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Authors: A. Shirazibeheshti, T. Radwan, A. Ettefaghian, G. Wilson, C. Luca, Farbod Khanizadeh

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Anticholinergic medication has been associated with events such as falls, delirium, and cognitive impairment in older patients. To further assess this, anticholinergic burden scores have been developed to quantify risk. A risk model based on clustering was deployed in a healthcare management system to cluster patients into multiple risk groups according to anticholinergic burden scores of multiple medicines prescribed to patients to facilitate clinical decision-making. To do so, anticholinergic burden scores of drugs were extracted from the literature, which categorizes the risk on a scale of 1 to 3. Given the patients’ prescription data on the healthcare database, a weighted anticholinergic risk score was derived per patient based on the prescription of multiple anticholinergic drugs. This study was conducted on over 300,000 records of patients currently registered with a major regional UK-based healthcare provider. The weighted risk scores were used as inputs to an unsupervised learning algorithm (mean-shift clustering) that groups patients into clusters that represent different levels of anticholinergic risk. To further evaluate the performance of the model, any association between the average risk score within each group and other factors such as socioeconomic status (i.e., Index of Multiple Deprivation) and an index of health and disability were investigated. The clustering identifies a group of 15 patients at the highest risk from multiple anticholinergic medication. Our findings also show that this group of patients is located within more deprived areas of London compared to the population of other risk groups. Furthermore, the prescription of anticholinergic medicines is more skewed to female than male patients, indicating that females are more at risk from this kind of multiple medications. The risk may be monitored and controlled in well artificial intelligence-equipped healthcare management systems.

Keywords: anticholinergic medicines, clustering, deprivation, socioeconomic status

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Authors: O.O. Ehinmowo, A.I. Fatuase, D.F. Oke

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Nigeria is endowed with resources that could boost the economy as well as generate income and provide jobs to the teaming populace. One of the keys of attaining this is by making the environment conducive for the entrepreneurs to excel in their respective enterprises so that more income could be accrued to the entrepreneurs. This study therefore examines income inequality among selected entrepreneurs in Ondo State, Nigeria using primary data. A multistage sampling technique was used to select 200 respondents for the study with the aid of structured questionnaire and personal interview. The data collected were subjected to descriptive statistics, Lorenz curve, Gini coefficient and Double - Log regression model. Results revealed that majority of the entrepreneurs (63%) were males and 90% were married with an average age of 44 years. About 40% of the respondents spent at most 12 years in school with 81% of the respondents had 4-6 members per household, while hair dressing (43.5%) and fashion designing (31.5%) were the most common enterprises among the sampled respondents. The findings also showed that majority of the entrepreneurs in hairdressing, fashion designing and laundry service earned below N200,000 per annum while the majority of those in restaurant and food vending earned between N400,000 – N600,000 followed by the entrepreneurs in pure water enterprise where majority earned N800,000 and above per annum. The result of the Gini coefficient (0.58) indicated that there was presence of inequality among the entrepreneurs which was also affirmed by the Lorenz curve. The Regression results showed that gender, household size and number of employees significantly affected the income of the entrepreneurs in the study area. Therefore, more female households should be encouraged into entrepreneurial businesses and government should give incentive cum conductive environment that could bridge the disparity in the income of the entrepreneurs in their various enterprises.

Keywords: entrepreneurs, Gini coefficient, income inequality, Lorenz curve

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Authors: Patcharapa Thaweekul, Paskorn Sritipsukho

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Background: During the training period of the 6-year medical curriculum, medical students seem to have many risk behaviors of developing obesity. This study aims to demonstrate the prevalence and risk behavior of obesity and related metabolic disorders among the final-year medical students of Thammasat University as well as the change in nutritional status during studying program. Methods: 123 participants were asked to complete the self-report questionnaires. Weight, height, waist circumference and blood pressure were obtained. Blood samples were drawn for total cholesterol, high-density lipoprotein, low-density lipoprotein, triglycerides and plasma glucose. Body weight and height of the medical students in the first year were obtained from the medical report at the entry. Results: The prevalence of overweight and obesity at the entry to medical school was 22.0% and increased to 30.1% in the final year. Two obese students (5.4%) was diagnosed as metabolic syndrome. During 6-year curriculum, the BMI gained in male medical students were more significant as compared to female students (1.76±1.74 and 0.43±1.82 kg/m2, respectively; p <.001). The current BMI is significantly correlated with the BMI at entry. Serum LDL-C in the overweight/obese students was significantly higher as compared to the normal weight and underweight group. Sleep deprivation was a significantly frequent behavior in the overweight/obese students. Conclusion: Medical students, as having high-risk behaviors, should be assessed for the nutritional status and metabolic parameters. Medical schools should promote the healthy behaviors to increase the healthy eating and exercise habits and reduced the risk behaviors among them.

Keywords: medical students, metabolic syndrome, obesity, risk behaviors

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Authors: Ashok Pandey, Rajan Adhikari

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Introduction: Menstruation is part of the female reproductive cycle that starts when girls become sexually mature at the time of puberty. It is a phenomenon unique to the females. During a menstrual period, a woman bleeds from her uterus via the vagina. For decades, in many countries, academic school ‘type,’ private or public, as a predictor of or factor in future academic success has been researched and debated. MATERIAL AND METHODS: The comparative study was carried out with adolescent girls studying in both public and private schools of Kathmandu valley. A total of 100 girls participated in the survey, and out of them 21 participated in the FGD and 5 in the in- depth interview. Quantitative data from the survey was analyzed using SPSS 16.0 software. Informed verbal consent with the respective head of school and the respondents were taken before data collection. Results:The age of the respondents ranges from 11 to 18 years, with mean age of menarche being 12.37 years in both school adolescent girls. 70 percent of the public school adolescent girls and 72 percent of the private school adolescent girls are feeling upset and tension during menarche. There is a statistically significant difference on take rest during the period and good hygienic practice during menstruation of public/private school, at α=0. 05 level of significance. There is a statistically significant difference on overall score of practice during menstruation between public and private adolescent girls. Conclusion: Private schools children are more knowledgeable and maintain hygiene as compere to public school even though, it can be said that among the adolescent school girls both in public and private school, menstrual knowledge and perceptions are poor and practices often not optimal for proper hygiene. Often ignored issues of privacy affect the hygienic practices and daily lives.

Keywords: Comparison, Menstruation, Private school, Public School

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Authors: Niyom Suwandej

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This research paper investigated the opinions of small and micro community enterprises from Jom Pluak Subdistrict, Bangkhontee District, Samut Songkram Province towards product quality control, and the findings are aimed to disseminate knowledge on quality control for upgrading product standards for small and micro community enterprises. The study employed both qualitative and quantitative methods, in which there were 23 samples in the study. The study was divided into 2 steps which were (1) studying the opinions of the respondents towards the community’s product quality control and upgrading product standards; (2) creating development guidance for product quality control and upgrading product standards for small and micro community enterprise. The demographic findings revealed female respondents as the majority, with most above 50 years of age and married. Most had more than 15 years of working experience. The education level reported by most respondents was primary school or lower followed by secondary school or lower with most respondents was vocational certificate level. Most respondents had the highest level of satisfaction with the existing condition of product quality control knowledge management. Pertaining to opinions on the guidance of knowledge creation for product quality control for small and micro community enterprise, the respondents were willing to apply the knowledge in upgrading their product standards. For the opinions of knowledge creation for product quality control and product standards, the respondents had the highest level of satisfaction. Guidance of knowledge creation for product quality control and product standards for small and micro community enterprises received the highest level of satisfaction from the respondents. Furthermore they had knowledge and comprehension in product quality control and product standards and could apply the knowledge in improving the quality of their production and product standards for small and micro community enterprises.

Keywords: product quality control, product standards, community enterprise, marketing management

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Authors: Hanan F. Aly, Fateheya M. Metwally, Hanaa H. Ahmed

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The current study is undertaken to elucidate a possible neuroprotective role of dehydroepiandrosterone (DHEA) against the development of Alzheimer’s disease in experimental rat model. Alzheimer’s disease was produced in young female ovariectomized rats by intraperitoneal administration of AlCl3 (4.2 mg/kg body weight) daily for 12 weeks. Half of these animals also received orally DHEA (250 mg/kg body weight, three times weekly) for 18 weeks. Control groups of animals received either DHAE alone, or no DHEA, or were not ovariectomized. After such treatment the animals were analyzed for oxidative stress biomarkers such as hydrogen peroxide, nitric oxide and malondialdehyde, total antioxidant capacity, reduced glutathione, glutathione peroxidase, glutathione reductase, superoxide dismutase and catalase activities, antiapoptotic marker Bcl-2 and brain derived neurotrophic factor. Also, brain cholinergic markers (acetylcholinesterase and acetylcholine) were determined. The results revealed significant increase in oxidative stress parameters associated with significant decrease in the antioxidant enzyme activities in Al-intoxicated ovariectomized rats. Significant depletion in brain Bcl-2 and brain-derived neurotrophic factor levels were also detected. Moreover, significant elevations in brain acetylcholinesterase activity accompanied with significant reduction in acetylcholine level were recorded. Significant amelioration in all investigated parameters was detected as a result of treatment of Al-intoxicated ovariectomized rats with DHEA. These results were confirmed by histological examination of brain sections. These results clearly indicate a neuroprotective effect of DHEA against Alzheimer’s disease.

Keywords: Alzheimer’s disease, oxidative stress, apoptosis, dehydroepiandrosterone

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Authors: Maatouk Mohamed, Nouira Mariem

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Background and aims: Healthcare-associated infections (HAI) represent a major public health problem worldwide. They represent one of the most serious adverse events in health care. The objectives of our study were to estimate the prevalence of HAI at the Charles Nicolle Hospital (CNH) and to identify the main associated factors as well as to estimate the frequency of antibiotic use. Methods: It was a cross sectional study at the CNH with a unique passage per department (OctoberDecember 2018). All patients present at the wards for more than 48 hours were included. All patients from outpatient consultations, emergency and dialysis departments were not included. The site definitions of infections proposed by the Centers for Disease Control and Prevention (CDC) were used. Only clinically and/or microbiologically confirmed active HAIs were included. Results: A total of 318 patients were included with a mean age of 52 years and a sex ratio (Female/Male) of 1.05. A total of 41 patients had one or more active HAIs, corresponding to a prevalence of 13.1% (95% CI: 9.3%-16.9%). The most frequent sites infections were urinary tract infections and pneumonia. Multivariate analysis among adult patients (>=18 years) (n=261), revealed that infection on admission (p=0.01), alcoholism (p=0.01), high blood pressure (p=0.008), having at least one invasive device inserted (p=0.004), and history of recent surgery (p=0.03), increased significantly the risk of HAIs. More than 1 of 3 patients (35.4%) were under antibiotics on the day of the survey, of which more than half (57.4%) were under 2 or more types of antibiotics. Conclusion: The prevalence of HAIs and antibiotic prescriptions at the CNH were considerably high. An infection prevention and control committee, as well as the development of an Antibiotic stewardship program with continuous monitoring using repeated prevalence surveys must be implemented to limit the frequency of these infections effectively.

Keywords: tumors, oesophagectomy, esophagogastric junction, systematic review

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Authors: Priyanka Sharma

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The women voter turnout in India is increasing. The rising female voter turnout is explained in part by men intimidating women in the household to vote. Women are more likely than men to be guided before voting. What is perhaps more significant is that the gender gap has shrunk significantly over the years. However, there are layers and categories of women voters in India. Some women are much more likely than the average woman to follow advice. Against this backdrop, this paper investigates the variation among women voters during the national elections of 2019 in India. The central question of this research paper is whether or not the development of greater political opinion among women would offset guided voting and allow them to emerge as more independent voters. So the independent variable of the study is Indian women’s opinion on politics, and the dependent variable is their voting behavior. The methodology used in this paper is both quantitative and qualitative. This study investigated and examined Lokniti’s election survey data. The sample size used in this survey is 11568. The analysis of this study has revealed that there is a considerable impact of women having a political opinion on their voting behavior. The Bivariate analysis of the variables states that 83% of Indian women who have opinions on political issues do not seek advice while going to vote. This proves the hypothesis of this paper that women with an opinion on politics are more likely to be independent voters. To check the statistical significance of the finding, a chi-square test was done and the p-value found is 0.009737, which shows it is statistically significant. Furthermore, a regression test has been done by controlling certain variables like age, educational qualification, caste, and financial position of the women to probe the influence on the dependent variable. The findings provide worthwhile insights into the relationship between these control variables and the women voting behavior in India.

Keywords: dependent voter, independent voter, political opinion, voting behavior, women voter

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Authors: Jhemson C. Elis, Alvin S. Magadia

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Our world is full of numbers, shapes, and figures that illustrate the wholeness of a thing. Indeed, this statement signifies that mathematics is everywhere. Mathematics in its broadest sense helps people in their everyday life that is why in education it is a must to be taken by the students as a subject. The study aims to determine the profile of the respondents in terms of gender and age, performance of the control and experimental groups in the pretest and posttest, impact of the instructional game used as instructional intervention in teaching algebra for high school students, significant difference between the level of performance of the two groups of respondents in their pre–test and post–test results, and the instructional intervention can be proposed. The descriptive method was also utilized in this study. The use of the certain approach was to that it corresponds to the main objective of this research that is to determine the effectiveness of the instructional game used as an instructional intervention in teaching algebra for high school students. There were 30 students served as respondents, having an equal size of the sample of 15 each while a greater number of female teacher respondents which totaled 7 or 70 percent and male were 3 or 30 percent. The study recommended that mathematics teacher should conceptualize instructional games for the students to learn mathematics with fun and enjoyment while learning. Mathematics education program supervisor should give training for teachers on how to conceptualize mathematics intervention for the students learning. Meaningful activities must be provided to sustain the student’s interest in learning. Students must be given time to have fun at the classroom through playing while learning since mathematics for them was considered as difficult. Future researcher must continue conceptualizing some mathematics intervention to suffice the needs of the students, and teachers should inculcate more educational games so that the discussion will be successful and joyful.

Keywords: instructional game in algebra, mathematical intervention, joyful, successful

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Authors: Racheal Ayanga, Nancy Katumba Muwangala, Jane Babirye, Harriet Kivumbi

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Background: Deaf adolescents are vulnerable. Deafness limits their access to resources that are accessed by their hearing peers. There is minimal attention placed on the SRH needs of persons with disabilities, especially in developing countries. We sought to assess barriers to access of SRH education and services for deaf adolescents in Uganda. Methods: We performed a cross sectional study using a questionnaire on knowledge of and access to SRH education and services from a selected sample of deaf adolescents aged 13-19 years at Wakiso Secondary school for the deaf. A consecutive sample of eligible participants was asked to join the study after obtaining informed consent until the target sample size was reached. Results: From 01 Jul 2022 to 30 Jan 2023, 70 quantitative interviews were conducted. Participants’ mean age was 17 years, and 66% were female. 89% had heard about several components of SRH. 99% reported a need for education and services but had challenges with access 85% of the time. 54% reported receipt of education and services from government or private facilities, and the rest from friends, parents, siblings, teachers and the internet. Conclusion: Government needs to look into availing tailored, sustainable SRH education/services to deaf adolescents at health facilities and teach health workers sign language. SRH education to parents, teachers and communities of deaf adolescents improves access in hard-to-reach areas. Integration of services into routine health care is key in creating and improving models of access to wider communities of persons with disabilities to improve their mental health.

Keywords: sexual and reproductive health, deaf, adolescents, education, services, disabilities, mental health, hard-to-reach areas

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Authors: Jose G. Tshikuka, Goabaone Rankgoane-Pono, Mgaywa G. M. D. Magafu, Julius C. Mwita, Tiny Masupe, Fortunat M. Kandanda, Shimeles G. Hamda, Roy Tapera, Mooketsi Molefi, John T. Tlhakanelo

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Background: Factors associated with overweight and obesity among antiretroviral therapy (ART) recipients have not been sufficiently studied in Botswana. We aimed to study (i) the prevalence and trends in overweight/obesity by duration of exposure to ART among recipients, (ii) changes in body mass index (BMI) categories among recipients before ART initiation (BMI-1) and after ART initiation (BMI-2), (iii) associations between ART and overweight/obesity and (iv) factors associated with BMI changes among ART recipients. Methods: A 12 years retrospective record-based review was conducted. Factors potentially associated with BMI change among patients after at least three years of ART exposure were examined using multiple regression model. Adjusted odds ratios (AOR) and their 95% confidence intervals (CIs) were computed. ART regimens, duration of exposure to ART, and recipients’ demographic and biomedical characteristics including the presence or absence of diabetes mellitus related comorbidities (DRC) were investigated as potential factors associated with overweight/obesity. Results: Twenty-nine percent of recipients were overweight, 16.6% had obesity of whom 2.4% were morbidly-obese at the last clinic visit. Overweight/obesity recipients were more likely to be female, to have DRC and less likely to have nadir CD4 count or CD4 count between 201 – 249 cells/mm³. Neither the first-line nor the second-, third-line ART regimens predicted overweight/obesity more than the other and neither did the duration of exposure to ART. No significant linear trends were observed in the prevalence of overweight/obesity by the duration of exposure to ART. Conclusions: These results indicate that overweight/obesity seen among ART recipients is not directly induced by ART. ART used CD4 and/or DRC pathway to induce overweight/obesity seen among recipients; suggesting that, weight gain documented herein is likely a reflection of improved health status that mirrors trends in the general population or a DRC related effect. Weight management programs may be important components of HIV care.

Keywords: overweight/obesity, recipients of antiretroviral therapy, HIV/AIDS, Botswana

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Authors: Vadim A. Kuznetsov, Anna M. Soldatova, Tatyana N. Enina, Elena A. Gorbatenko, Dmitrii V. Krinochkin

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The aim of the study was to evaluate potential parameters related with super-response to CRT. Methods: 60 CRT patients (mean age 54.3 ± 9.8 years; 80% men) with congestive heart failure (CHF) II-IV NYHA functional class, left ventricular ejection fraction < 35% were enrolled. At baseline, 1 month, 3 months and each 6 months after implantation clinical, electrocardiographic and echocardiographic parameters, NT-proBNP level were evaluated. According to the best decrease of left ventricular end-systolic volume (LVESV) (mean follow-up period 33.7 ± 15.1 months) patients were classified as super-responders (SR) (n=28; reduction in LVESV ≥ 30%) and non-SR (n=32; reduction in LVESV < 30%). Results: At baseline groups differed in age (58.1 ± 5.8 years in SR vs 50.8 ± 11.4 years in non-SR; p=0.003), gender (female gender 32.1% vs 9.4% respectively; p=0.028), width of QRS complex (157.6 ± 40.6 ms in SR vs 137.6 ± 33.9 ms in non-SR; p=0.044). Percentage of LBBB was equal between groups (75% in SR vs 59.4% in non-SR; p=0.274). All parameters of mechanical dyssynchrony were higher in SR, but only difference in left ventricular pre-ejection period (LVPEP) was statistically significant (153.0 ± 35.9 ms vs. 129.3 ± 28.7 ms p=0.032). NT-proBNP level was lower in SR (1581 ± 1369 pg/ml vs 3024 ± 2431 pg/ml; p=0.006). The survival rates were 100% in SR and 90.6% in non-SR (log-rank test P=0.002). Multiple logistic regression analysis showed that LVPEP (HR 1.024; 95% CI 1.004–1.044; P = 0.017), baseline NT-proBNP level (HR 0.628; 95% CI 0.414–0.953; P=0.029) and age at baseline (HR 1.094; 95% CI 1.009-1.168; P=0.30) were independent predictors for CRT super-response. ROC curve analysis demonstrated sensitivity 71.9% and specificity 82.1% (AUC=0.827; p < 0.001) of this model in prediction of super-response to CRT. Conclusion: Super-response to CRT is associated with better survival in long-term period. Presence of LBBB was not associated with super-response. LVPEP, NT-proBNP level, and age at baseline can be used as independent predictors of CRT super-response.

Keywords: cardiac resynchronisation therapy, superresponse, congestive heart failure, left bundle branch block

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Authors: Ayodeji Blessing Ajileye

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Introduction: Infertility is described as failure to conceive after one year of unprotected sexual intercourse. One of the causes of female infertility is caused by cervical abnormalities which may be due to bacterial and parasitological infections, hormonal imbalances of Lentinizing hormone, follicular stimulating hormone, oestrogen hormone and progesterone hormone. Aim of the Study: This study aimed to determine the prevalence and pattern of abnormal cervical Pap smear in women with infertility attending fertility clinics at Uniosun Teaching Hospitals Osogbo, Osun State. Methods: This study was conducted at the fertility clinic of University of Osun Teaching Hospital, Osogbo, Osun State. The study population comprised of 50 infertile women and 50 fertile women who are attending the gynecology clinic of University of Osun Teaching Hospital, Osogbo, Osun State. Questionnaire was used to obtain relevant data. Cervical sample was collected using Ayre’s spatula, two smears were prepared and stained with Papanicolaous and H&E staining techniques. Results were analyzed using frequency table. Results: This study observed the prevalence of abnormal cervical smear among infertility women to be 16(30%), while only 03(6%) were observed among the control group (fertile women). Atypical squamous cells of undetermined significance have the highest abnormalities observed in this study with 30%, about 28% of the Pap smear results were negative for inflammation, while total inflammation observed was 72% among the infertility women. Conclusion: This study concluded that abnormal pap smears in this study is significantly more often in women with infertility as compared with fertile women.

Keywords: infertility, oestrogen hormone, pap smears, progesterone hormone

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Authors: Anjelika Kremer, Irina Nachimov, Dan Justo

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Background: C-reactive protein (CRP) serum levels are commonly measured in hospitalized patients. Elevated admission CRP serum levels and in-hospital mortality has been seldom studied in the general population of elderly patients admitted to the acute Geriatrics department. Methods: A retrospective cross-sectional study was conducted at a tertiary medical center. Included were all elderly patients (age 65 years or more) admitted to a single acute Geriatrics department from the emergency room between April 2014 and January 2015. CRP serum levels were measured routinely in all patients upon the first 24 hours of admission. A logistic regression analysis was used to study if admission CRP serum levels were associated with in-hospital mortality independent of age, gender, functional status, and co-morbidities. Results: Overall, 498 elderly patients were included in the analysis: 306 (61.4%) female patients and 192 (38.6%) male patients. The mean age was 84.8±7.0 years (median: 85 years; IQR: 80-90 years). The mean admission CRP serum levels was 43.2±67.1 mg/l (median: 13.1 mg/l; IQR: 2.8-51.7 mg/l). Overall, 33 (6.6%) elderly patients died during the hospitalization. A logistic regression analysis showed that in-hospital mortality was independently associated with history of stroke (p < 0.0001), heart failure (p < 0.0001), and admission CRP serum levels (p < 0.0001) – and to a lesser extent with age (p = 0.042), collagen vascular disease (p=0.011), and recent venous thromboembolism (p=0.037). Receiver operating characteristic (ROC) curve showed that admission CRP serum levels predict in-hospital mortality fairly with an area under the curve (AUC) of 0.694 (p < 0.0001). Cut-off value with maximal sensitivity and specificity was 19.7 mg/L. Conclusions: Admission CRP serum levels may be used to predict in-hospital mortality in the general population of elderly patients admitted to the acute Geriatrics department.

Keywords: c-reactive protein, elderly, mortality, prediction

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Authors: Sushila Jaiswal, Awadhesh Kumar Jaiswal

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Background: Primary melanocytic tumors of the central nervous system (CNS) are uncommon lesions and arise from the melanocytes located within the leptomeninges. Aim and objective: The aim of the study was to evaluate the clinical details, histomorphology of the primary melanocytic tumor of CNS. Method: The study was performed by the retrospective review of the case records of the primary melanocytic tumors of CNS diagnosed in our department. The formalin-fixed, paraffin embedded tissue blocks and tissue sections were retrieved and reviewed. Results: Seven cases (6 males, 1 female; age range- 16-40 years; mean age- 27 years) of primary melanocytic tumors of CNS were retrieved over last seven years. The tumor was intracranial (n=5; frontal – 1 case, parietal – 1 case, cerebello-pontine angle- 1 case, occipital -1 case, foramen magnum-1 case) and intra spinal (n=2; cervical – 2 cases). All patients presented with the neurological deficits related to the location of the tumor. Four cases were malignant melanoma; two were melanocytoma of intermediate grade and remaining one was melanocytoma. On histopathology, melanocytoma and melanoma both displayed sheets of well-differentiated melanocytes having round to oval nuclei with finely dispersed chromatin, occasional single eosinophilic nucleoli and a moderate amount of cytoplasm with abundant granular melanin pigment. The absence of mitosis and macronucleoli was noticed in melanocytoma while melanoma showed frequent mitosis and macronucleoli. On immunohistochemistry, both showed diffuse strong HMB45 and S-100 immunopositivity. Conclusion: Primary melanocytic tumors of CNS are rare and predominantly seen in males. It is important to differentiate melanoma from melanocytoma as prognosis of later is good.

Keywords: melanocytoma, melanoma, brain tumor, melanin

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Authors: Lina Vyas

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Gender gap, unfortunately, is still prevalent in the workplace around the world. In most countries, women are less likely than men to participate in the workplace. They earn considerably less than men for doing the same work and are generally expected to prioritize family obligations over work responsibilities. Women often face more conflicts while balancing the increasingly normalized roles of both worker and mother. True gender equality in the workplace is still a long way off. In Hong Kong, no less is this true. Despite the fact that female students are outnumbered by males at universities, only 55% of women are active participants in the labour market, and for those in the workforce, the gender pay gap is 22%. This structural inequality also exacerbates the issues of confronting biases at work for choosing to be employed as a mother, as well as reinforces the societal expectation of women to be the primary caregiver at home. These pressures are likely to add up for women and contribute to increased levels of work-life conflict, which may be a further barrier for the inclusion of women into the workplace. Family-friendly policies have long been thought to be an alleviator of work-life conflict through helping employees balance the demands in both work and family. Particularly, for women, this could be a facilitator of their integration into the workplace. However, little research has looked at how family-friendly policies may also have a gender differential in effect, as opposed to traditional notions of having universal efficacy. This study investigates both how and how much the gender dimension impacts work-family conflict. In addition to disentangling the reasons for gender gaps existing in work-life conflict for women, this study highlights what can be done at an organizational level to alleviate these conflicts. Most importantly, the policies recommendations derived from this study serve as an avenue for more active participation for women in the workplace and can be considered as a pathway for promoting greater gender egalitarianism and fairness in a traditionally gender-segregated society.

Keywords: family-friendly policies, Hong Kong, work-family conflict, workplace

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Authors: Bahman Gorjian

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The notorious COVID-19 is known as an illness that is caused by a novel coronavirus. Since its breakthrough, most governments have decided to temporarily close educational institutions in an attempt to reduce the spread of this disease. Distance education in Iran, like other countries, started from the beginning of the pandemic and caused the closure of schools and universities as an immediate response to control the spread of the virus. The present study followed two aims: First, to investigate if Iraqi M.A students majoring in TEFL who have been studying in Iranian universities during the pandemic believe that COVID-19 had negative/positive effects on their educational achievement; and second, to find how frequently these Iraqi M.A students have experienced psychological problems (e.g., anxiety, numbness, nightmares, nervousness) during the COVID-19. The participants were both male and female students who were admitted for M.A. TEFL courses at 4 Iranian Universities (Abadan Brach, Ahvaz Branch, Science and Research Branch, and Shiraz Branch of Islamic Azad University) for the winter academic term of 2020. The start of their classes coincided with the global outbreak of COVID-19. They were invited to take part in the present study through snowball sampling and were asked to provide their views on two questionnaires. The instruments used for gathering the data were the educational achievement questionnaire and self-rating anxiety scale. The results of the analysis suggested that the participants believed in the negative effects of COVID-19 on their education; the results also suggested COVID-19 affected participants’ psychological states. The discussed findings may have implications for international students and experts interested in the online education system.

Keywords: COVID-19, distance education, Iraqi M.A. students, teaching English as a foreign language, educational impacts, psychological impacts

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Authors: Ibrahim Alhassan Libata

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This study was carried out to assess attitude of secondary school students towards science and technical education in Yauri metropolis, Kebbi State, Nigeria. The population of the study was 200. Proportionate random sampling method was used in selecting 132 as sample size. Science and technical education is the most powerful forces for change in the world today, and students who hope to have a hand in shaping a better future must participate for their advancements. Four Null hypotheses were generated to guide the conduct of the study, questionnaire was the only instrument used in the study; the instrument was subjected to test-retest reliability. The reliability index of the instrument was 0.69. Overall scores of the Students were analyzed and a mean score was determined, the mean score of students was 85. There were no significant differences between the attitudes of male and female students towards science and technical education. The results also revealed that there was significant difference between the attitude of boding and day school students towards science and technical education, personality constraints of students is one factor militating against the participation of students in science and technical education, socio-economic status of the parents over the years have been the dominant factor of student’s inadequate representation in the field of science and technical education. Based on the findings of this study, the researcher recommended that teachers should motivate students, which they can do through their teaching styles and by showing them the relevance of the learning topics to their everyday lives. Government and the school management should create the learning environment that helps motivate students not only to come to classes but also want to learn and enjoy learning science and technical education, establishment of more Science and Technical Colleges education, more Public enlightenment campaigns to motivate parents and the entire community to support their children in studying science and technical education.

Keywords: attitude, students, science, Yauri

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Authors: Syed Dawood M. Taimur

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Background: Peripheral arterial disease (PAD) is under diagnosed in primary care practices, yet the extent of unrecognized PAD in patients with coronary artery disease (CAD) is unknown. Objective: To assess the prevalence of previously unrecognized PAD in patients undergoing coronary angiogram and to determine the relationship between the presence of PAD and severity of CAD. Material & Methods: This five years retrospective study was conducted at an invasive lab of the department of Cardiology, Ibrahim Cardiac Hospital & Research Institute from January 2010 to December 2014. Total 77 patients were included in this study. Study variables were age, sex, risk factors like hypertension, diabetes mellitus, dyslipidaemia, smoking habit and positive family history for ischemic heart disease, coronary artery and peripheral artery profile. Results: Mean age was 56.83±13.64 years, Male mean age was 53.98±15.08 years and female mean age was 54.5±1.73years. Hypertension was detected in 55.8%, diabetes in 87%, dyslipidaemia in 81.8%, smoking habits in 79.2% and 58.4% had a positive family history. After catheterization 88.3% had peripheral arterial disease and 71.4% had coronary artery disease. Out of 77 patients, 52 had both coronary and peripheral arterial disease which was statistically significant (p < .014). Coronary angiogram revealed 28.6% (22) patients had triple vessel disease, 23.3% (18) had single vessel disease, 19.5% (15) had double vessel disease and 28.6% (22) were normal coronary arteries. The peripheral angiogram revealed 54.5% had superficial femoral artery disease, 26% had anterior tibial artery disease, 27.3% had posterior tibial artery disease, 20.8% had common iliac artery disease, 15.6% had common femoral artery disease and 2.6% had renal artery disease. Conclusion: There is a strong and definite correlation between coronary and peripheral arterial disease. We found that cardiovascular risk factors were in fact risk factors for both PAD and CAD.

Keywords: coronary artery disease (CAD), peripheral artery disease(PVD), risk, factors, correlation, cathetarization

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Authors: Ahlam Alnatour

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Background: To our knowledge, there is lack of studies that describe the experience of studying health promotion courses using an interactive approach, and compare students’ and teachers perceptions about this method of teaching. The purpose of this study is to provide a comparison between student and teacher experiences and perspectives in learning health promotion course using interactive learning. Design: A descriptive qualitative design was used to provide an in-depth description and understanding of students’ and teachers experiences and perceptions of learning health promotion courses using an interactive learning. Study Participants: About 14 fourteen students (seven male, seven female) and eight teachers at governmental university in northern Jordan participated in this study. Data Analysis: Conventional content analysis approach was used for participants’ scripts to gain an in-depth description for both students' and teacher’s experiences. Results: The main themes emerged from the data analysis describing the students’ and teachers perceptions of the interactive health promotion class: teachers’ and students positive experience in adopting interactive learning, advantages and benefits of interactive teaching, barriers to interactive teaching, and suggestions for improvement. Conclusion: Both teachers and students reflected positive attitudes toward interactive learning. Interactive learning helped to engage in learning process physically and cognitively. Interactive learning enhanced learning process, promote student attention, enhanced final performance, and satisfied teachers and students accordingly. Interactive learning approach should be adopted in teaching graduate and undergraduate courses using updated and contemporary strategies. Nursing scholars and educators should be motivated to integrate interactive learning in teaching different nursing courses.

Keywords: interactive learning, nursing, health promotion, qualitative study

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Authors: Nouf Aljohani

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The research project described in this presentation focuses on designing and evaluating oral tasks related to students’ needs and levels to foster communication and negotiation of meaning for a group of female Saudi university students. The significance of the current research project lies in its contribution to determining the usefulness of synchronous technology-mediated interactive group discussion in improving different speaking strategies through using synchronous technology. Also, it discovers how to optimize learning outcomes, expand evaluation for online learning tasks and engaging students’ experience in evaluating synchronous interactive tools and tasks. The researcher used SpeakApps, a synchronous technology, that allows the students to practice oral interaction outside the classroom. Such a course of action was considered necessary due to low English proficiency among Saudi students. According to the author's knowledge, the main factor that causes poor speaking skills is that students do not have sufficient time to communicate outside English language classes. Further, speaking and listening course contents are not well designed to match the Saudi learning context. The methodology included designing speaking tasks to match the educational setting; a CALL framework for designing and evaluating tasks; participant involvement in evaluating these tasks in each online session; and an investigation of the factors that led to the successful implementation of Task-based Language Teaching (TBLT) and using SpeakApps. The analysis and data were drawn from the technology acceptance model surveys, a group interview, teachers’ and students’ weekly reflections, and discourse analysis of students’ interactions.

Keywords: CALL evaluation, synchronous technology, speaking skill, task-based language teaching

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Authors: Eirini Arvanitaki

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Romance has incrementally grown in popularity over the last century. The first Mills & Boon romance novel was published in 1909 and since then romance has not only survived but it has become a long standing genre. There are several reasons behind its durability and success. First, its ability to please and appeal to a mass audience. Romance novels are products of commercial success situated in large scale production, especially if one takes into account the high volume of romance novels published, translated and distributed all around the world every month. Second, what has also contributed to keeping the romance genre alive is the content of the books and their effect on the reader. These are stories of two heterosexual individuals who meet, fall in love, face obstacles and successfully overcome them. Through the love plots, the books address anxieties, concerns and everyday troubles that the average reader can identify with. Additionally, the romance novel is a means of escapism from everyday life and responsibilities as well as a short-lived opportunity to enjoy personal time/space and focus on one’s self. Third, the genre’s ability to adapt to the periods and societies in which it is published has also assisted in prolonging its longevity. This paper discusses the ways in which popular romance authors write and engage with the body. Despite the claim that popular romance narratives adjust their contents in accordance with different time periods and social phenomena, the paper highlights the dissimilarities between writing the female and male body and suggests that women romance writers are yet to break free from phallogocentric law. The examination of the projections of the body and the language used to describe it indicates that these narratives are flexible enough to adjust to twenty-first century but only within the limits of their own conventionality.

Keywords: body, gender, language, literary representations, popular romance narratives, taboo

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Authors: Emmanuel Larbi Offei, Felix Agyei-Sasu, Maura Naa Densua Ashong

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Ghana has 26 universal banks and several banking and non-banking financial institutions operating in the country. The growing number of banks has heightened competition among banks to attract and retain customers more customers to ensure sustainability. Hence the need to identify and understand factors that influences customers’ choice of banks cannot be overemphasised. This study investigates the determinants of bank selection criteria by banking customers in Ghana. Four banks were purposively sampled for this study namely Barclays, Standard Chartered, Sahel Sahara and Unibank. Convenience sampling was then used to select 114 bank customers in Accra and interviewed. Questionnaires were used to collect data that were analysed in tables and charts with the use of STATA software. The findings of the study revealed that quick/prompt services and complaint handling, safety of funds, networked branches, easy access to functional Automated Teller Machines (ATMs) and low/moderate service charges were the major determinants of customers’ choice of banks. The results further show that 89.5 percent of all deposits are held in either current or savings accounts. About 22.1 percent of the respondents indicated that they have plans of changing their banks in the near future because they are not satisfied with their banks. A gender analysis of the choice criteria showed differences between the choice criteria of the male as compared to the female. The study recommends that banks in Ghana should focus on products and policies that will not compromise on the safety of funds of their customers. Again, banks must address customer complaints and dissatisfactions as promptly as possible by taking pragmatic steps to address administrative bureaucracies and infrastructural challenges that prolong the duration of banking transactions.

Keywords: Ghana, banks, determinants, customers’ choice, competition

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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: Vincent A. Adzika, Franklin N. Glozah, Collins S. K. Ahorlu

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Background: Sickle Cell Disease (SCD) is of major public-health concern globally, with majority of patients living in Africa. Despite its relevance, there is a dearth of research to determine the socio-demographic distribution and psychosocial impact of SCD in Africa. The objective of this study therefore was to examine the socio-demographic distribution and psychosocial consequences of SCD among patients in Ghana and to assess their quality of life and coping mechanisms. Methods: A cross-sectional research design was used, involving the completion of questionnaires on socio-demographic characteristics, quality of life of individuals, anxiety and depression. Participants were 387 male and female patients attending a sickle cell clinic in a public hospital. Results: Results showed no gender and marital status differences in anxiety and depression. However, there were age and level of education variances in depression but not in anxiety. In terms of quality of life, patients were more satisfied by the presence of love, friends, relatives as well as home, community and neighbourhood environment. While pains of varied nature and severity were the major reasons for attending hospital in SCD condition, going to the hospital as well as having Faith in God was the frequently reported mechanisms for coping with an unbearable SCD attacks. Multiple regression analysis showed that some socio-demographic and quality of life indicators had strong associations with anxiety and/or depression. Conclusion: It is recommended that a multi-dimensional intervention strategy incorporating psychosocial dimensions should be considered in the treatment and management of SCD.

Keywords: anxiety, depression, sickle cell disease, socio-demographic quality of life, characteristics, Ghana

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Authors: Pranee Suecharoen, Jaturat Kanpittaya

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Background: The incidence of adverse reactions to iodinated contrast media has risen. The dearth of reports on reactions to the administration of iso- and low-osmolar contrast media should be addressed. We, therefore, studied the profile of adverse reactions to iodinated contrast media; viz., (a) the body systems affected (b) causality, (c) severity, and (d) preventability. Objective: To study adverse reactions (causes and severity) to iodinated contrast media at Srinagarind Hospital. Method: Between March and July, 2015, 1,101 patients from the Department of Radiology were observed and interviewed for the occurrence of adverse reactions. The patients were classified per Naranjo’s algorithm and through use of an adverse reactions questionnaire. Results: A total of 105 cases (9.5%) reported adverse reactions (57% male; 43% female); among whom 2% were iso-osmolar vs. 98% low-osmolar. Diagnoses included hepatoma and cholangiocarcinoma (24.8%), colorectal cancer (9.5%), breast cancer (5.7%), cervical cancer (3.8%), lung cancer (2.9%), bone cancer (1.9%), and others (51.5%). Underlying diseases included hypertension and diabetes mellitus type 2. Mild, moderate, and severe adverse reactions accounted for 92, 5 and 3%, respectively. The respective groups of escalating symptoms included (a) mild urticaria, itching, rash, nausea, vomiting, dizziness, and headache; (b) moderate hypertension, hypotension, dyspnea, tachycardia and bronchospasm; and (c) severe laryngeal edema, profound hypotension, and convulsions. All reactions could be anticipated per Naranjo’s algorithm. Conclusion: Mild to moderate adverse reactions to low-osmolar contrast media were most common and these occurred immediately after administration. For patient safety and better outcomes, improving the identification of patients likely to have an adverse reaction is essential.

Keywords: adverse reactions, contrast media, computed tomography, iodinated contrast agents

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Authors: Shehu Aliyu

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This study investigated the effects of instructional materials on academic achievement among senior secondary school students on the concept of Heat Transfer in physics in Fagge Educational Zone, Kano State Nigeria. The population consisted of SSII students from 10 public schools. Out of this, 87 students were randomly selected from which 24 males and 22 females formed the experimental group and 41 students as control group. A quasi experiential design with pretest and post-test for both the groups was adopted. Two research questions and null hypotheses guided the conduct of the study. The experimental group was exposed to teaching using instructional materials while the control group was taught using the normal lecture mode. Head Transfer Performance Test (HTPT) was used for data collection. The instrument was validated by experts in the science education field. A Pearson Product Moment Correlation (PPMC) was used to determine the reliability co-efficient and was found to be r=0.83. The research questions were answered using descriptive statistics while the hypotheses were tested at p≤ 0.05 level of significance using t-test. The result obtained from the data analysis showed that students in experimental group performed significantly better than those in the control group and that there was no significant difference in the academic performance between male and female students in the experimental group. Based on the findings of this study, it was recommended among others that the physics teachers should be receiving regular training on the importance of using instructional materials whether ready made or improved in their teaching.

Keywords: heat transfer, physics, instructional materials, academic performance

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Authors: Papitchaya Papangkorn

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Matching the expectations of teachers and learners is significant for successful language learning. Moreover, teachers should discover what their learners think and feel about what and how they want to learn. Therefore, this study investigates International College, Suan Sunandha Rajabhat University students’ preferences toward error corrections in order to help SSRUIC teachers match their expectations and their learners because it is important for successful language learning. This study examined the learners’ attitude and preference toward error correction through 50 first year SSRUIC students both male (25) and female (25) in Bangkok, Thailand. The data were collected from a questionnaire and interviews to investigate the necessity and frequency, timing, type of errors, method of corrective feedback, and person who gives error correction in order to answer the overall research question and sub-questions. The findings indicate five suggestions regarding the overall research question. Firstly, errors should be treated, and always be treated. Secondly, treating errors after finish speaking is the most appropriate time. Thirdly, “errors that may cause problems in an understanding of listener” and “frequent spoken errors” should be treated. Fourthly, repetition and explicit feedback were the most popular types of feedback among males, whereas metalinguistic feedback was the most favoured types amongst females. Finally, teachers were the most preferred person to deliver corrective feedback for the learners. Although the results of the study are difficult to generalize to a larger population, which are Thai EFL learners because of the small sample, the findings provide useful information that may contribute to understanding of SSRUIC learners’ preferences toward error corrections and it might reduce the gap between what teachers employ and what students expect when receiving corrective feedback. The reduction of this gap may be useful for the learning process and could enhance the efforts of both teachers and learners in a Thai context.

Keywords: attitude, corrective feedback, error, preference

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Authors: R. Chinyakata, N. R. Raselekoane

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Migration has always been part of human history. Migration is spurred by globalisation which connects nations by encouraging the flow of goods, services, ideas and people across borders. Migration does not only involve movement of adults from one country to another. It also affects and involves the youth as they are the most mobile group. Musina area, like many other border areas, experiences a variety of challenges as a result of the influx of people from the neighbouring Zimbabwe and other African countries. Of great concern about this migration is the fact that the host country or area may become unsafe and unstable as a result of huge influx of migrants. There may also be tensions between local people and migrants over the resources. The study sought to investigate the effects of the Zimbabwean youth migration on Musina area. The study was undertaken in Musina area which is situated 18km from the Beit-Bridge border post. A qualitative research approach was used. Semi-structured interviews were used to collect data. Non-probability quota sampling technique was used to select the respondents. The study sample consisted of sixteen female and male respondents. Thematic coding was used to analyse the data. Ethical considerations such as informed consent, confidentiality, anonymity and voluntary participation were taken into account to protect the participants. The study found that the effects of the Zimbabwean youth migration on the Musina area include, among others, tensions between locals and the Zimbabwean youth migrants over resources, job and business opportunities, overcrowding and crime. Multi-pronged strategies which involve different stakeholders should be applied to address tensions over job and business opportunities, overcrowding and crime in the Musina area.

Keywords: host country, effects, migrant, migration, Musina, youth, Zimbabwe

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Authors: A. Goma Amira, U. E. Mahrous

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Measuring the effect of perinatal lead exposure on learning ability of offspring is considered as a sensitive and selective index for providing an early marker for central nervous system damage produced by this toxic metal. A total of 35 Sprague-Dawley adult rats were used to investigate the effect of lead acetate toxicity on behavioral patterns of adult female rats and learning ability of offspring. Rats were allotted into 4 groups, group one received 1g/l lead acetate (n=10), group two received 1.5g/l lead acetate (n=10), group three received 2g/l lead acetate in drinking water (n=10), and control group did not receive lead acetate (n=5) from 8th day of pregnancy till weaning of pups. The obtained results revealed a dose-dependent increase in the feeding time, drinking frequency, licking frequency, scratching frequency, licking litters, nest building, and retrieving frequencies, while standing time increased significantly in rats treated with 1.5g/l lead acetate than other treated groups and control. On the contrary, lying time decreased gradually in a dose-dependent manner. Moreover, movement activities were higher in rats treated with 1g/l lead acetate than other treated groups and control. Furthermore, time spent in closed arms was significantly lower in rats given 2g/l lead acetate than other treated groups, while they spent significantly much time spent in open arms than other treated groups which could be attributed to occurrence of adaptation. Furthermore, number of entries in open arms was-dose dependent. However, the ratio between open/closed arms revealed a significant decrease in rats treated with 2g/l lead acetate than the control group.

Keywords: lead toxicity, rats, learning ability, behavior

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