Search results for: nursing interventions

Authors: Rosalina Penaloza, Joanna Navarro, Pauline Jolly, Anna Junkins, Carlos Seas, Larissa Otero

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Background: Tuberculosis (TB) case detection in Peru relies on passive case finding. This strategy relies on the assumption that the community is aware that a persistent cough is a possible symptom of TB and that formal health care needs to be sought. Despite its importance, health knowledge specific to TB is underexplored in Peru. This study aimed to assess health literacy and level of TB knowledge among outpatients attending a referral hospital in Lima, Peru. The goal was to ascertain knowledge gaps in key areas relating to TB, to identify and prioritize subgroups for intervention, and to provide insight for policy and community interventions considering health literacy. Methods: An observational cross-sectional study was conducted using a survey to measure sociodemographic factors, tuberculosis knowledge, and health literacy. Bivariate and Multivariate logistic regression was performed to study the associations between variables and to account for potential confounders. The study was conducted at Hospital Cayetano Heredia in Lima, Peru from June – August 2017. Results: 272 participants were included in the analysis. 57.7% knew someone who had had TB before, 9% had had TB in the past. Two weeks a cough was correctly identified as a symptom that could be TB by 69.1%. High TB knowledge was found among 149 (54.8%) participants. High health literacy was found among 193 (71.0%) participants. Health literacy and TB knowledge were not significantly associated (OR 0.9 (95%CI 0.5-1.5)). After controlling for sex, age, district, education, health insurance, frequency of hospital visits and previous TB diagnosis: High TB knowledge was associated with knowing someone with TB (aOR 2.7 (95%CI 1.6-4.7)) and being a public transport driver, (aOR 0.2 (95%CI 0.05-0.9)). Not being poor was the single factor associated with high health literacy (aOR 3.8 (95%CI 1.6-8.9)). Conclusions: TB knowledge was fair, though 30% did not know the most important symptom of TB. Tailoring educational strategies to risk groups may enhance passive case detection especially amongst transport workers in Lima, Peru.

Keywords: health literacy, Peru, tuberculosis, tuberculosis knowledge

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Authors: Koteswara Rao Pagolu, Raghava Rao Tamanam

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In India, genetic disease is a disregarded service element in the community health- protection system. This study aims to gauge the accessibility of services for treating genetic disorders and also to evaluate the practices on deterrence and management services in the district health system. A cross-sectional survey of selected health amenities in the government health sector was conducted from 15 primary health centers (PHC’s), 4 community health centers (CHC’s), 1 district government hospital (DGH) and 3 referral hospitals (RH’s). From these, the existing manpower like 130 medical officers (MO’s), 254 supporting staff, 409 nursing staff (NS) and 45 lab technicians (LT’s) was examined. From the side of private health institutions, 25 corporate hospitals (CH’s), 3 medical colleges (MC’s) and 25 diagnostic laboratories (DL’s) were selected for the survey and from these, 316 MO’s, 995 NS and 254 LT’s were also reviewed. The findings show that adequate staff was in place at more than 70% of health centers, but none of the staff have obtained any operative training on genetic disease management. The largest part of the DH’s had rudimentary infrastructural and diagnostic facilities. However, the greater part of the CHC’s and PHC’s had inadequate diagnostic facilities related to genetic disease management. Biochemical, molecular, and cytogenetic services were not available at PHC’s and CHC’s. DH’s, RH’s, and all selected medical colleges were found to have offered the basic Biochemical genetics units during the survey. The district health care infrastructure in India has a shortage of basic services to be provided for the genetic disorder. With some policy resolutions and facility strengthening, it is possible to provide advanced services for a genetic disorder in the district health system.

Keywords: district health system, genetic disorder, infrastructural amenities, management practices

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Authors: Lenore Van Den Berg

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Vocabulary development is positively associated with reading development, reading comprehension, and academic achievement. It is frequently stated that South Africa is in the midst of a literacy crisis. The past 24 years since the first democratically elected government have not revolutionised the education system; rather, after various curriculum changes and continued struggles to incorporate all 11 official languages as languages of instruction, research shows that 78 per cent of South African Grade 4 learners are functionally illiterate. The study sets out to find solutions to this problem and to add to the research base on vocabulary acquisition by assessing the effect of integrating the principles of explicit, interactive vocabulary instruction, within the context of storybook reading, on Grade 1 vocabulary acquisition. Participants comprised of 69 Grade 1 English second language learners from three classes in two government primary schools. The two schools differ in socio-economic status (SES), with School A having a lower SES than School B. One Grade 1 class was randomly assigned to be the Experimental Group, while two other classes served as control groups. The intervention took place for a period of 18 weeks and consisted of 30-minute storybook reading sessions, accompanied by interactive vocabulary instruction, twice a week. The Peabody Picture Vocabulary Test IV (PPVT-IV) was the diagnostic test administered to all learners before the intervention, as a pre-test, and after the interventions as a post-test. Data regarding excising vocabulary instruction practices and approaches were also collected through classroom observations and individual, semi-structured interviews with the Experimental Group’s teacher. Findings suggest that second language storybook reading, accompanied by explicit, interactive vocabulary instruction, have a positive impact on Grade 1 vocabulary acquisition but that vocabulary teaching practices and socio-economic status also play a key role in vocabulary acquisition.

Keywords: interactive vocabulary instruction, second language vocabulary, storybook reading, vocabulary acquisition, reading development, PPVT

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Authors: C. Panebianco, K. Adamberg, S. Adamberg, C. Saracino, M. Jaagura, K. Kolk, A. Di Chio, P. Graziano, R. Vilu, V. Pazienza

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Background/Aims: Despite recent advances in treatment options, a modest impact on the outcome of the pancreatic cancer (PC) is observed so far. Short-term fasting cycles have the potential to improve the efficacy of chemotherapy against PC. However, diseased people may refuse to follow the fasting regimen and fasting may worsen the weight loss often occurring in cancer patients. Therefore, alternative approaches are needed. The aim of this study was to assess the effect of Engineered Low glycemic food ELGIF mimicking diet on growth of cancer cell lines in vitro and in an in vivo pancreatic cancer mouse xenograft model. Materials and Methods: BxPC-3, MiaPaca-2 and Panc-1 cells were cultured in control and ELGIF mimicking diet culturing condition to evaluate the tumor growth and proliferation pathways. Pancreatic cancer xenograft mice were subjected to ELGIF to assess the tumor volume and weight as compared to mice fed with control diet. Results: Pancreatic cancer cells cultured in ELGIF mimicking medium showed decreased levels of proliferation as compared to those cultured in the standard medium. Consistently, xenograft pancreatic cancer mice subjected to ELGIF diet displayed a significant decrease in tumor growth. Conclusion: A positive effect of ELGIF diet on proliferation in vitro is associated with the decrease of tumor progression in the in vivo PC xenograft mouse model. These results suggest that engineered dietary interventions could be supportive as synergistic approach to enhance the efficacy of existing cancer treatments in pancreatic cancer patients.

Keywords: functional food, microbiota, mouse model, pancreatic cancer

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

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

Keywords: disadvantaged, early learning, economically, health promotion

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Authors: Hannah K. M. Tang, Muhammad Ateeq, Mark J. Lake, Badr Abdullah, Frederic A. Bezombes

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There is little research applying virtual reality (VR) to the treatment of musculoskeletal injury in athletes. This is despite their prevalence, and the implications for physical and psychological health. Nevertheless, developments of wireless VR headsets better facilitate dynamic movement in VR environments (VREs), and more research is expected in this emerging field. This systematic review identified publications that used VR interventions for the analysis or treatment of lower-limb musculoskeletal injury of athletes. It established a search protocol, and through narrative discussion, identified existing trends. Database searches encompassed four term sets: 1) VR systems; 2) musculoskeletal injuries; 3) sporting population; 4) movement outcome analysis. Overall, a total of 126 publications were identified through database searching, and twelve were included in the final analysis and discussion. Many of the studies were pilot and proof of concept work. Seven of the twelve publications were observational studies. However, this may provide preliminary data from which clinical trials will branch. If specified, the focus of the literature was very narrow, with very similar population demographics and injuries. The trends in the literature findings emphasised the role of VR and attentional focus, the strategic manipulation of movement outcomes, and the transfer of skill to the real-world. Causal inferences may have been undermined by flaws, as most studies were limited by the practicality of conducting a two-factor clinical-VR-based study. In conclusion, by assessing the exploratory studies, and combining this with the use of numerous developments, techniques, and tools, a novel application could be established to utilise VR with dynamic movement, for the effective treatment of specific musculoskeletal injuries of athletes.

Keywords: athletes, lower-limb musculoskeletal injury, rehabilitation, return-to-sport, virtual reality

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Authors: Amro Matyori, Fatimah Sherbeny, Askal Ali, Olayiwola Popoola

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Objectives: The study evaluated the impact of COVID-19 on anxiety levels in the general population in the United States. Methods: The study used an online questionnaire. It adopted the Generalized Anxiety Disorder Assessment (GAD-7) instrument. It is a self-administered scale with seven items used as a screening tool and severity measure for generalized anxiety disorder. The participants rated the frequency of anxiety symptoms in the last two weeks on a Likert scale, which ranges from 0-3. Then the item points are summed to provide the total score. Results: Thirty-two participants completed the questionnaire. Among them, 24 (83%) females and 5 (17%) males. The age range of 18-24-year-old represented the most respondents. Only one of the participants tested positive for the COVID-19, and 39% of them, one of their family members, friends, or colleagues, tested positive for the coronavirus. Moreover, 10% have lost a family member, a close friend, or a colleague because of COVID-19. Among the respondents, there were ten who scored approximately five points on the GAD-7 scale, which indicates mild anxiety. Furthermore, eight participants scored 10 to 14 points, which put them under the category of moderate anxiety, and one individual who was categorized under severe anxiety scored 15 points. Conclusions: It is identified that most of the respondents scored the points that put them under the mild anxiety category during the COVID-19 pandemic. It is also noticed that severe anxiety was the lowest among the participants, and people who tested positive and/or their family members, close friends, and colleagues were more likely to experience anxiety. Additionally, participants who lost friends or family members were also at high risk of anxiety. It is obvious the COVID-19 outcomes and too much thinking about the pandemic put people under stress which led to anxiety. Therefore, continuous assessment and monitoring of psychological outcomes during pandemics will help to establish early well-informed interventions.

Keywords: anxiety and covid-19, covid-19 and mental health outcomes, influence of covid-19 on anxiety, population and covid-19 impact on mental health

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Authors: Nkrumak Micheal Atta Ofori

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The Vocational System is a decentralized Studies System implemented in Ghana as vocation studies strategy for grassroot that focuses on providing individuals with the specific skills, knowledge, and training necessary for a particular trade, craft, profession, or occupation. This article asks how devolution of vocational studies to local level authorities produces responsive and accountable representation and sustainable vocational learning under the vocational Studies System. It focuses on two case studies: Asokore Mampong and Atwima kwanwoma Municipal. Then, the paper asks how senior high school are developing new material and social practices around the vocational studies System to rebuild their livelihoods and socio-economic wellbeing. Here, the article focusses on Kumasi District, drawing lessons for the two other cases. The article shows how the creation of representative groups under the Vocational Studies System provides the democratic space necessary for effective representation of community aspirations. However, due to elite capture, the interests of privilege few people are promoted. The state vocational training fails to devolve relevant and discretionary resources to local teachers and do not follow the prescribed policy processes of the Vocational Studies System. Hence, local teachers are unable to promote responsive and accountable representation. Rural communities continue to show great interest in the Vocational Studies System, but the interest is bias towards gaining access to vocational training schools for advancing studies. There is no active engagement of the locals in vocational training, and hence, the Vocational Studies System exists only to promote individual interest of communities. This article shows how ‘failed’ interventions can gain popular support for rhetoric and individual gains.

Keywords: vocational studies system, devolution of vocational studies, local-level authorities, senior high schools and vocational learning, community aspirations and representation

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Authors: Aysegul Alyamac, Sukru Gulec

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Ankaferd Blood Stopper (ABS) is a plant extract used to stop bleeding caused by injuries and surgical interventions. ABS also involved in wound healing of intestinal mucosal damage due to oxidative stress and inflammation. Inflammatory Bowel Disease (IBD) is a common chronic disorder of the gastrointestinal tract that causes abdominal pain, diarrhea, and gastrointestinal bleeding, and increases the risk of colon cancer. Inflammation is an essential factor in the development of IBD. The various studies have been performed about the physiological effects of ABS; however, ABS dependent mechanism on colonic inflammation has not been elucidated. Thus, the protective effect of ABS on colonic inflammation was investigated in this study. The Caco-2 and RAW 264.7 murine macrophage cells were used as a model of in vitro colonic inflammation. RAW 264.7 cells were treated with lipopolysaccharide (LPS) for 12 hours to induce the inflammation, and a conditional medium was obtained. Caco-2 cells were treated with 15 µl/ml ABS for 4 hours, then incubated with conditional medium and the cells also were incubated with 15 µl/ml ABS and conditional medium together for 4 hours. Tumor necrosis factor alpha (TNF-α) protein levels were targeted in testing inflammatory condition and its level was significantly increased (25 fold, p<0.001) compared to the control group by using Enzyme-Linked Immunosorbent Assay (ELISA) method. The COX-2 mRNA level was used as a marker gene to show the possible anti-inflammatory effect of ABS in Caco-2 cells. RAW cells-derived conditional medium significantly (3.3 fold, p<0.001) induced cyclooxygenase-2 (COX-2) mRNA levels in Caco-2 cells. The pretreatment of Caco-2 cells caused a significant decrease (3.3 fold, p<0.001) in COX-2 mRNA levels relative to conditional medium given group. Furthermore, COX-2 mRNA level was significantly reduced (4,7 fold, p<0.001) in ABS and conditional medium treated group. These results suggest that ABS might have an anti-inflammatory effect in vitro.

Keywords: Ankaferd blood stopper, CaCo-2, colonic inflammation, RAW 264.7

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Authors: Khiara Claudine C. Carbonel, Patricia Joy A. Canapi, Tracy Gabriella M. Canlas, Teresa Zaine C. Canseco, Reena Marie A. Capistrano, Vernon A. Carandang, Carlo G. Ranoco

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Research problem: The main problem of the study was to determine the effect of Projecting the Reflection of the Individual’s Self-esteem (PRIDE) therapy on the level of self-esteem of physically challenged adolescents. Objectives of the Study: The study determined the effect of PRIDE (Projecting the Reflection of the Individuals Self-esteem) therapy on the level of self-esteem among physically challenged adolescents. Methodology: A quasi-experimental study was used which involved 30 randomly-assigned subjects, 15 in the experimental group and 15 in the control group. The Projecting the reflection of the Individuals’ Self-Esteem (PRDIE) therapy was administered to the experimental group. The researchers utilized the Sorensen Self-Esteem test tool as a pretest and posttest questionnaire and yielded a Cronbach’s alpha of .912. Paired T-test was used to analyze the gathered data. Results: The results showed that after the administration of PRIDE therapy, there was an increase on the level of self-esteem. The experimental group had a value of 3.590, which was significant and meant that the level of self-esteem is significantly increased. On the other hand, the control group, had a value of -2.207 which was also significant, therefore, the level of self esteem significantly decreased. Conclusion: the PRIDE Therapy is effective in increasing the level of self-esteem among physically challenged adolescent. Recommendations: The researchers recommend the use of PRIDE Therapy as an intervention in handling physically challenged patients, especially adolescents, in order to enhance their self-esteem. Also, the researchers recommend that nursing students be informed on the efficacy of PRIDE Therapy in enhancing the self-esteem of physically challenged patients. Furthermore, the inclusion of a psychologist during the implementation of PRIDE Therapy, specifically art therapy, to be able to have a more focused interpretation of the drawings and really be able to see the projection of their self-esteem is also recommended.

Keywords: PRIDE therapy, physically challenged adolescents, self-esteem, art therapy

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Authors: Camilo Andrés Agudelo Vélez, Lina María Martínez Sánchez, Isabel Cristina Ortiz Trujillo, Evert Armando Jiménez Cotes, Natalia Perilla Hernández, María de los Ángeles Rodríguez Gázquez, Daniel Duque Restrepo, Felipe Hernández Restrepo, Dayana Andrea Quintero Moreno, Juan José Builes Gómez, Camilo Ruiz Mejía, Ana Lucia Arango Gómez

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Preeclampsia is a clinical complication during pregnancy with high incidence in Colombia; therefore, it is important to evaluate the influence of external conditions and medical interventions, in order to promote measures that encourage improvements in the quality of life. Objective: Determine clinical and sociodemographic variables in women with preeclampsia. Methods: This cross-sectional study enrolled 50 patients with the diagnosis of preeclampsia, from a private institution in Medellin, during 2015. We used the software SPSS ver.20 for statistical analysis. For the qualitative variables, we calculated the mean and standard deviation, while, for ordinal and nominal levels of quantitative variables, ratios were estimated. Results: The average age was 26.8±5.9 years. The predominant characteristics were socioeconomic stratum 2 (48%), students (55%), mixed race (46%) and middle school as level of education (38%). As for clinical features, 72% of the cases were mild preeclampsia, and 22% were severe forms. The most common clinical manifestations were edema (46%), headache (62%), and proteinuria (55%). As for the Gyneco-obstetric history, 8% reported previous episodes of this disease and it was the first pregnancy for 60% of the patients. Conclusions: Preeclampsia is a frequent condition in young women; on the other hand, headache and edema were the most common reasons for consultation, therefore, doctors need to be aware of these symptoms in pregnant women.

Keywords: pre-eclampsia, hypertension, pregnancy complications, pregnancy, abdominal, edema

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Authors: Usma Iftikhar, Khorshed Alam

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Background: Digital health platforms and digital health interventions are gaining increasing importance with the shift to online health-seeking behaviour, especially post-Covid. Subsequently, the importance of digital health literacy is increasingly being recognized. With the surge in culturally and linguistically diverse populations in First World countries, especially females, the predictors of digital health access in this population remain elusive. Keeping in view the inadequate digital infrastructure in rural and remote Australia, with lack of specialist services, the determinants of digital access gain even more importance. Objectives: The objective of this research are to measure the digital health literacy levels in this population, including the predictors of digital health literacy like sociodemographics and the correlation between the predictors and digital health literacy levels. Methods: A population-based quantitative survey was carried out in Regional Queensland from Jan 2022- Dec 2023 on culturally and linguistically diverse adult females. Sociodemographics like age, literacy levels, socioeconomic status, access to digital devices were recorded after informed consent. Digital health literacy levels were measured by specially designed questionnaires. The relationship between sociodemographics and digital health literacy levels was estimated by Pearson correlation. Results: Mean DHL was 2.66 + 0.35. There was a negative significant relationship (p<0.005) between demographics like age and access to a digital device with digital health literacy levels. Also observed was a positive significant relationship between literacy levels and proficiency in English. Conclusion: Age, literacy levels and English proficiency are some of the highest predictors of digital health access. This is important because remote areas rely on digital health access due to less developed health infrastructure, including specialist services. Guide for Policy makers to focus on the populations most in need.

Keywords: digital health literacy, eHealth literacy, culturally and linguistically diverse, ethnic minorities, regional areas, rural and remote areas

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Authors: Tara Panday, Despina Learmonth

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Sex work is often constructed as being an interaction between male clients and female sex workers. As a result, street-based male sex workers are continuously overlooked in the South African literature. This qualitative study explored male sex workers’ subjective experiences and constructions of their male clients’ identities and the client-sex worker relationship. This research was conducted from a social-constructionist perspective, which allowed for a deeper understanding of the reasons and context driving the choices and actions of male sex workers. Semi-structured face-to-face interviews were conducted with 10 South African men working as sex workers in Cape Town. Data was analysed through thematic analysis. The findings of the study construct the client-sex worker relationship in terms of a professional relationship, constrained choice, sexual identity and need, as well as companionship for pay, potentially highlighting underlying reasons for supply and demand. The data which emerged around the client-sex worker relationship and the clients’ identities also served to illuminate the power-dynamics in the client-sex worker relationship. This data increases insight into the exploitation and disempowerment experienced by male sex workers through verbal abuse, physical and sexual violence, and unfairly enforced laws and regulations. The findings of this study suggest that, in the context of South Africa, male sex workers' experiences of the client-sex worker relationship cannot be completely understood without considering the intersectionality of the triple stigmatisation of: the criminality of sex work, race, and the lack of economic power, which systematically maintains marginalization. Motivating for the Law Reform Commission to continue to review all emerging research may assist with guiding related policy and thereby, the provision of equal human rights and adequate health and social interventions for all sex workers in South Africa.

Keywords: human rights, prostitution, power relations, sex work

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Authors: Lavinia Flueckiger, Roselind Lieb, Andrea H. Meyer, Cornelia Witthauer, Jutta Mata

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Objective: Health behaviors tend to show a high variability over time within the same person. However, most existing research can only assess a snapshot of a person’s behavior and not capture this natural daily variability. Two intensive longitudinal studies examine the variability in health behavior over one academic year and their implications for other aspects of daily life such as affect and academic performance. Can already a single day of increased physical activity, snacking, or improved sleep have beneficial effects? Methods: In two intensive longitudinal studies with up to 65 assessment days over an entire academic year, university students (Study 1: N = 292; Study 2: N = 304) reported sleep quality, physical activity, snacking, positive and negative affect, and learning goal achievement. Results: Multilevel structural equation models showed that on days on which participants reported better sleep quality or more physical activity than usual, they also reported increased positive affect, decreased negative affect, and better learning goal achievement. Higher day-to-day snacking was only associated with increased positive affect. Both, increased day-to-day sleep quality and physical activity were indirectly associated with better learning goal achievement through changes in positive and negative affect; results for snacking were mixed. Importantly, day-to-day sleep quality was a stronger predictor for affect and learning goal achievement than physical activity or snacking. Conclusion: One day of better sleep or more physical activity than usual is associated with improved affect and academic performance. These findings have important implications for low-threshold interventions targeting the improvement of daily functioning.

Keywords: sleep quality, physical activity, snacking, affect, academic performance, multilevel structural equation model

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Authors: Ogar Ofut Tumenayu, Olga Shabalina

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This paper describes the application of two types of pedagogical agents’ technology with different functions in an adaptive educational game with the sole aim of improving learning and enhancing interactivities in Digital Educational Games (DEG). This idea could promote the elimination of some problems of DEG, like isolation in game-based learning, by introducing a tutor and tutee pedagogical agents. We present an analysis of a learning companion interacting in a peer tutoring environment as a step toward improving social interactions in the educational game environment. We show that tutor and tutee agents use different interventions and interactive approaches: the tutor agent is engaged in tracking the learner’s activities and inferring the learning state, while the tutee agent initiates interactions with the learner at the appropriate times and in appropriate manners. In order to provide motivation to prevent mistakes and clarity a game task, the tutor agent uses the help dialog tool to provide assistance, while the tutee agent provides collaboration assistance by using the hind tool. We presented our idea on a prototype game called “Pyramid Programming Game,” a 2D game that was developed using Libgdx. The game's Pyramid component symbolizes a programming task that is presented to the player in the form of a puzzle. During gameplay, the Agents can instruct, direct, inspire, and communicate emotions. They can also rapidly alter the instructional pattern in response to the learner's performance and knowledge. The pyramid must be effectively destroyed in order to win the game. The game also teaches and illustrates the advantages of utilizing educational agents such as TrA and TeA to assist and motivate students. Our findings support the idea that the functionality of a pedagogical agent should be dualized into an instructional and learner’s companion agent in order to enhance interactivity in a game-based environment.

Keywords: tutor agent, tutee agent, learner’s companion interaction, agent collaboration

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Authors: Nuhu Mohammed Gali, Kenichi Matsui

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Climate change poses a significant threat to agriculture and food security in Africa. The UNFCC recognized the need to address climate change adaptation in the broader context of sustainable development. African countries have initiated a governance system for adapting and responding to climate change in their Nationally Determined Contributions (NDCs). Despite the implementation limitations, Africa’s adaptation initiatives highlight the need to strengthen and expand adaptation responses. This paper looks at the extent to which South-South cooperation facilitates the implementation of adaptation actions between nations for agriculture and sustainable development. We conducted a literature review and content analysis of reports prepared by international organizations, reflecting the diversity of adaptation activities taking place in Sub-Saharan Africa. Our analysis of the connection between adaptation and nationally determined contributions (NDCs) showed that climate actions are mainstreamed into sustainable development. The NDCs in many countries on climate change adaptation action for agriculture aimed to strengthen the resilience of the poor. We found that climate-smart agriculture is the core of many countries target to end hunger. We revealed that South-South Cooperation, in terms of capacity, technology, and financial support, can help countries to achieve their climate action priorities and the Sustainable Development Goals (SDGs). We found that inadequate policy and regulatory frameworks between countries, differences in development priorities and strategies, poor communication, inadequate coordination, and the lack of local engagement and advocacy are some key barriers to South-South Cooperation in Africa. We recommend a multi-dimensional partnership, provisionoffinancialresources, systemic approach for coordination and engagement to promote and achieve the potential of SSC in Africa.

Keywords: climate change, adaptation, food security, sustainable development goals

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Authors: Hanen Bouaziz, Françoise Croute, Najiba Zeghal

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In order to investigate the toxic effects of fluoride on cerebrum maturity of suckling mice, we treated adult female mice of Swiss Albinos strain by 500 ppm NaF in their drinking water from the 15th day of pregnancy until the day 14 after delivery. All mice were sacrificed on day 14 after parturition. During treatment, levels of thiobarbituric acid reactive substances, the marker of lipid peroxidation extend, increased, while the activities of the antioxidant enzymes such as glutathione peroxidase, superoxide dismutase and catalase and the level of glutathione decreased significantly in cerebellum compared with those of the control group. These results suggested that fluoride enhanced oxidative stress, thereby disturbing the antioxidant defense of nursing pups. In addition, acetylcholinesterase activity in cerebellum was inhibited after treatment with fluoride. In cerebellum of mice, migration of neurons from the external granular layer to the internal granular layer occurred postnatally. Key guidance signals to these migrating neurons were provided by laminin, an extracellular matrix protein fixed to the surface of astrocytes. In the present study, we examined the expression and distribution of laminin in cerebellum of 14-day-old mice. Immunoreactive laminin was disappeared by postnatal day 14 in cerebellum parenchyma of control pups and was restricted to vasculature despite the continued presence of granular cells in the external granular layer. In contrast, in cerebellum of NaF treated pups, laminin was deposited in organised punctuate clusters in the molecular layer. These data indicated that the disruption of laminin distribution might play a major role in the profound derangement of neuronal migration observed in cerebellum of NaF treated pups.

Keywords: acetylcholinesterase activity, cerebellum, laminin, oxidative stress, suckling mice

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Authors: Abdullah Al Farwan, Ya Zhang

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In today’s educational arena, it is critical to understand educational data and be able to evaluate important aspects, particularly data on student achievement. Educational Data Mining (EDM) is a research area that focusing on uncovering patterns and information in data from educational institutions. Teachers, if they are able to predict their students' class performance, can use this information to improve their teaching abilities. It has evolved into valuable knowledge that can be used for a wide range of objectives; for example, a strategic plan can be used to generate high-quality education. Based on previous data, this paper recommends employing data mining techniques to forecast students' final grades. In this study, five data mining methods, Decision Tree, JRip, Naive Bayes, Multi-layer Perceptron, and Random Forest with wrapper feature selection, were used on two datasets relating to Portuguese language and mathematics classes lessons. The results showed the effectiveness of using data mining learning methodologies in predicting student academic success. The classification accuracy achieved with selected algorithms lies in the range of 80-94%. Among all the selected classification algorithms, the lowest accuracy is achieved by the Multi-layer Perceptron algorithm, which is close to 70.45%, and the highest accuracy is achieved by the Random Forest algorithm, which is close to 94.10%. This proposed work can assist educational administrators to identify poor performing students at an early stage and perhaps implement motivational interventions to improve their academic success and prevent educational dropout.

Keywords: classification algorithms, decision tree, feature selection, multi-layer perceptron, Naïve Bayes, random forest, students’ academic performance

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Authors: Alongkorn Pekalee, Rossarin Gray

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Various determinants associated with older health include socio-demographic factors and health-promoting behaviors but lack in scholars recommended what factors associated with health status in specific sub-groups of older adults. The current study aims to explore the health-promoting behaviors and to examine and compare the associations of these factors with self-rated health status among three older age cohorts in Thai traditional context. Methods: This study is based on the Survey of Older Persons in Thailand (SOPT), in 2017, conducted by the National Statistical Office (NSO) of Thailand. Participants were classified into three groups by using the Thai contextual recommendation: youngest-old cohort (60-69), old-old cohort (70-79) and oldest old cohort (80 or older). Health promoting behaviors are the behaviors which associated with the health status of older adults include alcohol consumption, smoking, diet, and physical activity. Health status was defined as a subjective measurement by using self-rated health, a simple measure of general health. The socio-demographic factors, health-promoting behaviors, and health status were explained and summarized by descriptive statistics. The binary logistic regression was performed to analyze the data and evaluate the associations between independent and dependent variables. Results: Increase of age contributes to a higher proportion of health-promoting behaviors. All variables were associated with self-reported health status as good health among three older age cohorts statistically significant (p-value = 0.000). However, the influence of income sufficiency on health status is more notable, especially in older adults who aged 60-69 and 70-79. The influence of dietary and physical activity on health status became greater as age increased. Conclusion: the results suggest that income sufficiency should be noted in a plan to promote healthy aging, and co-residence should be more concerned especially in the oldest old cohort. Moreover, the interventions or policies to promote older health behaviors like diet and physical activity should be emphasized in the oldest old cohort more than others.

Keywords: health-promoting behaviors, older adults, self- rated health, Thailand

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Authors: Homa Hedayat

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Public spaces have been a central concern of urban planners for centuries but have been neglected for a long time. In the modernist planning, the focus has been on the requirements of cars rather than the needs and expectations of pedestrians, and therefore, cities have lost many qualities. Urban public space is a space within the city area which is accessible to all people and is the ground for their activity. People’s public life occurs in urban public spaces in a complex set of forms and functions. These spaces must facilitate diverse behavior, uses, and activities such as shopping, walking, conversation, entertainment, relaxation or even passing the time during festivities and events. One of the public spaces is the surrounding space of public transportation stations. Subway stations, although potentially encompass many different groups of people accommodate few social interactions. Making the surrounding areas of subway stations pedestrian-oriented, potentially increases the socialization capacity. The Sadeghieh Subway Station can be considered as the most important subway station in Tehran, which on the one hand is the rail port of Tehran's western entrance, and on the other is the port for railway journeys inside the city. The main concern of this study is to assess the success or failure of the interventions made by the municipality for changing the surrounding area of the Sadeghieh Subway Station into a pedestrian-oriented space and examine the amount of the area's improvement into a desirable space. The method used in this study is surveying, in which the data were collected using a questionnaire and interview. The study's population is all people who use Sadeghieh Subway, and the sample size for the study was 140 subjects. Using parametric one-sample t-test, we found improvement in factors such as transportation, security, pedestrian infrastructure, vitality and climate comfort. However, there was no improvement in mix use, recreational activity, readability.

Keywords: public space, public transportation stations, pedestrian-oriented space, socialization

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Authors: Ashwin Belle, Bryce Benson, Mark Salamango, Fadi Islim, Rodney Daniels, Kevin Ward

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A reliable, real-time, and non-invasive system that can identify patients at risk for hemodynamic instability is needed to aid clinicians in their efforts to anticipate patient deterioration and initiate early interventions. The purpose of this pilot study was to explore the clinical capabilities of a real-time analytic from a single lead of an electrocardiograph to correctly distinguish between rapid response team (RRT) activations due to hemodynamic (H-RRT) and non-hemodynamic (NH-RRT) causes, as well as predict H-RRT cases with actionable lead times. The study consisted of a single center, retrospective cohort of 21 patients with RRT activations from step-down and telemetry units. Through electronic health record review and blinded to the analytic’s output, each patient was categorized by clinicians into H-RRT and NH-RRT cases. The analytic output and the categorization were compared. The prediction lead time prior to the RRT call was calculated. The analytic correctly distinguished between H-RRT and NH-RRT cases with 100% accuracy, demonstrating 100% positive and negative predictive values, and 100% sensitivity and specificity. In H-RRT cases, the analytic detected hemodynamic deterioration with a median lead time of 9.5 hours prior to the RRT call (range 14 minutes to 52 hours). The study demonstrates that an electrocardiogram (ECG) based analytic has the potential for providing clinical decision and monitoring support for caregivers to identify at risk patients within a clinically relevant timeframe allowing for increased vigilance and early interventional support to reduce the chances of continued patient deterioration.

Keywords: critical care, early warning systems, emergency medicine, heart rate variability, hemodynamic instability, rapid response team

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Authors: Dagmawit Tewahido

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Purpose: This qualitative study was conducted to explore social norms around adolescent girls’ marriage practices in West Hararghe, Ethiopia, where early marriage is prohibited by law. Methods: Twenty Focus Group Discussions were conducted with Married and Unmarried adolescent girls, adolescent boys and parents of girls using locally developed vignettes. A total of 32 in-depth interviews were conducted with married and unmarried adolescent girls, husbands of adolescent girls and mothers-in-law. Key informant interviews were conducted with 36 district officials. Data analysis was assisted by Open Code computer software. The Social Norms Analysis Plot (SNAP) framework developed by CARE guided the development and analysis of vignettes. A thematic data analysis approach was utilized to summarize the data. Results: Early marriage is seen as a positive phenomenon in our study context, and girls who are not married by the perceived ideal age of 15 are socially sanctioned. They are particularly influenced by their peers to marry. Marrying early is considered a chance given by God and a symbol of good luck. The two common types of marriage are decided: 1) by adolescent girl and boy themselves without seeking parental permission (’Jalaa-deemaa’- meaning ‘to go along’), and 2) by just informing girl’s parents (‘Cabsaa’- meaning ‘to break the culture’). Relatives and marriage brokers also arrange early marriages. Girls usually accept the first marriage proposal regardless of their age. Parents generally tend not to oppose marriage arrangements chosen by their daughters. Conclusions: In the study context social norms encourage early marriage despite the existence of a law prohibiting marriage before the age of eighteen years. Early marriage commonly happens through consensual arrangements between adolescent girls and boys. Interventions to reduce early marriage need to consider the influence of Reference Groups on the decision makers for marriages, especially girls’ own peers.

Keywords: adolescent girls, social norms, early marriage, Ethiopia

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Authors: Anima Ashraf

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Over the past few decades biodiversity has become the issue of global concern for its rapid reduction worldwide. Bangladesh is no exception. The country is exceptionally endowed with a vast variety of flora and fauna, but due to tremendous population pressure, rural poverty and unemployment it has been decreased alarmingly. Since, both biodiversity and sustainable development are the part of human life in modern era and both work together to make our life safer and comfortable therefore balance should be kept in development and biodiversity conservation and priority should be given to alternative and sustainable development paths. This paper is based on study of two projects undertaken by Arannayk Foundation jointly with its local NGO partners. The aim was to understand previous, current and future scenarios for the hilly biodiversity of Khagrachari in the Chittagong Hill Tracts (CHT) of Bangladesh. It is also observed how alternative income generating activities (AIGA) improve livelihood of the tribal inhabitants of the area, decrease their dependency on forest resources and also aid conservation activities. Intensive field visits were made and interviews were conducted with key informants to see the progress and achievements of local NGOs working with the tribal community for the past seven years to restore the denuded hills of Khagrachari. The paper also covers the impacts and interventions of the projects and the methods used to aid conservation activities. Raising awareness among the villagers has reduced extraction of forests resources by 47% and granting funds and access to microcredit to adopt AIGAs have increased their average annual income by 25%. Finally, the paper concludes that effective community-based conservation practices are fundamental to ensure biodiversity conservation in the Chittagong Hill Tracts. In order to conserve biodiversity and restore the forests of CHT, livelihood development of the villagers has to be considered as the main component of the projects undertaken by all NGOs and the Government.

Keywords: biodiversity, conservation, forests, livelihood

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Authors: Aytakin Huseynli

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The paper reports findings of the study which examined under-five mortality rate among resource-rich countries. Typically when countries obtain wealth citizens gain increased wellbeing. Societies with new wealth create equal opportunities for everyone including vulnerable groups. But scholars claim that this is not the case for developing resource-rich countries and natural resources become the curse for them rather than the blessing. Spillovers from natural resource curse affect the social wellbeing of vulnerable people negatively. They get excluded from the mainstream society, and their situation becomes tangible. In order to test this hypothesis, the study compared under-5 mortality rate among resource-rich countries by using independent sample one-way ANOVA. The data on under-five mortality rate came from the World Bank. The natural resources for this study are oil, gas and minerals. The list of 67 resource-rich countries was taken from Natural Resource Governance Institute. The sample size was categorized and 4 groups were created such as low, low-middle, upper middle and high-income countries based on income classification of the World Bank. Results revealed that there was a significant difference in the scores for low, middle, upper-middle and high-income countries in under-five mortality rate (F(3(29.01)=33.70, p=.000). To find out the difference among income groups, the Games-Howell test was performed and it was found that infant mortality was an issue for low, middle and upper middle countries but not for high-income countries. Results of this study are in agreement with previous research on resource curse and negative effects of resource-based development. Policy implications of the study for social workers, policy makers, academicians and social development specialists are to raise and discuss issues of marginalization and exclusion of vulnerable groups in developing resource-rich countries and suggest interventions for avoiding them.

Keywords: children, natural resource, extractive industries, resource-based development, vulnerable groups

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Authors: Sopana Wongtawee

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Purpose: Adequate bowel cleansing is essential for a high quality, effective and safe colonoscopy. The aims of this study were to compare the efficacy of bowel preparation based on a low-residue diet before 8:00 followed by a clear-liquid diet, and a low-residue diet until 16:00 one day before colonoscopy using sodium phosphate solution (Xubil ®), the side effects of the two protocols and the patient satisfaction with them. Method: This was an endoscopist-blinded, prospective, randomized, controlled trial. A total of 224 patients (112 in each group) scheduled for outpatient colonoscopy met the criteria.They were randomized to either a low-residue diet consisting of white rice porridge with either fish, chicken or eggs before 8:00 followed by a clear-liquid diet (Group 1) or a low-residue diet consisting of the same food and drink, until 16:00 the day before colonoscopy(Group 2). All of them received 45 ml of sodium phosphate solution (Xubil ®) and three glasses of water (300 ml/glass) the evening before and the morning of the procedure. The cleansing efficacy of bowel preparation was rated according to the modified Rajawithi hospital bowel preparation score scale, patient satisfaction with bowel preparation was rated using Likert scale, and side effects of the 2 protocols was assessed using a patient questionnaire. Results: The cleansing efficacy between the two groups was significantly different (p=0.02). Satisfaction with bowel preparation and side effects were not different, except for the feeling of hunger in the first group (p=0.001). Conclusion: The low-residue diet consisting of white rice porridge with fish, chicken or eggs until 16:00 one day before colonoscopy achieved a better bowel-cleansing efficacy than the protocol consisting of clear liquid all day and rice porridge only before 8:00 one day before colonoscopy.

Keywords: bowel preparation, colonoscopy, sodium phosphate solution, nursing management

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Authors: S. M. Rashed Ul Islam, Shahina Tabassum, Afsana Anwar Miti

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Objective: HIV testing and counseling center (HTC) is an important component of the HIV/AIDS detection, prevention and control interventions. The service was first initiated at the Department of Virology, Bangabandhu Sheikh Mujib Medical University (BSMMU) since the first case detection in 1989. The present study aimed to describe the demographic profile among the attendees tested HIV positive. Methods: The present study was carried out among 219 HIV positive cases detected through screening at the Department of Virology of BSMMU during the year of 2012-2016. Data were collected through pre-structured written questionnaire during the counseling session. Data were expressed as frequency and percentages and analyzed using SPSS v20.0 program. Results: Out of 219 HIV cases detected, 77.6% were males, and 22.4% were females with a mean age (mean±SD) of 35.46±9.46 years. Among them, 70.7% belonged to the 26-45 age groups representing the sexually active age. The majority of the cases were married (86.3%) and 49.8% had primary level of education whereas, 8.7% were illiterate. Nearly 42% of cases were referred from Chittagong division (south-east part of the country) followed by Dhaka division (35.6%). The bulk of study population admitted to involvement in high-risk behaviour (90%) in the past and 42% of them had worked overseas. The Pearson Chi-square (χ2) analysis revealed significant relationship of gender with marital (χ2=7.88 at 2% level) and occupation status (χ2=120.48 at 6% level); however, no association was observed with risk behaviour and educational status. Recommendations: HIV risk behavior was found to be a prime source for HIV infection among the study population. So, there is need for health education and awareness program to bring about behavioral changes to halt the yearly increase of new cases in the country with special attention to our overseas workers on HIV/AIDS risk and safety.

Keywords: Bangladesh, health education, HIV testing and counseling (HTC), HIV/AIDS, risk behavior

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Authors: Radegunda Kessy, Justus Ochieng, Victor Afari-Sefa, Takemore Chagomoka, Ngoni Nenguwo

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Vegetables are excellent sources of dietary fiber, vitamins, and minerals which constitute an indispensable constituent of diets, but in Tanzania and other Sub-Saharan African countries, they are not readily available all year round due to seasonal variations in the production cycle. Drying of vegetables is one of the traditional methods for food preservation known to man. The Dodoma and Singida regions of Tanzania are characterized by semi-arid agro-climate, thereby experiencing short seasonal supply of fresh vegetables followed by long drought in which dried vegetables become an alternative to meet high household demands. A primary survey of 244 of rural consumers was carried out to understand how knowledge, attitudes, and perceptions of rural consumers affect consumption of dried vegetables. The sample respondents were all found to be aware of open sun drying of vegetables while less than 50% of them were aware of solar-dried vegetables. Consumers were highly concerned with the hygiene, nutritional values, taste, drying method, freshness, color of dried vegetables, timely availability and easiness of cooking as important factors they consider before they purchase dried vegetables. Logit model results show that gender, income, years of consuming dried vegetables, awareness of the importance of solar dried vegetables vis-à-vis sun-dried alternatives and employment status influenced rural consumer’s decision to purchase dried vegetables. Preference on dried vegetables differs across the regions which are also important considerations for any future planned interventions. The findings imply that development partners and policymakers need to design better social marketing and promotion techniques for the enhanced adoption of solar drying technology, which will greatly improve the quality and utilization of dried vegetables by target households.

Keywords: dried vegetables, postharvest management, sun drying, solar drying

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Authors: Ladda Leungratanamart, Seree Chadcham

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Fluid intelligence declines along with age, but it can be developed. For this reason, increasing fluid intelligence in young adults can be possible. This study examined the effects of a two-month treadmill exercise program on fluid intelligence. The researcher designed a treadmill exercise program to promote cardiorespiratory fitness. Thirty-eight healthy voluntary students from the Boromarajonani College of Nursing, Chon Buri were assigned randomly to an exercise group (n=18) and a control group (n=20). The experiment consisted of three sessions: The baseline session consisted of measuring the VO₂max, electroencephalogram and behavioral response during performed the Raven Progressive Matrices (RPM) test, a measure of fluid intelligence. For the exercise session, an experimental group exercises using treadmill training at 60 % to 80 % maximum heart rate for 30 mins, three times per week, whereas the control group did not exercise. For the following two sessions, each participant was measured the same as baseline testing. The data were analyzed using the t-test to examine whether there is significant difference between the means of the two groups. The results showed that the mean VO₂ max in the experimental group were significantly more than the control group (p<.05), suggesting a two-month treadmill exercise program can improve fluid intelligence. When comparing the behavioral data, it was found that experimental group performed RPM test more accurately and faster than the control group. Neuroelectric data indicated a significant increase in percentages of alpha band ERD (%ERD) at P3 and Pz compared to the pre-exercise condition and the control group. These data suggest that a two-month treadmill exercise program can contribute to the development of cardiorespiratory fitness which influences an increase fluid intelligence. Exercise involved in cortical activation in difference brain areas.

Keywords: treadmill exercise, fluid intelligence, raven progressive matrices test, alpha band

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Authors: Syahrul Bariah Abdul Hamid, Colin W. Binns, Jun Hui Chih

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The total of obese mothers is growing throughout Asia. Breastfeeding provides the perfect nutrition for infants, by promoting a higher IQ and protecting against childhood and adult diseases. A prospective cohort study was carried out of mothers attending eight antenatal clinics run by the Ministry of Health in Selangor, Malaysia to document the prevalence of obesity and its relationship with breastfeeding outcomes. Mothers were enrolled during the antenatal period and followed up until 6 months postpartum to document breastfeeding outcomes. A total of 652 Malay mothers were recruited for the study a response rate of 93.1 %. The pre-pregnancy body mass index (BMI) of the mothers showed that 36.5% of the mothers were overweight or obese. There were a total of 78 obese mothers in the sample and 41 (52.6%) of these mothers were able to initiate breastfeeding within one hour of birth compared to 238/337 (70.6 %, χ² 9.35, p<0.001) of those with a normal BMI. At 6 months, 23.1 % of obese mothers were exclusively breastfeeding their infants, compared to 56.0 % of the normal BMI mothers. On the other hand, the rate of infant formula feeding was higher in the obese mothers by 53.8 % compared to 19.0 % among normal weight mothers, χ² 37.6, p<0.001). Further analysis suggested these factors were found to be positively associated with discontinued exclusive breastfeeding at 6 months among obese mothers; mothers whom delayed breastfeeding initiation, had health problems during pregnancy, caesarean delivery, reported had insufficient colostrum/milk and babies had sucking problems at or before 4 weeks. Besides that, mothers who perceived their biological mothers had preference towards formula feeding or were ambivalent about the feeding method and had biological mothers without experience in breastfeeding for more than 1 month also were more likely to discontinue exclusive breastfeeding at 6 months. These findings suggested that the greater the pre-pregnant BMI, the earlier the cessation of exclusive breastfeeding and they were also less likely to initiate breastfeeding and have less adequate milk supply. Future investigations of the effects of maternal obesity on breastfeeding outcomes should be conducted along with effective interventions to advance the care of obese women at reproductive age and their children.

Keywords: exclusive breastfeeding, body mass index (BMI), breastfeeding discontinuation, maternal obesity

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Authors: Caren Hilger, Silke Burkert, Friederike Kendel

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Men with localized prostate cancer (PCa) have to choose among different treatment options, such as active surveillance (AS) and radical prostatectomy (RP). All available treatment options may be accompanied by specific psychological or physiological side effects. Depending on the nature and extent of these side effects, patients are more or less likely to be satisfied or to struggle with their treatment decision in the long term. Therefore, the aim of this study was to assess and explain decisional regret in men with localized PCa. The role of erectile functioning as one of the main physiological side effects of invasive PCa treatment, depressive symptoms as a common psychological side effect, and the association of erectile functioning and depressive symptoms with decisional regret were investigated. Men with localized PCa initially managed with AS or RP (N=292) were matched according to length of therapy (mean 47.9±15.4 months). Subjects completed mailed questionnaires assessing decisional regret, changes in erectile functioning, depressive symptoms, and sociodemographic variables. Clinical data were obtained from case report forms. Differences among the two treatment groups (AS and RP) were calculated using t-tests and χ²-tests, relationships of decisional regret with erectile functioning and depressive symptoms were computed using multiple regression. Men were on average 70±7.2 years old. The two treatment groups differed markedly regarding decisional regret (p<.001, d=.50), changes in erectile functioning (p<.001, d=1.2), and depressive symptoms (p=.01, d=.30), with men after RP reporting higher values, respectively. Regression analyses showed that after adjustment for age, tumor risk category, and changes in erectile functioning, depressive symptoms were still significantly associated with decisional regret (B=0.52, p<.001). Additionally, when predicting decisional regret, the interaction of changes in erectile functioning and depressive symptoms reached significance for men after RP (B=0.52, p<.001), but not for men under AS (B=-0.16, p=.14). With increased changes in erectile functioning, the association of depressive symptoms with decisional regret became stronger in men after RP. Decisional regret is a phenomenon more prominent in men after RP than in men under AS. Erectile functioning and depressive symptoms interact in their prediction of decisional regret. Screening and treating depressive symptoms might constitute a starting point for interventions aiming to reduce decisional regret in this target group.

Keywords: active surveillance, decisional regret, depressive symptoms, erectile functioning, prostate cancer, radical prostatectomy

Procedia PDF Downloads 203