Search results for: difficulty score

Authors: Marilia Correa Parecis De Oliveira

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This research looks at the novel Miguel e os demônios (2009), by the contemporary Brazilian author Lourenço Mutarelli. In it, the presence of film language resources is remarkable, creating thus a kind of scripted writing. We intend to analyze the presence of film language in work under study, in which there is a mixture of the characteristics of the novel and screenplay genres, trying to explore which aesthetic and meaning effects of the ownership of a visual language for the creation of a literary text create in the novel. The objective of this research is to identify and analyze the formal and thematic aspects that characterize the hybridity of literature and film in the novel by Lourenço Mutarelli. The method employed comprises reading and production cataloging of theoretical and critical texts, literary and film theory, historical review about the author, and also the realization of an analytical and interpretative reading of novel. In Miguel e os demônios there is a range of formal and thematic elements of popular narrative genres such as the detective story and action film, with a predominance of verb forms in the present and NPs - features that tend to make present the narrated scenes, as in the cinema. The novel, in this sense, is located in an intermediate position between the literary text and the pre-film text, as though filled with proper elements of the language of film, you can not fit it categorically in the genre script, since it does not reduce the script because aspires to be read as a novel. Therefore, the difficulty of fitting the work in a single gender also refused to be extra-textual factors - such as your publication as novel - but, rather, by the binary classifications serve solely to imprison the work on a label, which impoverish not only reading the text, as also the possibility of recognizing literature as a constant dialogue space and interaction with other media. We can say, therefore, that frame the work Miguel e os demônios in one of the two genres (novel or screenplay) proves not enough, since the text is revealed a hybrid narrative, consisting in a kind of scripted writing. In this sense, it is like a text that is born in a society saturated by audiovisual in their daily lives in order to be consumed by readers who, in ascending scale, exchange books by visual narratives. However, the novel uses film's resources without giving up its constitution as literature; on the contrary, it enriches the visual and linguistically, dialoguing with the complex contemporary horizon marked by the cultural industry.

Keywords: Brazilian literature, cinema, Lourenço Mutarelli, screenplay

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Authors: Vladyslav Povoroznyuk, Anna Musiienko, Nataliia Zaverukha, Roksolana Povoroznyuk

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Along with the global aging of population, the number of people with somatic diseases is increasing, including such interrelated pathologies as obesity, osteoarthritis (OA) and osteoporosis (OP). The objective of the study is to examine the connection between body mass index (BMI), OA and bone mineral density (BMD) of lumbar spine, femoral neck and trabecular bone score (TBS) in postmenopausal women with OA. We have observed 359 postmenopausal women (50-89 years old) and divided them into four groups by age: 50-59 yrs, 60-69 yrs, 70-79 yrs and over 80 years old. In addition, according to the American College of Rheumatology (ACR) Clinical classification criteria for knee and hip OA, we divided them into 2 groups: group I – 117 females with symptomatic OA (including 89 patients with knee OA, 28 patients with hip OA) and group II –242 women with a normal functional activity of large joints. Analysis of data was performed taking into account their BMI, classified by World Health Organization (WHO). Diagnosis of obesity was established when BMI was above 30 kg/m². In woman with obesity, a symptomatic OA was detected in 44 postmenopausal women (41.1%), a normal functional activity of large joints - in 63 women (58.9%). However, in women with normal BMI – 73 women, who account for 29.0% of cases, a symptomatic OA was detected. According to a chi-squared (χ2) test, a significantly higher level of BMI was detected in postmenopausal women with OA (χ2 = 5.05, p = 0.02). Women with a symptomatic OA had a significantly higher BMD of lumbar spine compared with women who had a normal functional activity of large joints. No significant differences of BMD of femoral necks or TBS were detected in either the group with OA or with a normal functional activity of large joints.

Keywords: bone mineral density, body mass index, obesity, overweight, postmenopausal women, osteoarthritis

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Authors: Donald B. Enu, Clement O. Ukpor, Abigail E. Okon

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Unreliable scoring of students’ performance by lecturers short-chains students’ assessment in terms of underequipping the school authority with facts as intended by society through the curriculum hence, the learners, the school and the society are cheated because the usefulness of testing is defeated. This study, therefore, examined lecturers’ scoring objectivity of essay items in the Department of Social Science Education, University of Calabar, Nigeria. Specifically, it assessed lecturers’ perception of the relevance of scoring rubrics and its level of application. Data were collected from all the 36 lecturers in the Department (28 members and 8 non-members adjourned to the department), through a 20-item questionnaire and checklist instruments. A case-study design was adopted. Descriptive statistics of frequency counts, weighted means, standard deviations, and percentages were used to analyze data gathered. A mean score of 2.5 and or 60 percent and above formed the acceptance or significant level in decision taking. It was found that lecturers perceived the use of scoring rubrics as a relevant practice to ensure fairness and reliable treatment of examiners scripts particularly in marking essay items and that there is a moderately high level of adherence to the application of scoring rubrics. It was also observed that some criteria necessary for the scoring objectivity of essay items were not fully put in place in the department. It was recommended strongly that students’ identities be hidden while marking and that pre-determined marking scheme should be prepared centrally and strictly adhered to during marking and recording of scores. Conference marking should be enforced in the department.

Keywords: essay items, objective scoring, scorers reliability, scoring rubrics

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Authors: Victor V. Ribeiro, Thais C. Lopes, Rafael A. A. Monteiro

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The Albatroz, Baleia Jubarte, Coral Vivo, Golfinho Rotador and Tamar projects make up the Young Sea Network (YSN), part of the BIOMAR Network, which aims to integrate the environmental youths of the Brazilian coast. For this, three editions of the Young Sea Meeting (YSM) were performed. Seeking to stimulate belonging, self-knowledge, participation, autonomy and youth protagonism, the Albatroz Project hosted the III YSM, in Bertioga (SP), in April 2019 and aimed to collectively plan the meeting. Five pillars of Environmental Education were used: identity, community, dialogue, power to act and happiness, the OCA Method and the Young Educates Young; Young Chooses Young; and One Generation Learns from the Other principals. In December 2018, still in the II YSM, the participatory planning of the III YSM began. Two "representatives" of each group were voluntarily elected to facilitate joint decisions, propose, receive and communicate demands from their groups and coordinators. The Young Albatroz Collective (YAC) facilitated the organization process as a whole. The purpose of the meeting was collectively constructed, answering the following question: "What is the YSM for?". Only two of the five pairs of representatives responded. There was difficulty gathering the young people in each group, because it was the end of the year, with people traveling. Thus, due to the short planning time, the YAC built a pre-programming to be validated by the other groups, defining as the objective of the meeting the strengthening of youth protagonism within the YSN. In the planning process, the YAC held 20 meetings, with 60 hours of face-to-face work, in three months, and two technical visits to the headquarters of the III YSM. The participatory dynamics of consultation, when it occurred, required up to two weeks, evidencing the limits of participation. The project coordinations stated that they were not being included in the process by their young people. There is a need to work more to be able to aloud the participation, developing skills and understanding about its principles. This training must take place in an articulated way between the network, implying the important role of the five projects in jointly developing and implementing educator processes with this objective in a national dimension, but without forgetting the specificities of each young group. Finally, it is worth highlighting the great potential of the III YSM by stimulating the exercise of leading environmental youth in more than 50 young people from Brazilian coast, linked to the YSN, stimulating the learning and mobilization of young people in favor of coastal and marine conservation.

Keywords: Marine Conservation, Environmental Education, Youth, Participation, Planning

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Authors: Roshanak Farjad, Amirhossein Hosseini

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Fecal incontinence (FI) is a stressful condition for children and their parents that may affect the patient’s psychological well-being. Evaluating the patients’ psychological status may help physicians manage the disease effectively. This study aimed to assess the emotional and behavioral disturbances in children with FI who were referred to the pediatric gastroenterology clinic in Mofid Children’s Hospital from April 2021 to 2022. This cross-sectional study included children (over four years old) with chronic constipation and fecal incontinence. The diagnosis of chronic constipation and FI were made according to Rome-IV criteria. The Child Behavior Checklist (CBCL) evaluated patients’ emotional, behavioral, and social problems. One hundred one patients with a mean age of 7.96 years were enrolled in the study; 67.32% were males. According to CBCL, 12% (12 patients) indicated emotional and behavioral problems, with CBCL scores in the clinical or at-risk range. We detected anxious/depressed problems in five (4.95%), withdrawn/depressed problems in eight (7.92%), somatic complaints in seven (6.93%), social problems in eight (7.92%), thought problems in nine (8.91%), attention problems in seven (6.93%), rule-breaking behavior in two (1.98%), and aggressive behavior in nine (8.91%) patients. The risk of internalizing and externalizing disorders was reported in four (3.96%) and five (4.95%) patients. Also, eight (7.92%) and seven (6.93%) patients had clinical symptoms of internalizing and externalizing disorders, respectively. There was no significant relationship between patients’ age and gender with the CBCL scores in any subscales. However, there was a significant difference in the total score among the age groups (P = 0.04). The relatively high prevalence of emotional, behavioral, and social problems in our study corroborates the importance of psychological screening of children with FI during the treatment process.

Keywords: chronic constipation, child behavior checklist (CBCL), fecal incontinence, rome-IV criteria

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Authors: Sasalanka Chamara Karunanayaka Pathirannehelage, Sarah Connelly

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Background: Knowledge, attitudes, and practices (KAP) toward the preventive aspect of COVID-19 are crucial for effective control and prevention of the disease. Sociodemographic factors can associate with KAP. This study aims to investigate KAP towards the preventive aspect of COVID-19 and associate sociodemographic factors among university nursing students at the University of Sunderland, 2021, United Kingdom. Methods: A cross-sectional online survey was conducted among 63 university nursing students between the 1st of July and the 13th of August 2021. A previously used, validated, self-administered questionnaire was applied to assess nursing students' KAP levels. Cross tabulation and chi-square were used to identify the associated sociodemographic factors with KAP. Results: Good knowledge was shown by 98.4% of respondents. 84.1 % of respondents reported positive attitudes, while 90.5% of respondents reported good practices toward the preventive aspect of COVID-19. The knowledge score of the students was significantly associated (p = 0.03) with the ethnicity of the respondents. Students' attitudes were significantly associated (p<0.05) with students' sex, student status (home student, international student), and course type (undergraduate student, postgraduate student). Student's age, student status, and course type were significantly associated (p < 0.05) with practices toward the preventive aspect of COVID-19. Conclusion: The finding of the study suggested that the university nursing student at the University of Sunderland demonstrate good knowledge, positive attitude, and good practice level towards the preventive aspect of COVID-19. Associated factors like age, sex, student status, and course type should be considered for effective strategies against COVID-19 as well as for future outbreaks.

Keywords: knowledge, attitudes, practices, nursing students

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Authors: Elizabeth Grier, Meg Gemmill, Mary Martin, Leora Reiter, Herman Tang, Alexandra Donaldson, Isis Lunsky, Mia Wu

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Background: Individuals with Cerebral Palsy (CP) and/or IDD face numerous physical and mental health challenges, including difficulty accessing effective palliative care. The aim of this study is to assess the knowledge and comfort of healthcare providers in providing community-based palliative care for patients with Cerebral Palsy (CP) and severe to profound Intellectual and Developmental Disabilities (IDD). Methods: This study includes a mixed methods approach obtaining both quantitative and qualitative data. Quantitative data from palliative care practitioners was obtained through an online survey assessing comfort in symptom management, grief assessment, and goals of care discussion. This survey was distributed to physicians and allied health practitioners across Canada through the College of Family Physicians of Canada Member Interest Groups for Palliative Care and for IDD. Survey results guided the development of a semi-structured interview template, which was used to conduct a focus group on the same topic. Participants were four palliative care providers (3 physicians and one spiritual care practitioner). The focus group transcript is currently undergoing thematic analysis using NVivo 12 software. Results: 57 palliative care practitioners completed the survey. 87% of participants indicated they have provided palliative care services for persons with CP and/or IDD. Findings suggest practitioners are somewhat confident in identifying specific physical symptoms (dyspnea, pressure ulcers) but less confident in identifying physical/emotional pain, addressing grief, and prognosticating life expectancy in this population. 54% of responses indicated they had little/no training on palliating those with CP or IDD, and 45% somewhat or strongly disagree members of their profession can manage symptoms for this population. Focus group analysis is underway, and results will be available at the time of the poster presentation. Conclusion: Persons with CP and IDD are more likely to experience severe health inequities when accessing palliative care. Results of this study suggest further education is needed for palliative care professionals to address the barriers and challenges in providing palliative care to this patient population.

Keywords: palliative care, symptom management, health equity, community healthcare, intellectual and developmental disabilities

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Authors: Usman Tunde Saadu, Adedayo Adesokan, Raseed Adewale Hamsat

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This study examined the influence of procrastination on the academic achievement of students in tertiary institutions in Kwara State, Nigeria. Descriptive survey was adopted for this study and the total number of 300 respondents participated in the study. Stratified and simple random sampling techniques were used to select 3 institutions and 30 departments respectively. Systematic sampling technique was used to select 10 final year students in each department. Two instruments were used to obtain data from the respondents. Procrastination Assessment Scale adapted from Solomon and Rothblum (1984) and a proforma designed by researchers to obtain students CGPA in 2013/2014 academic session. The reliability score of 0.80 was obtained for the instrument using split half method. One research question and one hypothesis were postulated for this study. Percentage was employed to answer research question while research hypothesis was tested with t-test statistical analysis at 0.05 level of significant. The findings of this study revealed that most of final year students in tertiary institutions in Kwara State procrastinated because 82.3% engaged in procrastination while 17.7% did not procrastinate. Also, the study revealed that there was a significant difference between the academic achievement of tertiary institution students who procrastinate and those who did not procrastinate (cal. t-value =2.634 < critical t-value = 1.960). Students who did not engage in act of procrastinate achieved better academically than students who engage in procrastination. Based on the findings of this study, the following recommendations were made; procrastination as a concept, should be taught at the various institutions so that students will understand what the concept is all about. Guidance and counsellor and educational psychologists should be employed at various institutions to handle students who procrastinate so that appropriate methods will be recommended so solve the problem.

Keywords: academic, achievement, procrastination, institution

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Authors: Emmanuel Kamal Aziz Saba, Hussein Al-Moghazy Sultan

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The aim of this study was to evaluate clinically and electro physiologically the autonomic nervous system changes associated with rheumatoid arthritis (RA). The present study included 25 patients with RA [22 women (88%)] and 30 apparently healthy control subjects [27 women (90%)]. A thorough clinical examination was carried out. Disease activity and functional disability were assessed. Tests for assessment of autonomic functions include active and passive orthostatic stress tests, and sympathetic skin response (SSR). The presence of abnormality in 2 tests or more was a clue for the presence of autonomic neuropathy (AN). Sural sensory nerve conduction study and posterior tibial motor nerve conduction study were done. There was a statistically significant decrease in standing systolic and diastolic blood pressure (BP) components of the active orthostatic stress test and SSR amplitude as well as statistically significant prolongation of SSR latency of RA patients when compared to control. Three patients (12%) had clinical symptoms suggestive of AN; increased to 14 patients (56 %) when orthostatic stress tests and SSR were utilized. There were no statistically significant differences between patients with different disease activity score 28 with 4 variables grades of RA activity and SSR latency and amplitude. There were no statistically significant differences between patients with different Stanford Health Assessment Questionnaire Disability Index grades of RA functional disability and SSR latency and amplitude. In conclusion, autonomic neuropathy is a common extra-articular manifestation of RA affecting sympathetic and parasympathetic fibers.

Keywords: autonomic neuropathy, orthostatic stress test, rheumatoid arthritis, sympathetic skin response

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Authors: Ghada M. El-Kassas, Maged A. El Wakeel, Salwa R. El-Zayat

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Background: Environmental enteric dysfunction (EED) is asymptomatic villous atrophy of the small bowel that is prevalent in the developing world and is associated with altered intestinal function and integrity. Evidence has suggested that supplementary omega-3 might ameliorate this damage by reducing gastrointestinal inflammation and may also benefit cognitive development. Objective: We tested whether omega-3 supplementation improves intestinal integrity, growth, and cognitive function in stunted children predicted to have EED. Methodology: 100 Egyptian stunted children aged 1-5 years and 100 age and gender-matched normal children as controls. At the primary phase of the study, we assessed anthropometric measures and fecal markers such as myeloperoxidase (MPO), neopterin (NEO), and alpha-1-anti-trypsin (AAT) (as predictors of EED). Cognitive development was assessed (Bayley or Wechsler scores). Oral n-3 (omega-3) LC-PUFA at a dosage of 500 mg/d was supplemented to all cases and followed up for 6 months after which the 2ry phase of the study included the previous clinical, laboratory and cognitive assessment. Results: Fecal inflammatory markers were significantly higher in cases compared to controls. (MPO), (NEO) and (AAT) showed a significant decline in cases at the end of the 2ry phase (P < 0.001 for all). Omega-3 supplementation resulted also in a significant increase in mid-upper arm circumference (MUAC) (P < 0.01), weight for age z-score, and skinfold thicknesses (P< 0.05 for both). Cases showed significant improvement of cognitive function at phase 2 of the study. Conclusions: Omega-3 supplementation successfully improved intestinal inflammatory state related to EED. Also, some improvement of anthropometric and cognitive parameters showed obvious improvement with omega-3 supplementation.

Keywords: cognitive functions, EED, omega-3, stunting

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Authors: Masahiro Takimoto

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The present study explored how the metaphor awareness-raising approach affects the involvement of the right hemisphere in developing EFL learners’ knowledge regarding the different degrees of politeness embedded within different request expressions. The present study was motivated by theoretical considerations regarding the conceptual projection and the metaphorical idea of politeness is distance, as proposed; this study applied these considerations to develop Japanese learners’ knowledge regarding the different politeness degrees and to explore the connection between the metaphorical concept projection and right-hemisphere dominance. Japanese EFL learners do not know certain language strategies (e.g., English requests can be mitigated with biclausal downgraders, including the if-clause with past-tense modal verbs) and have difficulty adjusting the politeness degrees attached to request expressions according to situations. The present study used a pre/post-test design to reaffirm the efficacy of the cognitive technique and its connection to right-hemisphere involvement by mouth asymmetry technique. Mouth asymmetry measurement has been utilized because speech articulation, normally controlled mainly by one side of the brain, causes muscles on the opposite side of the mouth to move more during speech production. The present research did not administer the delayed post-test because it emphasized determining whether metaphor awareness-raising approaches for developing EFL learners’ pragmatic proficiency entailed right-hemisphere activation. Each test contained an acceptability judgment test (AJT) along with a speaking test in the post-test. The study results show that the metaphor awareness-raising group performed significantly better than the control group with regard to acceptability judgment and speaking tests post-test. These data revealed that the metaphor awareness-raising approach could promote L2 learning because it aided input enhancement and concept projection; through these aspects, the participants were able to comprehend an abstract concept: the degree of politeness in terms of the spatial concept of distance. Accordingly, the proximal-distal metaphor enabled the study participants to connect the newly spatio-visualized concept of distance to the different politeness degrees attached to different request expressions; furthermore, they could recall them with the left side of the mouth being wider than the right. This supported certain findings from previous studies that indicated the possible involvement of the brain's right hemisphere in metaphor processing.

Keywords: metaphor awareness-raising, right hemisphere, L2 politeness, mouth asymmetry

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Authors: Watcharapong Yaowarat, Thanee Kaewthummanukul, Waruntorn Jongrungrotsakul

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Noise-induced hearing loss, the most significant occupational and safety problem among the working population, can be effectively prevented through hearing protection devices (HPDs) use. This study aimed to examine whether the following factors, perceived benefits, perceived barriers, perceived self-efficacy, and interpersonal and situational influences about using hearing protection could predict HPD use among 132 qualified workers in production lines at Kaolin Mineral Dressing factories, Uttaradit and Lampang provinces. Data collection was undertaken from August to September 2020 according to the interview form developed by Yaruang et al. (2010), which was assured by a panel of experts and its reliability value was at an acceptable level. Data analysis was performed using logistic regression analysis. The results revealed that only the situational factor of using hearing protection could predict HPD use, which accounted for 21.80 percent of the total variance for HPD use. It was also found that the study sample who had a score for the situational factors on using hearing protection greater than or equal to the median was 4.16 times more likely to use HPDs than those who had lower median scores. (OR = 4.16, p < .05). The results, thus, indicate that organization policies addressing worker health along with enhancing a supportive environment for HPD use, in particular, the provision of various HPDs, are of great importance. Therefore, occupational health nurses and related health teams should enhance workers’ use of HPDs effectively through knowledge dissemination by adopting strategies appropriate to the workplace context leading to an achievement of worker health policy focusing on work safety.

Keywords: predicting factors, hearing protection device, factors predicting hearing protection device use, kaolin mineral dressing factories

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Authors: Khanh To Duc, Monica Chiogna, Gianfranco Adimari

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With three diagnostic categories, assessment of the performance of diagnostic tests is achieved by the analysis of the receiver operating characteristic (ROC) surface, which generalizes the ROC curve for binary diagnostic outcomes. The volume under the ROC surface (VUS) is a summary index usually employed for measuring the overall diagnostic accuracy. When the true disease status can be exactly assessed by means of a gold standard (GS) test, unbiased nonparametric estimators of the ROC surface and VUS are easily obtained. In practice, unfortunately, disease status verification via the GS test could be unavailable for all study subjects, due to the expensiveness or invasiveness of the GS test. Thus, often only a subset of patients undergoes disease verification. Statistical evaluations of diagnostic accuracy based only on data from subjects with verified disease status are typically biased. This bias is known as verification bias. Here, we consider the problem of correcting for verification bias when continuous diagnostic tests for three-class disease status are considered. We assume that selection for disease verification does not depend on disease status, given test results and other observed covariates, i.e., we assume that the true disease status, when missing, is missing at random. Under this assumption, we discuss several solutions for ROC surface analysis based on imputation and re-weighting methods. In particular, verification bias-corrected estimators of the ROC surface and of VUS are proposed, namely, full imputation, mean score imputation, inverse probability weighting and semiparametric efficient estimators. Consistency and asymptotic normality of the proposed estimators are established, and their finite sample behavior is investigated by means of Monte Carlo simulation studies. Two illustrations using real datasets are also given.

Keywords: imputation, missing at random, inverse probability weighting, ROC surface analysis

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Authors: S. B. Rathna Kumar, Pranjali A Ujwane, Panchanan Mohanty

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The present study aimed to develop a battery for assessing speech recognition performance by adults in Marathi. A total of four word lists were developed by considering word frequency, word familiarity, words in common use, and phonemic balance. Each word list consists of 25 words (15 monosyllabic words in CVC structure and 10 monosyllabic words in CVCV structure). Equivalence analysis and performance-intensity function testing was carried using the four word lists on a total of 150 native speakers of Marathi belonging to different regions of Maharashtra (Vidarbha, Marathwada, Khandesh and Northern Maharashtra, Pune, and Konkan). The subjects were further equally divided into five groups based on above mentioned regions. It was found that there was no significant difference (p > 0.05) in the speech recognition performance between groups for each word list and between word lists for each group. Hence, the four word lists developed were equally difficult for all the groups and can be used interchangeably. The performance-intensity (PI) function curve showed semi-linear function, and the groups’ mean slope of the linear portions of the curve indicated an average linear slope of 4.64%, 4.73%, 4.68%, and 4.85% increase in word recognition score per dB for list 1, list 2, list 3 and list 4 respectively. Although, there is no data available on speech recognition tests for adults in Marathi, most of the findings of the study are in line with the findings of research reports on other languages. The four word lists, thus developed, were found to have sufficient reliability and validity in assessing speech recognition performance by adults in Marathi.

Keywords: speech recognition performance, phonemic balance, equivalence analysis, performance-intensity function testing, reliability, validity

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Authors: Atefeh Abdollahi, Maryam Bahreini, Babak Choobi Anzali, Fatemeh Rasooli

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Introduction: Triage becomes the main part of organization of care in Emergency department (ED)s. It is used to describe the sorting of patients for treatment priority in ED. The accurate triage of injured patients has reduced fatalities and improved resource usage. Besides, the nurses’ knowledge and skill are important factors in triage decision-making. The ability to define an appropriate triage level and their need for intervention is crucial to guide to a safe and effective emergency care. Methods: This is a prospective cross-sectional study designed for emergency nurses working in four public university hospitals. Five triage workshops have been conducted every three months for emergency nurses based on a standard triage Emergency Severity Index (ESI) IV slide set - approved by Iranian Ministry of Health. Most influential items on triage performance were discussed through brainstorming in workshops which then, were peer reviewed by five emergency physicians and two head registered nurses expert panel. These factors that might distract nurse’ attention from proper decisions included patients’ past medical diseases, the natural tricks of triage and system failure. After permission had been taken, emergency nurses participated in the study and were given the structured questionnaire. Data were analysed by SPSS 21.0. Results: 92 emergency nurses enrolled in the study. 30 % of nurses reported the past history of chronic disease as the most influential confounding factor to ascertain triage level, other important factors were the history of prior admission, past history of myocardial infarction and heart failure to be 20, 17 and 11 %, respectively. Regarding the concept of difficulties in triage practice, 54.3 % reported that the discussion with patients and family members was difficult and 8.7 % declared that it is hard to stay in a single triage room whole day. Among the participants, 45.7 and 26.1 % evaluated the triage workshops as moderately and highly effective, respectively. 56.5 % reported overcrowding as the most important system-based difficulty. Nurses were mainly doubtful to differentiate between the triage levels 2 and 3 according to the ESI VI system. No significant correlation was found between the work record of nurses in triage and the uncertainty in determining the triage level and difficulties. Conclusion: The work record of nurses hardly seemed to be effective on the triage problems and issues. To correct the deficits, training workshops should be carried out, followed by continuous refresher training and supportive supervision.

Keywords: assessment, education, nurse, triage

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Authors: Paria Baharvand, Mohammad Reza Abbasi, Soha Namazi

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Introduction: Uremic pruritus (UP) is one of the major complaints in hemodialysis patients. The aim of this randomized clinical trial study was the evaluation of the anti-pruritus effect of Melatonin on hemodialysis patients with UP. Methods: This multi-centered double, blinded randomized clinical trial study was conducted on hemodialysis patients with UP that referred to the dialysis department of Imam Khomeini Hospital, Labbafinezhad Hospital and Ghiasi Hospital in Tehran, Iran, in 2018. Forty participants were enrolled and block randomization was performed by using a randomized list and divided into 2 groups of twenty patients. Evaluation of the 12-Item Pruritus Severity Scale (12-PSS), Visual analog scale (VAS), and Calculation of the affected body surface area for pruritus extent (BSA %) was performed every week. The Melatonin group received a 10 mg soft gel capsule, and the placebo group received a soft gel capsule placebo after dinner. For statistical analysis used by SPSS version 21(IRCT20180714040462N1). Results: 38 hemodialysis patients enrolled in this study. The mean age in the placebo group and in the Melatonin group was 55.88 ± 11.70 and 54.52 ± 13.00 years (p> 0.05). Also, 46% of all participants were female. Aspartate transaminase, alanine transaminase and C-reactive protein have significant differences between the two groups (p< 0.05). VAS score reduction in the two groups had a statistically significant (CI 95% = -1.71, P= 0.015(.The results of BSA% showed Melatonin had a significant effect on the decrease of the pruritus extent compared to placebo (CI 95% = -22.82, P= 0.001(. Conclusion: According to the results of this study and the preliminary effects of Melatonin on uremic pruritus, we suggest performing advanced clinical trials studies.

Keywords: Melatonin, Uremic Pruritus, hemodialysis, anti-pruritus

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Authors: Shu-Pin Huang, Pai-Chi Teng, Hao-Han Chang, Chia-Hsin Liu, Yung-Lun Lin, Shu-Chi Wang, Hsin-Chih Yeh, Chih-Pin Chuu, Jiun-Hung Geng, Li-Hsin Chang, Wei-Chung Cheng, Chia-Yang Li

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The emergence of immune checkpoint inhibitors (ICIs) targeting proteins like PD-1 and PD-L1 has changed the treatment paradigm of bladder cancer. However, not all patients benefit from ICIs, with some experiencing early death. There's a significant need for biomarkers associated with the PD-1 pathway in bladder cancer. Current biomarkers focus on tumor PD-L1 expression, but a more comprehensive understanding of PD-1-related biology is needed. Our study has developed a seven-gene risk score panel, employing a comprehensive bioinformatics strategy, which could serve as a potential prognostic and predictive biomarker for bladder cancer. This panel incorporates the FYN, GRAP2, TRIB3, MAP3K8, AKT3, CD274, and CD80 genes. Additionally, we examined the relationship between this panel and immune cell function, utilizing validated tools such as ESTIMATE, TIDE, and CIBERSORT. Our seven-genes panel has been found to be significantly associated with bladder cancer survival in two independent cohorts. The panel was also significantly correlated with tumor infiltration lymphocytes, immune scores, and tumor purity. These factors have been previously reported to have clinical implications on ICIs. The findings suggest the potential of a PD-1 pathway-based transcriptomic panel as a prognostic and predictive biomarker in bladder cancer, which could help optimize treatment strategies and improve patient outcomes.

Keywords: bladder cancer, programmed cell death protein 1, prognostic biomarker, immune checkpoint inhibitors, predictive biomarker

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Authors: K. P. Gogoi

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The current research study investigates the motivational pattern viz Power motivation among the tribal college students of Assam. The sample consisted of 240 college students (120 tribal and 120 non-tribal) ranging from 18-24 years, 60 males and 60 females for both tribal’s and non-tribal’s. Attempts were made to include all the prominent tribes of Assam viz. Thematic Apperception Test, Power motive Scale and a semi structured interview schedule were used to gather information about their family types, parental deprivation, parental relations, social and political belongingness. Mean, Standard Deviation, and t-test were the statistical measures adopted in this 2x2 factorial design study. In addition to this discriminant analysis has been worked out to strengthen the predictive validity of the obtained data. TAT scores reveal significant difference between the tribal’s and non-tribal on power motivation. However results obtained on gender difference indicates similar scores among both the cultures. Cross validation of the TAT results was done by using the power motive scale by T. S. Dapola which confirms the results on need for power through TAT scores. Power motivation has been studied in three directions i.e. coercion, inducement and restraint. An interesting finding is that on coercion tribal’s score high showing significant difference whereas in inducement or seduction the non-tribal’s scored high showing significant difference. On the other hand on restraint no difference exists between both cultures. Discriminant analysis has been worked out between the variables n-power, coercion, inducement and restraint. Results indicated that inducement or seduction (.502) is the dependent measure which has the most discriminating power between these two cultures.

Keywords: power motivation, tribal, social, political, predictive validity, cross validation, coercion, inducement, restraint

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Authors: Katalin Gocze, Gabriella Kiss, Zsuzsanna Gurdan, Krisztian Kvell, Attila Trabert

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Introduction: On a worldwide scale running has become an increasingly popular leisure time activity during the past decade. Since the participation rate of women has risen significantly the aim of our study was to analyze the mental status, sleeping habits and the prevalence of depression among female runners. Methods: Cross-sectional analysis included the use of validated and globally used surveys for the comprehensive evaluation of insomnia (AIS), depression (BDI), exercise dependence (EDS) and exercise addiction (EAI). Recreational and amateur female runners participating at half-marathon events in Hungary were asked to take part in our pilot study. Results: Participants mean age was 42.03±9.03 years. The prevalence of imsomnia was 18.87%. 60.34% has worries regarding their weight and 43.1% think that they have an actual weight problem. 77.6% stated that their body weight has an influence on their mood. 2.7% displayed borderline clinical depression, the prevalence of mild mood disorders was 10.81%. 17.2% had previously problems with disordered eating. Participants had a mean total EDS score of 46.94±15.55 and a mean total of 13.49±3.80 on EAI. Component scores were the highest for tolerance (a need for increased amounts of exercise to achieve the desired effect or a diminished effect occurs with continued use of the same amount of exercise). Conclusion: Even tough running can help improve mental health, tackle depression and overcome adversity, athletes are at risk of experiencing psychological difficulties which have an impact on their physical perfomance as well. Further research can help initiate targeted educational and screening programs to ensure that female athletes find a path to emotional well-being.

Keywords: depression, eating disorder, exercise addiction, exercise dependence, insomnia, running

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Authors: Ananya Ananya, Karthik Rao

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Accurate segmentation of knee cartilage in 3-D magnetic resonance (MR) images for quantitative assessment of volume is crucial for studying and diagnosing osteoarthritis (OA) of the knee, one of the major causes of disability in elderly people. Radiologists generally perform this task in slice-by-slice manner taking 15-20 minutes per 3D image, and lead to high inter and intra observer variability. Hence automatic methods for knee cartilage segmentation are desirable and are an active field of research. This paper presents design and experimental evaluation of 2D convolutional neural networks based fully automated methods for knee cartilage segmentation in 3D MRI. The architectures are validated based on 40 test images and 60 training images from SKI10 dataset. The proposed methods segment 2D slices one by one, which are then combined to give segmentation for whole 3D images. Proposed methods are modified versions of U-net and dilated convolutions, consisting of a single step that segments the given image to 5 labels: background, femoral cartilage, tibia cartilage, femoral bone and tibia bone; cartilages being the primary components of interest. U-net consists of a contracting path and an expanding path, to capture context and localization respectively. Dilated convolutions lead to an exponential expansion of receptive field with only a linear increase in a number of parameters. A combination of modified U-net and dilated convolutions has also been explored. These architectures segment one 3D image in 8 – 10 seconds giving average volumetric Dice Score Coefficients (DSC) of 0.950 - 0.962 for femoral cartilage and 0.951 - 0.966 for tibia cartilage, reference being the manual segmentation.

Keywords: convolutional neural networks, dilated convolutions, 3 dimensional, fully automated, knee cartilage, MRI, segmentation, U-net

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Authors: Harshit Mittal, Neeraj Garg

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Hand symbol recognition is a pivotal component in the domain of computer vision, with far-reaching applications spanning sign language interpretation, human-computer interaction, and accessibility. This research paper discusses the approach with the integration of the Canny Edge algorithm and convolutional neural network. The significance of this study lies in its potential to enhance communication and accessibility for individuals with hearing impairments or those engaged in gesture-based interactions with technology. In the experiment mentioned, the data is manually collected by the authors from the webcam using Python codes, to increase the dataset augmentation, is applied to original images, which makes the model more compatible and advanced. Further, the dataset of about 6000 coloured images distributed equally in 5 classes (i.e., 1, 2, 3, 4, 5) are pre-processed first to gray images and then by the Canny Edge algorithm with threshold 1 and 2 as 150 each. After successful data building, this data is trained on the Convolutional Neural Network model, giving accuracy: 0.97834, precision: 0.97841, recall: 0.9783, and F1 score: 0.97832. For user purposes, a block of codes is built in Python to enable a window for hand symbol recognition. This research, at its core, seeks to advance the field of computer vision by providing an advanced perspective on hand sign recognition. By leveraging the capabilities of the Canny Edge algorithm and convolutional neural network, this study contributes to the ongoing efforts to create more accurate, efficient, and accessible solutions for individuals with diverse communication needs.

Keywords: hand symbol recognition, computer vision, Canny edge algorithm, convolutional neural network

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Authors: Sedef Şahin, Meral Huri

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Cerebral Palsy (CP) represents the most frequent cause of physical disability in children with a rate of 2,9 per 1000 live births. The activity-focused intervention is known to improve function and reduce activity limitations and barriers to participation of children with disabilities. The aim of the study was to assess the effects of occupational therapy on level of fatigue, activity performance and satisfaction in children with Unilateral Cerebral Palsy. Twenty-two children with hemiparetic cerebral palsy (mean age: 9,3 ± 2.1years; Gross Motor Function Classification System ( GMFCS) level from I to V (I = 54%, II = 23%, III = 14%, IV= 9%, V= 0%), Manual Ability Classification System (MACS) level from I to V (I = 40%, II = 32%, III = 14%, IV= 10%, V= 4%), were assigned to occupational therapy program for 6 weeks.Visual Analogue Scale (VAS) was used for intensity of the fatigue they experienced at the time on a 10 point Likert scale (1-10).Activity performance and satisfaction were measured with Canadian Occupational Performance Measure (COPM).A client-centered occupational therapy intervention was designed according to results of COPM. The results were compared with nonparametric Wilcoxon test before and after the intervention. Thirteen of the children were right-handed, whereas nine of the children were left handed.Six weeks of intervention showed statistically significant differences in level of fatigue, compared to first assessment(p<0,05). The mean score of first and the second activity performance scores were 4.51 ± 1.70 and 7.35 ± 2.51 respectively. Statistically significant difference between performance scores were found (p<0.01). The mean scores of first and second activity satisfaction scores were of 2.30± 1.05 and 5.51 ± 2.26 respectively. Statistically significant difference between satisfaction assessments were found (p<0.01). Occupational therapy is an evidence-based approach and occupational therapy interventions implemented by therapists were clinically effective on severity of fatigue, activity performance and satisfaction if implemented individually during 6 weeks.

Keywords: activity performance, cerebral palsy, fatigue, occupational therapy

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Authors: Bindu S., Malavika Anakkathil Anil, Jayashree S. Bhat

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The dyadic interaction between the parent and child during story narration facilitates the emergence of early literacy skills. Early shared reading experiences positively predict better reading and language outcomes in children who experience rich communicative and effective interactions during shared book reading. However, research is yet to systematically explore mother’s perspective towards story narration and how employment may influence their perspectives. The study analysed the perspectives of employed and unemployed mothers of typically developing children between the age ranges of 2 to 5 years through a questionnaire which covered domains on story narration exposure and parental attitudes & beliefs. The results indicate no statistical difference between employed mothers (M=8.5, SD=3.4) and unemployed mothers (M=10.1, SD=1.06). Whereas, post-hoc comparisons using the scheffe test, revealed a significant difference in scores. An increasing score was obtained as the age of the child increased. This change could be attributed due to the integration of children in preschools which could have contributed to the change of perception towards story narration. Older children’s mother perceive story narration to be an important part of their curriculum, which could facilitate rich vocabulary and language output. Younger children’s parents are however not realising the significance of story narration and its impact on the emergent literacy skills. Parent-child interaction is a significant contributor to a healthy social and cultural development. The study emphasises on the need of mothers to engage in preliteracy based activities which contribute to better academic performance in later stages.

Keywords: early literacy skill, employment, language development, mother’s perspective, story narration

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Authors: Sultan Çağırıcı, Arsida Bajrami, Beyza Aslan, Hacı Ali Erdoğan, Nejla Sözer Topçular, Dilek Bozkurt, Vildan Yayla

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Objective: Corticobasal syndrome (CBS) is phenotypically characterized by asymmetric rigidity, apraxia, alien-limb phenomenon, cortical sensory loss, dystonia and myoclonus. The underlying pathologies consists of corticobasal degeneration (CBD), progressive supra nuclear palsy, Alzheimer's, Creutzfeldt-Jakob and frontotemporal degeneration. CBD is a degenerative disease with clinical symptoms related to the prominent involvement of cerebral cortex and basal ganglia. CBD is a pathological diagnosis and antemortem clinical diagnosis may change many times. In this paper, we described the clinical features and discussed a cases diagnosed with symmetric CBS because of its rarity. Case: Seventy-five-year-old woman presented with a three years history of difficulty in speaking and reading. Involuntary hand jerks and slowness of movement also had began in the last six months. In the neurological examination the patient was alert but not fully oriented. The speech was non-fluent, word finding difficulties were present. Bilateral limited upgaze, bradimimia, bilateral positive cogwheel' rigidity but prominent in the right side, postural tremor and negative myoclonus during action on the left side were detected. Receptive language was normal but expressive language and repetition were impaired. Acalculia, alexia, agraphia and apraxia were also present. CSF findings were unremarkable except for elevated protein level (75 mg/dL). MRI revealed bilateral symmetric cortical atrophy prominent in the frontoparietal region. PET showed hypometabolism in the left caudate nucleus. Conclusion: The increase of data related to neurodegenerative disorders associated with dementia, movement disorders and other findings results in an expanded range of diagnosis and transitions between clinical diagnosis. When considered the age of onset, clinical symptoms, imaging findings and prognosis of this patient, clinical diagnosis was CBS and pathologic diagnosis as probable CBD. Imaging of CBD usually consist of typical asymmetry between hemispheres. Still few cases with clinical appearance of CBD may show symmetrical cortical cerebral atrophy. It is presented this case who was diagnosed with CBD although we found symmetrical cortical cerebral atrophy in MRI.

Keywords: symmetric cortical atrophy, corticobasal degeneration, corticobasal syndrome

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Authors: Eriko Ochiai, Fumiko Satoh, Keiko Miyashita, Yu Kakimoto, Motoki Osawa

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Sudden and unexpected deaths from unknown causes occur in infants and youths. Recently, molecular links between a part of these deaths and several genetic diseases are examined in the postmortem. For instance, hereditary long QT syndrome and Burgada syndrome are occasionally fatal through critical ventricular tachyarrhythmia. There are a large number of target genes responsible for such diseases, the conventional analysis using the Sanger’s method has been laborious. In this report, we attempted to analyze sudden deaths comprehensively using the next generation sequencing (NGS) technique. Multiplex PCR to subject’s DNA was performed using Ion AmpliSeq Library Kits 2.0 and Ion AmpliSeq Inherited Disease Panel (Life Technologies). After the library was constructed by emulsion PCR, the amplicons were sequenced 500 flows on Ion Personal Genome Machine System (Life Technologies) according to the manufacture instruction. SNPs and indels were analyzed to the sequence reads that were mapped on hg19 of reference sequences. This project has been approved by the ethical committee of Tokai University School of Medicine. As a representative case, the molecular analysis to a 40 years old male who received a diagnosis of Brugada syndrome demonstrated a total of 584 SNPs or indels. Non-synonymous and frameshift nucleotide substitutions were selected in the coding region of heart disease related genes of ANK2, AKAP9, CACNA1C, DSC2, KCNQ1, MYLK, SCN1B, and STARD3. In particular, c.629T-C transition in exon 3 of the SCN1B gene, resulting in a leu210-to-pro (L210P) substitution is predicted “damaging” by the SIFT program. Because the mutation has not been reported, it was unclear if the substitution was pathogenic. Sudden death that failed in determining the cause of death constitutes one of the most important unsolved subjects in forensic pathology. The Ion AmpliSeq Inherited Disease Panel can amplify the exons of 328 genes at one time. We realized the difficulty in selection of the true source from a number of candidates, but postmortem genetic testing using NGS analysis deserves of a diagnostic to date. We now extend this analysis to SIDS suspected subjects and young sudden death victims.

Keywords: postmortem genetic testing, sudden death, SIDS, next generation sequencing

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Authors: Salihu Mohammed Umar

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Perceived physical exercise benefits among staff of tertiary institutions in Adamawa State was investigated as a basis for formulating proper exercise intervention strategies. The study utilized descriptive survey design. The purpose of the study was to determine perceived exercise benefits among staff of tertiary institutions in Adamawa state, Nigeria. The instrument used for data collection was a questionnaire adapted from Exercise Benefit/Barrier Scale (EBBS) developed by Sechrist, Walker and Pender (1985) which was validated by five experts. Three hundred and thirty (330) copies of the questionnaire were distributed among study participants in six institutions of higher learning in Adamawa state. The scale comprised two components; Benefits and Barriers dimensions. To achieve this purpose, three research questions were posed. The instrument had a four response forced-choice Likert-type format with responses ranging from 4 = strongly agree (SA), 3 = Agree (A), 2 = Disagree (D) and 1 = Strongly Disagree (SD). The findings of the study revealed that both male and female staff in institutions of higher learning in Adamawa state perceived exercise as highly beneficial. However, male staff had higher perceived benefits score than their female counterparts. (Male: x̄ = 95.02. SD = 3.08) > female: x̄ = 94.04, SD = 4.35. There was also no significant difference in perceived exercise barriers between staff and students of tertiary institutions in Adamawa state. Based on the finding of the study, it was concluded that staff of tertiary institutions perceived exercise as highly beneficial. It was recommended that since staff of institutions of higher learning in Adamawa State irrespective of gender and religious affiliations have basic knowledge of perceived benefits of exercise, there is the need to explore programmes that will enable staff across the sub-groups to overcome barriers that could discourage physical exercise participation.

Keywords: perception, physical exercise, staff, benefits

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Authors: Muhammad S. Sajid, Asim Shamim, Muhammad Nisar Khan, Ashfaq A. Chatta, Muhammad Saqib

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Goats (Capra hircus) are a valued asset for resource poor farmers globally. But the parasitic infection especially Haemonchus contortus (Trichostrongylid), impact the health and production of goats globally. The present study intended to evaluate resilient and resistance to Haemonchus contortus in indigenous goat breeds (Teddy and Beetal) of Punjab, Pakistan. Out of 60, 30 goats of each breed were divided into 6 groups and each group contain five goats. Two group of each breed received challenged infection with 12000 and 18000 L3 (third stage) larvae of Haemonchus contortus under two infection protocol that is early and trickle and remaining two group of each breed was kept as control. Resilient and resistance of each breed was then measured on the basis of their phenotypic markers like: faecal egg counts, packed cell volume, FAMACHA score system, body weight, total protein, albumin and worm count on 2nd, 4th, 6th, and 8th week of post infection. Variation in response of each goat breeds to Haemonchus contortus was observed. Teddy breed showed significant (P < 0.05)resistance as compared to Beetal. It is probably first attempt to report an evaluation of goat breed response towards Haemonchus contortus in Pakistan. It was concluded that Teddy goats have a greater genetic tendency to resist against to the Haemonchus contortus infection and this breed could be kept and bred from the economic point of view. Evaluation of genetic markers are like: gene, protein expression, Immunoglobulin, Histamines and interleukins determination are recommended for future studies which can be helpful to be fined resistant breed of goats.

Keywords: goat, beetal, teddy, haemonchus contortus, resistance, resilience, phenotypic markers

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Authors: Madison Meyer

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Dermatological conditions are one of the most viewed medical subjects on the social media platform TikTok, resulting in the rise of several prominent American board-certified dermatologists as influencers. Notably, dermatology is one of the least diverse specialties. This cross-sectional study aimed to assess individuals’ preferences related to race, gender, and sexual identity of doctors in terms of dermatology-related information on TikTok and which group posts more reliable information. This study qualitatively and quantitatively evaluated the racial, gender, and sexual diversity of the top 55 dermatologist influencers on TikTok based on their follower count. The DISCERN tool was used to determine the reliability of consumer health content based on a score ranging from 1-5. Among the top 55 dermatologist influencers, African American (54,241.60) and Latinx (6,696) groups had the lowest mean number of followers compared to Caucasian (1,046,298.50) and Asian (1,403,393.50) physicians. Latinx and African American dermatologists had the highest DISCERN scores of 2 and 1.9, respectively. None of the physicians identified as a different gender or as LGBTQIA+ in any racial category. There is a considerable lack of minority dermatologist influencers on TikTok, especially Latinx, African American, and LGBTQIA+ physicians. The lack of diversity in the dermatology specialty can lead to inequitable care and health outcomes for racial/ethnic, gender, and sexual minority patient populations. This study’s findings also suggest Latinx and African American dermatologists post more reliable content compared with their Caucasian and Asian counterparts.

Keywords: dermatology, social media, sexual and gender minorities, racial minorities, skin of color, tiktok

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Authors: Pi-Chi Wu, Tsui-Ping Chu, Hsiu-Hung Wang

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Background: The ability to provide immediate medical service in outpatient departments is one of the keys to patient satisfaction. Objectives: This project used electronic equipment to integrate nursing care information to patient care at a blood pressure diagnostic counter. Through process reengineering, the average patient waiting time decreased from 35 minutes to 5 minutes, while service satisfaction increased from a score of 2.7 to 4.6. Methods: Data was collected from a local hospital in Southern Taiwan from a daily average of 2,200 patients in the outpatient department. Previous waiting times were affected by (1) space limitations, (2) the need to help guide patient mobility, (3) the need for nurses to appease irate patients and give instructions, (4), the need for patients to replace lost counter tickets, (5) the need to re-enter information, (6) the replacement of missing patient information. An ad hoc group was established to enhance patient satisfaction and shorten waiting times for patients to see a doctor. A four step strategy consisting of (1) counter relocation, (2) queue reorganization, (3) electronic information integration, (4) process reengineering was implemented. Results: Implementation of the developed strategy decreased patient waiting time from 35 minutes to an average of 5 minutes, and increased patient satisfaction scores from 2.7 to 6.4. Conclusion: Through the integration of information technology and process transformation, waiting times were drastically reduced, patient satisfaction increased, and nurses were allowed more time to engage in more cost-effective services. This strategy was simultaneously enacted in separate hospitals throughout Taiwan.

Keywords: process reengineering, electronic information integration, patient satisfaction, patient waiting time

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Authors: Sadaf Saeed

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The consideration of walkability as an urban design parameter in conjunction with transit-oriented development is an established trend in the developed countries but an upcoming trend in developing countries. In Pakistan, the first Bus Rapid Transit (locally called as Metro Bus) has been introduced in the city of Lahore in 2013 where around 40 percent of the riders access to transit stations by walking. To what extent the aspect of walkability has been considered in the local scenario? To address this question, this paper presents an account of urban design parameters regarding pedestrian provisions and quality of walking environment between Metro Bus stations and users’ destination in the transit neighbourhoods (areas up to 500-meter radius). The primary and secondary data for objective and subjective walkability measurements has been used for neighbourhoods of five selected transit stations ranked against the predefined critical assessed factors (CAF). The multi-criteria approach including visual and geospatially-based parameters at street level, along with walkability index score at selected sites linked with CAF evaluation were the selected methods for this study. The acceptability of walkability as an urban design parameter for transit planning in terms of connectivity and social implications of the concept has also been analysed in the local context. The paper highlights that the aspect of walkability in Lahore is being derelict owing to the focus of government on other initiatives such as park and ride and feeder bus services for mobility of passengers. However, the pedestrian-friendly design parameters as a part of future transit planning can enhance social, liveable and interactive walking environment within transit neighbourhoods.

Keywords: walkability, sustainability, transit neighborhoods, social communities

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