Search results for: best evidence

Authors: Cecilia Amponsem-Boateng, Timothy Bonney Oppongx, Weidong Zhang, Jonathan Boakye Yiadom, Lianke Wang, Kwabena Acheampong, Godfrey Opolot

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In Ghana, the management of hypertension in primary health care is a cost-effective way of addressing premature deaths from vascular disorders that include hypertension. There is little or no evidence of large-scale studies on the prevalence, risk, and knowledge/awareness of hypertension in students aged 12–22 years in Ghana. In a cross-sectional study, blood pressure, anthropometric indices, and knowledge/awareness assessment of students at second-cycle schools were recorded from 2018 to 2020 in three regions of Ghana. Multistage cluster sampling was used in selecting regions and the schools. Prevalence of prehypertension and hypertension was categorized by the Joint National Committee 7, where appropriate, chi-square, scatter plots, and correlations were used in showing associations. A total of 3165 students comprising 1776 (56.1%) females and 1389 (43.9%) males participated in this study within three regions of Ghana. The minimum age was 12 years and the maximum age was 22 years. The mean age was 17.21 with standard deviation (SD: 1.59) years. A 95% confidence interval was set for estimations and a P value < 0.05 was set as significant. The prevalence rate of overall hypertension was 19.91% and elevated (prehypertension) was 26.07%. Risk indicators such as weight, BMI, waist circumference, physical activity, and form of the diet were positively correlated with hypertension. Among Ghanaian students currently in second-cycle educational institutions, 19.91% were hypertensive and 26.07% were prehypertensive. This may indicate a probable high prevalence of hypertension in the future adult population if measures are not taken to curb the associated risks.

Keywords: hypertension, second-cycle schools, Ghana, youth

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Authors: Claudia Cedeno Nadal, Mei-Ling Villafana, Griela Rodriguez, Jessica Martin, Jennifer Martin, Megan Patel

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This study systematically examines the impact of Transcendental Mindfulness Meditation on anxiety symptoms in young females aged 18-25. Through a comprehensive literature review, we found consistent evidence supporting the positive influence of Transcendental Mindfulness Meditation on reducing anxiety, enhancing overall well-being, and decreasing perceived stress levels within this demographic. The mechanisms underlying these effects include heightened self-awareness, improved emotional regulation, and the development of effective stress-coping strategies. These findings have significant implications for mental health interventions targeting young females. However, the reviewed studies had some limitations, such as small sample sizes and reliance on self-report measures. To advance this field, future research should focus on larger sample sizes and utilize a broader range of measurement methods, including neuroscience assessments. Additionally, investigating the temporal relationships between Transcendental Mindfulness Meditation, proposed mediators, and anxiety symptoms will help establish causal specificity and a deeper understanding of the precise mechanisms of action. The development of integrative models based on these mechanisms can further enhance the effectiveness of Transcendental Mindfulness Meditation as an intervention for anxiety in this demographic. This study contributes to the current knowledge on the potential benefits of Transcendental Mindfulness Meditation for reducing anxiety in young females, paving the way for more targeted and effective mental health interventions in this population.

Keywords: mindfulness, meditation, anxiety, transcendental mindfulness

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Authors: Matthew Fleet, Savannah Elliott

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Background: This study investigates the use of teaching and learning to meet the needs of deaf children in the UK PE curriculum. Research has illustrated that deaf students in mainstream schools do not receive sufficient support from teachers in lessons. This research examines the impact of different types of hearing loss and its implications within Physical Education (PE) in secondary schools. Purpose: The purpose of this study is to highlight challenges PE teachers face and make recommendations for more inclusive learning environments for deaf students. The aims and objectives of this research are: to critically analyse the current situation for deaf students accessing the PE curriculum, by identifying barriers deaf students face; to identify the challenges for PE teachers in providing appropriate support for deaf students; to provide recommendations for deaf awareness training, to enhance PE teachers’ understanding and knowledge. Method: Semi-structured interviews collected data from both PE teachers and deaf students, to examine: the support available and coping mechanisms deaf students use when they do not receive support; strategies PE teachers use to provide support for deaf students; areas for improvement and potential strategies PE teachers can apply to their practice. Results & Conclusion: The findings from the study concluded that PE teachers were inconsistent in providing appropriate support for deaf students in PE lessons. Evidence illustrated that PE teachers had limited exposure to deaf awareness training. This impacted on their ability to support deaf students effectively. Communication was a frequent barrier for deaf students, affecting their ability to retain and learn information. Also, the use of assistive technology was found to be compromised in practical PE lessons.

Keywords: physical education, deaf, inclusion, education

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Authors: Muganyizi Jonas Bisheko, G. Rejikumar

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Reducing post-harvest losses could be a sustainable solution to enhance the food and income security of smallholder farmers in developing countries. While various research institutions have come up with a number of innovative post-harvest technologies for reducing post-harvest losses, most of them have not been extensively adopted by smallholder farmers. Despite this gap, the synthesized information about the major constraints of post-harvest technology is scarce. This study has been conducted to fill this gap and show the implications of the findings for future post-harvest research. The developed search strategy retrieved 2201 studies. However, after excluding duplicates, title, abstract and full article screening, a total of 41 documents were identified. The major findings are: (i) there is an outstanding deficiency of systematic evidence of the effect of climate change, off-farm income and sources of post-harvest information on the adoption of improved post-harvest technologies; (ii) there is very limited information on adoption constraints pertaining to matters of policy, rules and regulations; (iii) there is very thin literature on behavioral constraints associated with limited adoption of improved post-harvest technologies; (iv) most of the studies focused on post-harvest storage technologies (47%) followed by overall post-harvest management practices (25%), processing technologies (19%) and packaging technologies (3%). Much of the information was found on Cereals (58%), especially maize (44%); (v) geographically, Sub-Saharan Africa accounted for 79% of the reviewed interventions, while South Asia occupied only 21%. The findings of this review are intended to guide various post-harvest technologists and decision-makers in addressing the challenge of huge post-harvest losses.

Keywords: constraints, post-harvest loss, post-harvest technology , smallholder farmer

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Authors: Karen Butler

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Johnson C. Smith University, one of the nation’s oldest Historically Black Colleges and Universities, has a strong history of service learning and community service. We first integrated service learning and peer education into health education courses in the spring of 2000. Students enrolled in the classes served as peer educators for the semester. Since then, the program has evolved and expanded but remains an integral part of several courses. The purpose of this session is to describe our program in terms of development, successes, and obstacles, and feedback received. A detailed description of the service learning component in HED 235: Drugs and Drug Education and HED 337: Environmental Health will be provided. These classes are required of our Community Health majors but are also popular electives for students in other disciplines. Three sources of student feedback were used to evaluate and continually modify the component: the SIR II course evaluation, service learning reflection papers, and focus group interviews. Student feedback has been largely positive. When criticism was given, it was thoughtful and constructive – given in the spirit of making it better for the next group. Students consistently agreed that the service learning program increased their awareness of pertinent health issues; that both the service providers and service recipients benefited from the project; and that the goals/issues targeted by the service learning component fit the objectives of the course. Also, evidence of curriculum and learning enhancement was found in the reflection papers and focus group sessions. Service learning sets up a win-win situation. It provides a way to respond to campus and community health needs while enhancing the curriculum, as students learn more by doing things that benefit the health and wellness of others. Service learning is suitable for any health education course and any target audience would welcome the effort.

Keywords: black colleges, community health, health education, service learning

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Authors: Muhammad Umar Kibiya

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The study aims to examine whether regulatory changes have an impact on the financial reporting quality of Microfinance Banks in Nigeria. The research employed a panel data analysis technique, using data from 2018 to 2022. The sample includes 72 microfinance banks, using regression analyses to examine the relationship between variables. The findings indicate that Board Chairmanship has a positive and significant effect on financial reporting quality. It also reveals that share ownership has a negative and significant impact on financial reporting quality. The results suggest that regulatory changes have a positive and significant influence on financial reporting quality. Thus, findings have important implications for microfinance banks in Nigeria. It suggests that having a strong and competent board chairperson can enhance financial reporting quality, leading to more transparent and reliable information for stakeholders. Furthermore, the study highlights the importance of regulatory changes in improving financial reporting practices in the microfinance banking sector. The study contributes to the extant literature by providing empirical evidence on the relationship between board chairmanship, share ownership, financial reporting quality, and regulatory changes in microfinance banks. It further supports the concept that governance mechanisms and regulatory reforms play a crucial role in ensuring transparency and accountability within the microfinance banking sector. It recommends that microfinance banks should appoint experienced and qualified individuals as board chairpersons to enhance financial reporting quality. Furthermore, policymakers and regulatory authorities should continue to implement and enforce regulations that promote transparent financial reporting practices in microfinance banks.

Keywords: board chairman, share ownership, financial reporting quality, microfinance, regulatory changes

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Authors: Emily Adams, Eddie Donaghy, David Henderson, Lauren Ng, Caroline Sanders, Rowena Stewart, Maria Wolters, Stewart Mercer

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Ongoing review abstract: Older People Experiencing Homelessness (OPEH) can have mental and physical indicators of aging 10–20 years earlier than the general population and experience premature mortality due to age-related chronic conditions. Emerging literature suggests digital interventions could positively impact PEH’s well-being. However, the increased reliance on digital delivery may also perpetuate digital inequalities for socially excluded groups, including PEH. The potential triple disadvantage of being older, homeless, and digitally excluded creates a uniquely problematic situation that warrants further research. This scoping review aims to investigate and synthesise the range and type of digital interventions available to OPEH and the organisations that support OPEH. The following databases were searched on 28th July 2023: Medline, Scopus, International Bibliography of the Social Sciences (IBSS)‎, Applied Social Sciences Index & Abstracts (ASSIA)‎, Association for Computing Machinery Digital Library (ACMDL) and Policy commons. A search strategy was developed in collaboration with an academic librarian. The presentation will include: An introduction to OPEH and digital exclusion Overview of the results of this review: OPEH usage of digital platforms Current digital interventions available The role of support organisations Current gaps in the evidence, future research and recommendations for policy and practice

Keywords: homeless, digital exclusion, aging, technology

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Authors: Eli Maria Forti-Pazzianotto, Carolina Moraes Da Costa, Daniela Faleiros Berteli Merino, Maura Rigoldi Simões Da Rocha, Irineu Rasera-Junior

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There is no conclusive evidence to support the use of one type or brand of incentive espirometry over others. The decision as to which equipment is best, have being based on empirical assessment of patient acceptance, ease of use, and cost. The aim was to evaluate the effects of use of two methodologies of breathing exercises, performed by flow-oriented incentive spirometry, in the reversal of diaphragmatic dysfunction in postoperative bariatric surgery. 38 morbid obese women were selected. Respiratory muscle strength was evaluated through the nasal inspiratory pressure (NIP), and the respiratory muscles endurance, through incremental test by measurement of sustained maximal inspiratory pressure (SMIP). They were randomized in 2 groups: 1- Respiron® Classic (RC) the inspirations were slow, deep and sustained for as long as possible (5 sec). 2- Respiron® Athletic1 (RA1) - the inspirations were explosive, quick and intense, raising balls by the explosive way. 6 sets of 15 repetitions with intervals of 30 to 60 seconds were performed in groups. At the end of the intervention program (second PO), the volunteers were reevaluated. The groups were homogeneous with regard to initial assessment. However on reevaluating there was a significant decline of the variable PIN (p= < 0.0001) and SMIP (p=0.0004) in RC. In the RA1 group there was a maintenance of SMIP (p=0.5076) after surgery. The use of the Respiron Athletic 1, as well as the methodology of application used, can contribute positively to preserve the inspiratory muscle endurance and improve the diaphragmatic dysfunction in postoperative period.

Keywords: bariatric surgery, incentive spirometry, respiratory muscle, physiotherapy

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Authors: Zahra Khan

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Surface-Enhanced Raman Spectroscopy (SERS) has received increased attention in recent years, focusing on biological and medical applications due to its great sensitivity as well as molecular specificity. In the context of biological samples, there are generally two methodologies for SERS based applications: label-free detection and the use of SERS tags. The necessity of tagging can make the process slower and limits the use for real life. Label-free detection offers the advantage that it reports direct spectroscopic evidence associated with the target molecule rather than the label. Reproducible, highly monodisperse gold nanoparticles (Au NPs) were synthesized using a relatively facile seed-mediated growth method. Different capping agents (TRIS, citrate, and CTAB) were used during synthesis, and characterization was performed. They were then mixed with different analyte solutions before drop-casting onto a glass slide prior to Raman measurements to see which NPs displayed the highest SERS activity as well as their stability. A host of different analytes were tested, both non-biomolecules and biomolecules, which were all successfully detected using this method at concentrations as low as 10-3M with salicylic acid reaching a detection limit in the nanomolar range. SERS was also performed on samples with a mixture of analytes present, whereby peaks from both target molecules were distinctly observed. This is a fast and effective rapid way of testing samples and offers potential applications in the biomedical field as a tool for diagnostic and treatment purposes.

Keywords: gold nanoparticles, label free, seed-mediated growth, SERS

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Authors: Jing Yuan, Hongwei Yang

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This paper aims to understand U.S. middle school students’ mathematics achievements by examining relevant student and school-level predictors. Through a variance component analysis, the study first identifies evidence supporting the use of multilevel modeling. Then, a multilevel analysis is performed under Bayesian statistical inference where prior information is incorporated into the modeling process. During the analysis, independent variables are entered sequentially in the order of theoretical importance to create a hierarchy of models. By evaluating each model using Bayesian fit indices, a best-fit and most parsimonious model is selected where Bayesian statistical inference is performed for the purpose of result interpretation and discussion. The primary dataset for Bayesian modeling is derived from the Program for International Student Assessment (PISA) in 2012 with a secondary PISA dataset from 2003 analyzed under the traditional ordinary least squares method to provide the information needed to specify informative priors for a subset of the model parameters. The dependent variable is a composite measure of mathematics literacy, calculated from an exploratory factor analysis of all five PISA 2012 mathematics achievement plausible values for which multiple evidences are found supporting data unidimensionality. The independent variables include demographics variables and content-specific variables: mathematics efficacy, teacher-student ratio, proportion of girls in the school, etc. Finally, the entire analysis is performed using the MCMCpack and MCMCglmm packages in R.

Keywords: Bayesian multilevel modeling, mathematics education, PISA, multilevel

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Authors: Justina Ijeoma Ezebuwa, Catherine C. Ikewuchi, Eka B. Essien, Francis C. Anacletus

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Iron deficiency anemia (IDA) is a significant problem in Nigeria, especially in children under five. Intervention options for treating anemia in under-five children have also been the subject of research. This study aims to synthesize the evidence on dietary interventions for managing iron deficiency anemia in under-five children in Nigeria. This study uses a systematic review method to collect relevant studies to answer the research questions and a narrative synthesis to analyze and synthesize the findings of this study. Cochrane, PubMed, and ScienceDirect databases were thoroughly searched, and five (5) articles were selected for this study. The results show that dietary interventions, such as daily multi-nutrient fortified dairy-based drinks, biofortified (yellow/ white) cassava rich in pro-vitamin A, iron supplementation in foods, and ready-to-use therapeutic food (RUTF) may be relevant to the management of iron deficiency anemia in under-five children in Nigeria. The study also shows that daily multi-nutrient fortified dairy-based drinks may be more effective, feasible, and culturally acceptable for managing anemia in under-5 children in Nigeria. In addition, daily multi-nutrient fortified dairy-based drinks and ready-to-use therapeutic food (RUTF) were reported to have the potential to improve the growth, cognitive development, and overall health outcomes of under-five children with iron deficiency anemia in Nigeria. Recommendations for future studies in this research area and for public health practitioners and policymakers were provided.

Keywords: dietary intervention, iron deficiency anemia, under-five children, Nigeria

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Authors: Vesna Tumbas Šaponjac, Sonja Djilas, Jasna Čanadanović-Brunet, Gordana Ćetković, Jelena Vulić, Slađana Stajčić, Milica Vinčić

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Substantial interest has been expressed in fruits and berries due to their potential favourable health effects and high content of polyphenols, especially flavonoids and anthocyanins. Chokeberries (Aronia melanocarpa) are dark berries, similar to blackcurrants, that have been used by native Americans both as a food resource and in traditional medicine for treatment of cold. Epidemiological studies revealed positive effects of chokeberries on colorectal cancer, cardiovascular diseases, and various inflammatory conditions. Chokeberries are well known as good natural antioxidants, which contain phenolic compounds, flavonoids, anthocyanidins and antioxidant vitamins. The aim of this study was to provide information on polyphenolic compounds present in fresh chokeberries as well as to determine its antioxidant activity. Individual polyphenolic compounds have been identified and quantified using HPLC/UV-Vis. Results showed that the most dominant phenolic acid was protocatechuic acid (274.23 mg/100 g FW), flavonoid rutin (319.66 mg/100 g FW) and anthocyanin cyanidin-3-galactoside (1532.68 mg/100 g FW). Generally, anthocyanins were predominant compounds in fresh chokeberry (2342.82 mg/100 g FW). Four anthocyanins have been identified in fresh chokeberry and all of them were cyanidin glicosides. Antioxidant activity was determined using spectrophotometric DPPH assay and compared to standard antioxidant compound vitamin C. The resulting EC50 value (amount of fresh chokeberries that scavenge 50% of DPPH radicals) is 0.33 mg vitamin C equivalent/100 g FW. The results of this investigation provide evidence on high contents of phenolic compounds, especially anthocyanins, in chokeberries as well as high antioxidant activity of this fruit.

Keywords: chokeberry, polyphenols, antioxidant, DPPH radicals

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Authors: Kimberli Breen

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Background Check-In, Check-Out is noted as the most widely implemented evidence-based intervention for youth at-promise within schools. Over twenty years of peer-reviewed research demonstrates the powerful effects of this Positive Behavioral Interventions and Supports (PBIS) practice when implemented with fidelity. However, literature to date has not explicitly connected this intervention with Positive Psychology. Aims This session will illustrate the powerful role Positive Psychology and core elements of PERMA play in the worldwide success of this intervention and how more explicitly aligning Positive Behavioral Interventions and Supports (PBIS) practices with Positive Psychology might remove common barriers to current implementation. Method Students receiving the Check-In, Check-Out intervention experience a warm, positive greeting from a caring adult (CICO Coach) before entering their first class of the day. Teachers then provide high frequency positive feedback to the students at the end of each time block, or segment, of the day. An “optimistic close” to the day is then provided by the same CICO Coach at the end of the school day via the “check-out” process, where students assess the day’s accomplishments and goal-set for the next day. Results CICO clearly aligns with the Positive Psychology core elements of PERMA (Positive Emotion, Engagement, Relationships, Meaning and Accomplishments) and could be further strengthened through explicit integration. Conclusion The already powerful impact and reach of the Check-In, Check-Out intervention can be further enhanced and expanded through greater alignment with Positive Psychology elements and practices. Initiating this important alignment with CICO also offers promise for further integration of Positive Psychology and Positive Behavioral Interventions and Supports.

Keywords: positive pscyhology, check-In check-out, schools, alignment

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Authors: Nikita Katyal, Shubham Jain

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In today’s competitive business environment, the success of campaigns relies not only on their creation but also on effectively reaching the right customers. Campaigns often feature products that customers may not have considered or are unaware of, including popular items. This research aims to enhance retailer sales by leveraging an efficient recommender system that reminds targeted customers to purchase their preferred products and suggests additional items they hadn’t initially considered during a campaign. Our focus is on utilizing the recommender system to identify potential customers for a curated set of products selected by the marketing team for a specific campaign. Communicating with all customers can be time-consuming and costly, and irrelevant messages may harm customer loyalty. Therefore, the primary objective is to strategically select the right customers for a campaign, increasing sales and reducing communication costs. This paper provides valuable insights into connecting with the right customer segments to optimize revenue generation for businesses. The analysis shows that high-value customers (those generating the highest revenue) contributed to increases in average basket size, while win-back customers (with low engagement) and about to churn customers (those at risk of attrition) improved the effectiveness of marketing contacts by increasing engagement and reducing churn. Targeted communication, focused on revenue, also enhanced the quality of the relationship between the customer and the firm, helping to lower churn rates by engaging customers with suitable campaigns. This research provides empirical evidence supporting the theoretical benefits of targeting the right customers for a campaign.

Keywords: recommendation, ALS, marketing campaigns, target customers, churn

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Authors: Masocorro Gawned, Stephen Myers, Guat Siew Chew

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Nuclear Receptors (NR) are a super family of transcription factors that play a major role in lipid and glucose metabolism in skeletal muscle. Recently, pharmacological evidence supports the view that stimulation of nuclear receptors alleviates Type 2 Diabetes (T2D). The orphan nuclear receptors (ONR) are members of the nuclear receptor (NR) superfamily whose ligands and physiological functions remain unknown. To date, no systematic studies have been carried out to screen for ONRs expressed in insulin resistant (IR) skeletal muscle cells. Therefore, in this study, we have established a model for IR by treating C2C12 skeletal muscle cells with insulin (10nM) for 48 hours. Western Blot analysis of phosphorylated AKT confirmed IR. Real-time quantitative polymerase chain reaction (qPCR) results highlighted key ONRs including NUR77 (NR4A1), NURR1 (NR4A2) and NOR1 (NR4A3) which have been associated with fatty acid oxidation regulation and glucose homeostasis. Increased mRNA expression levels of estrogen-related receptors (ERRs), REV-ERBα, NUR77, NURR1, NOR1, in insulin resistant C2C12 skeletal muscle cells, indicated that these ONRs could potentially play a pivotal regulatory role of insulin secretion in lipid metabolism. Taken together, this study has successfully contributed to the complete analysis of ONR in IR, and has filled in an important void in the study and treatment of T2D.

Keywords: type 2 diabetes, orphan nuclear receptors, transcription receptors, quantitative mRNA expression

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Authors: Pornrut Rabintossaporn, Suphaket Saenthaweesuk, Amornnat Thuppia, Nuntiya Somparn

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Several dietary and herbal plants have been shown to possess cytoprotective and antioxidant effects with various mechanisms of action. The aim of this study was to determine the antioxidant effects and its mechanism of aqueous leaves extract of Ocimum americanum (OA), commonly known as American basil or 'hoary basil', in rat. The extract was screened for its phytochemical contents and antioxidant activity in vitro. Moreover, the extract was studied in rats to evaluate its effects in vivo. Rats were orally administered with the extract at the dose of 100, 200 and 400 mg/kg for 28 days. Phytochemical screening of plant extracts revealed the presence of alkaloid, cardiac glycosides, tannin and steroid compounds. The extract contained phenolic compounds 36.91 ± 0.66 mg of gallic acid equivalents per gram OA extract. The free radical scavenging activity assessed by DPPH assay gave IC50 of 41.27 ± 1.86 µg/mL, which is relatively lower than that of BHT with IC50 of 12.34 ± 1.14µg/mL. In the animals, the extract was well tolerated by the animals throughout the 28 days of study as shown by normal serum levels AST, ALP, ALT, BUN and Cr as well as normal histology of liver and pancreatic and kidney tissue. The protein expression of antioxidant enzymes, γ-glutamylcysteine ligase (γ-GCL) in liver was significantly increased compared with normal control. Consistent with the induction of γ-GCL protein expression significantly reduction of serum oxidative stress marker malondialdehyde (MDA) was found in rat treated with OA extract compared with control. Taken together, this study provides evidence that Ocimum americanum exhibits direct antioxidant properties and can induce cytoprotective enzyme in vivo.

Keywords: antioxidant, γ-glutamylcysteine ligase, MDA, Ocimum americanum

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Authors: Juliana Janet R. Martin-Puzon, Demetrio L. Valle, Windell L. Rivera

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This study aimed to determine the presence of bioactive phytochemical constituents and evaluate the in vitro antibacterial activities of Glinus oppositifolius or carpet weed, a plant valued for its use in traditional medicine and as a vegetable. The leaves, stems, and roots were extracted using chloroform, ethanol, and methanol. Phytochemical screening revealed that the entire G. oppositifolius plant, i.e. roots, stems, and leaves, is a rich source of alkaloids, flavonoids, glycosides, saponins, sterols, tannins, and triterpenes. The antibacterial activity of the leaf and stem extracts were evaluated through disc diffusion, minimum inhibitory concentration, and bactericidal concentration assays against methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), extended spectrum β-lactamase-producing (ESβL+), carbapenem-resistant Enterobacteriaceae (CRE), and metallo-β-lactamase-producing (MβL+) Pseudomonas aeruginosa and Acinetobacter baumannii. The leaf extracts revealed antibacterial activities, inhibiting the growth of non-resistant and multidrug-resistant (MDR) strains of the Gram-negative bacteria E. coli, P. aeruginosa, and A. baumanii. In conclusion, the various biological activities of G. oppositifolius, including its antibacterial activity, are due to the presence of diverse bioactive secondary metabolites. The presence of phytochemical compounds in G. oppositifolius is scientific evidence on its use for treatment of many ailments. Thus, the results demonstrate the great potential of the plant as a new, alternative source of antimicrobials and other components with therapeutic value.

Keywords: antibacterial, Glinus oppositifolius, multidrug-resistant, secondary metabolites

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Authors: Tyler D. Cesarone, Tatiana M. Wugalter

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The movement of patients from the Global North to the Global South in pursuit of inexpensive healthcare and touristic experiences dominates the academic discourse on international medical travel (IMT). However, medical travel exists in higher numbers between Global South countries as patients who lack trust in, and feel disenfranchised by, their national healthcare systems seek treatment in nearby countries. Through a review of the existing literature, this paper examines patterns of IMT in the Middle East, Southeast Asia, and Southern Africa, distinguishing North-South medical tourism from South-South intra-regional medical mobility (IRMM). Evidence from these case studies demonstrates that notions of medical distrust and disenfranchisement, rooted in low-resourced and poor quality healthcare systems, are key drivers of IRMM in the Global South. The movement of patients from lower income to proximate higher income countries not only reveals tensions between patients and their healthcare systems but widens gaps in the quality of healthcare between departing and destination countries. In analyzing these cross-regional similarities, the paper moves beyond the current literature’s focus on singular case studies to expose global patterns of South-South IRMM. This presents a shift from the traditional focus on North-South medical tourism, demonstrating how disparities in healthcare systems both influence and are influenced by IRMM.

Keywords: global South, healthcare quality, international medical travel (IMT), intra-regional medical mobility (IRMM), medical disenfranchisement, medical distrust, medical tourism

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Authors: Anna Zoli

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In recent years, we have been witnessing a surge of locally-sustained communities committed to promoting new ethical economies while fostering the full participation of socially excluded groups and individuals into the labor market. This article explores the practices of a particular community development model, Transition Towns, as implemented in Monteveglio, Italy. Data were gathered throughout two years long ethnography, using multiple qualitative techniques, namely participant observation, document analysis, and semi-structured interviews. Data were analyzed triangulating from multiple sources of evidence and using hybrid thematic analysis. Major findings show that Transition Town movement works on two main axes, vertical and horizontal. Vertical transition involves interactions with an overreaching political, economic, and social structure which is not transitioning, and therefore poses structural resistances to the transformative social change fostered by the TT. Conversely, horizontal transition involves intragroup dynamics within the communal relational and geographical spaces and therefore poses process resistances between 'self and others' to the interpersonal communication between TT members. The study concludes that a psychosocial approach to community development is essential in order to conflate macro-social dynamics and psychological processes that may obstacle grassroots social movements to thrive. Skills from psychosocial disciplines are a unique set that could facilitate communication and relational processes for community development, and ultimately enabling social change.

Keywords: community development, grassroots social movements, psychosocial approaches, Transition Towns

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Authors: Sammy Xiaoyan Ying

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Professional skepticism remains one of the most important and controversial topics in auditing. This study examines the influence of client cooperativeness and fraud risk on judgments of professional skepticism among Chinese entry-level auditors in the context of evaluation of client-provided audit evidence. Given that the essence of auditors’ PS rests on distrust of clients, this study invokes trust-related theories from psychological and cultural perspectives. Specifically, invoking psychology theories of trust concerning positive relationship between risk and distrust, this study hypothesizes that professional skepticism is likely to be positively associated with client fraud risk. The results support the hypothesis and show that lower (higher) levels of client fraud risk lead to lower (higher) levels of professional skepticism. Furthermore, drawing on analysis of relationship between cooperation and trust, with particular reference to guanxi dynamics in the Chinese culture, this study hypothesizes that professional skepticism is likely to be negatively associated with client cooperativeness. The results support the hypothesis and show that higher (lower) levels of client cooperativeness lead to lower (higher) levels of professional skepticism. The findings may assist audit firms and auditing educators in improving training and education programs and enhancing entry-level auditors’ abilities to maintain professional skepticism. Also, practitioners and regulators may benefit from increasing awareness of psychological factors in influencing professional skepticism.

Keywords: audit judgment, Chinese culture, entry-level auditor, professional skepticism

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Authors: Rajkumar Ghosh

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The Sutlej River Valley in Himachal Pradesh, India, is home to four Out-of-Sequence Thrusts (OOST) in the Higher Himalaya. These OOSTs include Jhakri Thrust (JT), Sarahan Thrust (ST), Chaura Thrust (CT), and Jeori Dislocation (JD). The study focuses on the rock types of these OOSTs, including ductile sheared gneisses and upper greenschist-amphibolite facies metamorphosed schists. Microstructural tests reveal a progressive increase in strain approaching the Jakhri thrust zone, with temperatures increasing from 400 to 750°C. The Chaura Thrust is assumed to be folded with this anticlinorium, with various branches that make up the thrust system. Fieldwork and microstructural research have revealed the following: (a) initial top-to-SW sense of ductile shearing (Chaura thrust); (b) brittle-ductile extension (Jeori Dislocation); and (c) uniform top-to-SW sense of brittle shearing (Jhakri thrust). Samples of Rampur Quartzite from the Rampur Group of Lesser Himalayan Crystalline and schistose rock from the Jutogh Group of Greater Himalayan Crystalline were examined.The study emphasizes the value of microscopic research in detecting different types of crenulated schistosity and documenting mylonitized zones. The paper explains the field evidence for the OOST and comes to the conclusion that the Chaura Thrust is not a blind thrust. The paper describes the box fold and its characteristics in the Himachal Himalayan regional geology.

Keywords: Out-of-sequence thrust (OOST), jakhri thrust (JT), sarahan thrust (ST), chaura thrust (CT), jeori dislocation (JD)

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Authors: M. Munirul Islam, Makhduma Khatun M., Janet M. Peerson, Tahmeed Ahmed, M. Abid Hossain Mollah, Kathryn G. Dewey, Kenneth H. Brown

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Information is required on the effects of dietary energy density (ED) and feeding frequency (FF) of complementary foods (CF) on food consumption during individual meals and time expended in child feeding. We evaluated the effects of varied ED and FF of CFs on food intake and time required for child feeding during individual meals. During 9 separate, randomly ordered dietary periods lasting 3-6 days each, we measured self-determined intakes of porridges by 18 healthy, breastfed children 8-11 mo old who were fed coded porridges with energy densities of 0.5, 1.0 or 1.5 kcal/g, during 3, 4, or 5 meals/d. CF intake was measured by weighing the feeding bowl before and after every meal. Children consumed greater amounts of CFs per meal when they received diets with lower ED (p = 0.044) and fewer meals per day (p < 0.001). Food intake was less during the first meal of the day than the other meals. Greater time was expended per meal when fewer meals were offered. Time expended per meal did not vary by ED, but the children ate the lower ED diets faster (p = 0.019). Food intake velocity was also greater when more meals were offered per day (p = 0.005). These results provide further evidence of young children’s ability to regulate their energy intakes, even during infancy; and they convey information on factors that affect the amount of time that caregivers must devote to child feeding.

Keywords: complementary foods, energy density, feeding frequency, young children

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Authors: Haaris Khan, Farhad Udwadia

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South Asians are the fastest-growing immigrant population in Canada and are 3-4 times more likely to develop diabetes. In a primary care setting, language barriers continue to persist as a prominent obstacle when delivering crucial health information. Given the abundance of languages in the South Asian community and the varying levels of English fluency, there is compelling evidence that these language barriers can adversely impact health outcomes. The microvascular and macrovascular complications of poor diabetic management are well established and universally recognized. However, these are often difficult concepts to grasp for even individuals fluent in English. In order to lessen the burden of language barriers, we developed a comprehensive guide in various languages that discuss the complications and screening guidelines for diabetic and prediabetic patients. The guide is presented in the form of a pamphlet, with an electronic version being constructed as well, that provides basic information on diabetic retinopathy, neuropathy and nephropathy as well as the screening recommendations. We also conducted a review of the literature around the topic and incorporated our findings into our project. Our goal is for primary care physicians to have this resource and to be able to provide the link or pamphlet to patients in need. Our presentation also provides a comprehensive overview of some of the other barriers that individuals in the South Asian community face when seeking care. Given the staggering number of individuals in the South Asian community with diabetes and the morbidity and mortality associated with diabetes and its complications, effective community-specific strategies are needed to mitigate the potential consequences of poor diabetes management.

Keywords: diabetes, patient education, ophthalmology, vascular surgery

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Authors: Tsige Reda

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Essential oil of Thymus vulgaris was extracted by means of hydro-distillation. This study was done to investigate the chemical composition, antibacterial and antioxidant activities. The chemical composition of the essential oils was determined using gas chromatography coupled to mass spectroscopy (GC-MS). Using disc diffusion assay the antibacterial activity was assessed on one Gram-positive bacteria and one Gram-negative bacteria. The percentage oil yield of the essential oil was found to be 0.97 ± 0.08% (w/w) with yellow color. The physicochemical constants of the oil were also noted. The phytochemical screening of the plant extract revealed the presence of tannins, saponins, phenol, flavonoids, terpenoids, steroids and alkaloids. A total of 18 chemical constituents were identified by Gas Chromatography-Mass Spectroscopy analysis representing 100% of the total essential oil of Thymus vulgaris, with thymol (31.977%), o-cymene (29.992%), and carvacrol (14.541%). Previous studies have revealed that the thymol, o-cymen and carvacrol components of Thymus vulgaris are responsible for their biological activities. Thymus vulgaris have been used traditionally to treat a wide variety of infections. Based on the extensive use and lack of scientific evidence, a study was embarked upon to determine its bioactivity. The essential oil of Thymus vulgaris leaves exhibited higher activity towards the Gram-positive bacteria (Staphylococcus aurous) than the Gram-negative bacteria (Escherichia coli) and also has good antioxidant activity, and can be used medicinal and therapeutic applications. This activity may be due to the high amount of thymol, o-cymen and carvacrol.

Keywords: hydro-distillation, Thymus vulgaris, essential oil composition, phytochemical screening, physicochemical constants, antioxidant activity, antibacterial activity

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Authors: A. V. Chandewar, Sanjay Bais

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Backgound: In India, drugs of herbal origin have been used in traditional systems of medicines such as Unani and Ayurveda since ancient times. WHO limit for Escherichia coli is 101/gm cfu, for Staphylococus aureus 105/gm cfu, and for Pseudomonas aeruginosa 103/gm cfu and for Salmonella species nil cfu. WHO mentions maximum permissible limits in raw materials only for arsenic, cadmium, and lead, which amount to 1.0, 0.3, and 10 ppm, respectively. Aim: The main purpose of the investigation was to document evidence for the users, and practitioners of marketed haematinic herbal formulations. In the present study haematinic herbal formulations marketed in Yavatmal India were determined for the presence of microbial and heavy metal content. Method: The investigations were performed by using specific medias and atomic absorption spectrometry. Result: The present work indicates the presence of heavy metal contents in herbal formulations selected for study. It was found that arsenic content in formulations was below the permissible limit in all formulations. The cadmium and lead content in six formulations were above the permissible limits. Such formulations are injurious to health of patient if consumed regularly. The specific medias were used to determining the presence of Escherichia coli 4 samples, Staphylococcus aureus 3 samples, and P. aeruginosa 4 samples. The data indicated suggest that there is requirement of in process improvement to provide better quality for consumer health in order to be competitive in international markets. Summary/Conclusion: The presence of microbial and heavy metal content above WHO limits indicates that the GMP was not followed during manufacturing of herbal formulations marketed in India.

Keywords: toxicological standardization, heavy metals, microbial contamination, haematinic herbal formulations

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Authors: Sidika McNeil

Abstract:

Borderline personality disorder (BPD) is a personality disorder that has been found to have strong origins in childhood trauma. One of the key symptoms of BPD is an association with irregular moods swings, as well as suicidal ideation (SI). Owing to the typically severe trauma patients experience during childhood, it is hard for them to control their emotions and thus makes it hard to emotionally regulate. It is then very common for those suffering from BPD to turn to unhealthy coping mechanisms, such as substance use, unhealthy relationships, and more, often unsuccessfully creating experiences that facilitate safety which leads to further negative experiences. With the high suicide rating among children, adolescents, and teens, and an ever-increasing number of children being diagnosed with BPD, it is very important that more research is done to find further treatments for patients who are currently suffering. Methods: Utilizing data found in prior studies, this paper will analyze the literature to focus on a comprehensive treatment plan for those with DBT. It is currently suggested that with the use of dialectical behavioral therapy (DBT), a therapy that focuses on changing negative thinking patterns and pushes for more positive ones is helpful for treatment for those with BPD. Though this therapy is not a cure to BPD, it does help mitigate the risk; this essay will explore other options that can further the treatment process, such as cognitive analytical therapy (CAT), which focuses on delving into the past to find the root causes of an issue to create coping strategies and harm reduction, a type of therapy used to aid patients in lowering the use of substances without complete cessation. Results: The research provides enough evidence to link between the treatment of BPD with the utilization of CAT.

Keywords: borderline personality disorder, cognitive analytical therapy, dialectical behavioral therapy, harm reduction, suicidal ideation

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Authors: Kamila Duś-Szachniewicz, Kinga M. Walaszek, Paweł Skiba, Paweł Kołodziej, Piotr Ziółkowski

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Cell adhesion is of fundamental importance in the cell communication, signaling, and motility, and its dysfunction occurs prevalently during cancer progression. The knowledge of the molecular and cellular processes involved in abnormalities in cancer cells adhesion has greatly increased, and it has been focused mainly on cellular adhesion molecules (CAMs) and tumor microenvironment. Unfortunately, most of the data regarding CAMs expression relates to study on cells maintained in standard oxygen condition of 21%, while the emerging evidence suggests that culturing cells in ambient air is far from physiological. In fact, oxygen in human tissues ranges from 1 to 11%. The aim of this study was to compare the effects of physiological lymph node normoxia (5% O2), and hyperoxia (21% O2) on the expression of cellular adhesion molecules of primary diffuse large B-cell lymphoma cells (DLBCL) isolated from 10 lymphoma patients. Quantitative RT-PCR and immunohistochemistry were used to confirm the differential expression of several CAMs, including ICAM, CD83, CD81, CD44, depending on the level of oxygen. Our findings also suggest that DLBCL cells maintained at ambient O2 (21%) exhibit reduced growth rate and migration ability compared to the cells growing in normoxia conditions. Taking into account all the observations, we emphasize the need to identify the optimal human cell culture conditions mimicking the physiological aspects of tumor growth and differentiation.

Keywords: adhesion molecules, diffuse large B-cell lymphoma, physiological normoxia, quantitative RT-PCR

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Authors: Seon-Young Lee, Harkiran Sagoo, Katherine Whitehurst, Georgina Wellstead, Alexander Fowler, Riaz Agha, Dennis Orgill

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Introduction: Systematic reviews attempt to answer research questions by synthesising the data within primary papers. They are an increasingly important tool within evidence-based medicine, guiding clinical practice, future research and healthcare policy. We sought to determine the reporting quality of recent systematic reviews in plastic surgery. Methods: This systematic review was conducted in line with the Cochrane handbook, reported in line with the PRISMA statement and registered at the ResearchRegistry (UIN: reviewregistry18). MEDLINE and EMBASE databases were searched in 2013 and 2014 for systematic reviews by five major plastic surgery journals. Screening, identification and data extraction was performed independently by two teams. Results: From an initial set of 163 articles, 79 met the inclusion criteria. The median PRISMA score was 16 out of 27 items (59.3%; range 6-26, 95% CI 14-17). Compliance between individual PRISMA items showed high variability. It was poorest for items related to the use of review protocol (item 5; 5%) and presentation of data on risk of bias of each study (item 19; 18%), while being the highest for description of rationale (item 3; 99%) and sources of funding and other support (item 27; 95%), and for structured summary in the abstract (item 2; 95%). Conclusion: The reporting quality of systematic reviews in plastic surgery requires improvement. ‘Hard-wiring’ of compliance through journal submission systems, as well as improved education, awareness and a cohesive strategy among all stakeholders is called for.

Keywords: PRISMA, reporting quality, plastic surgery, systematic review, meta-analysis

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Authors: Vatsal M. Patel, Navin B. Patel

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The present studies deal with the developing a series bearing a diphenyl ethers nucleus using structure-based drug design concept. A newer series of diphenyl ether based azetidinone namely N-(3-chloro-2-oxo-4-(3-phenoxyphenyl)azetidin-1-yl)-2-(substituted amino)acetamide (2a-j) have been synthesized by condensation of m-phenoxybenzaldehyde with 2-(substituted-phenylamino)acetohydrazide followed by the cyclisation of resulting Schiff base (1a-j) by conventional method as well as microwave heating approach as a part of an environmentally benign synthetic protocol. All the synthesized compounds were characterized by spectral analysis and were screened for in vitro antimicrobial, antitubercular and antiprotozoal activity. The compound 2f was found to be most active M. tuberculosis (6.25 µM) MIC value in the primary screening as well as this same derivative has been found potency against L. mexicana and T. cruzi with MIC value 2.09 and 6.69 µM comparable to the reference drug Miltefosina and Nifurtimox. To provide understandable evidence to predict binding mode and approximate binding energy of a compound to a target in the terms of ligand-protein interaction, all synthesized compounds were docked against an enoyl-[acyl-carrier-protein] reductase of M. tuberculosis (PDB ID: 4u0j). The computational studies revealed that azetidinone derivatives have a high affinity for the active site of enzyme which provides a strong platform for new structure-based design efforts. The Lipinski’s parameters showed good drug-like properties and can be developed as an oral drug candidate.

Keywords: antimycobacterial, antiprotozoal, azetidinone, diphenylether, docking, microwave

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Authors: Gerard Bray, Derek Mao, Arya Bahadori, Sachinka Ranasinghe

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The EAU currently recommends partial nephrectomy as the preferred management for localised cT1 renal tumours, irrespective of surgical approach. With the advent of robotic assisted partial nephrectomy, there is growing evidence that warm ischaemia time may be reduced compared to the traditional laparoscopic approach. There is still no clear differences between the two approaches with regards to other peri-operative and oncological outcomes. Current limitations in the field denote the lack of single surgeon series to compare the two approaches as other studies often include multiple operators of different experience levels. To the best of our knowledge, this study is the first single surgeon series comparing peri-operative outcomes of robotic assisted and laparoscopic PN. The current study aims to reduce intra-operator bias while maintaining an adequate sample size to assess the differences in outcomes between the two approaches. We retrospectively compared patient demographics, peri-operative outcomes, and renal function derangements of all partial nephrectomies undertaken by a single surgeon with experience in both laparoscopic and robotic surgery. Warm ischaemia time, length of stay, and acute renal function deterioration were all significantly reduced with robotic partial nephrectomy, compared to laparoscopic nephrectomy. This study highlights the benefits of robotic partial nephrectomy. Further prospective studies with larger sample sizes would be valuable additions to the current literature.

Keywords: partial nephrectomy, robotic assisted partial nephrectomy, warm ischaemia time, peri-operative outcomes

Procedia PDF Downloads 141