Search results for: husbands approval
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 359

Search results for: husbands approval

209 Carbon Capture and Storage in Geological Formation, its Legal, Regulatory Imperatives and Opportunities in India

Authors: Kalbende Krunal Ramesh

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The Carbon Capture and Storage Technology (CCS) provides a veritable platform to bridge the gap between the seemingly irreconcilable twin global challenges of ensuring a secure, reliable and diversified energy supply and mitigating climate change by reducing atmospheric emissions of carbon dioxide. Making its proper regulatory policy and making it flexible for the government and private company by law to regulate, also exploring the opportunity in this sector is the main aim of this paper. India's total annual emissions was 1725 Mt CO2 in 2011, which comprises of 6% of total global emission. It is very important to control the greenhouse gas emission for the environment protection. This paper discusses the various regulatory policy and technology adopted by some of the countries for successful using CCS technology. The brief geology of sedimentary basins in India is studied, ranging from the category I to category IV and deep water and potential for mature technology in CCS is reviewed. Areas not suitable for CO2 storage using presently mature technologies were over viewed. CSS and Clean development mechanism was developed for India, considering the various aspects from research and development, project appraisal, approval and validation, implementation, monitoring and verification, carbon credit issued, cap and trade system and its storage potential. The opportunities in oil and gas operations, power sector, transport sector is discussed briefly.

Keywords: carbon credit issued, cap and trade system, carbon capture and storage technology, greenhouse gas

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208 An Online Master's Degree Program for the Preparation of Adapted Physical Education Teachers for Children with Significant Developmental Disabilities

Authors: Jiabei Zhang

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Online programs developed for preparing qualified teachers have significantly increased over the years in the United States of America (USA). However, no online graduate programs for training adapted physical education (APE) teachers for children with significant developmental disabilities are currently available in the USA. The purpose of this study was to develop an online master’s degree program for the preparation of APE teachers to serve children with significant developmental disabilities. The characteristics demonstrated by children with significant developmental disabilities, the competencies required for certified APE teachers, and the evidence-based positive behavioral interventions (PBI) documented for teaching children with significant developmental disabilities were fully reviewed in this study. An online graduate program with 14 courses for 42 credit hours (3 credit hours per course) was then developed for training APE teachers to serve children with significant developmental disabilities. Included in this online program are five components: (a) 2 capstone courses, (b) 4 APE courses, (c) 4 PBI course, (d) 2 elective courses, and (e) 2 capstone courses. All courses will be delivered online through Desire2Learn administered by the Extended University Programs at Western Michigan University (WMU). An applicant who has a bachelor’s degree in physical education or special education is eligible for this proposed program. A student enrolled in this program is expected to complete all courses in 2.5 years while staying in their local area. This program will be submitted to the WMU curriculum committee for approval in the fall of 2018.

Keywords: adapted physical education, online program, teacher preparation, and significant disabilities

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207 The Neutrophil-to-Lymphocyte Ratio after Surgery for Hip Fracture in a New, Simple, and Objective Score to Predict Postoperative Mortality

Authors: Philippe Dillien, Patrice Forget, Harald Engel, Olivier Cornu, Marc De Kock, Jean Cyr Yombi

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Introduction: Hip fracture precedes commonly death in elderly people. Identification of high-risk patients may contribute to target patients in whom optimal management, resource allocation and trials efficiency is needed. The aim of this study is to construct a predictive score of mortality after hip fracture on the basis of the objective prognostic factors available: Neutrophil-to-lymphocyte ratio (NLR), age, and sex. C-Reactive Protein (CRP), is also considered as an alternative to the NLR. Patients and methods: After the IRB approval, we analyzed our prospective database including 286 consecutive patients with hip fracture. A score was constructed combining age (1 point per decade above 74 years), sex (1 point for males), and NLR at postoperative day+5 (1 point if >5). A receiver-operating curve (ROC) curve analysis was performed. Results: From the 286 patients included, 235 were analyzed (72 males and 163 females, 30.6%/69.4%), with a median age of 84 (range: 65 to 102) years, mean NLR values of 6.47+/-6.07. At one year, 82/280 patients died (29.3%). Graphical analysis and log-rank test confirm a highly statistically significant difference (P<0.001). Performance analysis shows an AUC of 0.72 [95%CI 0.65-0.79]. CRP shows no advantage on NLR. Conclusion: We have developed a score based on age, sex and the NLR to predict the risk of mortality at one year in elderly patients after surgery for a hip fracture. After external validation, it may be included in clinical practice as in clinical research to stratify the risk of postoperative mortality.

Keywords: neutrophil-to-lymphocyte ratio, hip fracture, postoperative mortality, medical and health sciences

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206 Regulating Nanocarrier and Mononuclear Phagocyte System Interactions through Esomeprazole-Based Preconditioning Strategy

Authors: Zakia Belhadj, Bing He, Hua Zhang, Xueqing Wang, Wenbing Dai, Qiang Zhang

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Mononuclear phagocyte system (MPS) forms an abominable obstacle hampering the tumor delivery efficiency of nanoparticles. Passively targeted nanocarriers have received clinical approval over the past 20 years. However, none of the actively targeted nanocarriers have entered clinical trials. Thus it is important to endue effective targeting ability to actively targeted approaches by overcoming biological barriers to nanoparticle drug delivery. Here, it presents that an Esomeprazole-based preconditioning strategy for regulating nanocarrier-MPS interaction to substantially prolong circulation time and enhance tumor targeting of nanoparticles. In vitro, the clinically approved proton pump inhibitor Esomeprazole “ESO” was demonstrated to reduce interactions between macrophages and subsequently injected targeted vesicles by interfering with their lysosomal trafficking. Of note, in vivo studies demonstrated that ESO pretreatment greatly decreased the liver and spleen uptake of c(RGDm7)-modified vesicles, highly enhanced their tumor accumulation, thereby provided superior therapeutic efficacy of c(RGDm7)-modified vesicles co-loaded with Doxorubicin (DOX) and Gefitinib (GE). This MPS-preconditioning strategy using ESO provides deeper insights into regulating nanoparticles interaction with the phagocytic system and enhancing their cancer cells' accessibility for anticancer therapy.

Keywords: esomeprazole (ESO), mononuclear phagocyte system (MPS), preconditioning strategy, targeted lipid vesicles

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205 Social Media Resignation the Only Way to Protect User Data and Restore Cognitive Balance, a Literature Review

Authors: Rajarshi Motilal

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The birth of the Internet and the rise of social media marked an important chapter in the history of humankind. Often termed the fourth scientific revolution, the Internet has changed human lives and cognisance. The birth of Web 2.0, followed by the launch of social media and social networking sites, added another milestone to these technological advancements where connectivity and influx of information became dominant. With billions of individuals using the internet and social media sites in the 21st century, “users” became “consumers”, and orthodox marketing reshaped itself to digital marketing. Furthermore, organisations started using sophisticated algorithms to predict consumer purchase behaviour and manipulate it to sustain themselves in such a competitive environment. The rampant storage and analysis of individual data became the new normal, raising many questions about data privacy. The excessive usage of the Internet among individuals brought in other problems of them becoming addicted to it, scavenging for societal approval and instant gratification, subsequently leading to a collective dualism, isolation, and finally, depression. This study aims to determine the relationship between social media usage in the modern age and the rise of psychological and cognitive imbalances in human minds. The literature review is positioned timely as an addition to the existing work at a time when the world is constantly debating on whether social media resignation is the only way to protect user data and restore the decaying cognitive balance.

Keywords: social media, digital marketing, consumer behaviour, internet addiction, data privacy

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204 Generation of Medical Waste in Hospitals in Interior of São Paulo, Brazil

Authors: Silvia Carla Da Silva André, Angela Maria Magosso Takayanagui

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Introduction: The Medical Waste (MW) are responsible per 2% of total waste generated for a city and has merited attention due the risks that offers to the public health and environment, representing an important aspect in waste management. In Brazil, the Resolution 306/04 of the National Health Surveillance Agency classifies the MW into 5 groups as follows: Group A (GA) biological, Group B (GB) chemical, Group C (GC) radioactive waste, Group D (GD) common, and Group E (GE) sharps. Objective: This study aimed to determine the amount of waste generated in hospitals of Ribeirão Preto, São Paulo, Brazil. Material and Methods: This is a field research, exploratory, using quantitative variables. The survey was conducted in 11 hospitals in Ribeirão Preto, located in the State of São Paulo, Brazil. It is noted that the study sample included general hospitals, skilled, university, maternity, and psychiatric; public, private, and philanthropic; and large, medium, and small. To quantify the MW, the weighing of the waste was held for six days, following methodology adapted from PAHO. Data were analyzed using descriptive statistics, determining the average global generation of MW and for each group. This research was carried out after approval by the Ethics in Research of the University of São Paulo. Thus, in order to comply with the ethical principles of research, to present the results hospitals were numbered from 1 to 11. Results: The data revealed a greater generation of biological waste among teaching hospitals, which can be justified by the use of materials for the realization of techniques.

Keywords: environmental health, management of medical waste, medical waste, public health

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203 Influence of Marital Status on Nutritional, Physical, Mental, and Social Health: A Study on Women in Faisalabad, Pakistan

Authors: Anum Obaid, Iman Fatima, Wanisha Feroz, Haleema Imran, Hammad Tariq

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Unmarried women over thirty years of age as a health issue is a relatively young phenomenon, but it is rapidly growing in Pakistan; therefore, it is a public health issue. The challenges affecting nutrition and public health are some of the indispensable components that need to be met to achieve sustainable development goals (SDGs). This research intends to explain these goals in the context of nutrition and public health, especially analyzing the issues related to unmarried women above the age of thirty in Faisalabad, Pakistan. Still, this research is not feasible in Pakistan. In Pakistan alone, 10 million women over the age of 35 are unmarried, based on a recent United Nations report. The United Nations, in cooperation with the World Health Organization, has identified health as a state of being healthy, free from illness or disease, and not just a condition where there are no diseases or bodily disabilities. The current generation of women is unmarried and living a life under constant pressure from society to deliver changes like the diet these women take, and hence, their nutritional status defines their comprehensive health triangle, a mix of physical, mental, and social well-being. The research was carried out under the qualitative research paradigm, specifically through interviews with the participants who were unmarried women and married women above the age of thirty. This qualitative study explores how marriage affects the intake of nutrients, nutritional health, psychological and social well-being and their effects. The realization of well-being consisted of factors like physical health, mental and emotional health, pressure from society, social health, economic independence, and decision-making power to reveal the impact of singleness on well-being. The findings disclosed that marital status had a notable impact on the diet habits and nutritional behaviors of women in Faisalabad. Also, it was found that single women suffer from more stress and are not as positive as married women because they are lonely, as their husbands are absent from their lives. The findings established that nutritional understanding is differentially affected by marital status as a determinant of the health triangle consisting of physical, mental, and social health. Awareness of these factors is significant in designing specific goal-directed interventions that can enhance the nutritional well-being and general health status of unmarried women in Faisalabad. Hence, this study underscores the necessity of maintaining supportive environments and increasing the regard concerning the health state of single ladies beyond thirty.

Keywords: health triangle, over thirty, singleness, age barriers, unmarried women, women’s health, well-being

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202 Dyadic Effect of Emotional Focused Psycho Educational Intervention on Spousal Emotional Abuse and Marital Satisfaction among Elderly Couples

Authors: Maryam Hazrati, Tengku Aizan Hamid, Rahimah Ibrahim, Siti Aishah Hassan, Farkhondeh Sharif, Zahra Bagheri

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Background: Emotional abuse is the most common type of spousal abuse. In a long-term marriage which lasts several decades, the couple will be faced with greater vulnerability due to illness, disability, and dependence. Emotional abuse can have a devastating impact on victims, leading to low self-esteem, depression, anxiety, and post-traumatic stress disorder. Research Aim: The aim of this study was to investigate the effects of an emotional-focused psychoeducational intervention (EFPEI) on emotional abuse and marital satisfaction among older adults couples and also to examine the dyadic effects of each partner’s emotional abuse behaviors (EAB) on his/her marital satisfaction (MS) in Shiraz-Iran. Methodology: The study was a randomized controlled trial (RCT). A total of 57 eligible couples were randomly assigned to either the experimental group or the control group. The experimental group received EFPEI, which consisted of 12 sessions, each lasting 90 minutes. The control group did not receive any intervention. Data were collected using demographic questionnaire, Multidimensional Measure of Emotional Abuse (MMEAQ), and Marital Satisfaction Questionnaire for Older People (MSQFOP). The data was analyzed using a variety of statistical methods, including repeated measures ANOVA, path analysis, and correlational analyses. Findings: The results of the study showed that the EFPEI was effective in reducing emotional abuse and increasing marital satisfaction among older adults couples. Specifically, the mean scores for emotional abuse and marital satisfaction were significantly lower in the experimental group than in the control group at the end of the intervention. These effects were maintained at a 3-month follow-up. Moreover, the dyadic analysis revealed that husbands’ EAB had no significant effects on his own marital satisfaction but a significant negative partner effect, while wives’ EAB had significant negative actor and partner effects. Conclusion: The findings of this study provide support for the use of EFPEI as an effective intervention for decreasing emotional abuse and improving marital dissatisfaction among older adults. EFPEI is a short-term, evidence-based intervention that can be delivered by trained professionals. The intervention focuses on helping couples to improve their communication skills, resolve conflict, and build a stronger emotional connection.

Keywords: spouse abuse, emotion, aged, satisfaction, dyadic effect

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201 Post Covid-19 Landscape of Global Pharmaceutical Industry

Authors: Abu Zafor Sadek

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Pharmaceuticals were one of the least impacted business sectors during the corona pandemic as they are the center point of Covid-19 fight. Emergency use authorization, unproven indication of some commonly used drugs, self-medication, research and production capacity of an individual country, capacity of producing vaccine by many countries, Active Pharmaceutical Ingredients (APIs) related uncertainty, information gap among manufacturer, practitioners and user, export restriction, duration of lock-down, lack of harmony in transportation, disruption in the regulatory approval process, sudden increased demand of hospital items and protective equipment, panic buying, difficulties in in-person product promotion, e-prescription, geo-politics and associated issues added a new dimension to this industry. Although the industry maintains a reasonable growth throughout Covid-19 days; however, it has been characterized by both long- and short-term effects. Short-term effects have already been visible to so many countries, especially those who are import-dependent and have limited research capacity. On the other hand, it will take a few more time to see the long-term effects. Nevertheless, supply chain disruption, changes in strategic planning, new communication model, squeezing of job opportunity, rapid digitalization are the major short-term effects, whereas long-term effects include a shift towards self-sufficiency, growth pattern changes of certain products, special attention towards clinical studies, automation in operations, the increased arena of ethical issues etc. Therefore, this qualitative and exploratory study identifies the post-covid-19 landscape of the global pharmaceutical industry.

Keywords: covid-19, pharmaceutical, businees, landscape

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200 Unlocking the Puzzle of Borrowing Adult Data for Designing Hybrid Pediatric Clinical Trials

Authors: Rajesh Kumar G

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A challenging aspect of any clinical trial is to carefully plan the study design to meet the study objective in optimum way and to validate the assumptions made during protocol designing. And when it is a pediatric study, there is the added challenge of stringent guidelines and difficulty in recruiting the necessary subjects. Unlike adult trials, there is not much historical data available for pediatrics, which is required to validate assumptions for planning pediatric trials. Typically, pediatric studies are initiated as soon as approval is obtained for a drug to be marketed for adults, so with the adult study historical information and with the available pediatric pilot study data or simulated pediatric data, the pediatric study can be well planned. Generalizing the historical adult study for new pediatric study is a tedious task; however, it is possible by integrating various statistical techniques and utilizing the advantage of hybrid study design, which will help to achieve the study objective in a smoother way even with the presence of many constraints. This research paper will explain how well the hybrid study design can be planned along with integrated technique (SEV) to plan the pediatric study; In brief the SEV technique (Simulation, Estimation (using borrowed adult data and applying Bayesian methods)) incorporates the use of simulating the planned study data and getting the desired estimates to Validate the assumptions.This method of validation can be used to improve the accuracy of data analysis, ensuring that results are as valid and reliable as possible, which allow us to make informed decisions well ahead of study initiation. With professional precision, this technique based on the collected data allows to gain insight into best practices when using data from historical study and simulated data alike.

Keywords: adaptive design, simulation, borrowing data, bayesian model

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199 The Signaling Power of ESG Accounting in Sub-Sahara Africa: A Dynamic Model Approach

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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198 Fostering Students' Engagement with Historical Issues Surrounding the Field of Graphic Design

Authors: Sara Corvino

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The aim of this study is to explore the potential of inclusive learning and assessment strategies to foster students' engagement with historical debates surrounding the field of graphic design. The goal is to respond to the diversity of L4 Graphic Design students, at Nottingham Trent University, in a way that instead of 'lowering standards' can benefit everyone. This research tests, measures, and evaluates the impact of a specific intervention, an assessment task, to develop students' critical visual analysis skills and stimulate a deeper engagement with the subject matter. Within the action research approach, this work has followed a case study research method to understand students' views and perceptions of a specific project. The primary methods of data collection have been: anonymous electronic questionnaire and a paper-based anonymous critical incident questionnaire. NTU College of Business Law and Social Sciences Research Ethics Committee granted the Ethical approval for this research in November 2019. Other methods used to evaluate the impact of this assessment task have been Evasys's report and students' performance. In line with the constructivist paradigm, this study embraces an interpretative and contextualized analysis of the collected data within the triangulation analytical framework. The evaluation of both qualitative and quantitative data demonstrates that active learning strategies and the disruption of thinking patterns can foster greater students' engagement and can lead to meaningful learning.

Keywords: active learning, assessment for learning, graphic design, higher education, student engagement

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197 Public Financial Management in Ghana: A Move beyond Reforms to Consolidation and Sustainability

Authors: Mohammed Sani Abdulai

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Ghana’s Public Financial Management reforms have been going on for some two decades now (1997/98 to 2017/18). Given this long period of reforms, Ghana in 2019 is putting together both a Public Financial Management (PFM) strategy and a Ghana Integrated Financial Management Information System (GIFMIS) strategy for the next 5-years (2020-2024). The primary aim of these dual strategies is assisting the country in moving beyond reforms to consolidation and sustainability. In this paper we, first, examined the evolution of Ghana’s PFM reforms. We, secondly, reviewed the legal and institutional reforms undertaken to strengthen the country’s key PFM institutions. Thirdly, we summarized the strengths and weaknesses identified by the 2018 Public Expenditure and Financial Accountability (PEFA) assessment of Ghana’s PFM system relating to its macro-fiscal framework, budget preparation and approval, budget execution, accounting and fiscal reporting as well as external scrutiny and audit. We, finally, considered what the country should be doing to achieve its intended goal of PFM consolidation and sustainability. Using a qualitative method of review and analysis of existing documents, we, through this paper, brought to the fore the lessons that could be learnt by other developing countries from Ghana’s PFM reforms experiences. These lessons included the need to: (a) undergird any PFM reform with a comprehensive PFM reform strategy; (b) undertake a legal and institutional reforms of the key PFM institutions; (c) assess the strengths and weaknesses of those reforms using PFM performance evaluation tools such as PEFA framework; and (d) move beyond reforms to consolidation and sustainability.

Keywords: public financial management, public expenditure and financial accountability, reforms, consolidation, sustainability

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196 Profile and Care of Stroke Patients in Angola: Preliminary Results of a Longitudinal Two-Center Study

Authors: L. José, S. Vieira, E. Melo, A. R. Pinheiro

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Objectives: This study aims to characterize the stroke profile and the health care provided for people with a stroke in Luanda, Angola. Methods: A prospective longitudinal study was conducted at two Health centers, from March to November 2023, enrolling stroke patients. Data was gathered using a survey created by the researchers and validated by a health panel of experts from Angola. The analysis focused on demographic and stroke characteristics, as well as the care provided. Ethical approval and informed consent were obtained. Results: Preliminary results of a total of 186 patients are described, 122 from a Central Acute Care Hospital, with a mean age of 51.3±14.35 years old, a BMI of 26.7±4.15 kg/m2, 41% male, and 64 patients from a Rehabilitation Center, with 55.6±11.55 years old, a BMI of 27.0±3.8 kg/m2, 53% male. Ischemic stroke was reported as the most representative type in both centers (71.3% and 70.3%, respectively), though 100% of patients had no imaging diagnosis confirmation, neither data about the subtype was given. For patients admitted to the Hospital, discharge occurred before rehabilitation, and no follow-up was possible. No rehabilitation care was delivered in the first 7 days after the stroke. In the Rehabilitation Center, patient’s rehabilitation started in the late subacute phase, after a mean of 171.8±11.5 days. Conclusions: Stroke diagnosis lacks imaging confirmation, which is decisive for proper treatment, and rehabilitation starts during the late subacute phase, which is too late considering the international guidelines and the best window of opportunity for neuroplasticity and recovery. These results highlight the urgent need for the definition of Stroke-directed Health Care Policies in Angola.

Keywords: stroke, personalized health care, functional recovery, quality of life, health policies

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195 A Controlled Natural Language Assisted Approach for the Design and Automated Processing of Service Level Agreements

Authors: Christopher Schwarz, Katrin Riegler, Erwin Zinser

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The management of outsourcing relationships between IT service providers and their customers proofs to be a critical issue that has to be stipulated by means of Service Level Agreements (SLAs). Since service requirements differ from customer to customer, SLA content and language structures vary largely, standardized SLA templates may not be used and an automated processing of SLA content is not possible. Hence, SLA management is usually a time-consuming and inefficient manual process. For overcoming these challenges, this paper presents an innovative and ITIL V3-conform approach for automated SLA design and management using controlled natural language in enterprise collaboration portals. The proposed novel concept is based on a self-developed controlled natural language that follows a subject-predicate-object approach to specify well-defined SLA content structures that act as templates for customized contracts and support automated SLA processing. The derived results eventually enable IT service providers to automate several SLA request, approval and negotiation processes by means of workflows and business rules within an enterprise collaboration portal. The illustrated prototypical realization gives evidence of the practical relevance in service-oriented scenarios as well as the high flexibility and adaptability of the presented model. Thus, the prototype enables the automated creation of well defined, customized SLA documents, providing a knowledge representation that is both human understandable and machine processable.

Keywords: automated processing, controlled natural language, knowledge representation, information technology outsourcing, service level management

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194 Pull String to Stop: Public Utility Vehicle Modernization Program

Authors: Frederick Kobe O. Obar, Preity B. Quinzon, Trisha B. Tumbokon, Mario Joshua D. Marron, Kenichi Katsuo Kichiro A. Rimorin

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The Public Utility Vehicle Modernization Program (PUVMP) is a program meant to reform the current state of the Philippines’ public transportation sector. This study determined the impact of the Public Utility Vehicle Modernization Program on San Fernando City, La Union's jeepney drivers, interviewing six individuals, three with traditional vehicles and three with modernized units. This study used a descriptive qualitative research design and employed purposive sampling to select the six participants suited for the study, who were then subjected to a semi-structured face-to-face interview. The gathered data was then analyzed through thematic analysis. The findings highlighted evidence that the jeepney drivers experienced abrupt and prevailing changes in their routine and in their everyday work. This study concludes that while the sentiment of the program was appreciated, it has changed the environment for jeepney drivers drastically, provoking many reactions. These changes have, of course, shifted the daily lives of the jeepney drivers significantly, but through adaptability, they found ways. Recommendations include flexible compliance policies, educational initiatives, and support for drivers, providing valuable insights for informed decision-making in the ongoing transportation modernization discussion. This study concluded that while the drivers are not opposed to reform, they are not entirely in approval of the current effects of the program as it is being implemented in their local area.

Keywords: transport reform, transport modernization, public transport, jeepney drivers, PUVMP, urban planning, public utility vehicles

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193 Isotretinoin and Psychiatric Adverse Events: A Review of the Evidence

Authors: Thodoris Tsagkaris, Marios Stavropoulos, Panagiotis Theodosis-Nobelos, Charalampos Triantis

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Isotretinoin is a widely used therapeutic for the treatment of acne vulgaris and various other skin disorders. However, since its approval, many side effects and contraindications have been described, particularly important, such as teratogenicity as well as liver disease and dermal deterioration. In a very important allegation, isotretinoin has been linked with psychiatric symptoms like depression, suicidal ideation, schizophrenia, and hypervitaminosis A syndrome characteristics. These adverse effects have raised significant concerns regarding the safety of isotretinoin. Numerous studies and research have associated isotretinoin with side effects on the mental health of patients and have proposed plausible mechanisms regarding this suspected causative relationship. However, the evidence is still contradicting, and the data disperse, making their validity less valuable. Thus, in the present study, we aim to analyze further the available literature and present a complete analysis of the side effects of isotretinoin, with particular emphasis on the effects it may have on the mental health of patients. The review is based on international articles from broad scientific electronic databases like PubMed and Scopus. This review concludes that although many studies have associated isotretinoin with mental effects like depression, bipolar disorder, schizophrenia, and suicidal ideation, the data are still insufficient and often contradictory. In fact, additional studies with accurate data and larger double-blinded samples, and more analytic systematic reviews are required. It is especially important to monitor the dose and the intervals that isotretinoin has to be administered in order to potentially cause mental health problems, as well as the duration of treatment and the role that the patient's medical and pharmaceutical history may play.

Keywords: acne, depression, isotretinoin, mental health

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192 Whether Buffer Zone Community Forests’ Benefits Are Distributed Fairly to Low-Income Users: Reflection From the Buffer Zone Community Forests in Bardia National Park, Nepal

Authors: Keshav Raj Acharya, Thakur Silwal, Neelam C. Poudyal

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Buffer zones, the peripheral areas around the national parks and wildlife reserves, are available for the purpose of benefitting the local inhabitants by providing forest products for subsistence needs of basic forest products outside the protected areas. The forest area within the buffer zone has been managed as a buffer zone community forest (BZCF) for the last 25 years after the approval of the buffer zone management regulation 1996. With a case study of select BZCF in Bardia National Park, this study aims to analyze whether the benefit provided by BZCF is equally available to poor users among other socioeconomic classes of the users. The findings are based on the analysis of cross-sectional data involving household surveys (n=305) and key informants’ interviews (n=10) as well as office records available at different 5 buffer zone community forest user groups offices. Results indicate that despite the provisions of subsidized rates for poor; poor households were more deprived due to higher forest products price particularly, the timber price in buffer zone. Evidence also indicate that due to the increased forest coverage, the incidence of wildlife damage has also increased and impacted the poor more due to lack of land ownership as well as limited alternatives. Clear community forest management guidelines with equitable benefit sharing and compensatory mechanisms to the users of poor socioeconomic class have been identified as a solution to increase the benefit to poor users in BZCFUGs.

Keywords: crop depredation, forest products, users, wellbeing ranking

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191 The Advancement of Environmental Impact Assessment for 5th Transmission Natural Gas Pipeline Project in Thailand

Authors: Penrug Pengsombut, Worawut Hamarn, Teerawuth Suwannasri, Kittiphong Songrukkiat, Kanatip Ratanachoo

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PTT Public Company Limited or simply PTT has played an important role in strengthening national energy security of the Kingdom of Thailand by transporting natural gas to customers in power, industrial and commercial sectors since 1981. PTT has been constructing and operating natural gas pipeline system of over 4,500-km network length both onshore and offshore laid through different area classifications i.e., marine, forest, agriculture, rural, urban, and city areas. During project development phase, an Environmental Impact Assessment (EIA) is conducted and submitted to the Office of Natural Resources and Environmental Policy and Planning (ONEP) for approval before project construction commencement. Knowledge and experiences gained and revealed from EIA in the past projects definitely are developed to further advance EIA study process for newly 5th Transmission Natural Gas Pipeline Project (5TP) with approximately 415 kilometers length. The preferred pipeline route is selected and justified by SMARTi map, an advance digital one-map platform with consists of multiple layers geographic and environmental information. Sensitive area impact focus (SAIF) is a practicable impact assessment methodology which appropriate for a particular long distance infrastructure project such as 5TP. An environmental modeling simulation is adopted into SAIF methodology for impact quantified in all sensitive areas whereas other area along pipeline right-of-ways is typically assessed as an impact representative. Resulting time and cost deduction is beneficial to project for early start.

Keywords: environmental impact assessment, EIA, natural gas pipeline, sensitive area impact focus, SAIF

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190 Analyzing Factors Impacting COVID-19 Vaccination Rates

Authors: Dongseok Cho, Mitchell Driedger, Sera Han, Noman Khan, Mohammed Elmorsy, Mohamad El-Hajj

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Since the approval of the COVID-19 vaccine in late 2020, vaccination rates have varied around the globe. Access to a vaccine supply, mandated vaccination policy, and vaccine hesitancy contribute to these rates. This study used COVID-19 vaccination data from Our World in Data and the Multilateral Leaders Task Force on COVID-19 to create two COVID-19 vaccination indices. The first index is the Vaccine Utilization Index (VUI), which measures how effectively each country has utilized its vaccine supply to doubly vaccinate its population. The second index is the Vaccination Acceleration Index (VAI), which evaluates how efficiently each country vaccinated its population within its first 150 days. Pearson correlations were created between these indices and country indicators obtained from the World Bank. The results of these correlations identify countries with stronger health indicators, such as lower mortality rates, lower age dependency ratios, and higher rates of immunization to other diseases, displaying higher VUI and VAI scores than countries with lesser values. VAI scores are also positively correlated to Governance and Economic indicators, such as regulatory quality, control of corruption, and GDP per capita. As represented by the VUI, proper utilization of the COVID-19 vaccine supply by country is observed in countries that display excellence in health practices. A country’s motivation to accelerate its vaccination rates within the first 150 days of vaccinating, as represented by the VAI, was largely a product of the governing body’s effectiveness and economic status, as well as overall excellence in health practises.

Keywords: data mining, Pearson correlation, COVID-19, vaccination rates and hesitancy

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189 The Overlooked Problem Among Surgical Patients: Preoperative Anxiety at Ethiopian University Hospital

Authors: Yohtahe Woldegerima Berhe, Tadesse Belayneh Melkie, Girmay Fitiwi Lema, Marye Getnet, Wubie Birlie Chekol

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Introduction: Anxiety was repeatedly reported as the worst aspect of the perioperative time. The objective of this study was to assess the prevalence of preoperative anxiety among adult surgical patients at the University of Gondar Comprehensive Specialized Hospital (UoGCSH), Northwest Ethiopia. Methodology: Hospital-based cross-sectional study was conducted among surgical patients at the university hospital. After obtaining ethical approval, 407 surgical patients were approached during the preoperative period. Preoperative anxiety was assessed by the State-Trait Anxiety Inventory. The association between variables was determined by using binary logistic regression analysis. The strength of association was described in adjusted odds ratio (AOR) and a p-value < 0.05 at a 95% confidence interval which was considered statistically significant. Results: A total of 400 patients were included in this study, with a 98.3% response rate. Preoperative anxiety was observed among 237 (59.3%) patients, and the median (IQR) STAI score was 50 (40 – 56.7). age ≥ 60 years (AOR: 5.7, CI: 1.6 – 20.4, P: 0.007), emergency surgery (AOR: 2.5, CI: 1.3 – 4.7, P: 0.005), preoperative pain (AOR: 2.6, CI: 1.2 – 5.4, P: 0.005), and rural residency (AOR: 1.8, CI: 1.1 – 2.9, P: 0.031) were found significantly associated with preoperative anxiety. Conclusions: The prevalence of preoperative anxiety among surgical patients was high. Older age (≥ 60 years), emergency surgery, preoperative pain, and rural residency were found to be significantly associated with preoperative anxiety. Assessment for preoperative anxiety should be a routine component of preoperative assessment of both elective and emergency surgical patients. Preoperative pain should be appropriately managed as it can help to reduce preoperative anxiety. Optimal anxiety reduction methods should be investigated and implemented in the hospital.

Keywords: preoperative anxiety, anxiety, anxiety of anesthesia and surgery, state-trait anxiety inventory, preoperative care

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188 The Importance of Erythrocyte Parameters in Obese Children

Authors: Orkide Donma, M. Metin Donma, Burcin Nalbantoglu, Birol Topcu, Feti Tulubas, Murat Aydin, Tuba Gokkus, Ahmet Gurel

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Increasing prevalence of childhood obesity has increased the interest in early and late indicators of gaining weight. Cell blood counts may be indicators of proinflammatory states. The aim was to evaluate associations of hematological parameters, including Hematocrit (HTC), hemoglobin, blood cell counts, and their indices with the degree of obesity in pediatric population. A total of 249; -139 morbidly obese (MO), 82 healthy Normal Weight (NW) and 28 Overweight (OW) children were included into the scope of the study. WHO BMI-for age percentiles were used to form age- and sex-matched groups. Informed consent forms and the Ethics Committee approval were obtained. Anthropometric measurements were performed. Hematological parameters were determined. Statistical analyses were performed using SPSS. The degree for statistical significance was p≤0.05. Significant differences (p=0.000) between waist-to-hip ratios and head-to-neck ratios (hnrs) of MO and NW children were detected. A significant difference between hnrs of OW and MO children (p=0.000) was observed. Red cell Distribution Width (RDW) was higher in OW children than NW group (p=0.030). Such finding couldn’t be detected between MO and NW groups. Increased RDW was prominent in OW children. The decrease in Mean Corpuscular Hemoglobin Concentration (MCHC) values in MO children was sharper than the values in OW children (p=0.006 vs p=0.042) compared to those in NW group. Statistically higher HTC levels were observed between MO-NW (p=0.014), but none between OW-NW. Though the cause-effect relationship between obesity and erythrocyte indices still needs further investigation, alterations in RDW, HTC, MCHC during obesity may be of significance in the early life.

Keywords: anthropometry, children, erythrocytes, obesity

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187 The Effect of Excess Workload on Lecturers in Higher Institution and Its Relation with Instructional Technology a Case Study of North-West Nigeria

Authors: Shitu Sani

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The paper is advanced on the historical background of the effects of excess work load on lecturers in higher institutions of learning which will assess the socio-economic and psychological disposition of lecturers in the realm of quality production. The paper further discusses the significant roles played by excess work load in general transformation of higher education, which will give the management and stake holders input for successful development of higher education. Even though all forms of work and organizational procedures are potential source of stress and stressors. In higher institution of leaning, lecturers perform many responsibilities such as lecturing, carrying out research and engaging in community services. If these multiple roles could not be handle property it would have result in stress which may have negative impact on job performance, and it’s relation with instructional technology. A sample 191 lecturers were randomly selected from the higher institutions in the northern west zone in Nigerian using two instruments i.e. work load stress management question and job performance Approval, data were collected on lecturers of socio-economic and physiological stress and job performances. Findings of the study shows that lecture experienced excess work load in academic activities. Lecturer’s job performance was negatively influences by socio-economic and psychological work stress. Among the recommendation made were the need for organizing regular induction courses for lecturers on stress, and enhance interpersonal relations among the lecturers as well as provision of electronic public address system to reduce the stress.

Keywords: effect, excess, lecturers, workload

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186 A Comparative Study of Environment Risk Assessment Guidelines of Developing and Developed Countries Including Bangladesh

Authors: Syeda Fahria Hoque Mimmi, Aparna Islam

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Genetically engineered (GE) plants are the need of time for increased demand for food. A complete set of regulations need to be followed from the development of a GE plant to its release into the environment. The whole regulation system is categorized into separate stages for maintaining the proper biosafety. Environmental risk assessment (ERA) is one of such crucial stages in the whole process. ERA identifies potential risks and their impacts through science-based evaluation where it is done in a case-by-case study. All the countries which deal with GE plants follow specific guidelines to conduct a successful ERA. In this study, ERA guidelines of 4 developing and 4 developed countries, including Bangladesh, were compared. ERA guidelines of countries such as India, Canada, Australia, the European Union, Argentina, Brazil, and the US were considered as a model to conduct the comparison study with Bangladesh. Initially, ten parameters were detected to compare the required data and information among all the guidelines. Surprisingly, an adequate amount of data and information requirements (e.g., if the intended modification/new traits of interest has been achieved or not, the growth habit of GE plants, consequences of any potential gene flow upon the cultivation of GE plants to sexually compatible plant species, potential adverse effects on the human health, etc.) matched between all the countries. However, a few differences in data requirement (e.g., agronomic conventions of non-transformed plants, applicants should clearly describe experimental procedures followed, etc.) were also observed in the study. Moreover, it was found that only a few countries provide instructions on the quality of the data used for ERA. If these similarities are recognized in a more framed manner, then the approval pathway of GE plants can be shared.

Keywords: GE plants, ERA, harmonization, ERA guidelines, Information and data requirements

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185 Prosocial Behavior and Satisfaction with School Life in Elementary Children: From the Perspective of Classroom Environment

Authors: Takuma Yamamoto

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Present study investigated the relationship between elementary school children’s prosocial behavior in classroom and satisfaction with school life (approval and victimization from other children) with considering from the perspective of classroom social goal structures (prosocial and compliance goal structures). Participants were 755 elementary school children (393 boys, 362 girls, mean range= 10-12, 5th grader and 6th grader) who were living in Chugoku District, Japan. They filled up questionnaire which was consisted of Murakami, Nishimura and Sakurai’s (2016) prosocial behavior toward friend scale, Kawamura and Tagami’s (1997) satisfaction in classroom scale and Ohtani, Okada, Nakaya and Ito’s (2016) classroom social goal structures scale. Regression lines that satisfaction in classroom is dependent variable and prosocial behavior is independent variable for each class were drawn. There were two types of classroom which children’s prosocial behavior correlated with satisfaction positively and did not. Then one-way MANOVA was conducted to further describe two types of classroom which prosocial behavior increased satisfaction in classroom (type 1) and prosocial behavior decreased satisfaction (type 2). MANOVA for Prosocial goal structure was significant, type 1 > type 2. There were two key findings from this study. First, MANOVA for prosocial goal structure was significant. Second, high score of prosocial goal structure was not necessary condition for the classroom type which children’s prosocial behavior correlated with satisfaction. The implications from these key findings were: (1) in the low prosocial goal structure classroom, children will not behave prosocially because of their negative expectation for the effect of prosocial behavior, (2) this study can be a contribution for classroom management that teachers need to consider about the negative possibilities of prosocial behavior when they try to increase the amount of children’s positive behavior.

Keywords: elementary school children, classroom social goal structure, satisfaction with school life, prosocial behavior

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184 Child Marriage in Indonesian Law Perspective

Authors: Sonny Dewi Judiasih

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Every person retains the right to marry and starts a family through a legitimized marriage. Indonesian Marriage Act has regulated the minimum age for boys to marry is 19 while the girls is 16, with an exception that the parents could ask for an exemption to the court or to the authorized official. Despite the age limit is set by the Marriage Act, however, with the influences from adat law and islamic law which allows younger persons to marry, the child marriage phenomenon is inevitable to happen in Indonesia. Child marriages in Indonesia have shown such alarming fact where 4.8 percentage of total marriage number come from persons with the age of 10 to 14 years old. The percentage was the result from a research conducted by the National Population and Family Planning Board (BKKBN). The result shows 41.9 percent of child marriages was contributed by girls who marry in the age of 15 to 19, which mostly comes from villagers. Other fact shows 50 percent of child marriages end in divorce with grounds varied from the mental health of the children, economic situation, and so on. With more children committed early marriages, more babies will be borned from indebted families. Subsequently, the government’s program to alleviate poverty will be short of expectations. Other risk for child marriages includes death of the mother and the child after giving birth. The people have challenged the legality of child marriages through judicial review filed to the Constitutional Court. The Court decided to reinforce the age limitation previously set by the Marriage Act by issuing judicial decision no: 30-74/PUU-Xii/2014. The Court stated that changes to the age limit must be in conform with cultural and traditional situation. Further, it stated child marriages are allowed to be arranged as an “emergency exit” if the parents filed such request to an exemption on the grounds of coercive situation and after the court or the authorized officials issued its approval.

Keywords: child, marriage, court, Indonesia

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183 Frenotomy for Tongue Tie: The Unlikely Benefit of Massage

Authors: Kailas Bhandarkar, Talib Dar, Laura Karia, Manasvi Upadhyaya

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Introduction: Frenotomy for tongue tie is commonly performed in breastfed infants who experience difficulty in latching after failed conservative management for tongue tie. However, there is no consensus for the routine use of massage following frenotomy. Our aim was to assess the efficacy of massage in preventing recurrence following frenotomy. Methods: The tongue tie service in our tertiary referral hospital consists of 5 consultants and a breastfeeding (BF) midwife. 3 consultants routinely advice massage post procedure. Babies are assessed by the midwife after the procedure and a follow-up consultation after a week. After due ethical approval, data were collected by two staff members who were independent of TT service on a standardized questionnaire to avoid bias. Fischer exact test was employed (p < 0.05 considered significant). Results: Six hundred and thirty-two babies attended the clinic from January 2018 to December 2018. Thirty-three of these were excluded as the procedure was not needed. Parents were contacted at a median of six months post-procedure (range 2-10 months). 282/599 were advised massage. 92/282 could be contacted. 40/ 92 adhered to massage regimen. None of these had a recurrence. 52/92 (54%), although advised, did not perform massage. Reasons cited for lack of adherence to massage included difficulty in performing massaging and conflicting advice given by other health care professionals involved in patient care like paediatricians and group practice and lack of information on the internet). Overall, 4/599 (0.66%) had recurrences, and this difference was not statistically significant. Conclusion: In our experience, the rate of recurrence after frenotomy is low enough for us to conclude that there is no significant benefit of massage after frenotomy for tongue tie. We could also conclude that among parents who were advised massage more than half failed to adhere to the advice.

Keywords: tongue tie, frenotomy, massage, recurrence

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182 Levels of Loneliness and Quality of Life Among Retirees in Kuwait: Implication to Practice

Authors: Hamad Alhamad

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Introduction: The number of retirees in Kuwait is rising quickly, and this is causing more people to become concerned about their well-being. Despite the fact that loneliness and quality of life are significant indices of retiree wellbeing, little research has been done on the topic among retirees in Kuwait. The aim of this study is to explore the level of loneliness and quality of life among retirees in Kuwait. Methods: This is a a cross-sectional descriptive research targeting retirees who live in Kuwait. The UCLA loneliness scale (version 3) and the 36-Item Short Form Survey (36- SF) were utilized. Data was analyzed using SPSS. The ethical approval was obtained from Kuwait University and the Ministry of Health (286). Results: Total respondents in this research were 202 (N=202). The results indicate 77.7% (N=157) experience moderate level of loneliness, 19.8% (N=40) experience high level of loneliness, and only 205% (N=5) experience low level of loneliness. The results of the SF-36 health related questionnaire, participants scores in the eight domains: Physical functioning, general health, role limitations due to physical and emotional health, energy, social functioning, pain, and emotional wellbeing , scored low means. The average of the means was calculated and was (49.8), which indicated that all participants have moderately low Quality of life. Significant relationship with p value equal to ( p= 0.004), was found between a sociodemographic characteristic and level of loneliness in which retirees who were married indicated higher levels of loneliness compared to the single, divorced, and widowed retirees. Conclusion: The study revealed retirees in Kuwait feel moderate loneliness and have a low Quality of Time. The study indicates that retirees should be more considered emotionally and improved and help explore the negative effects on their quality of time In addition to exploring the leading factors to the feeling of loneliness.

Keywords: older adults, social isolation, work, retirement

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181 A Study on the Ideal and Actual Coping Responses of Public and Private College School Teachers on Job-Related Stress

Authors: Zaralyn Bernardo, Dante Boac, Annabelle Del Rosario

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Professional individuals who are in a primary role to impart learning with the new generation are alarmingly tend to have a vast decrease in their workforce due to stress at work. Thus, the study used mixed method research design to explore the ideal and actual coping patterns of college school teachers, both private and public, using Coping Response Inventory-Adult (CRI-Adult). It was suggested that in order for coping to be effective there must be a congruence or good match between coping efforts and preferred coping style. Results basically provided the same information on sources of teacher stress. However, workload and low salary were more likely heightened, for public and private school, respectively. There is also a significant difference between the ideal and actual coping style of college school teachers. Though the public school teachers leaned towards problem-focused as their ideal way of coping, both public and private teachers are somewhat inclined to use emotion-focused coping in actual situation. Results of FGD identified the factors that contribute to the incongruence or mismatch in their preferred style of coping and actual efforts to cope. Identified factors based on thematic analysis (TA) are clustered into themes such as affectivity and rehearsal of the preferred coping responses, sensitivity to pressure impairs coping efficacy, seeking for social acceptance and approval, indefinite appraisal of perceived stress, emotional dysregulation, and impulsivity, immediate desire to terminate negative emotion and adversity. Most of the factors somewhat provide partial elucidation on the engagement of the respondents on emotion-focused coping.

Keywords: coping responses subtypes, appraisal, teacher stress, ideal and actual coping

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180 A Qualitative Study to Explore the Experiences of Muslim Nurses Working in an Acute Setting During the Covid-19 Pandemic

Authors: Sujatha Shanmugasundaram

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Background: It has been since one year that COVID-19 has emerged into the world. Since then, healthcare professionals facing a great challenge in to fight against this deadly virus. According to World Health Organization (WHO) 2021, it is estimated that more than 131 million confirmed cases and 2million deaths around the world due to this pandemic. Nurses are the frontline workers who play a major role in safeguarding the lives of the people in acute care settings. Evidence suggests that there are numbers of research have been carried out on nurses' and healthcare provider’s experiences during the pandemic. But, unfortunately, there are no or little evidence available on Muslim nurse’s perspective. Hence, this research will investigate the experiences of Muslim nurses working in an acute care setting during the pandemic. Purpose: The purpose of the study is to explore the experiences of Muslim nurses working in an acute setting during the COVID-19 pandemic. Research Methods: A qualitative research approach will be utilized for the study. Semi-structured interview schedule will be used to collect the data. Face to face interviews will be conducted. All interviews will be conducted in Arabic, and it will be audio recorded. Verbatim will be noted. Muslim nurses working in an acute setting will be included in the study. Convenient sampling technique will be used to recruit the participants. Ethical approval will be obtained from the study sites. Strauss and Corbin's thematic analysis will be used to analyze the data. Conclusion: Considering that nurses are the frontline workers, they have a significant role in dealing with this COVID-19. It is a great challenge for the nurses working in an acute care setting. Thus, this study will bring out significant findings that will impact the nursing practice.

Keywords: acute care, COVID-19, experiences, muslim nurses

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