Search results for: objectives

Authors: Thipsupar Pureprasert, Niwat Anuwongnukroh, Surachai Dechkunakorn, Surapich Loykulanant, Chaveewan Kongkaew, Wassana Wichai

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Objective: Orthodontic elastic bands made from natural rubber continue to be commonly used due to their favorable characteristics. However, there are concerns associated cytotoxicity due to harmful components released during conventional vulcanization (sulfur-based method). With the co-operation of The National Metal and Materials Technology Center (MTEC) and Faculty of Dentistry Mahidol University, a method was introduced to reduce toxic components by leaching the orthodontic elastic bands with NaOH solution. Objectives: To evaluate the mechanical properties of Thai and commercial orthodontic elastic brands (Ormco and W&H) leached with NaOH solution. Material and methods: Three elastic brands (N =30, size ¼ inch, 4.5 oz.) were tested for mechanical properties in terms of initial extension force, residual force, force loss, breaking strength and maximum displacement using a Universal Testing Machine. Results : Force loss significantly decreased in Thai-LEACH and W&H-LEACH, whereas the values increased in Ormco-LEACH (P < 0.05). The data exhibited a significantly decrease in breaking strength with Thai-LEACH and Ormco-LEACH, whereas all 3 brands revealed a significantly decrease in maximum displacement with the leaching process (P < 0.05). Conclusion: Leaching with NaOH solution is a new method, which can remove toxic components from orthodontic latex elastic bands. However, this process can affect their mechanical properties. Leached elastic bands from Thai had comparable properties with Ormco and have potential to be developed as a promising product.

Keywords: leaching, orthodontic elastics, natural rubber latex, orthodontic

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Authors: Farideh Gheitasi, Amir Hossain Jaberansari, Payam Abedini

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The World Health Organization (WHO) Manifesto for Safe Communities states that "All human beings have an equal right to health and safety". The purpose of a safe Community is to minimize the damages threatening people. It seems that not sufficient attention has been given to relate environment and objectives of the safe Community. The reason for that can be assigned to the lack of enough information about environmental parameters and their relation with indices of the safe community like type and effect time of damages resulting from air pollution. Air pollution can be characterized as one of main environmental problems of Tehran. This problem is mostly due to the special geographic and climate situation, high population density and irregular growth in the number of vehicles. This paper is aimed at investigating the necessity of considering environmental factors to obtain a safe community through determining the effects of environmental pollution, particularly air pollution, on 490000 elders (+65) of Tehran. The methodology used in this study was on the basis of Random sampling and social surveying. The number of questionnaires was determined to be 321 through using Cochran method and the questionnaires were filled out by elders during personal interviews. The analysis of obtained results indicated that elders believe the major effects of air pollution include heart and respiratory diseases, obligation to stay at home on polluted days and its associated mental problems. Moreover, it was found that there is direct link between the number of polluted days and mortality frequency of elders. Having an environmental view may have an appreciable influence on the qualitative and quantitative development of activities and also facilitate obtaining the goals of the Safe Communities. In addition to reduce damages caused by pollutions, this view will encourage friends of the environment to cooperate with authorities of the safe community.

Keywords: air pollution, elderly people, environment, waste management

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Authors: A. M. Bumbea, A. Musetescu, P. Ciurea, A. Bighea

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Objectives: The authors present a Parsonage Turner syndrome, a rare disease characterized by onset in apparently healthy person with shoulder and/or arm pain, sensory deficit, motor deficit. The causes are not established, could be determinate by vaccination, postoperative, immunologic disease, post traumatic etc. Methods: The authors present a woman case, 32 years old, (in 2006), no medical history, with arm pain and no other symptom. The onset was sudden with pain at very high level quantified as 10 to a 0 to 10 scale, with no response to classical analgesic and corticoids. The only drugs which can reduce the intensity of pain were oxycodone hydrochloride, 60 mg daily and pregabalinum150 mg daily. After two weeks the intensity of pain was reduced to 5. The patient started a rehabilitation program. After 6 weeks the patient associated sensory and motor deficit. We performed electromyography for upper limb that showed incomplete denervation with reduced neural transmission speed. The patient receives neurotrophic drugs and painkillers for a long period and physical and kinetic therapy. After 6 months the pain was reduced to level 2 and the patient maintained only 150 mg pregabalinum for another 6 months. Then, the evaluation showed no pain but general amiotrophy in upper limb. Results: At the evaluation in 2009, the patient developed a rheumatoid syndrome with tender and swelling joints, but no positive inflammation test, no antibodies or rheumatoid factor. After two years, in 2011 the patient develops an increase of antinuclear antibodies. This context certifies the diagnosis of lupus and the patient receives the specific therapy. Conclusions: This case is not a typical case of onset of lupus with PTS, but the onset of PTS could include the onset of an immune disease.

Keywords: lupus, arm pain, patient, swelling

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Authors: Harsha Kumar H. N., Anshu Kumar Jha, Khushboo Kamal Taneja, Krishan Kabra, Mohamed Hafeez Sadiq

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Introduction: The increasing use of preservatives and flavouring agents has the potential to cause health problem among the people. There are no published studies from India exploring the awareness, safety perception, & practices about Food Preservatives (FPs) and Flavouring Agents (FAs). So this study was conducted with the objectives of assessing the awareness, safety perceptions & practices about Food Preservatives (FPs), Flavouring Agents (FAs) in commonly bought / purchased packed food items. Materials & method: This cross-sectional study was conducted in January 2012. Sample size of 126 was computed using the formula for infinite population. People who bought packed food items in malls were approached and requested to fill a pre-tested semi-structured questionnaire. The questionnaire explored awareness, safety perception & practices of FPs & FAs. Data was then analyzed using SPSS version 10.0. Chi-square test was used to know if the observed differences were statistically significant. ‘p’ value <0.05 was considered significant. Results: Totally 123 people (males- 48.8% and females-51.2%) participated (response rate of 97.6%) in the study. Majority of the people were aware about presence of ‘FPs’ (91.7%) and ‘FAs’ (84.9%) though their knowledge was inadequate. Breakup of the study subjects according to level of awareness about FPs was as follows (%): Good (37.4), Satisfactory (40.6), Poor (22) & FAs (%): Good (49.6), Satisfactory (36) & Poor (14). Distribution according to type of practices for FPs was as follows (%): Favourable (14), Unfavourable (86) & FAs (%): Favourable (30.5), Unfavourable (69.5). There was a gap between knowledge and practices. Conclusion: Though there was awareness, the knowledge was inadequate. Unfavourable practices were observed. The gaps in the knowledge and unhealthy practices need to be addressed by public awareness campaign.

Keywords: food preservatives, flavouring agents, knowledge and practices, general population

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Authors: Benedetta Isella, Aleksander Drinic, Alissa Heim, Phillip Czichowski, Lisa Lauts, Hans Leemhuis

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Introduction: Membranes for guided bone regeneration are essential to perform a barrier function between the soft and the regenerating bone tissue. Bioabsorbable membranes are desirable in this field as they do not require a secondary surgery for removal, decreasing patient surgical risk. Collagen was the first bioabsorbable alternative introduced on the market, but its degradation time may be too fast to guarantee bone regeneration, and optimisation is needed. Silk fibroin, being biocompatible, slowly bioabsorbable, and processable into different scaffold types, could be a promising alternative. Objectives: The objective is to compare the general performance of a silk fibroin membrane for guided bone regeneration to current collagen alternatives developing suitable standardized tests for the mechanical and morphological characterization. Methods: Silk fibroin and collagen-based membranes were compared from the morphological and chemical perspective, with techniques such as SEM imaging and from the mechanical point of view with techniques such as tensile and suture retention strength (SRS) tests. Results: Silk fibroin revealed a high degree of reproducibility in surface density. The SRS of silk fibroin (0.76 ± 0.04 N), although lower than collagen, was still comparable to native tissues such as the internal mammary artery (0.56 N), and the same can be extended to general mechanical behaviour in tensile tests. The SRS could be increased by an increase in thickness. Conclusion: Silk fibroin is a promising material in the field of guided bone regeneration, covering the interesting position of not being considered a product containing cells or tissues of animal origin from the regulatory perspective and having longer degradation times with respect to collagen.

Keywords: guided bone regeneration, mechanical characterization, membrane, silk fibroin

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Authors: Moyosooore A. Babalola, Ayodeji S. Ogunleye

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The main focus of the study was to determine the profitability of investment in the Oil Palm value chain of Osun State, Nigeria in 2015. The specific objectives were to describe the socio-economic characteristics of Oil Palm investors (producers, processors and marketers), to determine the profitability of the investment to investors in the Oil Palm value chain, and to determine the factors affecting the profitability of the investment of the oil palm investors in Osun state. A sample of 100 respondents was selected in this cross-sectional survey. Multiple stage sampling procedure was used for data collection of producers and processors while purposive sampling was used for marketers. Data collected was analyzed using the following analytical tools: descriptive statistics, budgetary analysis and regression analysis. The results of the gross margin showed that the producers and processors were more profitable than the marketers in the oil palm value chain with their benefit-cost ratios as 1.93, 1.82 and 1.11 respectively. The multiple regression analysis showed that education and years of experience were significant among marketers and producers while age and years of experience had significant influence on the gross margin of processors. Based on these findings, improvement on the level of education of oil palm investors is recommended in order to address the relatively low access to post-primary education among the oil palm investors in Osun State. In addition to this, it is important that training be made available to oil palm investors. This will improve the quality of their years of experience, ensuring that it has a positive influence on their gross margin. Low access to credit among processors and producer could be corrected by making extension services available to them. Marketers would also greatly benefit from subsidized prices on oil palm products to increase their gross margin, as the huge percentage of their total cost comes from acquiring palm oil.

Keywords: oil palm, profitability analysis, regression analysis, value chain

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Authors: Turki Adnan Kamal, Abdulmajeed Ahmad Alsofiany, Nemer Khidhran Husain Alghamdi, Ali Eissa Hassan Al-Rajhi

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Background:- Health care workers are ranked as one of the most vulnerable groups experiencing violence and aggressive behavior compared to other occupational groups. Objectives:- To estimate the prevalence rate and characteristics and assess the avoidance measures, and notification of the violence among medical staff working in primary health care centers in Taif city. Subject and methods:- A cross-sectional study design was applied among all physicians and a representative sample of nurses working in primary health care centers affiliated with the Ministry of Health (MOH) in Taif city. A predesigned Arabic/English validated self-administered questionnaire was used. Results:- In this study, 56 physicians and 145 nurses responded, giving a response rate of 77.6%. Their age ranged from 25 and 60 years (36.2±8.2), with 59.7% of them aged between 25 and 35 years. Males represent 55.7% of them. More than half of them (52.2%) were Saudis. The prevalence of workplace violence was 30.3%. Verbal abuse was the commonest reported type (86.9%). The absence of security, training on the procedures that must be followed and special uniforms at the workplace were significantly associated with workplace violence. We concluded that workplace violence is a significant problem facing a considerable proportion of HCWs in primary health care centers in Taif, Saudi Arabia. Most violence incidents were verbal. Conclusion:- Findings of this study revealed that HCWs who were dealing with male patients only were at high risk of workplace violence and the absence of measures to avoid workplace violence, particularly security, training on the procedures that must be followed and special uniform at the workplace was significantly associated with workplace violence.

Keywords: violence, workplace, primary health care, prevalence, avoidance

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Authors: M. Jaculine Mary

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Today electronic resources are considered as an integral part of information sources to impart efficient services to the people aspiring to acquire knowledge in different fields. E-resources are those resources which include documents in e-format that can be accessed via the Internet in a digital library environment. The present study focuses on accessibility and use of e-resources by faculty and research scholars of academic libraries of Coimbatore, TamilNadu, India. The main objectives are to identify their purpose of using e-resources, know the users’ Information and Communication Technology (ICT) skills, identify satisfaction level of availability of e-resources, use of different e-resources, overall user satisfaction of using e-resources, impact of e-resources on their research and problems faced by them in the access of e-resources. The research methodology adopted to collect data for this study includes analysis of survey reports carried out by distributing questionnaires to the users. The findings of the research are based on the study of responses received from questionnaires distributed to a sample population of 200 users. Among the 200 respondents, 55 percent of research students and 45 percent of faculty members were users of e-resources. It was found that a majority of the users agreed that relevant, updated information at a fast pace had influenced them to use e-resources. Most of the respondents were of the view that more numbers of computers in the library would facilitate quick learning. Academic libraries have to take steps to arrange various training and orientation programmes for research students and faculty members to use the availability of e-resources. This study helps the librarian in planning and development of e-resources to provide modern services to their users of libraries. The study recommends that measures should be taken to increase the accessibility level of e-resource services among the information seekers for increasing the best usage of available electronic resources in the academic libraries.

Keywords: academic libraries, accessibility, electronic resources, satisfaction level, survey

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Authors: Nurlaili Syafar Wulan, Almurdi, Suprianto Kosno

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Introduction: Periodontitis defined as an inflammatory disease of teeth supporting tissue with irritation of specific pathogens as the main aetiology. Periodontitis can be cured by giving medical action accompanied by administration of an antibiotic, but the use of antibiotic has a side effect that can cause bacterial resistance. This side effect can be corrected by probiotic, which has antibiotic-like substance but do not have bacterial resistance effect; it makes probiotic became a promising future periodontitis medication. West Sumatran people has their own typical traditional food product made from fermented buffalo’s milk called dadih, and it contained probiotics. Objectives: The aim of this study was to determine the ability of probiotic Pediococcus pentosaceus isolated from dadih in inhibiting the growth of bacteria Aggregatibacter actinomycetemcomitans. Material and Method: This was a true experimental study with post-test and control group design. This study was conducted on 36 samples of 2 treatment groups, the test group with probiotic Pediococcus pentosacesus isolated from dadih and the negative control group with sterile aquadest. The antibacterial effect was tested using the Kirby-Bauer disk diffusion method and calculated by measuring the zone of inhibition on MHA around paper disk using a sliding caliper with 0.5 mm accuracy. Result: The result of bivariate analysis using Independent t-test was p=0.00 where p < 0.05 means that there is a significant difference between the tested group and negative control group. Conclusion: Probiotic Pediococcus pentosaceus isolated from dadih are able to inhibit the growth of Aggregatibacter actinomycetemcomitans.

Keywords: aggregatibacter actinomycetemcomitans, antibacterial activities, periodontitis, probiotic Pediococcus pentosaceus

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Authors: Rajapaksha J. S. R. L., Rajapaksha R. G. D. T., Ranawaka A. U. R., Rangalla R. D. M. P., Ranwala R. D. E. B., Chandratilake M. N.

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Introduction: Lesbian, gay, bisexual, and transgender (LGBT) patients experience discrimination, insensitivity, and ignorance about LGBT-specific health needs among healthcare providers. Developing the correct attitudes among medical students towards LGBT may help provide them with optimal healthcare. Objectives: This study aimed at assessing the attitudes of medical students towards the LBGT community. Methodology: A cross-sectional descriptive study was among all the medical students in the Faculty of Medicine, University of Kelaniya, Sri Lanka, using a validated online questionnaire. The questionnaire focused on eight areas. The data were descriptively analyzed, and the demographic groups were compared. Results: 358 students completed the survey. The response rate was 34.26%. Their attitudes on traditional gender roles and comfortability in interacting with LGBT people were moderate, and they disagreed with negative LGBT social beliefs. They knew less about the origin of sexuality/gender of LGBT. Although they accepted LGBT as a part of diversity, they discouraged normalizing the social practices of LGBT people. Their acceptance and association of LGBT were moderately positive. A minority has encountered LGBT in close social circles, and the majority of them were batch-mates. Although males’ knowledge about the origin of LGBT was higher, they favoured traditional gender roles more. The religious groups showed no differences. The favourability of attitudes towards LGBT reflected respondents’ political ideology. Conclusion: Although medical students’ knowledge on the sexuality/gender basis of LGBT is poor, they have moderately favourable attitudes towards them. They accept LGBT as a part of social diversity but not their social practices. Poor knowledge, lack of encounters, cultural influences, and political ideology may have influenced their attitudes.

Keywords: medical students, attitude, LGBT, diversity

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Authors: Igor Sukhotnik

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Objectives: Notch signaling is thought to act to drive cell versification in the lining of the small intestine. When Notch signaling is blocked, proliferation ceases, and epithelial cells become secretory. The purpose of the present study was to evaluate the role of Notch signaling pathway in stem cell differentiation in a rat model of intestinal ischemia-reperfusion (IR). Methods: Male Sprague-Dawley rats were randomly divided into four experimental groups: Sham-24 and Sham-48 rats underwent laparotomy and were killed 24 or 48 h later, respectively; IR-24 and IR-48 rats underwent occlusion of SMA and portal vein for 30 min followed by 24 or 48 h of reperfusion, respectively. Notch-related gene and protein expression were determined using Real Time PCR, Western blotting and immunohistochemistry. Wax histology and immunohistochemistry was used to determine cell differentiation toward absorptive (enterocytes) or secretory progenitors (goblet cells, enteroendocrine cells or Paneth cells). Results: IR-48 rats exhibited a significant decrease in Notch-1 protein expression (Western blot) that was coincided with a significant decrease in the number of Notch-1 positive cells (immunohistochemistry) in jejunum and ileum as well as Hes-1 positive cells in jejunum and ileum compared to Sham-48 rats. A significant down-regulation of Notch signaling related genes and proteins in IR animals was accompanied by a significant increase in the number of goblet and Paneth cells and decreased number of absorptive cells compared to control rats. Conclusions: Forty-eight hours following intestinal IR in rats, inhibited Notch signaling pathway was accompanied by intestinal stem cells differentiation toward secretory progenitors.

Keywords: Intestine, notch, ischemia-reperfusion, cell differentiation, secretory

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Authors: Madhur Verma, Meena Rajput, Kamal Kishore

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Background: The general view that obesity is a problem of prosperous Western countries has been repealed with substantial evidence showing that middle-income countries like India are now at the heart of a fat explosion. Neck circumference has evolved as a promising index to measure obesity, because of the convenience of its use, even in culture sensitive population. Objectives: To determine whether neck circumference (NC) was associated with overweight and obesity and contributed to the prediction like other classical anthropometric indices. Methodology: Cross-sectional study consisting of 1080 adults (> 19 years) selected through Multi-stage random sampling between August 2013 and September 2014 using the pretested semi-structured questionnaire. After recruitment, the demographic and anthropometric parameters [BMI, Waist & Hip Circumference (WC, HC), Waist to hip ratio (WHR), waist to height ratio (WHtR), body fat percentage (BF %), neck circumference (NC)] were recorded & calculated as per standard procedures. Analysis was done using appropriate statistical tests. (SPSS, version 21.) Results: Mean age of study participants was 44.55+15.65 years. Overall prevalence of overweight & obesity as per modified criteria for Asian Indians (BMI ≥ 23 kg/m2) was 49.62% (Females-51.48%; Males-47.77%). Also, number of participants having high WHR, WHtR, BF%, WC & NC was 827(76.57%), 530(49.07%), 513(47.5%), 537(49.72%) & 376(34.81%) respectively. Variation of NC, BMI & BF% with age was non- significant. In both the genders, as per the Pearson’s correlational analysis, neck circumference was positively correlated with BMI (men, r=0.670 {p < 0.05}; women, r=0.564 {p < 0.05}), BF% (men, r=0.407 {p < 0.05}; women, r= 0.283 {p < 0.05}), WC (men, r=0.598{p < 0.05}; women, r=0.615 {p < 0.05}), HC (men, r=0.512{p < 0.05}; women, r=0.523{p < 0.05}), WHR (men, r= 0.380{p > 0.05}; women, r=0.022{p > 0.05}) & WHtR (men, r=0.318 {p < 0.05}; women, r=0.396{p < 0.05}). On ROC analysis, NC showed good discriminatory power to identify obesity with AUC (AUC for males: 0.822 & females: 0.873; p- value < 0.001) with maximum sensitivity and specificity at a cut-off value of 36.55 cms for males & 34.05cms for females. Conclusion: NC has fair validity as a community-based screener for overweight and obese individuals in the study context and has also correlated well with other classical indices.

Keywords: neck circumference, obesity, anthropometric indices, body fat percentage

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Authors: Prem Bahadur Giri

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The nationalization of forests during the early 1960s had become counterproductive for the conservation of forests in Nepal. Realizing this fact, the Government of Nepal initiated a paradigm shift from a government-controlled forestry system to people’s direct participation in managing forestry, conceptualizing a community forest approach in the early 1980s. The community forestry approach is expected to promote sustainable forest management, restoring degraded forests to enhance the forest condition on the one hand, and on the other, improvement of livelihoods, particularly of low-income people and forest-dependent communities, as well as promoting community ownership of a forest. As a result, the establishment of community forests started and had taken faster momentum in Nepal. Of the total land in Nepal, forest occupies 6.5 million hectares which are around 45 percent of the forest area. Of the total forest area, 1.8 million hectares have been handed over to community management. A total of 19,361 ‘community forest users groups’ are already created to manage the community forest. To streamline the governance of community forests, the enactment of ‘The Forest Act 1993’ provides a clear legal basis for managing community forests in Nepal. This article is based on an in-depth study taking the case of Tarpakha Community Forest (TCF) located in Siranchok Rural Municipality of Gorkha District in Nepal. It mainly discusses the extent to which the TCF is able to achieve the twin objectives of this community forest for catalyzing socio-economic improvement of the targeted community and conservation of the forest. The primary information was generated through in-depth interviews along with group discussions with members, the management committee, and other relevant stakeholders. The findings reveal that there is a significant improvement in the regeneration of the forest and also changes in the socio-economic status of the local community. However, coordination with local municipalities and forest governing entities is still weak.

Keywords: community forest, socio-economic benefit, sustainable forest management, Nepal

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Authors: Hazel Ann Gianelli Cu, Stephanie Co, Radcliff Cobankiat

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Objectives: TRC101/Veverimer is an orally administered, non absorbed, sodium- and counterion-free hydrochloric acid binder for the treatment of metabolic acidosis associated with chronic kidney disease. The main objective of this study is to determine the efficacy of TRC 101/ Veverimer 6g/day in increasing serum bicarbonate levels of chronic kidney disease patients with metabolic acidosis. In this meta analysis, we also aim to look at safety outcomes, adverse effects and if the level of serum bicarbonate reached metabolic alkalosis when given TRC101/Veverimer. Methodology: Pubmed, Cochrane, Google Scholar and Science direct were used to search for randomized controlled trials about TRC101/Veverimer use in Chronic kidney disease patients with metabolic acidosis. Search strategy according to the Prisma checklist was done with evaluation of biases and synthesis of results using the Cochrane Review Manager software 5.4. Results: Two randomized controlled trials involving 371 chronic kidney disease patients were included in this study. Results show there was a significant increase in the serum bicarbonate level when given TRC101/Veverimer compared to the placebo. Both studies had a significant number of participants who completed the studies until the end. P value of <0.00001 was used in both studies with a confidence interval of 95%. Conclusion: TRC101/Veverimer 6g/day was shown to effectively and safely increase serum bicarbonate or achieve normalization in chronic kidney disease patients with metabolic acidosis as compared with a placebo. This was associated with delayed progression of kidney disease with improvement of physical functioning, however longer duration of future studies is ideal in order to assess further the long advantages and consequences of TRC 101/Veverimer.

Keywords: chronic kidney disease, metabolic acidosis, Veverimer, TRC101

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Authors: Panos Xenos, Milton Nektarios, John Yfantopoulos

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Background: Policy makers, professional organizations and payers have introduced a variety of initiatives and reforms for the health systems worldwide, aimed at improving hospital efficiency. Their efforts are concentrated in two main categories: to constrain increasing healthcare costs and to enhance quality of services provided. Research Objectives: This study examines the efficiency of 112 Greek public hospitals for the year 2009, evaluates the importance of bootstrapping techniques and investigates the effect of contextual factors on hospital efficiency. Furthermore, the effect of qualitative evidence, on hospital efficiency is explored using data from 28 large hospitals. Methods: We applied Data Envelopment Analysis, augmented by bootstrapping techniques, to estimate efficiency scores. In order to measure the effect of environmental factors on hospital efficiency we used Tobit regression analysis. The significance of our models is evaluated using statistical tests to compare distributions. Results: The Kolmogorov-Smirnov test between the original and the bootstrap-corrected efficiency indicates that their distributions are significantly different (p-value<0.01). The environmental factors, that seem to influence efficiency, are Occupancy Rating and the ratio between Outpatient Visits and Inpatient Days. Results indicate that the inclusion of the quality variable in DEA modelling generates statistically significant variations in efficiency scores (p-value<0.05). Conclusions: The inclusion of quality variables and the use of bootstrap resampling in efficiency analysis impose a statistically significant effect on the distribution of efficiency scores. As a policy conclusion we highlight the importance of these methods on hospital efficiency analysis and, by implication, on healthcare resource allocation.

Keywords: hospitals, efficiency, quality, data envelopment analysis, Greek public hospital sector

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Authors: Burcu Babadağ Savaş, Nihal Orlu, Güler Balcı Alparslan, Ertuğrul Çolak, Cengiz Korkmaz

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Introduction/objectives: We aimed to investigate the effect of humor on pain and state anxiety in patients with rheumatoid arthritis (RA) receiving biologic intravenous (IV) infusion therapy. Method: The study sample consisted of 36 patients who met the classification criteria for RA and inclusion criteria in a rheumatology outpatient clinic at a university hospital between September 2020 and November 2021. Two sample groups were formed: the intervention group (watching a comedy movie) (n=18) and the control group (n=18). The intervention group consisted of the patient watching a comedy movie of his/her choice from an archive created by the researchers during the biological IV infusion therapy (approximately 90-120 minutes). The data collection instruments used before and after the test were the descriptive identification form, the visual analog scale (VAS), and the state anxiety scale. Results: The mean VAS scores of patients in the intervention group were 5.05 ± 2.01 in the pre-test and 2.61 ± 1.91 in the post-test. The mean state anxiety scores of patients in the intervention group were 45.94 ± 9.97 in the pre-test and 34.22 ± 6.57 in the post-test. Thus, patients who watched comedy movies during biologic IV infusion therapy in the infusion center had a greater reduction in pain scores than the control group and the effect size was small. Although there was a decrease in state anxiety scores in both groups, there was no significant difference between groups and the effect size was not relevant. Conclusions: During IV infusion therapy, watching comedy movies is recommended as a nursing care intervention for reducing pain in patients with RA in cooperation with other health professionals.

Keywords: watching comedy movie, humor, pain, anxiety, nursing, care

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Authors: Muhammad Shahbaz Akhtar

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Background; Tuberculosis remains a significant public health challenge in Pakistan, with high incidence and prevalence rates, particularly among vulnerable populations. Addressing the TB burden requires comprehensive efforts to improve healthcare infrastructure, increase access to quality diagnosis and treatment services, raise public awareness, and address socioeconomic determinants of health. Objective; To assess the knowledge and practices of healthcare workers and patients regarding prevention of tuberculosis at a tertiary care hospital of Southern Punjab.Material and methods; Data will be collected from 135 healthcare workers and 135 TB patients visiting Nishtar Hospital, Multan in this descriptive cross – sectional study using non – probability consecutive sampling technique. Proper approval will be taken from Hospital authorities to conduct this study. Study participants will be recruited after taking informed written consent, describing them objectives of this study. The study participants will be ensured of their confidentiality of the data and interviewed to assess their knowledge and practices regarding prevention of tuberculosis. Data Analysis Procedure; Data will be entered and analyzed by using SPSS version 25 to calculated mean and standard deviation for the numerical data such as age, duration of disease and duration of experience. Frequencies and percentages will be calculated for gender, age groups, level of knowledge, qualification, designation and practices. Impact of confounders like gender, age groups, duration of experience, disease duration, years of experience and designation will be assessed by stratification. Post stratification chi – square test will be applied at 0.05 level of significance at 95 % CI.

Keywords: tuberculosis, data analysis, HIV/AIDS, preventable

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Authors: Fabiane Alves Farias Guimarães, Rodrigo Otávio Moretti-Pires, Ana Lúcia Schaefer Ferreira de Mello

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Introduction: Considering the last changes in Brazilian Health and Higher Educational Systems, the production of scientific knowledge regarding dental education and training has been increasing. The National Curriculum Guidelines for undergraduate courses in Dentistry established in 2002 the principles and procedures to perform a more generalist dental professional profile. Objectives: To perform a systematic review of the Brazilian scientific literature about dental education and training. Methods: The systematic review was conducted considering the Lilacs - Latin American Literature in Health Sciences and SciELO - Scientific Electronic Library Online data bases, using the combination of key words dentistry, education, teaching or training. It was select original research articles, published between 2010 and 2013, in Portuguese. Results: Based on the selection criteria, it was found 23 articles. In order to organize the outcomes, the analysis was separated in three themes: Ethical aspects of education (3 articles), integrating dental service with training (10 articles) and Dental education and the Brazilian curriculum guidelines (10 articles). Most of the studies were published between 2011 and 2012 (35% each) and were held in public universities. The studied populations included dental students, teachers, universities directors, health managers and dentists. The qualitative methodological approach was predominant. Conclusion: It was possible to identify a transience time in Brazilian undergraduate courses in Dentistry after curricular changes. The produced literature shows some advances, as the incorporation of ethical values on dental education and the inclusion of new practices environments for students by integrating education and training in diversified dental services scenarios.

Keywords: Teaching, Dental Students, Human resources in dentistry

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Authors: Mercy Okezue, Kari Clase, Stephen Byrn, Paddy Shivanand

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Medicines regulatory authorities expect pharmaceutical companies and contract research organizations to seek ways to certify that their laboratory control measurements are reliable. Establishing and maintaining laboratory quality standards are essential in ensuring the accuracy of test results. ‘ISO/IEC 17025:2017’ and ‘WHO Good Practices for Pharmaceutical Quality Control Laboratories (GPPQCL)’ are two quality standards commonly employed in developing laboratory quality systems. A review was conducted on the two standards to elaborate on areas on convergence and divergence. The goal was to understand how differences in each standard's requirements may influence laboratories' choices as to which document is easier to adopt for quality systems. A qualitative review method compared similar items in the two standards while mapping out areas where there were specific differences in the requirements of the two documents. The review also provided a detailed description of the clauses and parts covering management and technical requirements in these laboratory standards. The review showed that both documents share requirements for over ten critical areas covering objectives, infrastructure, management systems, and laboratory processes. There were, however, differences in standard expectations where GPPQCL emphasizes system procedures for planning and future budgets that will ensure continuity. Conversely, ISO 17025 was more focused on the risk management approach to establish laboratory quality systems. Elements in the two documents form common standard requirements to assure the validity of laboratory test results that promote mutual recognition. The ISO standard currently has more global patronage than GPPQCL.

Keywords: ISO/IEC 17025:2017, laboratory standards, quality control, WHO GPPQCL

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Authors: Mohd Salim Mahtab, Izharul Haq Farooqi, Anwar Khursheed

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Advanced oxidation processes (AOPs) based on Fenton are versatile options for treating complex wastewaters containing refractory compounds. However, the classical Fenton process (CFP) has limitations, such as high sludge production and reagent dosage, which limit its broad use and result in secondary contamination. As a result, long-term solutions are required for process intensification and the removal of these impediments. This study shows that Fenton sludge could serve as a catalyst in the Fe³⁺/Fe²⁺ reductive pathway, allowing non-regenerated sludge to be reused for complex wastewater treatment, such as landfill leachate treatment, even in the absence of Fenton's reagents. Experiments with and without pH adjustments in stages I and II demonstrated that an acidic pH is desirable. Humic compounds in leachate could improve the cycle of Fe³⁺/Fe²⁺ under optimal conditions, and the chemical oxygen demand (COD) removal efficiency was 22±2% and 62±2%% in stages I and II, respectively. Furthermore, excellent total suspended solids (TSS) removal (> 95%) and color removal (> 80%) were obtained in stage II. The processes underlying synergistic (oxidation/coagulation/adsorption) effects were addressed. The design of the experiment (DOE) is growing increasingly popular and has thus been implemented in the chemical, water, and environmental domains. The relevance of the statistical model for the desired response was validated using the explicitly stated optimal conditions. The operational factors, characteristics of reused sludge, toxicity analysis, cost calculation, and future research objectives were also discussed. Reusing non-regenerated Fenton sludge, according to the study's findings, can minimize hazardous solid toxic emissions and total treatment costs.

Keywords: advanced oxidation processes, catalysis, Fe³⁺/Fe²⁺ cycle, fenton sludge

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Authors: Zahra Khazaeipour, Ehsan Ahmadipour, Vafa Rahimi-Movaghar, Fereshteh Ahmadipour

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Research Objectives: Chronic pain is one of the common problems associated with spinal cord injuries (SCI), which causes many complications. Therefore, this study intended to evaluate the relationship between pain and demographic, injury characteristics, socio-economic and social support in individuals with spinal cord Injury in Iran. Design: Descriptive cross-sectional study. Setting: Brain and Spinal Cord Injury Research Center (BASIR), Tehran University of Medical Sciences, Tehran, Iran, between 2012 and 2013. Participants: The participants were 140 individuals with SCI, 101 (72%) men and 39 (28%) women, with mean age of 29.4 ±7.9 years. Main Outcome Measure: The Persian version of the Brief Pain Inventory (BPI) was used to measure the pain, and the Multidimensional Scale of Perceived Social Support (MSPSS) was used to measure social support. Results: About 50.7% complained about having pain, which 79.3% had bilateral pain. The most common locations of pain were lower limbs and back. The most quality of pain was described as aching (41.4%), and tingling (32.9%). Patients with a medium level of education had the least pain compared to high and low level of education. SCI individuals with good economic situation reported higher frequency of having pain. There was no significant relationship between pain and social support. There was positive correlation between pain and impairment of mood, normal work, relations with other people and lack of sleep (P < 0.001). Conclusion: These findings revealed the importance of socioeconomic factors such as economic situation and educational level in understanding chronic pain in people with SCI and provide further support for the bio-psychosocial model. Hence, multidisciplinary evaluations and treatment strategies are advocated, including biomedical, psychological, and psycho-social interventions.

Keywords: pain, social support, socio-economic indicators, spinal cord injury

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Authors: Betty Chiyangwa

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This is a work in progress project focused on exploring the complexities surrounding the second generation Mozambican migrant youth’s experiences to construct their identity and develop a sense of belonging in post-apartheid, Bushbuckridge in South Africa. Established in 1884, Bushbuckridge is one of the earliest districts to accommodate Mozambicans who migrated to South Africa in the 1970s. Bushbuckridge as a destination for Mozambican migrants is crucial to their search for social freedom and space to “belong to.” The action of deliberately seeking freedom is known as an act of agency. Four major objectives govern the paper. The first objective observes how second-generation Mozambican migrant youth living in South Africa negotiate and construct their own identities. Secondly, it explores second-generation Mozambican migrant youth narratives regarding their sense of belonging in South Africa. Thirdly, the study intends to understand how social processes of identity and belonging influence second-generation Mozambican migrant youth experiences and future aspirations in South Africa. The last objective examines how Sen’s Capability approach is relevant in understanding second-generation Mozambican migrant youth identity and belonging in South Africa. This is a single case study informed by data from semi-structured interviews and narratives with youth between the ages of 18 and 34 who are born and raised in South Africa to at least one former Mozambican refugee parent living in Bushbuckridge. Drawing from Crenshaw’s Intersectionality and Sen’s Capability approaches, this study significantly contributes to the existing body of knowledge on South to South migration by demonstrating how both approaches can be operationalized towards understanding complex experiences and capabilities of the disadvantaged group simultaneously. The subject of second-generation migrants is often under-researched in South African migration; thus, their perspectives have been marginalized in Social Science research.

Keywords: second-generation, Mozambican, migrant, youth, bushbuckridge

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Authors: Y. Cochet, A. Achim, Tom Flatman, J-C. Domec, J. Ogée, L. Wingate, Ram Oren

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It is accepted that atmospheric CO2 concentration will increase in the future. For the past 30 years, researchers have used FACE (Free-Air Carbon Dioxide Enrichment) facilities to study the development of terrestrial ecosystems under elevated CO2 (eCO2). Forest responses to eCO2 are likely to impact timber industries with potential feedbacks towards the atmosphere. The main objectives of this study were to examine whether eCO2 alone or in combination with N-fertilization alter wood properties and to identify changes in wood anatomy related to water transport. Wood disks were sampled at breast height from mature loblolly pine trees (Pinus taeda L.) harvested at the Duke FACE site (NC, USA). By measuring ring width and intra-ring changes in density (X-ray densitometry) and tracheid size (lumen and cell wall thickness) from pith to bark, the following hypotheses were tested: 1) eCO2 and N-fertilization interact positively to increase significantly above-ground primary productivity; 2) eCO2 and N-fertilization lead to a decrease in density; 3) eCO2 and N-fertilization increase lumen diameter and decrease cell wall thickness, thus affecting water transport capacity. Our results revealed a boost in earlywood tracheid production induced by eCO2 lasting a few years. The following decrease seemed to be buffered by N-fertilization. X-ray profiles did not show a marked decrease in wood density under eCO2 or N-fertilization, although there were changes in cell anatomical properties such as a reduction in cell-wall thickness and an increase in lumen diameter. If such effects of eCO2 are confirmed, forest management strategies for example N-fertilization should be redesigned.

Keywords: wood density, Duke FACE (free-air carbon dioxide enrichment), N fertilization, tree ring

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Authors: Tadesse Melaku Abegaz, Akshaya Srikanth Bahagavathula, Abdulla Shehab Sheab, Asim Hassen

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Objectives: Non-adherence and discontinuation of anticoagulant therapy lead to increased ischemic stroke risk and contributes to suboptimal outcomes of the anticoagulant treatment. This systematic review and meta-analysis were aimed to investigate the adherence to NOACs and adverse events in patients with AF. Methods: Original research articles conducted on patients with AF and using any NOACs (dabigatran, rivoraxaban and apixaban) reporting adherence for at least 35 days were included. Scientific databases including PubMed, Web of Science, and Google Scholar were searched using MeSH keywords to obtaining literature researched between 2008 to till June, 2016. Study characteristics, patient’s sociodemographic and clinical characteristics, medication adherence levels and bleeding events reported were recorded. Results: The overall sample size of the six studies is 1,640,157, with CHADS2 scores < 2 in 551 patients, CHADS2-VASc ≥ 2 in 62,232 AF patients. Three-forth [75.6% (95%CI= 66.5-84.8), p < 0.001] are adherent to NOACs. However, a higher rate [72.7% (62.5-82.9), p < 0.001] of adherence was observed with Dabigatran than Apixaban [59.9% (3.2-123.1), p=0.063] and Rivaroxaban [59.3% (38.7-80.0), p<0.001]. Sub-group analysis revealed that nearly 57% of the AF patients on NOACs have CHADS2 scores < 2 and 20% of these patients were non-adherent to NOACs. Overall bleeding events rate associated with NOACs non-adherent AF patients was found to be 7.5% (0.2-14.8), p=0.045. However, nearly 11.2% of AF patients experienced bleeding events were non-adherent to NOAC medications. A higher proportion of bleeding events were noticed with Dabigatran (14.7%). Conclusions: Adherence rates, while uniformly suboptimal, nevertheless varied considerably, lowest at 59.3% for rivaroxaban and 59.9% for apixaban, followed by dabigatran (75.6%). Overall bleeding events associated with NOACs rates were 7.5%. However, lower adherence to NOACs was associated with worse outcomes among patients with greater stroke risk.

Keywords: atrial fibrillation, bleeding events, meta-analysis, novel oral anticoagulants

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Authors: M. S. Matlala, I. Ignatious

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Environmental sustainability has taken the center stage in human life all over the world. Energy is the most essential component of our life. The conventional sources of energy are non-renewable and have a detrimental environmental impact. Therefore, there is a need to move from conventional to non-conventional renewable energy sources to satisfy the world’s energy demands. The study aimed at screening for microbial cellulolytic enzymes using a proteomic approach. The objectives were to screen for microbial cellulases with high specific activity and separate the cellulolytic enzymes using a combination of zymography and two-dimensional (2-D) gel electrophoresis followed by tryptic digestion, Matrix-assisted Laser Desorption Ionisation-Time of Flight (MALDI-TOF) and bioinformatics analysis. Fungal and bacterial isolates were cultured in M9 minimal and Mandel media for a period of 168 hours at 60°C and 30°C with cellobiose and Avicel as carbon sources. Microbial cells were separated from supernatants through centrifugation, and the crude enzyme from the cultures was used for the determination of cellulase activity, zymography, SDS-PAGE, and two-dimensional gel electrophoresis. Five isolates, with lytic action on carbon sources studied, were a bacterial strain (BARK) and fungal strains (VCFF1, VCFF14, VCFF17, and VCFF18). Peak cellulase production by the selected isolates was found to be 3.8U/ml, 2.09U/ml, 3.38U/ml, 3.18U/ml, and 1.95U/ml, respectively. Two-dimensional gel protein maps resulted in the separation and quantitative expression of different proteins by the microbial isolates. MALDI-TOF analysis and database search showed that the expressed proteins in this study closely relate to different glycoside hydrolases produced by other microbial species with an acceptable confidence level of 100%.

Keywords: cellulases, energy, two-dimensional gel electrophoresis, matrix-assisted laser desorption ionisation-time of flight, MALDI-TOF MS

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Authors: Saeed Abbasi, Davood Farsi, Soudabeh Shafiee Ardestani, Neda Valizadeh

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Objectives: Peripheral vertigo is a common complaint of patients who are visited in emergency departments. In our study, we wanted to evaluate the effect of betahistine as an oral drug vs. intravenous diazepam for the treatment of acute peripheral vertigo. We also wanted to see the possibility of substitution of parenteral drug with an oral one with fewer side effects. Materials and Methods: In this randomized, double-blind study, 101 patients were enrolled in the study. The patients were divided in two groups in a double-blind randomized manner. Group A took oral placebo and 10 mg of intravenous diazepam. Group B received 8mg of oral betahistine and intravenous placebo. Patients’ symptoms and signs (Vertigo severity, Nausea, Vomiting, Nistagmus and Gate) were evaluated after 0, 2, 4, 6 hours by emergency physicians and data were collected by a questionnaire. Results: In both groups, there was significant improvement in vertigo (betahistine group P=0.02 and Diazepam group P=0.03). Analysis showed more improvement in vertigo severity after 4 hours of treatment in betahistine group comparing to diazepam group (P=0.02). Nausea and vomiting were significantly lower in patients receiving diazepam after 2 and 6 hours (P=0.02 & P=0.03).No statistically significant differences were found between the groups in nistagmus, equilibrium & vertigo duration. Conclusion: The results of this randomized trial showed that both drugs had acceptable therapeutic effects in peripheral vertigo, although betahistine was significantly more efficacious after 4 hours of drug intake. As for higher nausea and vomiting in betahistine group, physician should consider these side effects before drug prescription.

Keywords: acute peripheral vertigo, betahistine, diazepam, emergency department

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Authors: Rafika Bayu Kusumandari, Istyarini, Ispen Safrel

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Character education will be more meaningful if carried out since early childhood. This is because early childhood education is the foundation of the formation of character. This study intends to find a model of character education in early childhood based on Javanese culture. In keeping with the focus of the study, long-term goals to be achieved through this research is to find once described the development of a model of character education in early childhood Javanese culture based in Semarang are then applied across early childhood education institutions in Semarang City. The specific objective of the study is: Describe the character models and management education in early childhood Java-based culture in Semarang City. The benefits of this research are; Provide an overview of the model and describe the management of character education in early childhood Java-based culture in Semarang City. Referring to the objectives of the research program was designed with a "Research and Development", meaning that a program of research followed by development programs for improvement or refinement. To produce a prototype model of character education in early childhood Java-based culture in the city, taken systematic measures in the form of the action, reflection, evaluation and innovation by applying qualitative research methods, descriptive, development, experimentation, and evaluation. This study aims to gain in-depth description of the model of character education in early childhood Java-based culture in the city of Semarang. The reason for the use of the use of qualitative methods researcher's knowledge, no study results and empirical research specifically about the model of character education in early childhood Java-based culture in the city of Semarang. On the implementation of character education early childhood adapted to the characteristics of each school and the emphasis of each agency arrangements for early childhood education, culture-based Java. Javanese culture should be introduced early in order not to erode the cultural lost outside the entrance as the era of globalization. In addition, Java is promoting a culture of courtesy and manners are very appropriate for the character formation of children of early age.

Keywords: education character, Javanese culture, childhood, character

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Authors: Jie Ji, Jing Xu, Yuehong Zhuang, Xiangqing Kang, Ying Qian, Ping Zhou, Di Xue

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Background: In 2014, there were 28,341 health professionals in Pudong new area of Shanghai and the number per 1000 population was 5.199, 55.55% higher than that in 2006. But it was always less than the average number of health professionals per 1000 population in Shanghai from 2006 to 2014. Therefore, allocation planning for the health professionals in Pudong new area has become a high priority task in order to meet the future demands of health care. In this study, we constructed an objective-based system dynamics model to forecast the number of health professionals in Pudong new area of Shanghai in 2020. Methods: We collected the data from health statistics reports and previous survey of human resources in Pudong new area of Shanghai. Nine experts, who were from health administrative departments, public hospitals and community health service centers, were consulted to estimate the current and future status of nine variables used in the system dynamics model. Based on the objective of the number of health professionals per 1000 population (8.0) in Shanghai for 2020, the system dynamics model for health professionals in Pudong new area of Shanghai was constructed to forecast the number of health professionals needed in Pudong new area in 2020. Results: The system dynamics model for health professionals in Pudong new area of Shanghai was constructed. The model forecasted that there will be 37,330 health professionals (6.433 per 1000 population) in 2020. If the success rate of health professional recruitment changed from 20% to 70%, the number of health professionals per 1000 population would be changed from 5.269 to 6.919. If this rate changed from 20% to 70% and the success rate of building new beds changed from 5% to 30% at the same time, the number of health professionals per 1000 population would be changed from 5.269 to 6.923. Conclusions: The system dynamics model could be used to simulate and forecast the health professionals. But, if there were no significant changes in health policies and management system, the number of health professionals per 1000 population would not reach the objectives in Pudong new area in 2020.

Keywords: allocation planning, forecast, health professional, system dynamics

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Authors: Bassem Nassar, Wessam Hussein, Medhat Mokhtar

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The crucial concern of satellite operations is to ensure the health and safety of satellites. The worst case in this perspective is probably the loss of a mission but the more common interruption of satellite functionality can result in compromised mission objectives. All the data acquiring from the spacecraft are known as Telemetry (TM), which contains the wealth information related to the health of all its subsystems. Each single item of information is contained in a telemetry parameter, which represents a time-variant property (i.e. a status or a measurement) to be checked. As a consequence, there is a continuous improvement of TM monitoring systems in order to reduce the time required to respond to changes in a satellite's state of health. A fast conception of the current state of the satellite is thus very important in order to respond to occurring failures. Statistical multivariate latent techniques are one of the vital learning tools that are used to tackle the aforementioned problem coherently. Information extraction from such rich data sources using advanced statistical methodologies is a challenging task due to the massive volume of data. To solve this problem, in this paper, we present a proposed unsupervised learning algorithm based on Principle Component Analysis (PCA) technique. The algorithm is particularly applied on an actual remote sensing spacecraft. Data from the Attitude Determination and Control System (ADCS) was acquired under two operation conditions: normal and faulty states. The models were built and tested under these conditions and the results shows that the algorithm could successfully differentiate between these operations conditions. Furthermore, the algorithm provides competent information in prediction as well as adding more insight and physical interpretation to the ADCS operation.

Keywords: space telemetry monitoring, multivariate analysis, PCA algorithm, space operations

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Authors: Wichai Srisud, Shunnawat Pungbangkradee, Sukanya Chaemchoy

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This research study aims to analyze and assess school management guidelines designed to enhance the level of Student School Engagement of students at Bangkok Christian College, according to three following primary objectives: 1) to evaluate the level of Student School Engagement among Bangkok Christian College students, 2) to examine the Priority Needs Index of school management for promoting an optimum level of Student School Engagement among Bangkok Christian College students, and 3) to develop additional guidelines for school management to further enhance the level of Student School Engagement of Bangkok Christian College students. The research was conducted using Explanatory Design research methodology, with data obtained from a sample comprised of 291 students and 6 administrative personnel. The research findings indicated that: 1) The overall level of Student School Engagement was high. Emotional engagement averaged at the highest level, followed by Behavioral Engagement and Cognitive Engagement, respectively. 2) The Priority Needs Index of school management for promoting Student School Engagement of Bangkok Christian College students was examined, revealing that Evaluation averaged at the highest PNI level, followed by Planning and Implementation, respectively. 3) Guidelines for school management to enhance Student School Engagement of Bangkok Christian College students should consist of four approaches: 3.1) A Cognitive Engagement Enhancing Approach, which must include (1) fostering students’ problem-solving flexibility, and their ability to devise solutions for overcoming potential challenges, and (2) encouraging students to deal effectively with academic setbacks, rather than becoming overwhelmed by what they may perceive as failures, 3.2) An Emotional Engagement Enhancing Approach, cultivating students’ interests, aspirations and goals in learning to maximize emotional investment in their academic pursuits, and 3.3) A Behavioral Engagement Enhancing Approach, for elevating students’ focus and attentiveness during learning, and improving their ability to avoid distractions during study time.

Keywords: school engagement, guidelines for school management

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