Search results for: Gumbel-Hougaard family copula
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3089

Search results for: Gumbel-Hougaard family copula

1169 OptiBaha: Design of a Web Based Analytical Tool for Enhancing Quality of Education at AlBaha University

Authors: Nadeem Hassan, Farooq Ahmad

Abstract:

The quality of education has a direct impact on individual, family, society, economy in general and the mankind as a whole. Because of that thousands of research papers and articles are written on the quality of education, billions of dollars are spent and continuously being spent on research and enhancing the quality of education. Academic programs accredited agencies define the various criterion of quality of education; academic institutions obtain accreditation from these agencies to ensure degree programs offered at their institution are of international standards. This R&D aims to build a web based analytical tool (OptiBaha) that finds the gaps in AlBaha University education system by taking input from stakeholders, including students, faculty, staff and management. The input/online-data collected by this tool will be analyzed on core areas of education as proposed by accredited agencies, CAC of ABET and NCAAA of KSA, including student background, language, culture, motivation, curriculum, teaching methodology, assessment and evaluation, performance and progress, facilities, availability of teaching materials, faculty qualification, monitoring, policies and procedures, and more. Based on different analytical reports, gaps will be highlighted, and remedial actions will be proposed. If the tool is implemented and made available through a continuous process the quality of education at AlBaha University can be enhanced, it will also help in fulfilling criterion of accreditation agencies. The tool will be generic in nature and ultimately can be used by any academic institution.

Keywords: academic quality, accreditation agencies, higher education, policies and procedures

Procedia PDF Downloads 290
1168 Approximation of Geodesics on Meshes with Implementation in Rhinoceros Software

Authors: Marian Sagat, Mariana Remesikova

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In civil engineering, there is a problem how to industrially produce tensile membrane structures that are non-developable surfaces. Nondevelopable surfaces can only be developed with a certain error and we want to minimize this error. To that goal, the non-developable surfaces are cut into plates along to the geodesic curves. We propose a numerical algorithm for finding approximations of open geodesics on meshes and surfaces based on geodesic curvature flow. For practical reasons, it is important to automatize the choice of the time step. We propose a method for automatic setting of the time step based on the diagonal dominance criterion for the matrix of the linear system obtained by discretization of our partial differential equation model. Practical experiments show reliability of this method. Because approximation of the model is made by numerical method based on classic derivatives, it is necessary to solve obstacles which occur for meshes with sharp corners. We solve this problem for big family of meshes with sharp corners via special rotations which can be seen as partial unfolding of the mesh. In practical applications, it is required that the approximation of geodesic has its vertices only on the edges of the mesh. This problem is solved by a specially designed pointing tracking algorithm. We also partially solve the problem of finding geodesics on meshes with holes. We implemented the whole algorithm in Rhinoceros (commercial 3D computer graphics and computer-aided design software ). It is done by using C# language as C# assembly library for Grasshopper, which is plugin in Rhinoceros.

Keywords: geodesic, geodesic curvature flow, mesh, Rhinoceros software

Procedia PDF Downloads 133
1167 Under the 'Umbrella' Project: A Volunteer-Mentoring Approach for Socially Disadvantaged University Students

Authors: Evridiki Zachopoulou, Vasilis Grammatikopoulos, Michail Vitoulis, Athanasios Gregoriadis

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In the last ten years, the recent economic crisis in Greece has decreased the financial ability and strength of several families when it comes to supporting their children’s studies. As a result, the number of students who are significantly delaying or even dropping out of their university studies is constantly increasing. The students who are at greater risk for academic failure are those who are facing various problems and social disadvantages, like health problems, special needs, family poverty or unemployment, single-parent students, immigrant students, etc. The ‘Umbrella’ project is a volunteer-based initiative to tackle this problem at International Hellenic University. The main purpose of the project is to provide support to disadvantaged students at a socio-emotional, academic, and practical level in order to help them complete their undergraduate studies. More specifically, the ‘Umbrella’ project has the following goals: (a) to develop a consulting-supporting network based on volunteering senior students, called ‘i-mentors’. (b) to train the volunteering i-mentors and create a systematic and consistent support procedure for students at-risk, (c), to develop a service that, parallel to the i-mentor network will be ensuring opportunities for at-risk students to find a job, (d) to support students who are coping with accessibility difficulties, (e) to secure the sustainability of the ‘Umbrella’ project after the completion of the funding of the project. The innovation of the Umbrella project is in its holistic-person-centered approach that will be providing individualized support -via the i-mentors network- to any disadvantaged student that will come ‘under the Umbrella.’

Keywords: peer mentoring, student support, socially disadvantaged students, volunteerism in higher education

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1166 Innovative Practices That Have Significantly Scaled up Depot Medroxy Progesterone Acetate-SC Self-Inject Services

Authors: Oluwaseun Adeleke, Samuel O. Ikani, Fidelis Edet, Anthony Nwala, Mopelola Raji, Simeon Christian Chukwu

Abstract:

Background The Delivering Innovations in Selfcare (DISC) project promotes universal access to quality selfcare services beginning with subcutaneous depot medroxy progesterone acetate (DMPA-SC) contraceptive self-injection (SI) option. Self-inject (SI) offers women a highly effective and convenient option that saves them frequent trips to providers. Its increased use has the potential to improve the efficiency of an overstretched healthcare system by reducing provider workloads. State Social and Behavioral Change Communications (SBCC) Officers lead project demand creation and service delivery innovations that have resulted in significant increases in SI uptake among women who opt for injectables. Strategies Service Delivery Innovations The implementation of the "Moment of Truth (MoT)" innovation helped providers overcome biases and address client fear and reluctance to self-inject. Bi-annual program audits and supportive mentoring visits helped providers retain their competence and motivation. Proper documentation, tracking, and replenishment of commodities were ensured through effective engagement with State Logistics Units. The project supported existing state monitoring and evaluation structures to effectively record and report subcutaneous depot medroxy progesterone acetate (DMPA-SC) service utilization. Demand creation Innovations SBCC Officers provide oversight, routinely evaluate performance, trains, and provides feedback for the demand creation activities implemented by community mobilizers (CMs). The scope and intensity of training given to CMs affect the outcome of their work. The project operates a demand creation model that uses a schedule to inform the conduct of interpersonal and group events. Health education sessions are specifically designed to counter misinformation, address questions and concerns, and educate target audience in an informed choice context. The project mapped facilities and their catchment areas and enlisted the support of identified influencers and gatekeepers to enlist their buy-in prior to entry. Each mobilization event began with pre-mobilization sensitization activities, particularly targeting male groups. Context-specific interventions were informed by the religious, traditional, and cultural peculiarities of target communities. Mobilizers also support clients to engage with and navigate online digital Family Planning (FP) online portals such as DiscoverYourPower website, Facebook page, digital companion (chat bot), interactive voice response (IVR), radio and television (TV) messaging. This improves compliance and provides linkages to nearby facilities. Results The project recorded 136,950 self-injection (SI) visits and a self-injection (SI) proportion rate that increased from 13 percent before the implementation of interventions in 2021 to 62 percent currently. The project cost-effectively demonstrated catalytic impact by leveraging state and partner resources, institutional platforms, and geographic scope to scale up interventions. The project also cost effectively demonstrated catalytic impact by leveraging on the state and partner resources, institutional platforms, and geographic scope to sustainably scale-up these strategies. Conclusion Using evidence-informed iterations of service delivery and demand creation models have been useful to significantly drive self-injection (SI) uptake. It will be useful to consider this implementation model during program design. Contemplation should also be given to systematic and strategic execution of strategies to optimize impact.

Keywords: family planning, contraception, DMPA-SC, self-care, self-injection, innovation, service delivery, demand creation.

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1165 The Specificity of Mother's Attitude to a Preschool Child Having Complex Disorders: The Key to Adaptive Functioning

Authors: Alla Tvardovskaya

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The family of a child with disabilities is an important mechanism of socialization. The relationship of mother and child with developmental difficulties is a significant predictor of the emergence, development and interiorization of various forms of mental activity. Complex impairments of the child form nonconstructive maternal attitude and destructive behavior strategies that complicate the dyadic relationship ‘mother-child’. The study of psychological characteristics of mother's personality was conducted within four years, and adaptive abilities of a child with a complex disorder were evaluated as well. 25 diads (25 mothers and 25 preschool children aged between 4-7 years with complex developmental disorders) took part in the study. Typological features of mothers rearing deafblind preschoolers are described. Constructive and non-constructive types of mothers’ attitude to a pre-school child with complex disorders are specified. The research shows that mothers of deafblind children are more depressed, they are engaged in children’s rearing more, and at the same time they experience difficulties to control negative emotions towards children or demonstrate impulsive behavior with a high level of anxiety. The correlation analysis of relationships between Vineland scales and the dominant type of mothers’ attitude to a child shows the presence of both general and specific links. Adaptive profile analysis of a child with complex disabilities allows to plan specific ways to increase their adaptation by developing a dyadic constructive relationship system. Techniques to develop constructive parental attitudes toward the child are proposed.

Keywords: adaptive behavior, complex disorder, constructive maternal attitude, deaf-blindness, pre-school child

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1164 Extraction and Characterization of Ethiopian Hibiscus macranthus Bast Fiber

Authors: Solomon Tilahun Desisa, Muktar Seid Hussen

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Hibiscus macranthus is one of family Malvaceae and genus Hibiscus plant which grows mainly in western part of Ethiopia. Hibiscus macranthus is the most adaptable and abundant plant in the nation, which are used as an ornamental plant often a hedge or fence plant, and used as a firewood after harvesting the stem together with the bark, and used also as a fiber for trying different kinds of things by forming the rope. However, Hibiscus macranthus plant fibre has not been commercially exploited and extracted properly. This study of work describes the possibility of mechanical and retting methods of Hibiscus macranthus fibre extraction and characterization. Hibiscus macranthus fibre is a bast fibre which obtained naturally from the stem or stalks of the dicotyledonous plant since it is a natural cellulose plant fiber. And the fibre characterized by studying its physical and chemical properties. The physical characteristics were investigated as follows, including the length of 100-190mm, fineness of 1.0-1.2Tex, diameter under X100 microscopic view 16-21 microns, the moisture content of 12.46% and dry tenacity of 48-57cN/Tex along with breaking extension of 0.9-1.6%. Hibiscus macranthus fiber productivity was observed that 12-18% of the stem out of which more than 65% is primary long fibers. The fiber separation methods prove to decrease of non-cellulose ingredients in the order of mechanical, water and chemical methods. The color measurement also shows the raw Hibiscus macranthus fiber has a natural golden color according to YID1925 and paler look under both retting methods than mechanical separation. Finally, it is suggested that Hibiscus macranthus fibre can be used for manufacturing of natural and organic crop and coffee packages as well as super absorbent, fine and high tenacity textile products.

Keywords: Hibiscus macranthus, bast fiber, extraction, characterization

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1163 Analyzing the Usage of Social Media: A Study on Elderly in Malaysia

Authors: Chan Eang Teng, Tang Mui Joo

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In the beginning of the prevalence of social media, it would be an obvious trend that the young adult age group has the highest population among the users on social media. However, apart from the age group of the users are becoming younger and younger, the elderly group has become a new force on social media, and this age group has increased rapidly. On top of that, the influence of social media towards the elderly is becoming more significant and it is even trending among them. This is because basic computer knowledge is not instilled into their life when they were young. This age group tends to be engrossed more than the young as this is something new for them, and they have the mindset that it is a new platform to approach things, and they tend to be more engrossed when they start getting in touch with the social media. Generally, most of the social media has been accepted and accessed by teenagers and young adult, but it is reasonable to believe that the social media is not really accepted among the elderly. Surprisingly, the elderlies are more addicted to the social media than the teenagers. Therefore, this study is to determine and understand the relationship between the elderly and social media, and how they employ social media in their lives. An online survey on 200 elderly aged 45-80 and an interview with a media expert are conducted to answer the main questions in the research paper. Uses and Gratification Approach is employed in theoretical framework. Finding revealed that majority of the respondents use social media to connect with family, friends, and for leisure purposes. The finding concluded that the elderly use social media differently according to their needs and wants which is in par with the highlight of Uses and Gratification theory. Considering the significantly large role social media plays in our culture and daily life today, the finding will shed some light on the effect of social media on the elderly or senior citizens who are usually relegated into a minority group in today’s age where the internet and social media are of great importance to our society and humanity in general. This may also serve to be useful in understanding behavioral patterns and preference in terms of social media usage among the elderly.

Keywords: elderly, Facebook, Malaysia, social media

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1162 Patient Care Needs Assessment: An Evidence-Based Process to Inform Quality Care and Decision Making

Authors: Wynne De Jong, Robert Miller, Ross Riggs

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Beyond the number of nurses providing care for patients, having nurses with the right skills, experience and education is essential to ensure the best possible outcomes for patients. Research studies continue to link nurse staffing and skill mix with nurse-sensitive patient outcomes; numerous studies clearly show that superior patient outcomes are associated with higher levels of regulated staff. Due to the limited number of tools and processes available to assist nurse leaders with staffing models of care, nurse leaders are constantly faced with the ongoing challenge to ensure their staffing models of care best suit their patient population. In 2009, several hospitals in Ontario, Canada participated in a research study to develop and evaluate an RN/RPN utilization toolkit. The purpose of this study was to develop and evaluate a toolkit for Registered Nurses/Registered Practical Nurses Staff mix decision-making based on the College of Nurses of Ontario, Canada practice standards for the utilization of RNs and RPNs. This paper will highlight how an organization has further developed the Patient Care Needs Assessment (PCNA) questionnaire, a major component of the toolkit. Moreover, it will demonstrate how it has utilized the information from PCNA to clearly identify patient and family care needs, thus providing evidence-based results to assist leaders with matching the best staffing skill mix to their patients.

Keywords: nurse staffing models of care, skill mix, nursing health human resources, patient safety

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1161 Characteristic and Prevalence of Cleft Lip and Palate Patient in Bandung Cleft Lip and Palate Center: A Descriptive Study

Authors: Kusmayadi Ita Nursita, Sundoro Ali

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Cleft lip and palate are one of the most common congenital abnormalities in the face. It could happen to anyone, but mostly affect Asian population including Indonesia. Factors that influence the occurrence of cleft lip and palate vary from genetic to environmental factors. Children with cleft lip and palate will often have various problems such as airway disorders, eating disorders, speech and language developmental disorders, hearing disorders and psycho-social disorders, one of which is caused by appearance disorders. During his life, the child will experience multidisciplinary surgery and non-surgical treatment and can be accompanied by a psychological and financial burden on himself and his family. In Indonesia, there are no detailed scientific data on the prevalence and characteristic of cleft lip and palate patients. It was mainly caused by the absence of a national level organization, differences in geographical location, and the absence of national guidelines. This study aimed to describe the characteristic and prevalence of cleft lip and palate patients in Bandung Cleft Lip and Palate Center from 1 January 2016 to 31 December 2017. A total of 560 patients were included in the study. The highest percentage of cases are left unilateral cleft lip and palate with higher number of female patient and labioplasty as the most often surgical procedure to be conducted in Bandung Cleft Lip and Palate Center. In order to improve quality of life in patients with cleft lip and palate, early recognition and early treatment based on actual comprehensive data should be conducted. The data from Bandung Cleft Lip and Palate Center as one of the largest center of cleft lip and palate in West Java Indonesia hopefully could provide a big step of further comprehensive data collection in Indonesia and for the better overall management of cleft lip and palate in the future.

Keywords: cleft lip, cleft palate, characteristic, prevalence

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1160 Novel Recombinant Betasatellite Associated with Vein Thickening Symptoms on Okra Plants in Saudi Arabia

Authors: Adel M. Zakri, Mohammed A. Al-Saleh, Judith. K. Brown, Ali M. Idris

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Betasatellites are small circular single stranded DNA molecules found associated with begomoviruses on field symptomatic plants. Their genome size is about half that of the helper begomovirus, ranging between 1.3 and 1.4 kb. The helper begomoviruses are usually members of the family Geminiviridae. Okra leaves showing vein thickening were collected from okra plants growing in Jazan, Saudi Arabia. Total DNA was extracted from leaves and used as a template to amplify circular DNA using rolling circle amplification (RCA) technology. Products were digested with PstI to linearize the helper viral genome(s), and associated DNA satellite(s), yielding a 2.8kbp and 1.4kbp fragment, respectively. The linearized fragments were cloned into the pGEM-5Zf (+) vector and subjected to DNA sequencing. The 2.8 kb fragment was identified as Cotton leaf curl Gezira virus genome, at 2780bp, an isolate closely related to strains reported previously from Saudi Arabia. A clone obtained from the 1.4 kb fragments he 1.4kb was blasted to GeneBank database found to be a betasatellite. The genome of betasatellite was 1357-bp in size. It was found to be a recombinant containing one fragment (877-bp) that shared 91% nt identity with Cotton leaf curl Gezira betasatellite [KM279620], and a smaller fragment [133--bp) that shared 86% nt identity with Tomato leaf curl Sudan virus [JX483708]. This satellite is thus a recombinant between a malvaceous-infecting satellite and a solanaceous-infecting begomovirus.

Keywords: begomovirus, betasatellites, cotton leaf curl Gezira virus, okra plants

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1159 The Influence of Culture on Manifestations of Animus

Authors: Anahit Khananyan

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The results of the long-term Jungian analysis with female clients from Eastern and Asian countries, which belong to collectivist cultures, are summarised in the article. The goal of the paper is to describe the cultural complex, which was found by the author in the analysis of women of collectivistic culture. It was named “the repression of Animus”. Generally, C.G.Jung himself and the Post-Jungians studied conditions caused by the possession by Animus. The conditions and cases of the repressed Animus, depending on the type of culture and cultural complexes, as we know, were not widely disseminated. C.G. Jung discovered and recognized the Animus as the second component of a pair of opposites of the psyche of women – femininity and Animus. In the way of individuation, an awareness of manifestations of Animus plays an important role: understanding the differences between negative and positive Animus as well as the Animus and the Shadow, then standing the tension of the presence of a pair of opposites - femininity and Animus, acceptance of the tension of them, finding the balance between them and reconciliation of this opposites. All of the above are steps towards the realization of the Animus, its release Animua, and the healing of the psyche. In the paper, the author will share her experience of analyzing the women of different collectivist cultures and her experience of recognizing the repressed Animus during the analysis. Also, she will describe some peculiarities of upbringing and cultural traditions, which reflected the cultural complex of repression of Animus. This complex is manifested in the traditions of girls' upbringing in accordance with which an image of a woman with overly developed femininity and an absence or underdeveloped Animus is idealized and encouraged as well as an evaluating attitude towards females who have to correspond to this image and fulfill the role prescribed in this way in the family and society.

Keywords: analysis, cultural complex, animus, manifestation, culture

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1158 Depression and Associated Factors among Adolescent Females in Riyadh, Kingdom of Saudi Arabia: A Cross‑Sectional Study

Authors: Hafsa Raheel

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Background: Adolescents who suffer from depression early in life, have an increase in suicidal tendency, anxiety, conduct disorders, substance abuse, and continue to be depressed, later on in life. This study was conducted to identify the prevalence and correlates of depression among adolescent girls in Riyadh city in order to carry out early intervention. Methods: A cross‑sectional, school‑based survey was conducted among 1028 adolescent girls aged 15–19 years in secondary schools of Riyadh city. Riyadh was divided into clusters and within each cluster, both public and private schools were enrolled. From the selected schools students from grade 10–12 were surveyed. Survey was conducted using a structured questionnaire including the beck depression inventory‑II, and questions exploring the correlates of depression. Results: About 30% of participants were found to be depressed. Depression was more prevalent among female adolescents whose household income was inferior to 12,000 Saudi Riyal/month (odds ratio [OR] 2.17, confidence interval [CI] 0.97–6.84), did not have a good relationship with peers and family members (OR 4.63, CI 2.56–8.41), lived with single parent or alone (OR 1.77, CI 0.97–3.23), had been emotionally abused (OR 3.45, CI 2.56–8.41), and those who had been subjected to physical violence at least once (OR 3.34, CI 1.89–5.91). Conclusions: Strategies need to be developed to identify early signs and symptoms of depression among Saudi female adolescents. Training can be given to groups of students to help their peers, and also to the teachers to identify, and help students identify early signs of depression and provide them with better‑coping strategies to combat progression of depression and anxiety among such adolescents.

Keywords: adolescents, depression, Saudi Arabia, mental health

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1157 Effects of Boron Compounds in Rabbits Fed High Protein and Energy Diet: A Metabolomic and Transcriptomic Approach

Authors: Nuri Başpınar, Abdullah Başoğlu, Özgür Özdemir, Çağlayan Özel, FundaTerzi, Özgür Yaman

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Current research is targeting new molecular mechanisms that underlie non-alcoholic fatty liver disease (NAFLD) and associated metabolic disorders like nonalcoholic steatohepatitis (NASH). Forty New Zealand White rabbits have been used and fed a high protein (HP) and energy diet based on grains and containing 11.76 MJ/kg. Boron added to 3 experimental groups’ drinking waters (30 mg boron/L) as boron compounds. Biochemical analysis including boron levels, and nuclear magnetic resonance (NMR) based metabolomics evaluation, and mRNA expression of peroxisome proliferator-activated receptor (PPAR) family were performed. LDL-cholesterol concentrations alone were decreased in all the experimental groups. Boron levels in serum and feces were increased. Content of acetate was in about 2x higher for anhydrous borax group, at least 3x higher for boric acid group. PPARα mRNA expression was significantly decreased in boric acid group. Anhydrous borax attenuated mRNA levels of PPARα, which was further suppressed by boric acid. Boron supplementation decreased the degenerative alterations in hepatocytes. Except borax group other boron groups did not have a pronounced change in tubular epithels of kidney. In conclusion, high protein and energy diet leads hepatocytes’ degenerative changes which can be prevented by boron supplementation. Boric acid seems to precede in this effectiveness.

Keywords: high protein and energy diet, boron, metabolomics, transcriptomic

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1156 Polycystic Ovary Syndrome - Clinical Profile of Women Attending NPFDB Subfertility Clinic

Authors: Komathy Thiagarajan, Mohd. Azizuddin Mohd. Yussof, Hasnoorina Husin, Noor Azreena Abd Aziz, Faezah Shekh Abdullah, Abdul Wahaf Abdul Wahid

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Polycystic Ovary Syndrome (PCOS) presents with a plethora of clinical features owing to the multifaceted underlying pathophysiology. This study was conducted to determine the clinical features unique to the sub fertile women attending the Sub fertility Clinic of the National Population and Family Development Board (NPFDB) so that a more holistic approach can be adopted to further enhance the pregnancy outcome in those women. This was a case-control study conducted over a span of three years (from January 2014 until December 2016), whereby women who fulfilled the Rotterdam Criteria 2004 were classified as PCOS (n=79) and women who did not fulfill the Rotterdam Criteria were classified as controls (n=88). The mean age of the women was 30.1 years and the mean duration of marriage was 3.93 years. The majority of women suffered from primary sub fertility (82.6%). The median age was lower among PCOS women (29.0 years) compared to the controls (30.0 years), p<0.05. The majority of PCOS women (43.0%) were obese (BMI > 30 kg/m2) compared to only 19.3% who were obese in the control group, p<0.05. Hypertension was present in 59.5% of PCOS women and only in 36.4% of the control group, p<0.05. There were significantly more women who presented with hirsutism in PCOS group (27.8%) as compared to the control group (5.7%), p<0.05. The findings of this study elucidate that the clinical features of significance among sub fertile women suffering from PCOS, if detected early, are amenable to lifestyle modifications and timely interventions can potentially improve the fertility outcomes in this group of women.

Keywords: clinical features, fertility, lifestyle modification, PCOS

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1155 The Proportion of and Factors Associated With Thyroid Dysfunction among Individuals Referred To A Tertiary Care Facility in Kabul, Afghanistan

Authors: Mohammad Naeem Lakanwall

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Background:The thyroid gland, located just below the vocal cord on each side of and anterior to the trachea, is one of the main endocrine glands. Its normal weight is 15 to 20 grams in adults. The thyroid secretes two most important hormones, thyroxine and triiodothyronine, usually called T4 and T3, respectively. These hormones greatly increase the metabolic rate of the body. In addition to T3 and T4, the thyroid gland secrets calcitonin as well which is a significant hormone for calcium metabolism. Objective: The aim of this study is to estimate the proportion of and to identify factors associated with thyroid dysfunction among individuals coming to a tertiary care facility in Kabul, Afghanistan. Material and Methods: An analytical cross-sectional study design was conducted from July to Sep 2018. Blood samples were obtained, serum TSH levels were measured, and the patients were divided into three diagnostic categories according to their serum TSH concentrations. 1) Hypothyroidism 2) Hyperthyroidism 3) Normal thyroid Results: A total of 127 individuals were part of the sample for the final analysis. The majority of study participants (77%) were females. A large number of the participants (92%) did not have a family history of thyroid dysfunction and the majority of the female participants, (85%) were not pregnant in the last two years. Furthermore, 98% of participants, were non-smokers. Conclusion: The findings of the current study showed a high prevalence of thyroid dysfunctions in individuals coming to FMIC for thyroid functions tests. The findings also indicated that aging and smoking are the factors associated with thyroid dysfunctions. Further studies are needed to find out the prevalence of and factors associated with thyroid dysfunctions.

Keywords: Afghanistan, Kabul, hypothyroidism, hyperthyroidism, triiodothyronine, thyroxine

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1154 Chemical Composition, in vitro Antioxidant Activity and Gas Chromatography–Mass Spectrometry Analysis of Essential Oil and Extracts of Ruta chalpensis aerial Parts Growing in Tunisian Sahara

Authors: Samir Falhi, Neji Gharsallah, Adel Kadri

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Ruta chalpensis L. is a medicinal plant in the family of Rutaceae, has been used as an important traditional in the Mediterranean basin in the treatment of many diseases. The current study was devoted to investigate and evaluate the chemical composition, total phenolic, flavonoid and tannin contents, and in vitro antioxidant activities of ethyl acetate, ethanol and hydroalcoholic extracts and essential oil from the aerial parts of Ruta chalpensis from Tunisian Sahara. Total phenolic, flavonoid and tannin contents of extracts ranged from 40.39 ± 1.87 to 75.13 ± 1.22 mg of GAE/g, from 22.62 ± 1.55 to 27.51 ± 1.04 mg of QE/g, and from 5.56 ± 1.32 to 10.89 ± 1.10 mg of CE/g respectively. Results showed that the highest antioxidant activities was determined for ethanol extract with IC50 value of 26.23 ± 0.91 µg/mL for 2,2-diphenyl-1-picrylhydrazyl assay, and for hydroalcoholic extract with EC50 value of 412.95±6.57 µg/mL and 105.52±2.45 mg of α-tocopherol/g for ferric reducing antioxidant power and total antioxidant capacity assays, respectively. Furthermore, Gas Chromatography–Mass Spectrometry (GC-MS) analysis of essential oil led to identification of 20 compounds representing 98.96 % of the total composition. The major components of essential oil were 2-undecanone (39.13%), 2-nonanone (25.04), 1-nonene (13.81), and α-limonene (7.72). Spectral data of Fourier-transform infrared spectroscopy analysis (FT-IR) of extracts revealed the presence of functional groups such as C= O, C─O, ─OH, and C─H, which confirmed its richness on polyphenols and biological active functional groups. These results showed that Ruta chalpensis could be a potential natural source of antioxidants that can be used in food and nutraceutical applications.

Keywords: antioxidant, FT-IR analysis, GC-MS analysis, phytochemicals contents, Ruta chalpensis

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1153 Empowering Women through the Fishermen of Functional Skills for City Gorontalo Indonesia

Authors: Abdul Rahmat

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Community-based education in the economic empowerment of the family is an attempt to accelerate human development index (HDI) Dumbo Kingdom District of Gorontalo economics (purchasing power) program developed in this activity is the manufacture of functional skills shredded fish, fish balls, fish nuggets, chips anchovies, and corn sticks fish. The target audience of this activity is fishing se mothers subdistrict Dumbo Kingdom include Talumolo Village, Village Botu, Kampung Bugis Village, Village North and Sub Leato South Leato that each village is represented by 20 participants so totaling 100 participants. Time activities beginning in October s/d November 2014 held once a week on every Saturday at 9.00 s/d 13:00/14:00. From the results of the learning process of testing the skills of functional skills of making shredded fish, fish balls, fish nuggets, chips anchovies, fish and corn sticks residents have additional knowledge and experience are: 1) Order the concept include: nutrient content, processing food with fish raw materials , variations in taste, packaging, pricing and marketing sales. 2) Products made: in accordance with the wishes of the residents learned that estimated Eligible selling, product packaging logo creation, preparation and realization of the establishment of Business Study Group (KBU) and pioneered the marketing network with restaurant, store / shop staple food vendors that are around CLC.

Keywords: community development, functional skills, gender, HDI

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1152 Reasons for Adhesion of Membership: A Case Study of Brazilian Soccer Team

Authors: Alexandre Olkoski, Marcelo Curth

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Football in Brazil is considered a passion, being the most popular sport in the country, both by the consumer public and by the means of communication that divulge it individually, when compared with other sports modalities. In the last two decades, the soccer teams have given greater importance to the management, since they understood that the same should be managed as a company, but with peculiarities related to the business. In this sense, Brazilian soccer clubs started to make bigger investments for the adhesion of fans in their social frames, allowing a greater need of understanding about the profile of this group of fans/clients. Thus, this work aims to understand the reasons that cause the fans to join the club and identify variables present in the process of intention to join the club. For that, a qualitative exploratory research was conducted, in which thirty-one membership of a soccer club from southern Brazil were interviewed. Based on the interviews, five categories were classified as emotional aspects (passion and love), cognitive aspects (easy access to the stadium and promotional values in tickets), external influences (family and friends), situational aspects (club moment) and aspects related to the event (engagement by modality). As results found in the analysis, it can be highlighted that the motivation of the majority of the respondents to become a member of the analyzed club, is related to the emotional aspects, such as passion and love. Thus, it is perceived that sport, in the case of soccer, generates in the involved ones (fans and leaders) different manifestations, suggesting that the management of this type of business has great complexity and should not be observed only by the spectrum of the club like a business.

Keywords: consumer behavior, marketing, membership, soccer

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1151 A Novel Method for Isolation of Kaempferol and Quercetin from Podophyllum Hexandrum Rhizome

Authors: S. B. Bhandare, K. S. Laddha

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Podphyllum hexandrum belonging to family berberidaceae has gained attention in phytochemical and pharmacological research as it shows excellent anticancer activity and has been used in treatment of skin diseases, sunburns and radioprotection. Chemically it contains lignans and flavonoids such as kaempferol, quercetin and their glycosides. Objective: To isolate and identify Kaempferol and Quercetin from Podophyllum rhizome. Method: The powdered rhizome of Podophyllum hexandrum was subjected to soxhlet extraction with methanol. This methanolic extract is used to obtain podophyllin. Podohyllin was extracted with ethyl acetate and this extract was then concentrated and subjected to column chromatography to obtain purified kaempferol and quercetin. Result: Isolated kaempferol, quercetin were light yellow and dark yellow in colour respectively. TLC of the isolated compounds was performed using chloroform: methanol (9:1) which showed single band on silica plate at Rf 0.6 and 0.4 for kaempferol and quercetin. UV spectrometric studies showed UV maxima (methanol) at 259, 360 nm and 260, 370 nm which are identical with standard kaempferol and quercetin respectively. Both IR spectra exhibited prominent absorption bands for free phenolic OH at 3277 and 3296.2 cm-1 and for conjugated C=O at 1597 and 1659.7 cm-1 respectively. The mass spectrum of kaempferol and quercetin showed (M+1) peak at m/z 287 and 303.09 respectively. 1H NMR analysis of both isolated compounds exhibited typical four-peak pattern of two doublets at δ 6.86 and δ 8.01 which was assigned to H-3’,5’ and H-2’,6’ respectively. Absence of signals less than δ 6.81 in the 1H NMR spectrum supported the aromatic nature of compound. Kaempferol and Quercetin showed 98.1% and 97% purity by HPLC at UV 370 nm. Conclusion: Easy and simple method for isolation of Kaempferol and Quercetin was developed and their structures were confirmed by UV, IR, NMR and mass studies. Method has shown good reproducibility, yield and purity.

Keywords: flavonoids, kaempferol, podophyllum rhizome, quercetin

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1150 The Study of Spray Drying Process for Skimmed Coconut Milk

Authors: Jaruwan Duangchuen, Siwalak Pathaveerat

Abstract:

Coconut (Cocos nucifera) belongs to the family Arecaceae. Coconut juice and meat are consumed as food and dessert in several regions of the world. Coconut juice contains low proteins, and arginine is the main amino acid content. Coconut meat is the endosperm of coconut that has nutritional value. It composes of carbohydrate, protein and fat. The objective of this study is utilization of by-products from the virgin coconut oil extraction process by using the skimmed coconut milk as a powder. The skimmed coconut milk was separated from the coconut milk in virgin coconut oil extraction process that consists approximately of protein 6.4%, carbohydrate 7.2%, dietary fiber 0.27 %, sugar 6.27%, fat 3.6 % and moisture content of 86.93%. This skimmed coconut milk can be made to powder for value - added product by using spray drying. The factors effect to the yield and properties of dry skimmed coconut milk in spraying process are inlet, outlet air temperature and the maltodextrin concentration. The percentage of maltodextrin content (15, 20%), outlet air temperature (80 ºC, 85 ºC, 90 ºC) and inlet air temperature (190 ºC, 200 ºC, 210 ºC) were conducted to the skimmed coconut milk spray drying process. The spray dryer was kept air flow rate (0.2698 m3 /s). The result that shown 2.22 -3.23% of moisture content, solubility, bulk density (0.4-0.67g/mL), solubility, wettability (4.04 -19.25 min) for solubility in the water, color, particle size were analyzed for the powder samples. The maximum yield (18.00%) of spray dried coconut milk powder was obtained at 210 °C of temperature, 80°C of outlet temperature and 20% maltodextrin for 27.27 second for drying time. For the amino analysis shown that the high amino acids are Glutamine (16.28%), Arginine (10.32%) and Glycerin (9.59%) by using HPLP method (UV detector).

Keywords: skimmed coconut milk, spray drying, virgin coconut oil process (VCO), maltodextrin

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1149 Galtung’s Violence Triangle: We Need to Be Thinking Upside Down

Authors: Michael Fusi Ligaliga

Abstract:

Peace and Conflict Studies (PACS), despite being a new pedagogical discipline, is a growing interdisciplinary academic field that has expanded its presence from the traditional lens of war, conflict, and violence to addressing various social issues impacting society. Family and domestic violence (FDV) has seldom been explored through the PACS lens despite some studies showing that “on average, nearly 20 people per minute are physically abused by an intimate partner in the United States. Over one year, this equates to more than 10 million women and men.” In the Pacific, FDV rates are some of the highest in the world. The friction caused by cultural practices reinforcing patriarchy and male impunity, compounded by historical colonial experiences, as well as the impact of Christianity on the Pacific region, creates a complex social landscape when thinking about and addressing FDV in the Pacific. This paper seeks to re-examine Johan Galtung’s violence triangle (GVT) theory and its application to understanding FDV in the Pacific. Galtung argues that there are three forms of violence – direct, structural, and cultural. Direct violence (DV) is behaviors that threaten life itself or diminishes the ability of a person to meet his or her basic needs. This form of violence is visible because it is manifested in behaviors such as killing, maiming, sexual assault, etc. Structural violence (SV) exists when people do not get equal access to goods and services (health, education, justice) that enable them to reach their full potential. When ideologies embedded in cultural norms and practices are used to justify and advocate acts of violence by shifting the moral parameters from being wrong to right or acceptable, this, according to Galtung, is referred to as Cultural violence (CV).

Keywords: direct violence, cultural violence, structural violence, indigenous peacebuilding, samoa

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1148 Border Between the Violation of Dental Ethics and the Occurrence of Dental Malpractice

Authors: Saimir Heta, Rialda Xhizdari, Kers Kapaj, Ilma Robo

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Background: The interests of both individuals involved, both the dentist with his professionalism, and the patient who claims and expects the proper professional dental service, are determined in cases of dental malpractice. The latter is a phenomenon that is also wearing the "cloak" of bilateral manipulations, which in themselves require strong legal control to regulate the relations between the involved parties. The two individuals are involved both individually and even professionally and emotionally, with support in the "ultimate" interests of the two people, which in the case of conflicts or grievances, which as a result are transported to the family or society of the affected individual. Main text: The reason for malpractice is the most difficult part to find and then to interpret. It can be professional in the view of "so much I know how to do, so much done", or in the view of the impossibility of individual health conditions to achieve high professional expectations. But, the reason can also be individual with the intention of doing bad without reason or with the source of an unhealthy mind and the source of malicious thinking. The professional himself is a human being and as such may be under the effect of individual treatments or vices, therefore causing misuse, a case that must be distinguished from intentional misuse and which must be judged for the results or damages caused by the professional based on criminal law. Conclusions: Malpractice in some cases may be unavoidable, beyond the good intention of the dental intervention, which should be well understood by both parties involved in this relationship. Malpractice is not necessarily related only to difficult clinical cases, but sometimes also appears as a random deviation of a dental treatment with a welldefined professional protocol. The legal support in the interpretation of malpractice cases should be much more specific according to previous cases, this practice specifically, perhaps also according to different religious states.

Keywords: dental ethics, malpractice, professional dental service, legal support

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1147 Effects of Achillea millefolium L. Extract on Rat Spermatogenesis

Authors: Nasrin Takzaree, Gholamreza Hassanzadeh, Abbas Hadjiakhoondi, Mohammadreza Rouini

Abstract:

Introduction: Today herbal medicine are extensively used for various therapeutic reasons. Whereas Achillea millefolium L. comprises different chemical compounds it is used in classic and modern medicine for different purposes. Concerning the family planning as a principle matter, the idea of using specific herbal medicine is of great importance. Purpose: To investigate the effects of Achillea millefolium L. extract on fertility power and spermatogenesis process in male mature Wistar rats and the anti-fertility effects of this extract in male genital system. Material and methods: In this study 32 male mature Wistar rats were randomly divided in to 4 experimental groups. 1st experimental group included 8 rats receiving Achillea millefolium extract at the dose of 200 mg/kg intraperitoneally. Second and third groups received the extract the same at the doses of 400 and 800 mg/kg respectively. 4th group was considered as control group in which the parenteral distilled water was administered. after 20 days, rats were sacrificed and the spermatogenesis process was histologically examined. Results: In experimental groups receiving high doses of extract comparing with control group, thickness in seminiferous tubules basal membrane, decrease in germinal epithelium cells, congestion in testicular tissue, disarrangement in germinal epithelium cells as well as decrease in cellular condense were observed (p<0.001). Conclusion: Findings suggest that alcoholic extract of Achillea millefolium at high concentrations lead to the structural alterations and changes in spermatogenesis in testicular tissue.

Keywords: spermatogenesis, alcoholic extract of Achillea millefolium L., testis, Wistar rat

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1146 Feeding Habitat of Parrot (Ringed Necked Parakeet) in District Mirpurkhas Sindh Pakistan

Authors: Aisha Liaquat Ali, Ghulam Sarwar Gachal, Muhammad Yusuf Sheikh

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The parrot (Rose Ringed) commonly known as tota, belongs to the order ‘psiitaciformes’ and family ‘Psittacidea’, Four species of parakeet inhabits tropical and subtropical regions of Pakistan mostly adopted parks in cities deciduous woodlands, light secondary jungles, semidesert, and scrubland and in orchards and cultivated farmlands. They are mostly feed on citrus fruits, guava, mango, green unripen seed and almond nuts as well as bud and flowers etc. the core aim of the present study was to investigate the Feeding Habitat of Parrot (Ringed Necked Parakeet) in District Mirpurkhas Sindh Pakistan. Sampling was obtained from various adjoining areas of District Mirpurkhas by Non-Random Method, which was conducted from June to Nov 2017. During the present study, a total no: of 84 specimens were collected from different localities of City Mirpurkhas (42.8%) were male ♂ and (57.1%) were female ♀. Maximum population density of Psittaculla Krameri Borealis (50.0%) was collected from Guava (Psidium Guajava) Orchards, Mango (Mangifera Indica) orchard (41.6%), chekoo (Manilkara Zapota) orchard (5.9%) and the Minimum No: of Psittaculla krameri Borealis (2.3%) collected Date (Phoenix Dactylifera) orchard. It was observed that Psittaculla krameri Borealis were highly consumed Guava (Psidium Guajava) and the minimum consume food was Date (Phoenix Dactylifera).

Keywords: district Mirpur Khas Sindh Pakistan, feeding, habitat, parrot (ringed necked parakeet)

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1145 Antibacterial Activity of Methanol Extract of Punica Granatum Linn. (Punnicaceae) Fruit Peel Against Selected Bacterial Species

Authors: Afzan Mahmad, Santibuana Abd Rahman, Gouri Kumar Dash, Mohd. Syafiq Bin Abdullah

Abstract:

Antibacterial activity of the methanol extract of fruit peel of Punica granatum Linn (Family: Punicaceae) was evaluated against two Gram positive and two Gram negative bacteria. The Gram positive bacteria included Staphylococcus aureus, Streptococcus pneumoniae and the Gram negative organisms included Escherichia coli and Pseudomonas aeruginosa respectively. The culture media used for antibacterial assay was Mueller Hinton agar for the growth of S. aureus, E. coli, and P. aeruginosa. The media used for the growth of S. pneumoniae was Mueller Hinton blood agar. The antibacterial assay was performed through Disc diffusion technique. The methanol extract was tested at three different concentrations (50, 100 and 200 mg/ml). Standard antibiotic discs containing vancomycin (30 μg) for S. pneumoniae, penicillin (10 units) for S. aureus, ceftriaxone (30 μg) for E. coli and ciprofloxacin (5 μg) for P. aeruginosa were used for the activity comparison. The results of the study revealed that the extract possesses antibacterial activity against S. aureus, S. pneumoniae and P. aeruginosa at all tested concentrations. The maximum zone of inhibition of 19 mm of the extract at 200 mg/ml was observed against S. pneumoniae. However, no zone of inhibition was observed against E. coli at the tested concentrations of the extract. Based on the results obtained in this study, it may be concluded that the fruit peel of P. granatum possess broad spectrum of antibacterial activity against a number bacteria.

Keywords: Punica granatum Linn., methanol extract, antibacterial, zone of inhibition

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1144 Impact of a Home-Based Health Intervention on Older Adults at Risk of Chronic Diseases: A Study Protocol

Authors: Elaine Wong Yee-Sing

Abstract:

Older adults are at high risk of chronic health conditions in Singapore. A closer examination at all facets of their aging process has revealed that they may not be necessary aging well. This demands for an increasing healthcare services brought to their home environment due to limited mobility and in the interest of time management. The home environment is an ideal setting to implement self-directed health promoting activities at their convenience and enable family’s support and motivation. This research protocol aims to explore their healthcare concerns, and creation of age appropriate interventions targeted to improve their chronic disease biomarkers. Convenience sampling of 130 families residing in private housing within five major districts in Singapore will be selected to participate in the health intervention. Statistical Package for Social Science 25 will be used to examine the pre and post screening results of their lipid, glycaemia and anthropometric outcomes. Using focus interviews, data results will be translated and transcribed to investigate on enablers, barriers and improvement on these services. Both qualitative and quantitative research outcomes are crucial to examine the impact of these services for these older adults living in private housing as they are not exposed to government subsidized community health programs. It is hypothesized that provision of relevant yet engaging health programs at their homes may mitigate the rising burden of chronic health conditions and result in successful aging outcomes among older Singaporeans.

Keywords: chronic diseases, health program, older adults, residential homes

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1143 Detonalization of Punjabi: Towards a Loss of Linguistic Indigeneity

Authors: Sukhvinder Singh

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Punjabi language is related to the languages of New Indo-Aryan group that, in turn, is related to the branch of Indo-European language family. Punjabi language covers the areas of Western part (that is in Pakistan) and Eastern part (the Punjab state, Haryana, Delhi Himachal and J&K) and abroad (particularly Canada, USA, U.K. and Arab Emirates), where it is spoken widely. Besides India and Pakistan, Punjabi is the third language spoken in Canada after English, French having more than one hundred millions speakers worldwide. It is the fourth language spoken in Canada after English, French, and Chinese. It is also being taught as second language in most of the community school of British Columbia. The total number of Punjabi speakers is more than one hundred millions including India, Pakistan and abroad. Punjabi has a long tradition of linguistic tradition. A large number of scholars have studied Punjabi at different linguistic levels. Various studies are devoted to its special phonological characteristics, especially the tone, which has now started disappearing in favour of aspiration, a rare example of a language change in progress in its reversal direction. This process of language change in progress in reversal is dealt with in this paper a change towards a loss of linguistic indigeneity. The tone being a distinctive linguistic feature of Punjabi language is getting lost due to the increasing influence of Hindi and English particularly in the speech Urban Punjabi and Punjabi settled abroad. In this paper, an attempt has been made to discuss the sociolinguistics and sociology of Punjabi language and Punjab to trace the initiation and progression of this change towards a loss of Linguistic Indigeneity.

Keywords: language change in reversal, reaspiration, detonalization, new Indo-Aryan group

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1142 Cultural Analysis of Dowry System with Relation to Women Prestige in District Swabi

Authors: Ullah Aman

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The practice of giving dowry was meant to assist a newly-wed couple to start their life together with ease; however, now it has turned into a commercial transaction in which monetary considerations receive priority over the personal merits of the bride. The present study was designed to explore the causes and consequences of dowry system and to measure the association between dowry and women prestige in district Swabi. A sample size of 378 household (female) Respondents was randomly selected through proportional allocation method. The data was interpreted into frequency and percentages while to measure the relationship between Dowry system and Women Prestige, Chi-Square statistic was applied. Result indicated that majority of the 316(83.6%) respondents stated that Family members are in favor of high dowry because high dowry is today’s women need which is disclosed by 302(79.9%) of the sample size. In addition to this, most 320(84.7%) of the respondents has opined that low dowry leads to broken families in the society. Moreover, a strong association (p=0.000) was determined between high dowry and women prestige. Similarly, a strong significant relation was found (p=0.000) between women prestige and low dowry mortifying women prestige in our society. The study concluded that dowry, deeply rooted in the society is an immorality which must be strictly banned in the country. It is a herculean task to completely eliminate dowry system from the nation but slowly and gradually efforts are being made in this direction. Dowry is a sure cause of promoting intense conflicts between the families, quarrels and inculcates greed in the society. Government and the builders of the social fabric should strictly work on it, banning this system for each and every class in Pakistan. Moreover, for curbing this mal practice we must put effort to bring social awareness to the society are some of the recommendation.

Keywords: Dowry, women, prestige, causes,

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1141 Islamic Perspective on Autism Spectrum Disorder: Lived Experience of Muslim Families of Children with Autism Spectrum Disorder in a City in the UK

Authors: Hawa Khan

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Autism is a complex disorder related to abnormalities in the development of brain structure and neurological function and a new phenomenon which is epidemically on the increase. The Muslim community, with its profound commitment to the all-encompassing Islamic precedence, views all phenomena in the light of religious imperatives. How autism is understood and treated in these communities is key to successful inclusive services. Moreover, parents mentioned their Islamic faith as a coping mechanism for the challenges they faced while caring for their child. This study utilises interpretative phenomenology analysis as a methodology that seeks to interpret the meaning the participants make of their experiences, which extends descriptive analysis. Semi-structured interviews were conducted with 5 family units that included fathers, mothers, grandparents, and siblings. In the preliminary stage, this study found families give high importance of accessible Islamic education for their child and questioning the accountability of the child who might not be able to follow the Islamic way of life entirely or understand the concept of Allah. Moreover, the families expressed their beliefs in traditional and religious treatment as an effective way to treat and cure autism. This poses a major barrier between families seeking support and professionals providing services. Consequentially, it can also result in a low uptake of mainstream services from the Muslim community. Exploring the lived experiences of parents from the Muslim community and how ASD is conceptualised in this community could have implications for improved and effective home, community, and service collaboration.

Keywords: autism spectrum disorder, Islamic education, religious beliefs, mainstream services

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1140 Knowledge, Attitude and Practices Regarding Advance Directives among Resident Physicians in Vicente Sotto Memorial Medical Center

Authors: Marica Pidor-Quingco, Francis Cabatingan

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Background: One of the essential roles of a physician is to assess a patient’s worth and support them in making decisions regarding their future preferences when it comes to medical care. Advance Directives is a patient-centered approach which is liked to a better-quality treatment at the end of life. General Objective: To assess and describe the knowledge, attitudes and practices of resident physicians regarding advance directive among the resident physicians in Vicente Sotto Memorial Medical Study. Methods: An analytical cross-sectional study was conducted at Vicente Sotto Memorial Medical Center. There was a total of 129 respondents who gave their consent and was given survey questionnaire containing the demographic profile, knowledge, attitude and practices. Categorical variables were presented as frequency and percentage. Chi Square Test was used to determine the association of demographic profile with knowledge and attitude. Man-Whitney U test was utilized for the association of age with knowledge and attitude. Results: Out of 129 respondents, 36.59% were in favor towards self-determination and autonomy. Majority of the revealed an adequate knowledge and positive attitude regarding advance directives. Based on the results, there were no significant correlations between sociodemographic of the residents towards to knowledge and attitude. Over 66.7% of the respondents had used Advance Directives to their patients but 25% were not comfortable about it. Though most of the respondents was able to discuss AD with their patients, 7.0% of them are not willing to open the topic to the family. Conclusion: VSMMC is a tertiary hospital which also caters Hospice, Palliative and Supportive care to the patients. One of the services offered is initiating Advance Directives which may be a factor for a positive knowledge, attitude and practices towards this topic.

Keywords: advance directives, philippines, physicians, palliative

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