Search results for: aged care

Authors: Mitra Mesgar

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Online learning environment is becoming more popular among learners because of their multiple information representations. Despite the growing importance of online reading strategies among adult learners, little attention has been carried out to postgraduate EFL learners. This study is quantitative research designed and aimed to investigate metacognitive reading strategies employed by Iranian postgraduate learners to read online academic texts. This study is conducted by over 50 Iranian postgraduate students studying in different Malaysian universities. This study used two different survey questionnaires, namely, 1) background questionnaire and 2) OSORS questionnaire. The collected data were analyzed using SPSS. The findings of the study emphasized metacognitive reading strategies used by different aged adult learners. The results of the survey questionnaires revealed that adult learners use global reading strategies as well as problem-solving strategies and support reading strategies. Also, through one-way analysis of variance toward age factor revealed that it has no meaningful changes on metacognitive reading strategy usage. This means that metacognitive reading strategies used by adult learners are independent of age variable. Drawing from findings, adult learners have learning goals, and since they have more exposure to online academic texts, they are able to use different metacognitive online reading strategies that affect their understanding of academic texts.

Keywords: online reading strategies, metacognitive strategies, online learning, independent students, locus of control

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Authors: Sara Sousa, Veronique Gomes, Nélio Veiga, Maria José Correia

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Objectives: To assess the presence or absence of Streptococcus mutans, Streptococcus gordonii and Streptococcus salivarius in the oral biofilm of children in an elementary school of Viseu, Portugal, and verify the relationship between Streptococcus gordonii and Streptococcus salivarius and the absence of dental caries. Methods: A cross-sectional study was designed with a final sample of 40 children aged 6-11 years old. Oral examination was accomplished with the identification of their oral health status and oral biofilm collection. Analysis of biological samples by molecular techniques of DNA isolation and identification of three Streptococci bacteria by Polimerase Chain Reaction (PCR) was made. Results: We identified Streptococcus salivarius and Streptococcus gordoni only in the lower interincisal region. These species were also present mainly in the first permanent non-decayed molars. On the contrary, Streptococcus mutans was found mostly in decayed first permanent molars. Conclusion: This preliminary study establishes a possible association between the absence of dental caries and the presence of Streptococcus gordonii and Streptococcus salivarius. Since these two species are described as alkali producers, it is suggested that their presence somehow confers protection against caries. These results support new dental caries prevention strategies based on oral biofilm modulation by enrichment with alkalinogenic species.

Keywords: dental caries, oral biofilm, Streptococcus gordonii, Streptococcus salivarius

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Authors: Jihene Jlassi, Ahmed Frikha, Wazna Kortli

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The objectives of Nurse-Patient Assignment are the minimization of the overall hospital cost and the maximization of nurses ‘preferences. This paper aims to assess nurses' satisfaction related to the implementation of patient acuity tool-based assignments. So, we used an integer linear program that assigns patients to nurses while balancing nurse workloads. Then, the proposed model is applied to the Paediatrics Department at Kasserine Hospital Tunisia. Where patients need special acuities and high-level nursing skills and care. Hence, numerical results suggested that proposed nurse-patient assignment models can achieve a balanced assignment

Keywords: nurse-patient assignment, mathematical model, logistics, pediatrics department, balanced assignment

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Authors: Sheena Christabel Pravin, M. Palanivelan

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Speech disfluencies are common in spontaneous speech. The primary purpose of this study was to distinguish linguistic disfluencies from stuttering disfluencies in bilingual Tamil–English (TE) speaking children. The secondary purpose was to determine whether their disfluencies are mediated by native language dominance and/or on an early onset of developmental stuttering at childhood. A detailed study was carried out to identify the prosodic and acoustic features that uniquely represent the disfluent regions of speech. This paper focuses on statistical modeling of repetitions, prolongations, pauses and interjections in the speech corpus encompassing bilingual spontaneous utterances from school going children – English and Tamil. Two classifiers including Hidden Markov Models (HMM) and the Multilayer Perceptron (MLP), which is a class of feed-forward artificial neural network, were compared in the classification of disfluencies. The results of the classifiers document the patterns of disfluency in spontaneous speech samples of school-aged children to distinguish between Children Who Stutter (CWS) and Children with Language Impairment CLI). The ability of the models in classifying the disfluencies was measured in terms of F-measure, Recall, and Precision.

Keywords: bi-lingual, children who stutter, children with language impairment, hidden markov models, multi-layer perceptron, linguistic disfluencies, stuttering disfluencies

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Authors: Denise Allison D. Garcia, Camille C. Garcia, Keanu Raphael Garrido, Crestita B. Tan

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Introduction: Anxiety is a common problem among pre-operative patients. Several methods or interventions are being applied in order to relieve anxiety. Laughter yoga, however, is a method that has been used to relieve anxiety but has not yet been tested to pre-operative patients. Therefore, this study determined the effectiveness of laughter yoga in reducing anxiety among pre-operative middle-aged patients scheduled for major surgery. Methods: After Ethics Review Board approval, a quasi-experimental study was conducted among 40 purposely-selected pre-operative patients in two tertiary hospitals. Anxiety level was measured prior to administration of laughter yoga using the State-Trait Anxiety Inventory with a Cronbach alpha of 0.83. After Laughter yoga, anxiety level was then measured again. Gathered data were analyzed in SPSS version 20 using paired and independent t-test and ANCOVA. Results: After analysis of the data gathered, the results showed that there was a significant decrease in the anxiety level of patients in the experimental group. From an anxiety level of 44.00, the rating went down to 36.85. Meanwhile in the control group, the anxiety level at the pretest at 41.25 went up to 42.50. Laughter yoga was an effective non-pharmacologic intervention for reducing anxiety of pre-operative patients. Conclusion: It is therefore concluded that laughter yoga causes a significant decrease in the anxiety level of patients.

Keywords: anxiety, laughter yoga, non-pharmacologic, pre-operative

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Authors: Rami S. Alasmari, Abdullah Al Zahrani, Hattan A. Hassani, Hattan A. Hassani, Nawwaf A. Almalky, Abdullah F. Bokhari, Alwalied A. Hafez

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Diabetes mellitus type 2 (DMT2) is a major chronic condition that is considered common among elderly people, with multiple potential complications that could contribute to falls. However, this concept is not well understood, thus, the aim of this study is to determine whether diabetes is an independent risk factor for falls in elderly. In this observational cross-sectional study, 309 diabetic patients aged 60 or more who visited the primary healthcare centers of the Ministry of National Guard Health Affairs in Jeddah were chosen via convenience sampling method. To collect the data, Semi-structured Fall Risk Assessment questionnaire and Fall Efficacy Score scale were used. The mean age of the participants was estimated to be 68.5 (SD:7.4) years. Among the participants, 48.2% experienced falling before, and 63.1% of them suffered falls in the past 12-months. The results showed that gait problems were independently associated with a higher likelihood of fall among the elderly patients (OR = 1.98, 95%CI, 1.08 to 3.62, p = 0.026. This paper suggests that diabetes mellitus is an independent fall risk factor among elderly. Therefore, identifying such patients as being at higher risk and prompt referral to a specialist falls clinic is recommended.

Keywords: diabetes, fall, elderly, risk factors

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Authors: Lauren Dixon, David Galvani

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Objective: Sharing devastating news with patients is often considered the most difficult task of doctors. This study aimed to explore patients’ perceptions of receiving bad news including which features improve the experience and which areas need refining. Methods: A questionnaire was written based on the steps of the SPIKES model for breaking bad news. 20 patients receiving treatment for a haematological malignancy completed the questionnaire. Results: Overall, the results are promising as most patients praised their consultation. ‘Poor’ was more commonly rated by women and participants aged 45-64. The main differences between the ‘excellent’ and ‘poor’ consultations include the doctor’s sensitivity and checking the patients’ understanding. Only 35% of patients were asked their existing knowledge and 85% of consultations failed to discuss the impact of the diagnosis on daily life. Conclusion: This study agreed with the consensus of existing literature. The commended aspects include consultation set-up and information given. Areas patients felt needed improvement include doctors determining the patient’s existing knowledge and exploring how the diagnosis will affect the patient’s life. With a poorer prognosis, doctors should work on conveying appropriate hope. The study was limited by a small sample size and potential recall bias.

Keywords: cancer, diagnosis, haematology, patients

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Authors: Suzanne L. Stewart, Sarah J. Ponton, Mikaela D. Gabriel, Roy Strebel, Xinyi Lu

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Indigenous Peoples have faced unique barriers to accessing and receiving culturally safe and appropriate mental health care while also facing daunting rates of mental health diagnoses and comorbidities. Indigenous researchers and clinicians have well established the connection of the current mental health issues in Indigenous communities as a direct result of colonization by way of intergenerational trauma throughout Canada’s colonial history. Such mental health barriers and challenges have become exacerbated during the COVID-19 pandemic. Throughout the pandemic, access to mental health, cultural, ceremonial, and community services were severely impacted and restricted; however, it is these same cultural activities and community resources that are key to supporting Indigenous mental health from a traditional and community-based perspective. This research employed a unique combination of a thorough, analytical scoping review of the existent mental health literature of Indigenous mental health in the COVID-19 pandemic, alongside narrative interviews employing an oral storytelling tradition methodology with key community informants that provide comprehensive cultural services to the Indigenous community of Toronto, as well as across Canada. These key informant interviews provided a wealth of insights into virtual transitions of Indigenous care and mental health support; intersections of historical underfunding and current financial navigation in technology infrastructure; accessibility and connection with Indigenous youth in remote locations; as well as maintaining community involvement and traditional practices in a current pandemic. Both the scoping review and narrative interviews were meticulously analyzed for overarching narrative themes to best explore the extent of the literature on Indigenous mental health and services during COVID-19; identify gaps in this literature; identify barriers and supports for the Indigenous community, and explore the intersection of community and cultural impacts to mental health. Themes of the scoping review included: Historical Context; Challenges in Culturally-Based Services; and Strengths in Culturally-Based Services. Meta themes across narrative interviews included: Virtual Transitions; Financial Support for Indigenous Services; Health Service Delivery & Wellbeing; and Culture & Community Connection. The results of this scoping review and narrative interviews provide wide application and contribution to the mental health literature, as well as recommendations for policy, service provision, autonomy in Indigenous health and wellbeing, and crucial insights into the present and enduring mental health needs of Indigenous Peoples throughout the COVID-19 pandemic.

Keywords: indigenous community services, indigenous mental health, indigenous scoping review, indigenous peoples and Covid-19

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Authors: Alina Rahim, Joanne Moffatt, Jessica Taylor, Joseph Hartland, Tamer Abdelrazik

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Background: In 2011, 15% of maternal deaths in Uganda were due to hypertensive disorders (pre-eclampsia and eclampsia). The majority of these deaths are avoidable with optimum antenatal care. The aim of the study was to evaluate how antenatal monitoring of pre-eclampsia was carried out in a low resource setting and to identify barriers to best practice as recommended by the World Health Organisation (WHO) as part of a 4th year medical student External Student Selected component field trip. Method: Women admitted to hospital with pre-eclampsia in rural Uganda (Villa Maria and Kitovu Hospitals) over a year-long period were identified using the maternity register and antenatal record book. It was not possible to obtain notes for all cases identified on the maternity register. Therefore a total of thirty sets of notes were reviewed. The management was recorded and compared to Ugandan National Guidelines and WHO recommendations. Additional qualitative information on routine practice was established by interviewing staff members from the obstetric and midwifery teams. Results: From the records available, all patients in this sample were managed according to WHO recommendations during labour. The rate of Caesarean section as a mode of delivery was noted to be high in this group of patients; 56% at Villa Maria and 46% at Kitovu. Antenatally two WHO recommendations were not routinely met: aspirin prophylaxis and calcium supplementation. This was due to lack of resources, and lack of attendance at antenatal clinic leading to poor detection of high-risk patients. Medical management of pre-eclampsia varied between individual patients, overall 93.3% complied with Ugandan national guidelines. Two patients were treated with diuretics, which is against WHO guidance. Discussion: Antenatal monitoring of pre-eclampsia is important in reducing severe morbidity, long-term disability and mortality amongst mothers and their babies 2 . Poor attendance at antenatal clinic is a barrier to healthcare in low-income countries. Increasing awareness of the importance of these visits for women should be encouraged. The majority of cases reviewed in this sample of women were treated according to Ugandan National Guidelines. It is recommended to commence the use of aspirin prophylaxis for women at high-risk of developing pre-eclampsia and the creation of detailed guidelines for Uganda which would allow for standardisation of care county-wide.

Keywords: antenatal monitoring, low resource setting, pre-eclampsia, Uganda

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Authors: Shantol McIntosh

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Due to environmental and underlying health disparities, the COVID-19 pandemic has caused an added set of economic implications worldwide. Black and Hispanic individuals are more susceptible to contract COVID-19, and if they do, they are more likely to have a severe case that necessitates hospitalization or results in death (Altarum et al., 2020). The literature shows that disparities in health and health treatment are nothing new as they have been recorded for decades and indicate systemic and structural imbalances rooted in racism and discrimination. The purpose of this study is to determine the frequency with which these populations have access to healthcare and treatment. The study will also highlight the key drivers of health disparities. Findings and implications for research and policy will be discussed.

Keywords: COVID-19, racial and ethnic disparities, discrimination, policy

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Authors: Anne Hovgaard Jorgensen

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This study investigates how Muslim fathers in Denmark are struggling to overcome notions of mistrust from teachers and educators. Starting from school-home-cooperation (parent conferences, school-home communication, etc.), the study finds that many Muslim fathers do not feel acknowledged as a resource in the upbringing of their children. To explain these experiences further, the study suggest the notion of ‘mistrusted masculinity’ to grasp the controlling image these fathers meet in various schools and child-care-institutions in the Danish Welfare state. The paper is based on 9 months of fieldwork in a Danish school, a social housing area and in various ‘father groups’ in Denmark. Additional, 50 interviews were conducted with fathers, children, mothers, schoolteachers, and educators. By using Connell's concepts 'hegemonic' and 'marginalized' masculinity as steppingstones, the paper argues that these concepts might entail a too static and dualistic picture of gender. By applying the concepts of 'emergent masculinity' and 'emergent fatherhood' the paper brings along a long needed discussion of how Muslim men in Denmark are struggling to overcome and change the controlling images of them as patriarchal and/or ignorant fathers regarding the upbringing of their children. As such, the paper shows how Muslim fathers are taking action to change this controlling image, e.g. through various ‘father groups’. The paper is inspired by the phenomenological notions of ‘experience´ and in the light of this notion, the paper tells the fathers’ stories about their upbringing of their children and aspirations for fatherhood. These stories share light on how these fathers take care of their children in everyday life. The study also shows that the controlling image of these fathers have affected how some Muslim fathers are actually being fathers. The study shows that fear of family-interventions from teachers or social workers e.g. have left some Muslim fathers in a limbo, being afraid of scolding their children, and being confused of ‘what good parenting in Denmark is’. This seems to have led to a more lassie fair upbringing than these fathers actually wanted. This study is important since anthropologists generally have underexposed the notion of fatherhood, and how fathers engage in the upbringing of their children. Over more, the vast majority of qualitative studies of fatherhood have been on white middleclass fathers, living in nuclear families. In addition, this study is crucial at this very moment due to the major refugee crisis in Denmark and in the Western world in general. A crisis, which has resulted in a vast number of scare campaigns against Islam from different nationalistic political parties, which enforces the negative controlling image of Muslim fathers.

Keywords: fatherhood, Muslim fathers, mistrust, education

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Authors: Marek Halenár, Eva Tvrdá, Tomáš Slanina, Ľubomír Ondruška, Eduard Kolesár, Peter Massányi, Adriana Kolesárová

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The present in vitro study was designed to reveal whether amygdalin (AMG) is able to cause changes to the motility, viability and mitochondrial activity of rabbit spermatozoa. New Zealand White rabbits (n = 10) aged four months were used in the study. Semen samples were collected from each animal and used for the in vitro incubation. The samples were divided into five equal parts and diluted with saline supplemented with 0, 0.5, 1, 2.5 and 5 mg/mL AMG. At times 0h, 3h and 5h spermatozoa motion parameters were assessed using the SpermVision™ computer-aided sperm analysis (CASA) system, cell viability was examined with the metabolic activity (MTT) assay, and the eosin-nigrosin staining technique was used to evaluate the viability of rabbit spermatozoa. All AMG concentrations exhibited stimulating effects on the spermatozoa activity, as shown by a significant preservation of the motility (P<0.05 with respect to 0.5 mg/mL and 1 mg/mL AMG; Time 5 h) and mitochondrial activity (P< 0.05 in case of 0.5 mg/mL AMG; P< 0.01 in case of 1 mg/mL AMG; P < 0.001 with respect to 2.5 mg/mL and 5 mg/mL AMG; Time 5 h). None of the AMG doses supplemented had any significant impact of the spermatozoa viability. In conclusion, the data revealed that short-term co-incubation of spermatozoa with AMG may result in a higher preservation of the sperm structural integrity and functional activity.

Keywords: amygdalin, CASA, mitochondrial activity, motility, rabbits, spermatozoa, viability

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Authors: Jessica Gladden

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This study explored the perceived benefits of trauma-sensitive yoga programs. Participants attended one of two six-week trauma-sensitive yoga programs utilizing the G.R.A.C.E model, a format developed based on Emerson’s trauma-sensitive yoga guidelines and modified by the instructors. Participants in this study completed surveys on their experiences. The results of the surveys indicated that participants perceived improvements in self-care, embodiment, and mood. These results show that trauma-sensitive yoga may have benefits beyond the treatment of specific diagnoses that could be applied to a variety of populations. Reflections from one of the researchers who teaches in this program, as well as qualitative statements from the participants, will be shared to support the continued use of this method.

Keywords: yoga, trauma-sensitive, yoga therapy, trauma

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Authors: Gabriela Smeckova

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The entire world is becoming more and more diverse. The reasons why people migrate are different and unique for each family /individual. Professionals delivering services (including speech-language pathologists) must be prepared to work with clients coming from different cultural and/or linguistic backgrounds. Well-educated speech-language pathologists will consider many factors when delivering services. Some of them will be discussed during the presentation (language spoken, beliefs about health care and disabilities, reasons for immigration, etc.). The communication styles of the client can be different than the styles of the speech-language pathologist. The goal is to become culturally responsive in service delivery.

Keywords: culture, cultural competence, culturallly responsive practices, speech-language pathologist, cultural and linguistical variables, communication styles

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Authors: Maria Ahmad, Michael Page, Danë Goodsman

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‘Educational’ debriefing – a construct distinct from clinical debriefing – is used following simulated scenarios and is central to learning and development in fields ranging from aviation to emergency medicine. However, little research into educational debriefing in prehospital medicine exists. This qualitative study explored the facilitation and effects of prehospital educational debriefing and identified obstacles to debriefing, using the London’s Air Ambulance Pre-Hospital Care Course (PHCC) as a model. Method: Ethnographic observations of moulages and debriefs were conducted over two consecutive days of the PHCC in October 2019. Detailed contemporaneous field notes were made and analysed thematically. Subsequently, seven one-to-one, semi-structured interviews were conducted with four PHCC debrief facilitators and three course participants to explore their experiences of prehospital educational debriefing. Interview data were manually transcribed and analysed thematically. Results: Four overarching themes were identified: the approach to the facilitation of debriefs, effects of debriefing, facilitator development, and obstacles to debriefing. The unpredictable debriefing environment was seen as both hindering and paradoxically benefitting educational debriefing. Despite using varied debriefing structures, facilitators emphasised similar key debriefing components, including exploring participants’ reasoning and sharing experiences to improve learning and prevent future errors. Debriefing was associated with three principal effects: releasing emotion; learning and improving, particularly participant compound learning as they progressed through scenarios; and the application of learning to clinical practice. Facilitator training and feedback were central to facilitator learning and development. Several obstacles to debriefing were identified, including mismatch of participant and facilitator agendas, performance pressure, and time. Interestingly, when used appropriately in the educational environment, these obstacles may paradoxically enhance learning. Conclusions: Educational debriefing in prehospital medicine is complex. It requires the establishment of a safe learning environment, an understanding of participant agendas, and facilitator experience to maximise participant learning. Aspects unique to prehospital educational debriefing were identified, notably the unpredictable debriefing environment, interdisciplinary working, and the paradoxical benefit of educational obstacles for learning. This research also highlights aspects of educational debriefing not extensively detailed in the literature, such as compound participant learning, display of ‘professional honesty’ by facilitators, and facilitator learning, which require further exploration. Future research should also explore educational debriefing in other prehospital services.

Keywords: debriefing, prehospital medicine, prehospital medical education, pre-hospital care course

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Authors: Sahar Hooshmand, Mohammad Reza Bagherzadeh Anasari

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The aim of this study was to examine the effect of breakfast eating pattern (between frequencies of breakfast consumers and non-consumers) on nutritional status (weight for age, height for age and weight for height). A total 4570 primary school children aged 6-9 years old constituted the sample. From these, 2234 Iranian school children (1218 girls and 1016 boys) and 2336 Indian school children (1096 girls and 1240 boys) were included in a cross sectional study. Breakfast frequency consumption was recorded through an interview with mothers of children. Height and wight of children were taken and body mass index were calculated. The World Health Organization’s (WHO) AnthroPlus software used to assess the nutritional status of the children. Weight for age z-scores were slightly associated with frequency of consuming breakfast in both India (χ2 = 60.083, p=0.000) and Iran (χ2 = 18.267, p=0.032). A significant association was seen between frequency of child‘s breakfast intake and the height z-scores in both India (χ2 = 31.334, p=0.000) and Iran (χ2 = 19.443, p=0.022). Most of children with normal height had breakfast daily in both countries. A significant association was seen with children‘s BMI z-scores of Indian children (χ2 = 31.247, p=0.000) but it was not significant in Iran (χ2 = 10.791, p=0.095). The present study confirms the observations of other studies that showed more frequency in having breakfast is associated with better nutritional status.

Keywords: breakfast, schoolchildren, nutritional status, global food security

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Authors: Alshaimaa Abdelwahab, Allegra Cattani, Caroline Floccia

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Assessing children’s language is fundamental for changing their developmental outcome as it gives a chance for a quick and early intervention with the suitable planning and monitoring program. The importance of language assessment lies in helping to find the right test fit for purpose, in addition to achievement and proficiency. This study examines the validity of a new Arabic assessment tool, the Arabic Communicative Development Inventory ‘Arabic CDI’. It assesses the development of language in Arabic children in different Arabic countries, allowing to detect children with language delay. A concurrent validity is set to compare the Arabic CDI to the Arabic Language test. Twenty-three typically developing Egyptian healthy children and their mothers participated in this study. Their age is 24 months (+ or -) two weeks. The sample included 13 males and 10 females. Mothers completed the Arabic CDI either before or after the Arabic Language Test was conducted with the child. The score for comprehension in the Arabic CDI (M= 52.7, SD= 9.7) and words understood in the Arabic Language Test (M= 59.6, SD= 12.5) were strongly and positively correlated (r= .62, p= .002). At the same time, the scores for production in the Arabic CDI (M= 38.4, SD= 14.8) and words expressed in the Arabic Language Test (M= 52.1, SD= 16.3) were also strongly and positively correlated (r= .82, p= .000). The new Arabic CDI is an adequate tool for assessing the development of comprehension and production at Arabic children. In addition, it could be used for detecting children with language impairment. Standardization of the Arabic CDI across 18 different Arabic dialects in children aged 8 to 30 months is underway.

Keywords: Arabic CDI, assessing children, language development, language impairment

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Authors: Rajish Shil, Mohammad Ali Houri, Mohammad Milad Ismail, Fatimah Al Kaabi

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The clinical presentation of Primary hyperparathyroidism can vary from simple asymptomatic hypercalcemia to severe life-threatening hypercalcemic crisis with multi-organ dysfunction, which can be due to parathyroid adenoma or sometimes with malignant cancer. This cascade of clinical presentation can lead to a diagnostic and therapeutic challenge for treating the disease. We are presenting a case of severe hypercalcemic crisis due to parathyroid adenoma with an emphasis on early management, diagnosis, and interventions to prevent any lifelong complications and any permanent organ dysfunction. A 30 years old female with a history of primary Infertility, admitted to Al Ain Hospital critical care unit with Acute Severe Necrotizing Pancreatitis. She initially had a 1-month history of abdominal pain on and off, for which she was treated conservatively with no much improvement, and later on, she developed life-threatening severe pancreatitis, which required her to be admitted to the critical care unit. She was transferred from a private healthcare facility, where she was found to have a very high level of calcium up to 15mmol/L. She received systemic Zoledronic Acid, which lowered her calcium level transiently and later was increased again. She went on to develop multiple end-organ damages along with multiple electrolytes disturbances. She was found to have high levels of Parathyroid hormone, which was correlated with a parathyroid mass on the neck via radiological imaging. After a long course of medical treatment to lower the calcium to a near-normal level, parathyroidectomy was done, which showed parathyroid adenoma on histology. She developed hungry bone syndrome after the surgery and pancreatic pseudocyst after resolving of pancreatitis. She required aggressive treatment with Intravenous calcium for her hypocalcemia as she received zoledronic acid at the beginning of the disease. Later on, she was discharged on long term calcium and other electrolytes supplements. In patients presenting with hypercalcemia, it is prudent to investigate and start treatment early to prevent complications and end-organ damage from hypercalcemia and also to treat the primary cause of the hypercalcemia, with conscious follow up to prevent hypocalcemic complications after treatment. It is important to follow up patients with parathyroid adenomas for a long period in order to detect any recurrence of the tumor or to make sure if the primary tumor is either benign or malignant.

Keywords: hypercalcemia, pancreatitis, hypocalcemia, hyperparathyroidism

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Authors: Dr., Suchita Daokar

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Background: Successful orthodontic treatment has always relied on anchorage. The stability of the implants depends on bone quantity, mini-implant design, and placement conditions. Out of the various methods of gaining stability, Platelet concentrations are gaining popularity for various reasons. PRF is a minimally invasive method, and there are various studies that has shown its role in enhancing the stability of general implants. However, there is no literature found regarding the effect of PRF in enhancing the stability of the orthodontic implant. Therefore, this study aimed to evaluate and assess the efficacy of PRF on the stability of the orthodontic implant. Methods: The study comprised of 9 subjects aged above 18 years of age. The split mouth technique was used; Group A (where implants were coated before insertion) and group B (implant were normally inserted). The stability of the implant was measured using resonance frequency analysis at insertion (T0), 24 hours (T1), 2 weeks (T2), at 4 weeks (T3), at 6 weeks (T4), and 8 weeks (T5) after insertion. Result: Statistically significant findings were found when group A was compared to group B using ANOVA test (p<0.05). The stability of the implant of group A at each time interval was greater than group B. The implant stability was high at T0 and reduces at T2, and increasing through T3 to T5. The stability was highest at T5. Conclusion: A chairside, minimally invasive procedure ofPRF coating on implants have shown promising results in improving the stability of orthodontic implants and providing scope for future studies.

Keywords: Orthodontic implants, stablity, resonance Frequency Analysis, pre

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Authors: Nursel Koyuncu, Nihal Ata Tutkun

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Frailty model is a survival model that takes into account the unobserved heterogeneity for exploring the relationship between the survival of an individual and several covariates. In the recent years, proposed survival models become more complex and this feature causes convergence problems especially in large data sets. Therefore selection of sample from these big data sets is very important for estimation of parameters. In sampling literature, some authors have defined new sampling schemes to predict the parameters correctly. For this aim, we try to see the effect of sampling design in semi-parametric frailty model. We conducted a simulation study in R programme to estimate the parameters of semi-parametric frailty model for different sample sizes, censoring rates under classical simple random sampling and ranked set sampling schemes. In the simulation study, we used data set recording 17260 male Civil Servants aged 40–64 years with complete 10-year follow-up as population. Time to death from coronary heart disease is treated as a survival-time and age, systolic blood pressure are used as covariates. We select the 1000 samples from population using different sampling schemes and estimate the parameters. From the simulation study, we concluded that ranked set sampling design performs better than simple random sampling for each scenario.

Keywords: frailty model, ranked set sampling, efficiency, simple random sampling

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Authors: Abdulrahman Algaeed

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The Ophthalmic Ultrasound is the easiest method of early diagnosing Retinoblastoma after clinical examination. It can be done with ease without sedation. King Khaled Eye Specialist Hospital is a tertiary care center where Retinoblastoma patients are often seen and treated there. The first modality to rule out the disease is Ophthalmic Ultrasound. Classic Retinoblastoma is easily diagnosed by using the conventional 10MHz Ophthalmic Ultrasound probe in the regular clinic setup. Retinal lesion with multiple, very highly reflective surfaces within lesion typical of Calcium deposits. The use of Standardized A-scan is very useful where internal reflectivity is classified as very highly reflective. Color Doppler is extremely useful as well to show the blood flow within lesion/s. In conclusion: Ophthalmic Ultrasound should be the first tool to be used to diagnose Retinoblastoma after clinical examination. The accuracy of the Exam is very high.

Keywords: doppler, retinoblastoma, reflectivity, ultrasound

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Authors: Sijia Hu

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Tensile creep tests were performed along the normal direction on the as-solutioned (AS) and as-aged (AA) samples of a commercial ZK60 alloy in this work. The results showed that the AA sample obtained a stronger 0.2% proof stress but a poorer creep resistance in comparison to the AS sample. It was revealed that the creep deformation in the AS sample was attributed to basal slip and twinning, while the creep behavior of the AA sample was controlled by basal slip, pyramidal slip and twinning. Besides, the reasons for the poorer creep resistance of the AA sample were unveiled. Pyramidal dislocations towards various moving directions were found to accelerate the creep deformation, and basal dislocations kinking at twin boundaries were found to induce heavy stress concentration. Furthermore, massive dynamic precipitates, including beta 1 prime and beta 2 prime types, were formed in the AS sample during the creep exposure, contributing to the superior creep resistance. But in the AA sample, plentiful beta 1 prime and beta 2 prime phases generated during the prior peak-aging treatment dissolved into the matrix fast and only beta 1 prime re-precipitated during the creep process. With the decreased area fractions of precipitates, the age-hardening effect slacked off and failed to enhance the creep resistance.

Keywords: Mg alloy, creep, precipitation, microstructure

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Authors: Eftekhari M. H., Mozaffari-Khosravi H., Shidfar F.

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Background: Many Iranian adolescent girls are iron deficient, but it is unclear whether the iron deficiency is associated with other nutritional risk indicators. Objective: we aimed to investigate the association between iron deficiency and weight status (measured as BMI) among a reprehensive sample of teenage girls. Methods: A cross-sectional study was performed in a region of southern I.R.Iran. One hundred eighty-seven iron-deficient participants (aged between 11 to 14) were selected by systematic random sampling among all students in grades 1 to 3 from high schools for girls. We assayed hemoglobin, hematocrit, serum ferritin, iron and total iron binding capacity and measured weight and height. Body mass index was calculated according to age and gender-specific BMI growth charts for children 2 to 20 years of age. Results: 13% were at risk for being overweight and 8.3% were overweight. The severity of iron deficiency increased as BMI increased from normal to at risk for overweight and overweight. Iron deficiency anemia was most prevalent among overweight adolescents than at risk for overweight and normal weight adolescents (28%, 18%, and 13%, respectively). Conclusions: The results of this study showed an inverse association of BMI with serum ferritin. Overweight adolescents demonstrated an increased prevalence of anemia. Because of the potentially harmful effects of iron deficiency, obese adolescents should be routinely screened and treated as necessary.

Keywords: adolescent, over weight, iron deficiency, Iran

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Authors: Jong Yeop Kim, Ji Eun Kim, Hyun Jeong Kwak, Sook Young Lee

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Background: This prospective, randomized, controlled study was performed to evaluate the usefulness of the McGrath VL compared to Macintosh laryngoscopy in children with expected normal airway during endotracheal intubation, by comparing the time to intubation and ease of intubation. Methods: Eighty-four patients, aged 1-10 years undergoing endotracheal intubation for elective surgery were randomly assigned to McGrath group (n = 42) or Macintosh group (n = 42). Anesthesia was induced with propofol 2.5-3.0 mg/kg and sevoflurane 5-8 vol%. Orotracheal intubation was performed 2 minutes after injection of rocuronium 0.6 mg/kg with McGrath VL or Macintosh laryngoscope. The primary outcome was time to intubation. The Cormack and Lehane glottic grade, intubation difficulty score (IDS), and success rate of intubation were assessed. Hemodynamic changes also were recorded. Results: Median time to intubation [interquartile range] was not different between the McGrath group and the Macintosh group (25.0 [22.8-28.3] s vs. 26.0 [24.0-29.0] s, p = 0.301). The incidence of grade I glottic view was significantly higher in theMcGrath group than in the Macintosh group (95% vs. 74%, p = 0.013). Median IDS was lower in the McGrath group than in the Macintosh group (0 [0-0] vs. 0 [0-1], p = 0.018). There were no significant differences in success rate on intubation or hemodynamics between the two groups. Conclusions: McGrath VL provides better laryngeal views and lower IDS, but similar intubation times and success rates compared to the Macintosh laryngoscope in children with the normal airway.

Keywords: intubation, Macintosh laryngoscopy, Mcgrath videolaryngoscopy, pediatrics

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Authors: Tiffany Wicks

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Queer patients can face issues with self-advocating due to the factors of implicit provider bias, lack of tools and resources to self-advocate, and lack of comfortability in self-advocating based on prior experiences. In this study, five participants who identify as queer discussed their interactions with their healthcare providers. This exploratory study revealed that there is a need for healthcare provider education to reduce implicit bias and judgments about queer patients. There is also an important need for peer advocates in order to further inform healthcare promotion and decision-making before and during provider visits in an effort for a better outcome. Through this exploration, queer patients voiced their experiences and concerns to inform a need for change in healthcare collaboration between providers and patients in the queer community.

Keywords: queer, LGBT, patient, self-advocacy, healthcare

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Authors: Rosemary I. Eneji, Stephen Adi Odey, Edem Carole, Eucharia Nwagbara

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Sexual and reproductive health behaviors are the main causes of death, disability, and disease among adolescents in Nigeria. In this study, we determined the accessibility of youth-friendly sexual and reproductive health services to secondary school adolescents in southern Cross River state, Nigeria. Nineteen randomly selected public secondary schools across the seven local government areas in the zone were used. The respondents were four hundred senior secondary (classes SSI - SS3) students aged 15-19 years, comprising 63.7% females and 36.3% males. A 50-item structured questionnaire was used for the study. There was a strong influence of age and sex of adolescents, income and occupation of parents, knowledge and awareness of adolescents, and tradition on the accessibility and use of youth-friendly sexual and reproductive health services (YFSRHS) to the adolescents. The attitude of health workers towards accessibility was of little effect. Overall, youth-friendly sexual and reproductive health services were not easily accessible to adolescents in the study area. Thus, there is need to enforce adolescent reproductive health policies in the area. Training and use of trained caregivers and peer educators to attend to adolescents and the inclusion of adolescent reproductive health as a subject in the curriculum are strongly recommended.

Keywords: youth, reproductive health, cross river state, secondary schools, Nigeria

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Authors: Kazi Muhammad Rezaul Karim, Tasmia Tasnim

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Introduction: Pregnancy is a condition of higher nutrient requirement but in developing countries like Bangladesh most of the pregnant women can not meet their nutrient requirement and sometimes they are neglected in the family. The purpose of the study was to assess the nutritional status and dietary nutrient intake by the pregnant women, in Dhaka city, Bangladesh. Methods: The study population comprised of pregnant women from urban or semi-urban, aged between 18 to 35 and free of pregnancy related complication and other diseases. Under a cross-sectional design, 30 healthy non-pregnant as well as 130 pregnant women, at 3 different trimesters of pregnancy were assessed. A questionnaire was developed to obtain demographic, socio-economic, anthropometric, drug and medical history. Three day consecutive 24-hour food recalls were used to assess food intake and then converted to nutrient intake. Results: The average BMI of the nonpregnant women was 22.89 ± 3.4 kg/m2 and that of pregnant women was 23.52 ± 3.71 kg/m2. The mean dietary nutrient intake of dietary fiber, calorie, protein, fat, carbohydrate, calcium, iron, thiamine, riboflavin, vitamin C, Vitamin A, folate, vitamin B6 and Vitamin B12 of the pregnant mothers were 4.38 g, 1619 kcal, 60.05 g, 30.38 g, 268.79 g, 537.21 mg, 21.53 mg, 1.15 mg, 0.94 mg, 97.36 mg, 647.6 µg, 153.93 µg, 1.41 mg and 4.09 µg respectively. Most of pregnant women (more than 90%) can not meet their energy, calcium and folate requirements. Conclusion: Most of the pregnant mother in Bangladesh can not meet their dietary requirements during pregnancy.

Keywords: pregnancy, dietary nutrient, nutritional status, BMI

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Authors: Monika Paleczna, Barbara Szmigielska

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Adolescence is a developmental period, covering the period from 10 to 20 years of age, in which young people face many challenges. One of the most important tasks of the adolescence period is getting a structured identity. The development of identity is possible by undertaking various activities. Nowadays, virtual activities are very common among young people. One of the main adolescents’ activities in the online environment is playing computer games. The main aim of this work is to answer the question about the relationship between the identity style of adolescents and immersion, -a phenomenon often observed while playing computer games. The concept of identity created by Berzonsky is considered as one of the best-defined concepts of identity. He defines identity as both a structure and a process and distinguishes three styles of identity: informational, normative, and diffuse/avoidant. Immersion is a concept that can be applied in a broad context, but in the game environment, it is a specific psychological experience of being involved in a computer game. It refers to the relocation of the attention resources to the game world, with a limited or impossible perception of stimuli from reality. Considering how much time adolescents spend playing computer games, the question about the relationship between their identity and the immersion in the game seems to be extremely interesting. Fifty adolescents aged 15-17 participated in the study. They played a computer game and completed the Identity Style Inventory and the Immersion Questionaire.

Keywords: identity, immersion, computer games, adolescence

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Authors: Sharon Ganzer

Abstract:

Older adults want choices about where they ‘age-in-place’ and express the desire to remain in their home for as long as possible because it maintains feelings of independence and autonomy, perpetuates a sense of identity, enable people to have space for their belongings and supports connections and social engagement. When circumstances change, and alternative living arrangements are required, more and more older adults are considering a transition to a retirement village – the liminal space between home and residential care. This qualitative study explores the lived experience of older adults who relocate to a retirement village in Queensland, Australia, and the role that material culture plays in this process.

Keywords: material culture, social gerontology, concepts of home, retirement villages

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Authors: Gauranga Das

Abstract:

People in cities have prosperity but there is immense pollution, chaos in the mind, anxiety and turbulence. People in the villages experience pristine pure environment but they also experience poverty. There is a need to find out ways by which the cities and the villages can complement each other through their strengths and take care of each other’s weaknesses. In order to do this, the case study of Govardhan Ecovillage has been explored in this paper. All its environment, social and economic initiatives along with eco-tourism and wellness features are being analyzed. The analysis shows that Govardhan Ecovillage is successfully able to harmonize its different initiatives and provide a package which has created a win-win solution for the city people and also the villagers. Such kind of Eco-tourism initiatives should be supported and replicated in other places in the world to benefit everyone.

Keywords: sustainability, ecotourism, ecology, rural development, wellness, biodiversity

Procedia PDF Downloads 233