Search results for: pain scores

Authors: Anthoni Jeorge

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Throughout the history of the world, servant leadership has been researched, and favourable results such as individual, team, and organizational have been linked to the construct. This research paper designates St. Camillus de Lellis, a practitioner of servant leadership and founder of the Ministers of the Sick as a servant leader in his approach to care for the sick. Service is the visible face of his servant leadership. First of all, despite many challenges, St. Camillus de Lellis practiced leadership by the example of compassionate service to the sick. Second, he made service to the sick the highest priority of his life. Third, Camillus displayed servant leadership such that his manner of leadership gave birth to a New School of Service to the Sick. The paper identifies the distinctive dimensions and essential elements which characterized his service-centered leadership. Furthermore, discuss the six major characteristics of a servant leader as set forth by St. Camillus’s life example. The research illustrates the transformational power of servant leadership infield healthcare in general and, in doing so, provides servant leadership seekers ways servant leadership can transform elder care in one’s own field (St. Camillus Health Systems). Thus, it ascertains that servant leadership is best-fit for humanized elder care. Supported by the review of literature, the paper ascertains that Camillus, by identifying himself with the sick, gained deeper insights concerning the pain and suffering of the population. Uniquely drawn from his true grit, Camillus’ service-centered leadership is value-based, people-oriented, and compassion-filled. His way of service to the sick is the prolongation of gestures of mercy and compassion. It is hoped that the results of this study will help health care workers and servant leadership practitioners to humanize elder care and cultivate servant leadership attitude in their health care services to the sick. By incorporating such service-oriented elements into their leadership orientation, health care workers will be true servant leaders of the sick.

Keywords: leadership, service, healthcare, compassion

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Authors: Ahmed A. Abd El Rahim, Mohamed M. M. Essa, Magdy M. A. Shabana, Said A. Mohamed, Mohamed Ibrahim Mabrouk

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Background: Sacroiliac joint (SIJ) dysfunction is considered the main cause of pregnancy-related back pain, which may continue to persist postnatally. Myofascial release technique (MFR) is an application of low-intensity, prolonged stretch to myofascial structures to improve function by increasing the sliding properties of restricted myofascial tissues. Purpose: This study was designed to investigate the effect of MFR on postnatal SIJ hypo-mobility. Materials and Methods: Fifty postnatal women complaining of SIJ hypo-mobility participated in this study. Their ages ranged from 26 to 35 yrs., and their body mass index (BMI) didn`t exceed 30 kg/m2. They were randomly assigned to two equal groups, group A (Gr. A) and group B (Gr. B). Both groups received three sessions per week for eight successive weeks. Gr. A received a traditional physical therapy program, while Gr. B received a traditional physical therapy program in addition to MFR. Doppler imaging of vibration was utilized to measure SIJ mobility pre- and post-intervention, and an electronic digital goniometer was used to measure back flexion and extension Range of motion. Results: Findings revealed a statistical improvement in post-intervention values of SIJ mobility in addition to trunk flexion and extension ROM in Gr. B compared to Gr. A (P<0.001). Conclusion: Adding MFR to traditional physical therapy programs is highly recommended in the treatment of SIJ hypo-mobility in postnatal women.

Keywords: sacroiliac hypo-mobility, sacroiliac dysfunction, myofascial release technique, traditional physical therapy, postnatal

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Authors: Raymond Li

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In this project a web-based classroom response system (CRS) was used in the teaching an intermediate level economics course. This system allows the instructor to post a question on the screen and students to answer questions using their own electronic mobile devices. The questions and the results summarizing student responses can be shown to students simultaneously and the instructor can make timely feedback to students in class. CRS gives students a chance to respond to the instructor’s question privately, encouraging students who might not typically speak up in class to express their thoughts and opinions. There is a vast literature on the advantages and challenges of using CRS. However, empirical evidence on the student attributes that increase the effectiveness of CRS in improving student learning outcomes is sparse. The purpose of this project is to (1) find out if the use of CRS is beneficial to students taking economics, and (2) discover key student attributes that will likely make CRS more effective. Students’ performance in examinations and an end-of-semester questionnaire were used to assess the effectiveness of CRS in this project. Comparing the examination scores of the CRS treatment group and control group, the treatment group performed considerably better and statistically significant differences were found basing on paired t-tests on the differences. According to the questionnaire results, around 75% of the students in the treatment group generally agreed that CRS allowed them to express their views more freely. We also observed that students who prefer to use instant messaging rather than making conversations are generally more positive towards CRS. The use of CRS also benefits the instructor – students’ rating of the instructor in the teaching evaluation was significantly higher for the CRS treatment group.

Keywords: education technology, classroom response system, student attributes, economics education

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Authors: Gauri Shankar Shah

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Objectives: The Type I diabetes mellitus in children is frequently a missed diagnosis and children presents in emergency with diabetic ketoacidosis having significant morbidity and mortality. The present study was done to find out the clinical presentation and outcome at a tertiary-care centre. Methods: This was retrospective analysis of data of Type I diabetes mellitus reporting to our centre during last one year (2012-2013). Results: There were 12 patients (8 males) and the age group was 4-14 years (mean ± 3.7). The presenting symptoms were fever, vomiting, altered sensorium and fast breathing in 8 (66.6%), 6 (50%), 4 (33.3%), and 4 (33.3%) cases, respectively. The classical triad of polyuria, polydypsia, and polyphagia were present only in two patients (33.2%). Seizures and epigastric pain were found in two cases each (33.2%). The four cases (33.3%) presented with diabetic ketoacidosis due to discontinuation of insulin doses, while 2 had hyperglycemia alone. The hemogram revealed mean hemoglobin of 12.1± 1.6 g/dL and total leukocyte count was 22,883.3 ± 10,345.9 per mm3, with polymorphs percentage of 73.1 ± 9.0%. The mean blood sugar at presentation was 740 ± 277 mg/ dl (544–1240). HbA1c ranged between 7.1-8.8 with mean of 8.1±0.6 %. The mean sodium, potassium, blood ph, pCO2, pO2 and bicarbonate were 140.8 ± 6.9 mEq/L, 4.4 ± 1.8mEq/L, 7.0 ± 0.2, 20.2 ± 10.8 mmHg, 112.6 ± 46.5 mmHg and 9.2 ± 8.8 mEq/L, respectively. All the patients were managed in pediatric intensive care unit as per our protocol, recovered and discharged on intermediate insulin given twice daily. Conclusions: Thus, it shows that these patients have uncontrolled hyperglycemia and often presents in emergency with ketoacidosis and deranged biochemical profile. The regular administration of insulin, frequent monitoring of blood sugar and health education are required to have better metabolic control and good quality of life.

Keywords: type I diabetes mellitus, hyperglycemia, outcome, glycemic control

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Authors: Claudia Patricia Beltran Miranda, Mónica López Anaya, Mónica Navarro Meza, Maria Leonor Valderrama Chairez

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Background: Mexico occupies the second world-wide place of morbid obese people (10- 12 million). Factors that predispose the development of MO are genetic, environmental, physiological, psycho-social and behavioral (nourishing habits). Objective: Associate Gln223Arg polymorphism of gene LEPR, levels of leptina and nourishing habits with the presence of morbid obesity in adolescents of the south of Jalisco (México). Methods: In 41 adolescents (18 normal weight and 23 morbid obesity) of 12 to 19 years of age, both sexes that were measure size and weight with tanita scale and stadimeter to determine IMC. Morbid obesity was determined by tables of the WHO and was established with a standard deviation >3. The Gln223Arg polymorphism have been identify by PCR and leptina levels by ELISA. Nourishing habits were evaluate by the questionnaire the Adolescent Food Habits Checklist. The statistical analysis was performed to compare mean scores obtained from the questionnaire when we compare morbid obesity vs. normal weight adolescents with p=0.03 and a significance of 95%. Results: frequencies alellics and genics were not stadistics significatives p= 0,011 and p=0,279 respectly when were compared between normal weight adolescents and morbib obesity Leptin levels and nourishing habits were associated with morbid obesity. The polymorphism not shown significance with morbid obesity. Conclusions: Dietary habits and leptin levels in adolescents are important factor that predisposes the development of obesity in adolescents. The presence of the polymorphism are not associated with morbid obesity in these subjects.

Keywords: leptin, nourishing habits, morbid obesity, polymorphism

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Authors: Suruchi Shukla, Shantanu Prakash, Amita Jain

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Introduction: Arboviral diseases are one of the most common causes of viral hemorrhagic fever (VHF). Of which, Dengue and Chikungunya pose a significant health problem in India. Arbovirus has a tendency to cross the territories and emerge in the new region. Considering the above issues, in the current study active surveillance was conducted among viral hemorrhagic fever (VHF) cases reported from Uttar Pradesh (UP), India. We studied the arboviral etiology of VHF; mainly Dengue, Chikungunya, and ZIKA. Methods: Clinical samples of 465 suspected VHF cases referred to tertiary care referral center of UP, India were enrolled in the study during a period from 15th May 2016 to 9th March 2018. Serum specimens were collected and analyzed for the presence of Dengue, Chikungunya, and ZIKA either by serology and/or by molecular assays. Results: Of all tested, 165 (35.4%) cases were positive for either Dengue or Chikungunya. Dengue (21.2%) was found to be the most prevalent, followed by Chikungunya, (6.6%). None of the cases tested positive for ZIKA virus. Serum samples of 35 (7.5%) cases were positive for both Dengue and Chikungunya. DEN-2 serotype was the most predominant serotype. Phylogenetic and sequence analysis of DEN-2 strains showed 100% clustering with the Cosmopolitan genotype strain. Bleeding from several sites, jaundice, abdominal pain, arthralgia, haemoconcentration, and thrombocytopenia were significantly higher in dengue hemorrhagic cases. However, the rash was significantly more common in Chikungunya patients. Most of the Dengue and Chikungunya positive cases (Age group 6-40 years) were seen in post monsoon season (September to November). Conclusion: Only one-third of total VHF cases are positive for either Dengue/Chikungunya or both. This necessitates the screening of other etiologies capable of causing hemorrhagic manifestations.

Keywords: viral hemorrhagic fever, dengue, chikungunya, zika, India

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Authors: Haruna Maama

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Environmental, social and governance (ESG) reporting is gaining considerable attention despite being voluntary. Meanwhile, it consumes resources to provide ESG reporting, raising a question of its value relevance. The study examined the impact of ESG reporting on the market value of listed firms in SSA. The annual and integrated reports of 276 listed sub-Sahara Africa (SSA) firms. The integrated reporting scores of the firm were analysed using a content analysis method. A multiple regression estimation technique using a GMM approach was employed for the analysis. The results revealed that ESG has a positive relationship with firms’ market value, suggesting that investors are interested in the ESG information disclosure of firms in SSA. This suggests that extensive ESG disclosures are attempts by firms to obtain the approval of powerful social, political and environmental stakeholders, especially institutional investors. Furthermore, the market value analysis evidence is consistent with signalling theory, which postulates that firms provide integrated reports as a signal to influence the behaviour of stakeholders. This finding reflects the value placed on investors' social, environmental and governance disclosures, which affirms the views that conventional investors would care about the social, environmental and governance issues of their potential or existing investee firms. Overall, the evidence is consistent with the prediction of signalling theory. In the context of this theory, integrated reporting is seen as part of firms' overall competitive strategy to influence investors' behaviour. The findings of this study make unique contributions to knowledge and practice in corporate reporting.

Keywords: environmental accounting, ESG accounting, signalling theory, sustainability reporting, sub-saharan Africa

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Authors: Rukminingsih Rukmi

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This paper addresses the issue of L2 teaching speaking to ESL students by fostering their active learning through project-based learning. Project-based learning was employed in classrooms where teachers support students by giving sufficient guidance and feedback. The students drive the inquiry, engage in research and discovery, and collaborate effectively with teammates to deliver the final work product. The teacher provides the initial direction and acts as a facilitator along the way. This learning approach is considered helpful for fostering students’ active learning. that the steps in implementing of project-based learning that fosters students’ critical thinking in TEFL class are in the following: (1) Discussing the materials about Speaking Class, (2) Working with the group to construct scenario of ways on speaking practice, (3) Practicing the scenario, (4) Recording the speaking practice into video, and (5) Evaluating the video product. This research is aimed to develop a strategy of teaching speaking by implementing project-based learning to improve speaking skill in the second Semester of English Department of STKIP PGRI Jombang. To achieve the purpose, the researcher conducted action research. The data of the study were gathered through the following instruments: test, observation checklists, and questionnaires. The result was indicated by the increase of students’ average speaking scores from 65 in the preliminary study, 73 in the first cycle, and 82 in the second cycle. Besides, the results of the study showed that project-based learning considered to be appropriate strategy to give students the same amount of chance in practicing their speaking skill and to pay attention in creating a learning situation.

Keywords: active learning, project-based learning, speaking ability, L2 teaching speaking

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Authors: Sadeq Al Yaari, Ayman Al Yaari, Adham Al Yaari, Montaha Al Yaari, Aayah Al Yaari, Sajedah Al Yaari

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Background & Objectives: Audio-visual aids and computer-assisted language instruction (CALI) effects are strong in teaching language components (sound system, grammatical structures and vocabulary) to students of special needs. To explore the effects of the audio-visual aids and CALI in teaching sound system to this class of students by speech language therapists (SLTs), an experiment has been undertaken to evaluate their performance during their study of the sound system course. Methods: Forty students (males and females) of special needs at al-Malādh school for teaching students of special needs in Dhamar (Yemen) range between 8 and 18 years old underwent this experimental study while they were studying language sound system course. Pre-and-posttests have been administered at the begging and end of the semester. Students' treatment was compared to a similar group (control group) of the same number under the same environment. Whereas the first group was taught using audio-visual aids and CALI, the second was not. Students' performances were linguistically and statistically evaluated. Results & conclusions: Compared with the control group, the treatment group showed significantly higher scores in the posttest (72.32% vs. 31%). Compared with females, males scored higher marks (1421 vs. 1472). Thus, we should take the audio-visual aids and CALI into consideration in teaching sound system to students of special needs.

Keywords: language components, sound system, audio-visual aids, CALI, students, special needs, SLTs

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Authors: Samira K. Al-Nasser, Siamak Noroozi, Roya Haratian, Adrian Harvey

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A total knee replacement (TKR) is a surgical procedure necessary when there is severe pain and/or loss of function in the knee. Surgeons balance the load in the knee and the surrounding soft tissue by feeling the tension at different ranges of motion. This method can be unreliable and lead to early failure of the joint. The ideal kinematics and load distribution have been debated significantly based on previous biomechanical studies surrounding both TKRs and normal knees. Intraoperative sensors like VERASENSE and eLibra have provided a method for the quantification of the load indicating a balanced knee. A review of the literature written about intraoperative sensors and tension/stability of the knee was done. Studies currently debate the quantification of the load in medial and lateral compartments specifically. However, most research reported that following a TKR the medial compartment was loaded more heavily than the lateral compartment. In several cases, these results were shown to increase the success of the surgery because they mimic the normal kinematics of the knee. In conclusion, most research agrees that an intercompartmental load differential of between 10 and 20 pounds, where the medial load was higher than the lateral, and an absolute load of less than 70 pounds was ideal. However, further intraoperative sensor development could help improve the accuracy and understanding of the load distribution on the surgical outcomes in a TKR. A reduction in early revision surgeries for TKRs would provide an improved quality of life for patients and reduce the economic burden placed on both the National Health Service (NHS) and the patient.

Keywords: intraoperative sensors, joint load forces, kinematics, load balancing, and total knee replacement

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Authors: Tannistha Dasgupta

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This study explores the aspects of second language (L2) spoken fluency that are related to L2 linguistic knowledge and processing skill. It draws on Levelt’s ‘blueprint’ of the L2 speaker which discusses the cognitive issues underlying the act of speaking. However, L2 speaking assessments have largely neglected the underlying mechanism involved in language production; emphasis is given on the relationship between subjective ratings of L2 speech sample and objectively measured aspects of fluency. Hence, in this study, the relation between L2 linguistic knowledge and processing skill i.e. Cognitive Fluency (CF), and objectively measurable aspects of L2 spoken fluency i.e. Utterance Fluency (UF) is examined. The participants of the study are L2 learners of English, studying at high school level in Hyderabad, India. 50 participants with intermediate level of proficiency in English performed several lexical retrieval tasks and attention-shifting tasks to measure CF, and 8 oral tasks to measure UF. Each aspect of UF (speed, pause, and repair) were measured against the scores of CF to find out those aspects of UF which are reliable indicators of CF. Quantitative analysis of the data shows that among the three aspects of UF; speed is the best predictor of CF, and pause is weakly related to CF. The study suggests that including the speed aspect of UF could make L2 fluency assessment more reliable, valid, and objective. Thus, incorporating the assessment of psycholinguistic mechanisms into L2 spoken fluency testing, could result in fairer evaluation.

Keywords: attention-shifting, cognitive fluency, lexical retrieval, utterance fluency

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Authors: Kofi Kyei, Kenchi Matsui

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Loss of vegetable products has been a major constraint in the post-harvest chain. Sources of post-harvest loss in the vegetable industry start from the time of harvesting to its handling and at the various market centers. Identifying vegetable farmers’ perceptions about post-harvest loss sources is one way of addressing this issue. In this paper, we assessed farmers’ perceptions about sources of post-harvest losses in the Ashanti Region of Ghana. We also identified the factors that influence their perceptions. To clearly understand farmers’ perceptions, we selected Sekyere-Kumawu District in the Ashanti Region. Sekyere-Kumawu District is one of the major producers of vegetables in the Region. Based on a questionnaire survey, 100 vegetable farmers growing tomato, pepper, okra, cabbage, and garden egg were purposely selected from five communities in Sekyere-Kumawu District. For farmers’ perceptions, the five points Likert scale was employed. On a scale from 1 (no loss) to 5 (extremely high loss), we processed the scores for each vegetable harvest. To clarify factors influencing farmers’ perceptions, the Pearson Correlation analysis was used. Our findings revealed that farmers perceive post-harvest loss by pest infestation as the most extreme loss. However, vegetable farmers did not perceive loss during transportation as a serious source of post-harvest loss. The Pearson Correlation analysis results further revealed that farmers’ age, gender, level of education, and years of experience had an influence on their perceptions. This paper then discusses some recommendations to minimize the post-harvest loss in the region.

Keywords: Ashanti Region, pest infestation, post-harvest loss, vegetable farmers

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Authors: Ghadeer M Alkusayer, Adelicia Yu, Pamela Orr

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Study objective: To report a case of postpartum pulmonary cryptococcal infection (CCI) in an otherwise healthy 35-year-old woman. Additionally, the cases of pulmonary cryptococcal infections either in the antepartum or the postpartum period with pregnancy outcomes, were systematically reviwed. Methods: A systematic search of Cochrane Library, MEDLINE, and EMBASE was conducted for peer-reviewed studies without date restrictions, published in English and relating to CCI during pregnancy or postpartum period. Conference press, editorials, opinion pieces and letters were excluded. Two authors independently screened citations and full-text articles, extracted data and assessed study quality. Given the heterogeneity of study designs, a narrative synthesis was conducted. Results: The search identified 128 references, of which 22 case reports and series met the inclusion criteria. This is a total of 29 women (including the current case) . The mean age of the women was 28.3 ± 12.3 years. Nine (31.03%) presented and were diagnosed in the postpartum period. Two (6.90%) of the patients were reported as immunocompromised with HIV. Four maternal deaths (13.79%) were found in this case series with one (4.3%) patient with severe neurological deficits. Four (17.4%) infant deaths were reported. Women primary presentation varied with chest pain 13 (44.82%), headache 10 (35.70%), dyspnea 19 (65.51%), or fever 12 (41.38%). Three studies reported placental pathology positive for C. neoformans. Conclusion: This case of pulmonary cryptococcal infection in the postpartum period is an important addition to the literature of this rare infection in pregnancy. The patient is not immunocompromised. The patient was successfully treated with 4 months of Fluconazole 400 mg and continued to breastfeed the healthy baby.

Keywords: pulmonary cryptococcus, pregnancy, cryptococci , postpartum

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Authors: Redouane Larbi Boufeniza, Jing-Jia Luo

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This study assesses the suitability of deep learning (DL) for downscaling sea surface temperature (SST) over the Mediterranean Sea in the context of seasonal forecasting. We design a set of experiments that compare different DL configurations and deploy the best-performing architecture to downscale one-month lead forecasts of June–September (JJAS) SST from the Nanjing University of Information Science and Technology Climate Forecast System version 1.0 (NUIST-CFS1.0) for the period of 1982–2020. We have also introduced predictors over a larger area to include information about the main large-scale circulations that drive SST over the Mediterranean Sea region, which improves the downscaling results. Finally, we validate the raw model and downscaled forecasts in terms of both deterministic and probabilistic verification metrics, as well as their ability to reproduce the observed precipitation extreme and spell indicator indices. The results showed that the convolutional neural network (CNN)-based downscaling consistently improves the raw model forecasts, with lower bias and more accurate representations of the observed mean and extreme SST spatial patterns. Besides, the CNN-based downscaling yields a much more accurate forecast of extreme SST and spell indicators and reduces the significant relevant biases exhibited by the raw model predictions. Moreover, our results show that the CNN-based downscaling yields better skill scores than the raw model forecasts over most portions of the Mediterranean Sea. The results demonstrate the potential usefulness of CNN in downscaling seasonal SST predictions over the Mediterranean Sea, particularly in providing improved forecast products.

Keywords: Mediterranean Sea, sea surface temperature, seasonal forecasting, downscaling, deep learning

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Authors: Kimiyo Shimomai, Mihoko Harada

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This study is a literature review of the psychological reactions that occur in end-of-life cancer patients who are nearing death. It searched electronic databases and selected literature related to psychological studies of end-of-life patients. There was no limit on the search period, and the search was conducted until the second week of December 2021. The keywords were specified as “death and dying”, “terminal illness”, “end-of-life”, “palliative care”, “psycho-oncology” and “research”. These literatures referred to Holly (2017): Comprehensive Systematic Review for Advanced Practice Nursing, P268 Figure 10.3 to ensure quality. These literatures were selected with a dissertation score of 4 or 5. The review was conducted in two stages with reference to the procedure of George (2002). First, these references were searched for keywords in the database, and then relevant references were selected from the psychology and nursing studies of end-of-life patients. The number of literatures analyzed was 76 for overseas and 17 for domestic. As for the independent variables, "physical variable" was the most common in 36 literatures (66.7%), followed by "psychological variable" in 35 literatures (64.8%), "spiritual variable" in 21 literatures (38%), and "social variable" in 17 literatures. (31.5%), "Variables related to medical care / treatment" were 16 literatures (29.6%). To summarize the relationship between these independent variables and the dependent variable, when the dependent variable is "psychological variable", the independent variables are "psychological variable", "social variable", and "physical variable". Among the independent variables, the physical variables were the most common. The psychological responses that occur in end-stage cancer patients who are nearing death are mutually influenced by psychological, social, and physical variables. Therefore, it supported the "total pain" advocated by Cicely Saunders.

Keywords: cancer patient, end-of-life, literature review, psychological process

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Authors: Adetunji Abiola Olaoye

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The study examined the students’ self-concepts and mathematics achievement viz-a-viz the existing three theoretical models: Humanist self-concept (M1), Contemporary self-concept (M2) and Skills development self-concept (M3). As a qualitative research study, it comprised of one research question, which was transformed into hypothesis viz-a-viz the existing theoretical models. Sample to the study comprised of twelve public secondary schools from which twenty-five mathematics teachers, twelve counselling officers and one thousand students of Upper Basic II were selected based on intact class as school administrations and system did not allow for randomization. Two instruments namely 10 items ‘Achievement test in Mathematics’ (r1=0.81) and 10 items Student’s self-concept questionnaire (r2=0.75) were adapted, validated and used for the study. Data were analysed through descriptive, one way ANOVA, t-test and correlation statistics at 5% level of significance. Finding revealed mean and standard deviation of pre-achievement test scores of (51.322, 16.10), (54.461, 17.85) and (56.451, 18.22) for the Humanist Self-Concept, Contemporary Self-Concept and Skill Development Self-Concept respectively. Apart from that study showed that there was significant different in the academic performance of students along the existing models (F-cal>F-value, df = (2,997); P<0.05). Furthermore, study revealed students’ achievement in mathematics and self-concept questionnaire with the mean and standard deviation of (57.4, 11.35) and (81.6, 16.49) respectively. Result confirmed an affirmative relationship with the Contemporary Self-Concept model that expressed an individual subject and specific self-concept as the primary determinants of higher academic achievement in the subject as there is a statistical correlation between students’ self-concept and mathematics achievement viz-a-viz the existing three theoretical models of Contemporary (M2) with -Z_cal<-Z_val, df=998: P<0.05*. The implication of the study was discussed with recommendations and suggestion for further studies proffered.

Keywords: contemporary, humanists, self-concepts, skill development

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Authors: Amina Aquil, Abdeljalil El Got

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Background: Sleep quality is one of the most important indicators related to the quality of life of patients suffering from cancer. Many factors could affect this quality of sleep and then be considered as associated predictors. Methods: The aim of this study was to assess the prevalence of sleep disorders and the associated factors with impaired sleep quality in Moroccan women with gynecological cancer. A cross-sectional study was carried out within the oncology department of the Ibn Rochd University Hospital, Casablanca, on Moroccan women who had undergone radical surgery for gynecological cancer (n=100). Translated and validated Arabic versions of the following international scales were used: Pittsburgh sleep quality index (PSQI), Hospital Anxiety and Depression Scale (HADS), Rosenberg's self-esteem scale (RSES), and Body image scale (BIS). Results: 78% of participants were considered poor sleepers. Most of the patients exhibited very poor subjective quality, low sleep latency, a short period of sleep, and a low rate of usual sleep efficiency. The vast majority of these patients were in poor shape during the day and did not use sleep medication. Waking up in the middle of the night or early in the morning and getting up to use the bathroom were the main reasons for poor sleep quality. PSQI scores were positively correlated with anxiety, depression, body image dissatisfaction, and lower self-esteem (p < 0.001). Conclusion: Sleep quality and its predictors require a systematic evaluation and adequate management to prevent sleep disturbances and mental distress as well as to improve the quality of life of these patients.

Keywords: body image, gynecological cancer, self esteem, sleep quality

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Authors: Aravella Flores, Jose Rafael E. Sotelo, Luis Romulus Phillippe R. Javier, Josh Christian V. Nunez

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This study focuses on analyzing the performance of Grade 12 STEM students of De La Salle University - Integrated School that has completed the Disaster Readiness and Risk Reduction course in handling fire hazards through Minecraft Java Edition. This platform is suitable because fire DRRR is challenging to learn in a practical setting as well as questionable with regard to supplementing the successful implementation of textbook knowledge into actual practice. The purpose of this study is to acknowledge whether Minecraft can be a suitable environment to familiarize oneself to fire DRRR. The objectives are achieved through utilizing Minecraft in simulating fire scenarios which allows the participants to freely act upon and practice fire DRRR. The experiment was divided into the grounding and validation phase, where researchers observed the performance of the participants in the simulation. A pre-simulation and post-simulation survey was given to acknowledge the change in participants’ perception of being able to utilize fire DRRR procedures and their vulnerabilities. The paired t-test was utilized, showing significant differences in the pre-simulation and post-simulation survey scores, thus, insinuating improved judgment of DRRR, lessening their vulnerabilities in the possibility of encountering a fire hazard. This research poses a model for future research which can gather more participants and dwell on more complex codes outside just command blocks and into the code lines of Minecraft itself.

Keywords: minecraft, DRRR, fire, disaster, simulation

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Authors: Diaa Othman, Muhammad Adil Khan, Muhammad Riaz

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Without an early intervention to correct the unilateral complete cleft lip and palate deformity, nasal architecture can progress to an exaggerated cleft nose deformity. We present the results of a modified unilateral cleft rhinoplasty procedure ‘the Gujrat technique’ to correct this deformity. Ninety pediatric and adult patients with non-syndromic unilateral cleft lip underwent primary and secondary composite cleft rhinoplasty using the Gujrat technique as a single stage operation over a 10-year period. The technique involved an open rhinoplasty with Tennison lip repair, and employed a combination of three autologous cartilage grafts, seven cartilage-molding sutures and a prolene mesh graft for alar base support. Post-operative evaluation of nasal symmetry was undertaken using the validated computer program ‘SymNose’. Functional outcome and patient satisfaction were assessed using the NOSE scale and ROE (rhinoplasty outcome evaluation) questionnaires. The single group study design used the non-parametric matching pairs Wilcoxon Sign test (p < 0.001), and showed overall good to excellent functional and aesthetic outcomes, including nasal projection and tip definition, and higher scores of the digital SymNose grading system. Objective assessment of the Gujrat cleft rhinoplasty technique demonstrates its aesthetic appeal and functional versatility. Overall it is a simple and reproducible technique, with no significant complications.

Keywords: cleft lip and palate, congenital rhinoplasty, nasal deformity, secondary rhinoplasty

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Authors: Bilge B. Calik, Ummuhan B. Aslan, Suat Erel, Sehmus Aslan

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Objective: Intellectual disability (ID) is characterized by limitations in both intellectual functioning and adaptive behavior, which covers many everyday social and practical skills. The aim of this study was to evaluate the balance and coordination performance determined between mild and moderate ID adolescents who regularly play sport. Methods: The study comprised a total of 179 participants, of which 135 were male adolescents with mild and moderate-level ID who regularly play sports (16.52 ± 2.17 years) and 44 age-matched male adolescents with typical development without ID who do not do any sports (16.52 ± 0.99 years). The participants with ID were students of Special Education Schools for the mentally disabled and had been diagnosed with ID at a Ministry of Health Hospital. The adolescents with mild and moderate ID had been playing football in their school teams at least 2 days a week, for at least one year. Balance and coordination of adolescents were assessed by Bilateral coordination and balance subtests of Short Form Bruininks-Oseretsky Test of Motor Proficiency (BOT-2 SF). Results: As a result of the evaluations comparing coordination and balance scores significant differences were determined between all three groups in favor of the peers without ID (p<0.05). Conclusions: It was observed that balance and coordination levels of adolescents with mild ID were better than those of adolescents with moderate-level ID but lower than those of peers without ID. These results indicate a relationship between IQ level and motor performance. Further comparative studies are needed on individuals with ID who play and do not play sports in order to examine the impact of participation in sports on the motor skills of individuals with ID.

Keywords: balance, coordination, intellectual disability, motor skills, sport

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

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

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

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Authors: Keivan Jmahidi, Afshin Zahedi

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To evaluate neurotoxic effects of ACR on hypothalamus of rat, amino-cupric silver staining technique of de Olmos and electron microscopic examination were conducted. For this purpose 60 adult male Wistar rats (± 250 g) were selected. Randomly assigned groups of rats (10 rats per exposure group, as A, B, C, D, E) were exposed to 0.5, 5, 50, 100 and 500 mg/kg per day×11days i.p. respectively. The remaining 10 rats were housed in group F as control group. Control rats received daily i.p. injections of 0.9% saline (3ml/kg). As indices of developing neurotoxicity, daily weight gain, gait scores and landing hindlimb foot splay (LHF) were determined. After 11 days, two rats for silver stain, and two rats for EM, were randomly selected, dissected and proper samples were collected from hypothalamus. Rats in groups D and E died within 1-2 hours due to sever toxemia. In histopathological studies no argyrophilic neurons or processes were observed in stained sections obtained from hypothalamus of rats belong to groups A, B and F, while moderate to severe argyrophilic changes were observed in different nuclei and regions of stained sections obtained from hypothalamus of rats belong to group C. In ultrastructural studies some variations in the myelin sheet of injured axons including decompactation, interlaminar space formation, disruption of the laminar sheet, accumulation of neurofilaments, vacculation and clumping inside the axolem, and finaly complete disappearance of laminar sheet were observed.

Keywords: acrylamide (ACR), amino-cupric silver staining technique of de Olmos, argyrophilia, hypothalamic neuropathy

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Authors: Qaisara Parveen, M. Imran Yousuf

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The purpose of this study was to find the effectiveness of the use of advance organizer model for enhancing meta-cognition of students in the subject of science. It was hypothesized that the students of experimental group taught through advance organizer model would show the better cognition than the students of control group taught through traditional teaching. The population of the study consisted of all secondary school students studying in government high school located in Rawalpindi. The sample of the study consisted of 50 students of 9th class of humanities group. The sample was selected on the basis of their pretest scores through matching, and the groups were randomly assigned for the treatment. The experimental group was taught through advance organizer model while the control group was taught through traditional teaching. The self-developed achievement test was used for the purpose of pretest and posttest. After collecting the pre-test score and post-test score, the data was analyzed and interpreted by use of descriptive statistics as mean and standard deviation and inferential statistics t-test. The findings indicate that students taught using advance organizers had a higher level of meta-cognition as compared to control group. Further, meta cognition level of boys was found higher than that of girls students. This study also revealed the fact that though the students at different meta-cognition level approached learning situations in a different manner, Advance organizer model is far superior to Traditional method of teaching.

Keywords: descriptive, experimental, humanities, meta-cognition, statistics, science

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Authors: Mannan Mridha, Mohammad S. Islam

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Innovative medical technologies offer more effective medical care, with less risk to patient and healthcare personnel. Medical technology and devices when properly used provide better data, precise monitoring and less invasive treatments and can be more targeted and often less costly. The Intensive Care Unit (ICU) equipped with patient monitoring, respiratory and cardiac support, pain management, emergency resuscitation and life support devices is particularly prone to medical errors for various reasons. Many people in the developing countries now wonder whether their visit to hospital might harm rather than help them. This is because; clinicians in the developing countries are required to maintain an increasing workload with limited resources and absence of well-functioning safety system. A team of experts from the medical, biomedical and clinical engineering in Sweden and Bangladesh have worked together to study the incidents, adverse events at the ICU in Bangladesh. The study included both public and private hospitals to provide a better understanding for physical structure, organization and practice in operating processes of care, and the occurrence of adverse outcomes the errors, risks and accidents related to medical devices at the ICU, and to develop a ICT based support system in order to reduce hazards and errors and thus improve the quality of performance, care and cost effectiveness at the ICU. Concrete recommendations and guidelines have been made for preparing appropriate ICT related tools and methods for improving the routine for use of medical devices, reporting and analyzing of the incidents at the ICU in order to reduce the number of undetected and unsolved incidents and thus improve the patient safety.

Keywords: intensive care units, medical errors, medical devices, patient care and safety

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Authors: Nikk Leavitt, Peter Kellett, Cheryl Currie, Richard Larouche

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Background: Masculinity has been associated with poor mental health outcomes in adult men and is colloquially referred to as toxic. Masculinity is traditionally measured using the Male Role Norms Inventory, which examines behaviors that may be common in men but that are themselves associated with poor mental health regardless of gender (e.g., aggressiveness). The purpose of this study was to examine if masculinity is associated with generalized anxiety among men using this inventory vs. a man’s personal definition of it. Method: An online survey collected data from 1,200 men aged 18-65 across Canada in July 2022. Masculinity was measured using: 1) the Male Role Norms Inventory Short Form and 2) by asking men to self-define what being masculine means. Men were then asked to rate the extent they perceived themselves to be masculine on a scale of 1 to 10 based on their definition of the construct. Generalized anxiety disorder was measured using the GAD-7. Multiple linear regression was used to examine associations between each masculinity score and anxiety score, adjusting for confounders. Results: The masculinity score measured using the inventory was positively associated with increased anxiety scores among men (β = 0.02, p < 0.01). Masculinity subscales most strongly correlated with higher anxiety were restrictive emotionality (β = 0.29, p < 0.01) and dominance (β = 0.30, p < 0.01). When traditional masculinity was replaced by a man’s self-rated masculinity score in the model, the reverse association was found, with increasing masculinity resulting in a significantly reduced anxiety score (β = -0.13, p = 0.04). Discussion: These findings highlight the need to revisit the ways in which masculinity is defined and operationalized in research to better understand its impacts on men’s mental health. The findings also highlight the importance of allowing participants to self-define gender-based constructs, given they are fluid and socially constructed.

Keywords: masculinity, generalized anxiety disorder, race, intersectionality

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Authors: Leila Habibi, Hadi Hakimi, Hadi Sadeghian, Maryam Jafari Mehrabadi

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Nowadays, the importance of information technology and web-based information in tourism is very obvious. Increasing of sales and promotion of brands, the rise of information about tourist attractions and tourist areas, entrepreneurship and making money, introducing of hotels and side information to tourists via web are some examples of website effects on tourism. The hotels using web-based information can succeed in attracting tourists and improve the quality of services to the tourists. So, the study of hotel websites has become one of the most important issues in tourism. Therefore, this research aims to analyze the status of hotel websites in Yazd County as one of the most tourist visited counties in Iran. The quality of hotel website in a county can be very vital for tourism. Hence, this research compares the status of hotel websites in Yazd County with standard indexes and items that extracted from literature and theoretical framework. Content analysis is used for analyzing hotel websites with indexes and items in methodology. In the other words, all of the items are compared with the content of hotel-websites in Yazd one by one. Finally, every hotel archived final score which represents the position of the hotel among the others. All of scores and status of hotels are displayed in their own figures. The result of this research shows that many hotels do not offer standard web-based services and information. So, the existing situation is not very suitable for the attraction of web users or improving the tourism. The result of this research may help the managers and authorities of tourism to offer and improve the web-based services and information.

Keywords: e-tourism, hotel websites, tourism, web-tourism

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Authors: Elizabeth O'Brien, Raegan Murphy

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Research suggests that high levels of empathy in individuals with partners with mental health difficulties can lead to improved outcomes for their partner while compromising their own mental health. Specifically, it is proposed that the affective dimension of empathy diminishes resilience to the distress of a partner, whereas cognitive empathy (CE) enhances it. The relationship between different empathy dimensions and psychological resilience measures has not been investigated in partners of people with depression. Psychological inflexibility (PI) is a construct that can be understood as distress intolerance and is suggested to be an important feature of psychological resilience. The current study, therefore, aimed to investigate the differential role of dispositional empathy dimensions in PI for people living with a partner with depression. A cross-sectional design was employed in which 148 participants living with a partner with depression and 45 participants for a comparison sample were recruited using online platforms. Participants completed online surveys with measures relating to demographics, empathy, and PI. Scores were compared between the study and comparison samples. The study sample scored significantly lower for CE and affective empathy (AE) and significantly higher for PI than the comparison sample. Exploratory and regression analyses were run to examine associations between variables within the study sample. Analyses revealed that CE predicted the resilience outcome whilst AE did not. These results suggest that interventions for partners of people with depression that bolster the CE dimension alone may improve mental health outcomes for both members of the couple relationship.

Keywords: affective empathy, cognitive empathy, depression, partners, psychological inflexibility

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Authors: Ana Luiza Blanco, Juliana Cordeiro Carvalho, Tábatta Renata Pereira Brito, Ariene Angelini dos Santos Orlandi, Ligiana Pires Corona, Daniella Pires Nunes

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Depressive symptoms are recurrent in older adults and affect the quality of life and well-being of individuals. One of the strategies to reduce depression is social support, but studies are still needed to determine which types of social support are most effective in moderating this effect in certain populations. The objective was to identify the relationship between social support and depressive symptoms in participants of a University of the Third Age. This is a cross-sectional study. Participants were 82 individuals (≥ 50 years) who responded to the Geriatric Depression Scale - GDS and the Medical Outcomes Study - MOS. Data collection was carried out from November 2020 to May 2021. The Chi-Square and Mann Whitney tests were used, at a significance level of 5% for data analysis. Among the participants, 83.4% were female, 57.3% were age between 60 to 69 years, 83.1% studied 12 year or more and 48.1% receive from 4 to 10 minimum wages. The prevalence of depressive symptoms was 12.2%. The type of support with the highest median score was affective (100 points) and the lowest, or emotional (87.5 points). The results showed that participants without depressive symptoms had higher median scores for informational support when compared to those with depressive symptoms (p=0.029). The other types of social support were not statistically significant. The findings suggested that informational support is related to depressive symptoms in older adults. Promote informational support and educational actions in Universities of the Third Age may be an important strategy for preventing depressive symptoms and improve the quality of life of this population.

Keywords: aged, depressive symptoms, social support, university of the third age

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Authors: Surbhi Aggarwal, Jaishree Paul

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Background: Role of GABA has been implicated in autoimmune diseases like multiple sclerosis, type1 diabetes and rheumatoid arthritis where they modulate the immune response but role in gut inflammation has not been defined. Ulcerative colitis (UC) and diarrhoeal predominant irritable bowel syndrome (IBS-D) both involve inflammation of gastrointestinal tract. UC is a chronic, relapsing and idiopathic inflammation of gut. IBS is a common functional gastrointestinal disorder characterised by abdominal pain, discomfort and alternating bowel habits. Mild inflammation is known to occur in IBS-D. Aim: Aim of this study was to investigate the role of GABA in UC as well as in IBS-D. Materials and methods: Blood and biopsy samples from UC, IBS-D and controls were collected. ELISA was used for measuring level of GABA in serum of UC, IBS-D and controls. RT-PCR analysis was done to determine GABAergic signal system in colon biopsy of UC, IBS-D and controls. RT-PCR was done to check the expression of proinflammatory cytokines. CurveExpert 1.4, Graphpad prism-6 software were used for data analysis. Statistical analysis was done by unpaired, two-way student`s t-test. All sets of data were represented as mean± SEM. A probability level of p < 0.05 was considered statistically significant. Results and conclusion: Significantly decreased level of GABA and altered GABAergic signal system was detected in UC and IBS-D as compared to controls. Significantly increased expression of proinflammatory cytokines was also determined in UC and IBS-D as compared to controls. Hence we conclude that insufficient level of GABA in UC and IBS-D leads to overproduction of proinflammatory cytokines which further contributes to inflammation. GABA may be used as a promising therapeutic target for treatment of gut inflammation or other inflammatory diseases.

Keywords: diarrheal predominant irritable bowel syndrome, γ-aminobutyric acid (GABA), inflammation, ulcerative colitis

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Authors: R. Marhenke, M. Martini

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The distraction of attentional resources after learning hinders long-term memory consolidation compared to several minutes of post-encoding inactivity in form of wakeful resting. We tested whether an 8-minute period of wakeful resting, compared to performing an adapted version of the d2 test of attention after learning, supports memory retention. Participants encoded and immediately recalled a word list followed by either an 8 minute period of wakeful resting (eyes closed, relaxed) or by performing an adapted version of the d2 test of attention (scanning and selecting specific characters while ignoring others). At the end of the experimental session (after 12-24 min) and again after 7 days, participants were required to complete a surprise free recall test of both word lists. Our results showed no significant difference in memory retention between the experimental conditions. However, we found that participants who completed the first lines of the d2 test in less than the given time limit of 20 seconds and thus had short unfilled intervals before switching to the next test line, remembered more words over the 12-24 minute and over the 7 days retention interval than participants who did not complete the first lines. This interaction occurred only for the first test lines, with the highest temporal proximity to the encoding task and not for later test lines. Differences in retention scores between groups (completed first line vs. did not complete) seem to be widely independent of the general performance in the d2 test. Implications and limitations of these exploratory findings are discussed.

Keywords: long-term memory, retroactive interference, attention, forgetting

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