β=0.376, P<.001) had the greatest impact in terms of behavior practice. Radiation safety managers and workers think positively about radiation safety management, but are poorly informed organizational environment of their institution. Thus, each institution need to efforts to settlement of radiation safety culture. Also, pedagogical interventions for improving knowledge on radiation safety needs in terms of safety accident prevention.

Keywords: radiation safety management, factor analysis, SPSS, republic of Korea

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Authors: Chi H. Lin, Chi C. Lin, Chih L. Hsieh

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Motor Imagery (MI) alone or combined with action observation (AO) has been shown to enhance motor performance and skill learning. The most effective way to combine these techniques has received limited scientific scrutiny. In the present study, we examined the effects of simultaneous (i.e., observing an action whilst imagining carrying out the action concurrently), alternate (i.e., observing an action and then doing imagery related to that action consecutively) and synthesis (alternately perform action observation and imagery action and then perform observation and imagery action simultaneously) AOMI combinations on improving golf putting performance and learning. Participants, 45 university students who had no formal experience of using imagery for the study, were randomly allocated to one of four training groups: simultaneous action observation and motor imagery (S-AOMI), alternate action observation and motor imagery (A-AOMI), synthesis action observation and motor imagery (A-S-AOMI), and a control group. And it was applied 'Different Experimental Groups with Pre and Post Measured' designs. Participants underwent eighteen times of different interventions, which were happened three times a week and lasting for six weeks. We analyzed the information we received based on two-factor (group × times) mixed between and within analysis of variance to discuss the real effects on participants' golf putting performance and learning about different intervention methods of different types of combined action observation and motor imagery. After the intervention, we then used imagery questionnaire and journey to understand the condition and suggestion about different motor imagery and action observation intervention from the participants. The results revealed that the three experimental groups both are effective in putting performance and learning but not for the control group, and the A-S-AOMI group is significantly better effect than S-AOMI group on golf putting performance and learning. The results confirmed the effect of motor imagery combined with action observation on the performance and learning of golf putting. In particular, in the groups of synthesis, motor imagery, or action observation were alternately performed first and then performed motor imagery, and action observation simultaneously would have the best effectiveness.

Keywords: motor skill learning, motor imagery, action observation, simulation

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Authors: Wu Liching

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Aim This case aims to discuss the pathogenesis, clinical manifestations and medical treatment of strokes caused by mitochondrial gene mutations. Methods Diagnosis of ischemic stroke caused by mitochondrial gene defect by means of "next-generation sequencing mitochondrial DNA gene variation detection", imaging examination, neurological examination, and medical history; this study took samples from the neurology ward of a medical center in northern Taiwan cases diagnosed with acute cerebral infarction as the research objects. Result This case is a 49-year-old married woman with a rare disease, mitochondrial gene mutation inducing ischemic stroke. She has severe hearing impairment and needs to use hearing aids, and has a history of diabetes. During the patient’s hospitalization, the blood test showed that serum Lactate: 7.72 mmol/L, Lactate (CSF) 5.9 mmol/L. Through the collection of relevant medical history, neurological evaluation showed changes in consciousness and cognition, slow response in language expression, and brain magnetic resonance imaging examination showed subacute bilateral temporal lobe infarction, which was an atypical type of stroke. The lineage DNA gene has m.3243A>G known pathogenic mutation point, and its heteroplasmic level is 24.6%. This pathogenic point is located in MITOMAP and recorded as Mitochondrial Encephalopathy, Lactic Acidosis, and Stroke-like episodes (MELAS) , Leigh Syndrome and other disease-related pathogenic loci, this mutation is located in ClinVar and recorded as Pathogenic (dbSNP: rs199474657), so it is diagnosed as a case of stroke caused by a rare disease mitochondrial gene mutation. After medical treatment, there was no more seizure during hospitalization. After interventional rehabilitation, the patient's limb weakness, poor language function, and cognitive impairment have all improved significantly. Conclusion Mitochondrial disorders can also be associated with abnormalities in psychological, neurological, cerebral cortical function, and autonomic functions, as well as problems with internal medical diseases. Therefore, the differential diagnoses cover a wide range and are not easy to be diagnosed. After neurological evaluation, medical history collection, imaging and rare disease serological examination, atypical ischemic stroke caused by rare mitochondrial gene mutation was diagnosed. We hope that through this case, the diagnosis of rare disease mitochondrial gene variation leading to cerebral infarction will be more familiar to clinical medical staff, and this case report may help to improve the clinical diagnosis and treatment for patients with similar clinical symptoms in the future.

Keywords: acute stroke, MELAS, lactic acidosis, mitochondrial disorders

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Authors: Tadesse Melaku Abegaz

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Background: there was paucity of data on the self-reported adverse drug reactions (ADRs), level of adherence and clinical outcomes with antidepressants among major depressive disorder (MDD) patients in Ethiopia. Hence, the present study sought to determine the level of adherence for and clinical outcome with antidepressants and the magnitude of ADRs. Methods: A prospective cross-sectional study was employed on MDD patients from September 2016 to January 2017 at Gondar university hospital psychiatry clinic. All patients who were available during the study period were included under the study population. The Naranjo adverse drug reaction probability scale was employed to assess the adverse drug reaction. The rate of medication adherence was determined using morisky medication adherence measurement scale eight. Clinical Outcome of patients was measured by using patient health questionnaire. Multivariable logistic carried out to determine factors for adherence and patient outcome. Results: two hundred seventy patients were participated in the study. More than half of the respondents were males 122(56.2%). The mean age of the participants was 30.94 ± 8.853. More than one-half of the subjects had low adherence to their medications 124(57.1%). About 186(85.7%) of patients encountered ADR. The most common ADR was weight gain 29(13.2). Around 198(92.2%) ADRs were probable and 19(8.8%) were possible. Patients with long standing MDD had high risk of non-adherence COR: 2.458[4.413-4.227], AOR: 2.424[1.185-4.961]. More than one-half 125(57.6) of respondents showed improved outcome. Optimal level of medication adherence was found to be associated with reduced risk of progression of the diseases COR: 0.37[0.110-5.379] and AOR: 0.432[0.201-0.909]. Conclusion: Patient reported adverse drug reactions were more prevalent in major depressive disorder patients. Adherence to medications was very poor in the setup. However, the clinical outcome was relatively higher. Long standing depression was associated with non-adherence. In addition, clinical outcome of patients were affected by non-adherence. Therefore, adherence enhancing interventions should be provided to improve medication adherence and patient outcome.

Keywords: adverse drug reactions, clinical outcomes, Ethiopia, prospective study, medication adherence

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Authors: Ani Demetrashvili

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As online learning continues to reshape the landscape of education, questions arise regarding its efficacy for diverse learning styles, particularly for visual learners. This abstract delves into the impact of online learning on visual learners, exploring how digital mediums influence their educational experience and how educational platforms can be optimized to cater to their needs. Visual learners comprise a significant portion of the student population, characterized by their preference for visual aids such as diagrams, charts, and videos to comprehend and retain information. Traditional classroom settings often struggle to accommodate these learners adequately, relying heavily on auditory and written forms of instruction. The advent of online learning presents both opportunities and challenges in addressing the needs of visual learners. Online learning platforms offer a plethora of multimedia resources, including interactive simulations, virtual labs, and video lectures, which align closely with the preferences of visual learners. These platforms have the potential to enhance engagement, comprehension, and retention by presenting information in visually stimulating formats. However, the effectiveness of online learning for visual learners hinges on various factors, including the design of learning materials, user interface, and instructional strategies. Research into the impact of online learning on visual learners encompasses a multidisciplinary approach, drawing from fields such as cognitive psychology, education, and human-computer interaction. Studies employ qualitative and quantitative methods to assess visual learners' preferences, cognitive processes, and learning outcomes in online environments. Surveys, interviews, and observational studies provide insights into learners' preferences for specific types of multimedia content and interactive features. Cognitive tasks, such as memory recall and concept mapping, shed light on the cognitive mechanisms underlying learning in digital settings. Eye-tracking studies offer valuable data on attentional patterns and information processing during online learning activities. The findings from research on the impact of online learning on visual learners have significant implications for educational practice and technology design. Educators and instructional designers can use insights from this research to create more engaging and effective learning materials for visual learners. Strategies such as incorporating visual cues, providing interactive activities, and scaffolding complex concepts with multimedia resources can enhance the learning experience for visual learners in online environments. Moreover, online learning platforms can leverage the findings to improve their user interface and features, making them more accessible and inclusive for visual learners. Customization options, adaptive learning algorithms, and personalized recommendations based on learners' preferences and performance can enhance the usability and effectiveness of online platforms for visual learners.

Keywords: online learning, visual learners, digital education, technology in learning

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