Search results for: hospital facilities
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3751

Search results for: hospital facilities

1441 Entrepreneurship in Pakistan: Opportunities and Challenges

Authors: Bushra Jamil, Nudrat Baqri, Muhammad Hassan Saeed

Abstract:

Entrepreneurship is creating or setting up a business not only for the purpose of generating profit but also for providing job opportunities. Entrepreneurs are problem solvers and product developers. They use their financial asset for hiring a professional team and combine the innovation, knowledge, and leadership leads to a successful startup or a business. To be a successful entrepreneur, one should be people-oriented and have perseverance. One must have the ability to take risk, believe in his/her potential, and have the courage to move forward in all circumstances. Most importantly, have the ability to take risk and can assess the risk. For STEM students, entrepreneurship is of specific importance and relevance as it helps them not just to be able to solve real life existing complications but to be able to recognize and identify emerging needs and glitches. It is becoming increasingly apparent that in today’s world, there is a need as well as a desire for STEM and entrepreneurship to work together. In Pakistan, entrepreneurship is slowly emerging, yet we are far behind. It is high time that we should introduce modern teaching methods and inculcate entrepreneurial initiative in students. A course on entrepreneurship can be included in the syllabus, and we must invite businessmen and policy makers to motivate young minds for entrepreneurship. This must be pitching competitions, opportunities to win seed funding, and facilities of incubation centers. In Pakistan, there are many good public sector research institutes, yet there is a void gap in the private sector. Only few research institute are meant for research and development. BJ Micro Lab is one of them. It is SECP registered company and is working in academia to promote and facilitate research in STEM. BJ Micro Lab is a women led initiative, and we are trying to promote research as a passion, not as an arduous burden. For this, we are continuously arranging training workshops and sessions. More than 100 students have been trained in ten different workshops arranged at BJ Micro Lab.

Keywords: entrepreneurship, STEM, challenges, oppurtunties

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1440 The Relationship between Land Use Factors and Feeling of Happiness at the Neighbourhood Level

Authors: M. Moeinaddini, Z. Asadi-Shekari, Z. Sultan, M. Zaly Shah

Abstract:

Happiness can be related to everything that can provide a feeling of satisfaction or pleasure. This study tries to consider the relationship between land use factors and feeling of happiness at the neighbourhood level. Land use variables (beautiful and attractive neighbourhood design, availability and quality of shopping centres, sufficient recreational spaces and facilities, and sufficient daily service centres) are used as independent variables and the happiness score is used as the dependent variable in this study. In addition to the land use variables, socio-economic factors (gender, race, marital status, employment status, education, and income) are also considered as independent variables. This study uses the Oxford happiness questionnaire to estimate happiness score of more than 300 people living in six neighbourhoods. The neighbourhoods are selected randomly from Skudai neighbourhoods in Johor, Malaysia. The land use data were obtained by adding related questions to the Oxford happiness questionnaire. The strength of the relationship in this study is found using generalised linear modelling (GLM). The findings of this research indicate that increase in happiness feeling is correlated with an increasing income, more beautiful and attractive neighbourhood design, sufficient shopping centres, recreational spaces, and daily service centres. The results show that all land use factors in this study have significant relationship with happiness but only income, among socio-economic factors, can affect happiness significantly. Therefore, land use factors can affect happiness in Skudai more than socio-economic factors.

Keywords: neighbourhood land use, neighbourhood design, happiness, socio-economic factors, generalised linear modelling

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1439 Transperineal Repair Is Ideal for the Management of Rectocele with Faecal Incontinence

Authors: Tia Morosin, Marie Shella De Robles

Abstract:

Rectocele may be associated with symptoms of both obstructed defecation and faecal incontinence. Currently, numerous operative techniques exist to treat patients with rectocele; however, no single technique has emerged as the optimal approach in patients with post-partum faecal incontinence. The purpose of this study was to evaluate the clinical outcome in a consecutive series of patients who underwent transperineal repair of rectocele for patients presenting with faecal incontinence as the predominant symptom. Twenty-three consecutive patients from April 2000 to July 2015 with symptomatic rectocele underwent transperineal repair by a single surgeon. All patients had a history of vaginal delivery, with or without evidence of associated anal sphincter injury at the time. The median age of the cohort was 53 years (range 21 to 90 years). The median operating time and length of hospital stay were 2 hours and 7 days, respectively. Two patients developed urinary retention post-operatively, which required temporary bladder catheterization. One patient had wound dehiscence, which was managed by absorbent dressing applied by the patient and her carer. There was no operative mortality. In all patients with rectocele, there was a concomitant anal sphincter disruption. All patients had satisfactory improvement with regard to faecal incontinence on follow-up. This study suggests this method provides excellent anatomic and physiologic results with minimal morbidity. However, because none of the patients gained full continence postoperatively, pelvic floor rehabilitation might be also needed to achieve better sphincter function in patients with incontinence.

Keywords: anal sphincter defect, faecal incontinence, rectocele, transperineal repair

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1438 An Empirical Assessment of Indoor Environmental Quality in Developing Sub-Saharan Countries: Evaluation of Existing Gaps and Potential Risk

Authors: Jean-Paul Kapuya Bulaba Nyembwe, John Omomoluwa Ogundiran, Manuel Carlos Gameiro da Silva

Abstract:

Indoor environmental quality (IEQ) remains a global concern because it impacts people's comfort, health, performance, and general well-being. People spend a significant amount of time in buildings or while commuting, hence ensuring the minimal risk in indoor spaces by ensuring suitable IEQ. IEQ studies are limited regarding developing sub-Saharan countries, whereas there is also a huge risk and concern for the current population and geometric growth as many cities in the region will become mega-cities by 2040 (World Bank report). The absence of suitable IEQ regulations and energy poverty are reasons to assess the IEQ gaps for increased awareness of sustainable interventions to minimize the associated risk. This study evaluates the gaps and potential hazards that exist in the IEQ of sub-Saharan countries using empirical studies of hospital occupants and BRT bus passengers and drivers. The Surveys were conducted in 3 cities of the Democratic Republic of Congo and Lagos metropolis of Nigeria. The results suggest that gaps exist in IEQ for these regions. The gaps indicate existential risk to people’s health, comfort, and well-being. The inferential conclusions are that there is a need for further scientific studies, improvement in IEQ conditions, and ensuring suitable regulations for developing sub-Saharan countries.

Keywords: health hazards, hospitals indoor environmental quality, indoor spaces, occupants, sub-Saharan countries, vehicles

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1437 Influence of Social, Economic, Political and Legal Environment of Sport Organizations on Sport Development in Zone Ten (10) of National Zonal Sport Offices in Nigeria

Authors: Ejeh Benjamin Ijuo

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The purpose of this study was to investigate the influence of social, economic, political, and legal environment of sport organizations on sport development in zone ten (10) national zonal sport offices in Nigeria (Plateau, Nasarawa, Benue and F.C.T Abuja). To achieve this purpose, a structured 26 item questionnaire (ISEPLESOQ) designed by the researcher was used for this study. Related literature to this study was reviewed. 311 copies of questionnaire were administered to randomly selected respondents. Out of this number, 306 was dully completed and returned representing 98.4%. The respondents included: Athletes, games masters/ mistresses, coaches in state sport councils, zonal sport coordinators, team managers, directors of state sports council. Four research questions were answered using the mean and standard deviation, while the inferential statistics of chi-square(x2) test of goodness of fit was used to test the four hypotheses at 0.05 alpha levels. The findings of this study revealed that the social, economic, political and legal environment of sport organizations significantly influenced sport development in zone ten (10) national zonal sport offices in Nigeria. It was also established that the general environment of sport organizations influences people’s participation in sport, funding and sponsorship of sports, sitting of equipment and facilities at different locations, selection of athletes. It was therefore, recommended among other things that government should privatize and commercialized sport programmes to enable corporate organizations and individuals participation. Lt was further suggested that the federal government should harness her social, economic, political and legal environment to improve sport development in Nigeria.

Keywords: sport organization, sport development, sport environment, zonal sport offices

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1436 Use of Social Media in PR: A Change of Trend

Authors: Tang Mui Joo, Chan Eang Teng

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The use of social media has become more defined. It has been widely used for the purpose of business. More marketers are now using social media as tools to enhance their businesses. Whereas on the other hand, there are more and more people spending their time through mobile apps to be engaged in the social media sites like YouTube, Facebook, Twitter and others. Social media has even become common in Public Relations (PR). It has become number one platform for creating and sharing content. In view to this, social media has changed the rules in PR where it brings new challenges and opportunities to the profession. Although corporate websites, chat-rooms, email customer response facilities and electronic news release distribution are now viewed as standard aspects of PR practice, many PR practitioners are still struggling with the impact of new media though the implementation of social media is potentially reducing the cost of communication. It is to the point that PR practitioners are not fully embracing new media, they are ill-equipped to do so and they have a fear of the technology. Somehow that social media has become a new style of communication that is characterized by conversation and community. It has become a platform that allows individuals to interact with one another and build relationship among each other. Therefore, in the use of business world, consumers are able to interact with those companies that have joined any social media. Based on their experiences with social networking site interactions, they are also exposed to personal interaction while communicating. This paper is to study the impact of social media to PR. This paper discovers the potential changes of PR practices in a developing country like Malaysia. Eventually the study reflects on how PR practitioners are actually using social media in the country. This paper is based on two theories in its development of this research foundation. Media Ecology Theory is to support the impact and changes to PR. Social Penetration Theory is to reflect on how the use of social media is among PRs. This research is using survey with PR practitioners in its data collection. The results have shown that PR professionals value social media more than they actually use it and the way of organizations communicate had been changed due to the transformation of social media.

Keywords: new media, social media, PR, change of trend, communication, digital culture

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1435 Outcomes Following Overcorrecting Minus Lens Therapy for Intermittent Distance Exotropia

Authors: Alasdair Warwick, Luna Dhir

Abstract:

Aim: To ascertain the efficacy of overcorrecting minus lens therapy in intermittent distance exotropia. Methods: Retrospective audit of all intermittent distance exotropia patients seen in the Chelsea and Westminster Hospital pediatric eye clinic between 1st January 2014 and 1st March 2016. Change in LogMAR visual acuity, stereopsis, near and distance angles of deviation, as well as the proportions of patients converting to exophoria or undergoing strabismus surgery, were recorded. Results: 22 patients were identified, 45% male, mean age 5 years (range 0.6 to 18.5 years). The median overminus prescription was -1.0 dioptres (range -0.5 to -1.75 dioptres) and mean follow-up was 15 months (range 3 to 54 months). Visual acuity, near and distance angles of deviation improved but were not statistically significant: -0.15 LogMAR, -0.2 prism dioptres and -1.2 prism dioptres respectively (p>0.05). However, a significant change in stereopsis was observed: -74'' (p<0.01). 27% underwent strabismus surgery and 36% converted to exophoria whilst wearing their overminus prescription. Conclusions: Overcorrecting minus lens therapy is an effective therapy for intermittent distance exotropia. There was no deterioration in visual acuity and a significant improvement in stereopsis was seen in our cohort, with many patients converting to an exophoria. The proportion of patients requiring strabismus surgery was comparable to other studies. Further, follow-up is needed to ascertain long-term outcomes.

Keywords: exotropia, overcorrecting minus lens, refraction, strabismus

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1434 The Emergence of Smart Growth in Developed and Developing Countries and Its Possible Application in Kabul City, Afghanistan

Authors: Bashir Ahmad Amiri, Nsenda Lukumwena

Abstract:

The global trend indicates that more and more people live and will continue to live in urban areas. Today cities are expanding both in physical size and number due to the rapid population growth along with sprawl development, which caused the cities to expand beyond the growth boundary and exerting intense pressure on environmental resources specially farmlands to accommodate new housing and urban facilities. Also noticeable is the increase in urban decay along with the increase of slum dwellers present another challenge that most cities in developed and developing countries have to deal with. Today urban practitioners, researchers, planners, and decision-makers are seeking for alternative development and growth management policies to house the rising urban population and also cure the urban decay and slum issues turn to Smart Growth to achieve their goals. Many cities across the globe have adopted smart growth as an alternative growth management tool to deal with patterns and forms of development and to cure the rising urban and environmental problems. The method used in this study is a literature analysis method through reviewing various resources to highlight the potential benefits of Smart Growth in both developed and developing countries and analyze, to what extent it can be a strategic alternative for Afghanistan’s cities, especially the capital city. Hence a comparative analysis is carried on three countries, namely the USA, China, and India to identify the potential benefits of smart growth likely to serve as an achievable broad base for recommendations in different urban contexts.

Keywords: growth management, housing, Kabul city, smart growth, urban-expansion

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1433 A Study of Preliminary Findings of Behavioral Patterns under Captive Conditions in Chinkara (Gazella bennettii) with Prospects for Future Conservation

Authors: Muhammad Idnan, Arshad Javid, Muhammad Nadeem

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The present study was conducted from April 2013 to March 2014 to observe the behavioral parameters of Chinkara (Gazella bennettii) under captive conditions by comparing the captive-born and wild-caught animals for conservation strategies. Understanding the behavioral conformations plays a significant role in captive management. Due to human population explosion and mechanized hunting, the captive breeding seems to be the best way for sports hunting, bush meat, for leather industry and horns for traditional medicinal usage. Primarily, captive management has been used on trial and error basis due to deficiency of ethology of this least concerned species. Behavior of [(20 wild-caught (WC) and 10 captive-bred (CB)] adult Chinkara was observed at captive breeding facilities for ungulates at Ravi Campus, University of Veterinary and Animal Sciences at Kasur district which is situated on southeast side of Lahore. The average annual rainfall is about 650 mm, with frequent raining during monsoon. A focal sample was used to observe the various behavioral patterns for CB and WC chinkara. A similarity was observed in behavioral parameters in WC and CB animals, however, when the differences were considered, WC male deer showed a significantly higher degree of agonistic interaction as compared to the CB male chinkara. These findings suggest that there is no immediate impact of captivity on behavior of chinkara nevertheless 10 generations of captivity. It is suggested that the Chinkara is not suitable for domestication and for successful deer farming, a further study is recommended for ethology of chinkara.

Keywords: Chinkara (Gazella bennettii), domestication, deer farming, ex-situ conservation

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1432 Application and Limitation of Heavy Metal Pollution Indicators in Coastal Environment of Pakistan

Authors: Noor Us Saher

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Oceans and Marine areas have a great importance, mainly regarding food resources, fishery products and reliance of livelihood. Aquatic pollution is common due to the incorporation of various chemicals mainly entering from urbanization, industrial and commercial facilities, such as oil and chemical spills. Many hazardous wastes and industrial effluents contaminate the nearby areas and initiate to affect the marine environment. These contaminated conditions may become worse in those aquatic environments situated besides the world’s largest cities, which are hubs of various commercial activities. Heavy metal contamination is one of the most important predicaments for marine environments and during past decades this problem has intensified due to an increase in urbanization and industrialization. Coastal regions of Pakistan are facing severe threats from various organic and inorganic pollutants, especially the estuarine and coastal areas of Karachi city, the most populated and industrialized city situated along the coastline. Metal contamination causes severe toxicity in biota resulting the degradation of Marine environments and depletion of fishery resources and sustainability. There are several abiotic (air, water and sediment) and biotic (fauna and flora) indicators that indicate metal contamination. However, all these indicators have certain limitations and complexities, which delay their implementation for rehabilitation and conservation in the marine environment. The inadequate evidences have presented on this significant topic till the time and this study discussed metal pollution and its consequences along the marine environment of Pakistan. This study further helps in identification of possible hazards for the ecological system and allied resources for management strategies and decision making for sustainable approaches.

Keywords: coastal and estuarine environment, heavy metals pollution, pollution indicators, Pakistan

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1431 Innovative Waste Management Practices in Remote Areas

Authors: Dolores Hidalgo, Jesús M. Martín-Marroquín, Francisco Corona

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Municipal waste consist of a variety of items that are everyday discarded by the population. They are usually collected by municipalities and include waste generated by households, commercial activities (local shops) and public buildings. The composition of municipal waste varies greatly from place to place, being mostly related to levels and patterns of consumption, rates of urbanization, lifestyles, and local or national waste management practices. Each year, a huge amount of resources is consumed in the EU, and according to that, also a huge amount of waste is produced. The environmental problems derived from the management and processing of these waste streams are well known, and include impacts on land, water and air. The situation in remote areas is even worst. Difficult access when climatic conditions are adverse, remoteness of centralized municipal treatment systems or dispersion of the population, are all factors that make remote areas a real municipal waste treatment challenge. Furthermore, the scope of the problem increases significantly because the total lack of awareness of the existing risks in this area together with the poor implementation of advanced culture on waste minimization and recycling responsibly. The aim of this work is to analyze the existing situation in remote areas in reference to the production of municipal waste and evaluate the efficiency of different management alternatives. Ideas for improving waste management in remote areas include, for example: the implementation of self-management systems for the organic fraction; establish door-to-door collection models; promote small-scale treatment facilities or adjust the rates of waste generation thereof.

Keywords: door to door collection, islands, isolated areas, municipal waste, remote areas, rural communities

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1430 Outdoor Physical Play as Critical to Early Childhood Development: Findings from Saudi Arabia

Authors: Rana S. Alghamdi

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Play in early childhood education has been stifled across the world due to an overemphasis on academic achievement and a reduced focus on physical play and motor development. In Saudi Arabia, teachers reticent to allocate more time to play for fear of retribution from parents and administrators that children are losing academic seat time. This practice has proven to be detrimental to the social, emotional, physical, and cognitive development of children. Teachers are pressured to prioritize Arabic, math, and science while providing minimal time for physical activities. Administrators tend to push for an ever-increasing emphasis on academia in order to achieve higher test scores. However, young children often find it difficult to concentrate if they are not able to get out energy through physical play. Furthermore, many youth educators are not qualified to oversee physical activities, and many facilities are unprepared for safe, outdoor play. This results in children getting little to no outdoor activity. They are stuck in a strict academic regimen that may dampen the creativity and imagination easily fostered through cooperative play. For a stronger educational system and more well-rounded students, Saudi schools should enact policies that extend the number of required hours dedicated to outdoor and physical play. They should also offer training for unqualified teachers. This training should focus on the benefits of physical play and instruct them on how to facilitate these activities safely and effectively. School administrators must focus on providing adequate equipment and safe environments for the purpose of outdoor play and education. In doing so, they will be setting their students up for a successful future and improving their abilities in all aspects of education.

Keywords: early childhood education, play, outdoor, Saudi Arabia

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1429 The Strategies to Develop Post-Disaster Multi-Mode Transportation System from the Perspective of Traffic Resilience

Authors: Yuxiao Jiang, Lingjun Meng, Mengyu Zhan, Lichunyi Zhang, Yingxia Yun

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On August 8th of 2015, a serious explosion occurred in Binhai New Area of Tianjin. This explosion led to the suspension of Tianjin-Binhai Light Rail Line 9 which was an important transportation mean connecting the old and new urban areas and the suspension causes inconvenience to commuters traveling from Tianjin to Binhai or Binhai to Tianjin and residents living by Line 9. On this regard, this paper intends to give suggestions on how to develop multi-mode transportation system rapidly and effectively after a disaster and tackle with the problems in terms of transportation infrastructure facilities. The paper proposes the idea of traffic resilience which refers to the city’s ability to restore its transportation system and reduce risks when the transportation system is destroyed by a disaster. By doing questionnaire research, on the spot study and collecting data from the internet, a GIS model is established so as to analyze the alternative traffic means used by different types of residents and study the transportation supply and demand. The result shows that along the Line 9, there is a larger demand for alternative traffic means in the place which is nearer to the downtown area. Also, the distribution of bus stations is more reasonable in the place nearer to downtown area, however, the traffic speed in the area is slower. Based on traffic resilience, the paper raises strategies to develop post-disaster multi-mode transportation system such as establishing traffic management mechanism timely and effectively, building multi-mode traffic networks, improving intelligent traffic systems and so on.

Keywords: traffic resilience, multi-mode transportation system, public traffic, transportation demand

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1428 Assessment of the Neuroprotective Effect of Oral Hypoglycemic Agents in Patients with Acute Ischemic Stroke

Authors: A. Alhusban, M. Alqawasmeh, F. Alfawares

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Introduction: Diabetes is a chronic health problem and a major risk factor of stroke. A number of therapeutic modalities exist for diabetes management. It’s still unknown whether the different oral hypoglycemic agents would ameliorate the detrimental effect of diabetes on stroke severity. The objective of this work is to assess the effect of pretreatment with oral hypoglycemic agents, insulin and their combination on stroke severity at presentation. Patients and Methods: Patients admitted to the King Abdullah University Hospital (KAUH)-Jordan with ischemic stroke between January 2015 and December 2016 were evaluated and their comorbid diseases, treatment on admission and their neurologic severity was assessed using the National Institute of Health Stroke Scale (NIHSS) were documented. Stroke severity was compared for non-diabetic patients and diabetic patients treated with different antidiabetic agents. Results: Data from 324 patients with acute stroke was documented. The median age of participants was 69 years. Diabetes was documented in about 50% of the patients. Multinomial regression analysis identified diabetes treatment status as an independent predictor of neurological severity of stroke (p=0.032). Patients treated with oral hypoglycemic agents had a significantly lower NIHSS as compared to nondiabetic patients and insulin treated patients (p < 0.02). The positive effect of oral hypoglycemic agents was blunted by insulin co-treatment. Insulin did not alter the severity of stroke as compared to non-diabetics. Conclusion: Oral hypoglycemic agents may reduce the severity of neurologic deficit of ischemic stroke and may have neuroprotective effect.

Keywords: diabetes, stroke, neuroprotection, oral hypoglycemic agents

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1427 Interactions between Residential Mobility, Car Ownership and Commute Mode: The Case for Melbourne

Authors: Solmaz Jahed Shiran, John Hearne, Tayebeh Saghapour

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Daily travel behavior is strongly influenced by the location of the places of residence, education, and employment. Hence a change in those locations due to a move or changes in an occupation leads to a change in travel behavior. Given the interventions of housing mobility and travel behaviors, the hypothesis is that a mobile housing market allows households to move as a result of any change in their life course, allowing them to be closer to central services, public transport facilities and workplace and hence reducing the time spent by individuals on daily travel. Conversely, household’s immobility may lead to longer commutes of residents, for example, after a change of a job or a need for new services such as schools for children who have reached their school age. This paper aims to investigate the association between residential mobility and travel behavior. The Victorian Integrated Survey of Travel and Activity (VISTA) data is used for the empirical analysis. Car ownership and journey to work time and distance of employed people are used as indicators of travel behavior. Change of usual residence within the last five years used to identify movers and non-movers. Statistical analysis, including regression models, is used to compare the travel behavior of movers and non-movers. The results show travel time, and the distance does not differ for movers and non-movers. However, this is not the case when taking into account the residence tenure-type. In addition, car ownership rate and number found to be significantly higher for non-movers. It is hoped that the results from this study will contribute to a better understanding of factors other than common socioeconomic and built environment features influencing travel behavior.

Keywords: journey to work, regression models, residential mobility, commute mode, car ownership

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1426 Lipidomic Response to Neoadjuvant Chemoradiotherapy in Rectal Cancer

Authors: Patricia O. Carvalho, Marcia C. F. Messias, Salvador Sanchez Vinces, Caroline F. A. Gatinoni, Vitor P. Iordanu, Carlos A. R. Martinez

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Lipidomics methods are widely used in the identification and validation of disease-specific biomarkers and therapy response evaluation. The present study aimed to identify a panel of potential lipid biomarkers to evaluate response to neoadjuvant chemoradiotherapy in rectal adenocarcinoma (RAC). Liquid chromatography–mass spectrometry (LC-MS)-based untargeted lipidomic was used to profile human serum samples from patients with clinical stage T2 or T3 resectable RAC, after and before chemoradiotherapy treatment. A total of 28 blood plasma samples were collected from 14 patients with RAC who recruited at the São Francisco University Hospital (HUSF/USF). The study was approved by the ethics committee (CAAE 14958819.8.0000.5514). Univariate and multivariate statistical analyses were applied to explore dysregulated metabolic pathways using untargeted lipidic profiling and data mining approaches. A total of 36 statistically significant altered lipids were identified and the subsequent partial least-squares discriminant analysis model was both cross validated (R2, Q2) and permutated. Lisophosphatidyl-choline (LPC) plasmalogens containing palmitoleic and oleic acids, with high variable importance in projection score, showed a tendency to be lower after completion of chemoradiotherapy. Chemoradiotherapy seems to change plasmanyl-phospholipids levels, indicating that these lipids play an important role in the RAC pathogenesis.

Keywords: lipidomics, neoadjuvant chemoradiotherapy, plasmalogens, rectal adenocarcinoma

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1425 Effects of Low Sleep Efficiency and Sleep Deprivation on Driver Physical Fatigue

Authors: Chen-Yu Tsai, Wen-Te Liu, Chen-Chen Lo, Kang Lo, Yin-Tzu Lin

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Background: Driving drowsiness related to insufficient or disordered sleep accounts for a major percentage of vehicular accidents. Sleep deprivation is the primary reason related to low sleep efficiency. Nevertheless, the mechanism of sleep deprivation induces driving fatigue to remain unclear. Objective: The objective of this study is to associate the relationship between insufficient sleep efficiency and driving fatigue. Methodologies: The physical condition while driving was obtained from the questionnaires to classify the state of driving fatigue. Sleep efficiency was quantified as the polysomnography (PSG), and the sleep stages were sentenced by the reregistered Technologist during examination in a hospital in New Taipei City (Taiwan). The independent T-test was used to investigate the correlation between sleep efficiency, sleep stages ratio, and driving drowsiness. Results: There were 880 subjects recruited in this study, who had been done polysomnography for evaluating severity for obstructive sleep apnea syndrome (OSAS) as well as completed the driver condition questionnaire. Four-hundred-eighty-four subjects (55%) were classified as fatigue group, and 396 subjects (45%) were served as the control group. The ratio of stage three sleep (N3) (0.032 ± 0.056) in fatigue group were significantly lower than the control group (p < 0.01). The significantly higher value of snoring index (242.14 ± 205.51 /hours) was observed in the fatigue group (p < 0.01). Conclusion: We observe the considerable correlation between deep sleep reduce and driving drowsiness. To avoid drowsy driving, the sleep deprivation, and the snoring events during the sleeping time should be monitored and alleviated.

Keywords: driving drowsiness, sleep deprivation, stage three sleep, snoring index

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1424 Role of Activated Partial Thromboplastin Time (APTT) to Assess the Need of Platelet Transfusion in Dengue

Authors: Kalyan Koganti

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Background: In India, platelet transfusions are given to large no. of patients suffering from dengue due to the fear of bleeding especially when the platelet counts are low. Though many patients do not bleed when the platelet count falls to less than 20,000, certain patients bleed even if the platelet counts are more than 20,000 without any comorbid condition (like gastrointestinal ulcer) in the past. This fear has led to huge amounts of unnecessary platelet transfusions which cause significant economic burden to low and middle-income countries like India and also sometimes these transfusions end with transfusion-related adverse reactions. Objective: To identify the role of Activated Partial Thromboplastin Time (APTT) in comparison with thrombocytoenia as an indicator to assess the real need of platelet transfusions. Method: A prospective study was conducted at a hospital in South India which included 176 admitted cases of dengue confirmed by immunochromatography. APTT was performed in all these patients along with platelet count. Cut off values of > 60 seconds for APTT and < 20,000 for platelet count were considered to assess the bleeding manifestations. Results: Among the total 176 patients, 56 patients had bleeding manifestations like malena, hematuria, bleeding gums etc. APTT > 60 seconds had a sensitivity and specificity of 93% and 90% respectively in identifying bleeding manifestations where as platelet count of < 20,000 had a sensitivity and specificity of 64% and 73% respectively. Conclusion: Elevated APTT levels can be considered as an indicator to assess the need of platelet transfusion in dengue. As there is a significant variation among patients who bleed with respect to platelet count, APTT can be considered to avoid unnecessary transfusions.

Keywords: activated partial thromboplastin time, dengue, platelet transfusion, thrombocytopenia

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1423 Prognostic and Predictive Value of Tumor: Infiltrating Lymphocytes in Triple Negative Breast Cancer

Authors: Wooseok Byon, Eunyoung Kim, Junseong Kwon, Byung Joo Song, Chan Heun Park

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Background/Purpose: Previous preclinical and clinical data suggest that increased lymphocytic infiltration would be associated with good prognosis and benefit from immunogenic chemotherapy especially in triple-negative breast cancer (TNBC). We investigated a single-center experience of TNBC and relationship with lymphocytic infiltration. Methods: From January 2004 to December 2012, at the Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, we retrospectively reviewed 897 breast cancer patients-clinical outcomes, clinicopathological characteristics, breast cancer subtypes. And we reviewed lymphocytic infiltration of TNBC specimens by two pathologists. Statistical analysis of risk factors associated with recurrence was performed. Results: A total of 897 patients, 76 were TNBC (8.47%). Mean age of TNBC patients were 50.95 (SD10.42) years, mean follow-up periods was 40.06 months. We reviewed 49 slides, and there were 8 recurrent breast cancer patients (16.32%), and 4 patients were expired (8.16%). There were 9 lymphocytic predominant breast cancers (LPBC)-carcinomas with either intratumoral lymphocytes in >60% of tumor cell nests. 1 patient of LPBC was recurred and 8 were not. In multivariate logistic regression, the odds ratio of lymphocytic infiltration was 0.59 (p=0.643). Conclusion: In a single-center experience of TNBC, the lymphocytic infiltration in tumor cell nest might be a good trend on the prognosis but there was not statistically significant.

Keywords: tumor-infiltrating lymphocytes, triple negative breast cancer, medical and health sciences

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1422 Role of Surfactant Protein D (SP-D) as a Biomarker of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection

Authors: Lucia Salvioni, Pietro Giorgio Lovaglio, Valerio Leoni, Miriam Colombo, Luisa Fiandra

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The involvement of plasmatic surfactant protein-D (SP-D) in pulmonary diseases has been long investigated, and over the last two years, more interest has been directed to determine its role as a marker of COVID-19. In this direction, several studies aimed to correlate pulmonary surfactant proteins with the clinical manifestations of the virus indicated SP-D as a prognostic biomarker of COVID-19 pneumonia severity. The present work has performed a retrospective study on a relatively large cohort of patients of Hospital Pio XI of Desio (Lombardia, Italy) with the aim to assess differences in the hematic SP-D concentrations among COVID-19 patients and healthy donors and the role of SP-D as a prognostic marker of severity and/or of mortality risk. The obtained results showed a significant difference in the mean of log SP-D levels between COVID-19 patients and healthy donors, so as between dead and survived patients. SP-D values were significantly higher for both hospitalized COVID-19 and dead patients, with threshold values of 150 and 250 ng/mL, respectively. SP-D levels at admission and increasing differences among follow-up and admission values resulted in the strongest significant risk factors of mortality. Therefore, this study demonstrated the role of SP-D as a predictive marker of SARS-CoV-2 infection and its outcome. A significant correlation of SP-D with patient mortality indicated that it is also a prognostic factor in terms of mortality, and its early detection should be considered to design adequate preventive treatments for COVID-19 patients.

Keywords: SARS-CoV-2 infection, COVID-19, surfactant protein-D (SP-D), mortality, biomarker

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1421 Comparison of the Glidescope Visualization and Neck Flexion with Lateral Neck Pressure Nasogastric Tube Insertion Techniques in Anaesthetized Patients: A Prospective Randomized Clinical Study

Authors: Pitchaporn Purngpiputtrakul, Suttasinee Petsakul, Sunisa Chatmongkolchart

Abstract:

Nasogastric tube (NGT) insertion in anaesthetized and intubated patients can be challenging even for experienced anesthesiologists. Various techniques have been proposed to facilitate NGT insertion in these patients. This study aimed to compare the success rate and time required for NGT insertion between the GlideScope visualization and neck flexion with lateral neck pressure techniques. This randomized clinical trial was performed at a teaching hospital on 86 adult patients undergoing abdominal surgery under relaxant general anaesthesia who required intraoperative NGT insertion. The patients were randomized into two groups, the GlideScope group (group G) and the neck flexion with lateral neck pressure group (group F). The success rate of first and second attempts, duration of insertion, and complications were recorded. The total success rate was 79.1% in Group G compared with 76.7% in Group F (P=1) The median time required for NGT insertion was significantly longer in Group G, for both first and second attempts (97 vs 42 seconds P<0.001) and (70 vs 48.5 seconds P=0.015), respectively. Complications were reported in 23 patients (53.5%) in group G and 13 patients (30.2%) in group F. Bleeding and kinking were the most common complications in both techniques. Using GlideScope visualization to facilitate NGT insertion was comparable to neck flexion with lateral neck pressure technique in degree of success rate of insertion, while neck flexion with lateral neck pressure technique had fewer complications and was less time-consuming.

Keywords: anaesthesia, nasogastric tube, GlideScope, intubation

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1420 In-Service Training to Enhance Community Based Corrections

Authors: Varathagowry Vasudevan

Abstract:

This paper attempts to demonstrate the importance of capacity building of the para-professionals in community based corrections for enhancing family and child welfare as a crucial factor in providing in-service training as a responsive methodology in community based corrections to enhance the best practices. The Diploma programme in community-based corrections initiated by the National Institute of Social Development has been engaged in this noble task of training quality personnel knowledgeable in the best practices and fieldwork skills on community-based correction and its best practice. To protect the families and children and enhance best practices, National Institute of Social Development with support from the department of community-based corrections initiated a Diploma programme in community-based corrections to enhance and update the knowledge, skills, attitudes with the right mindset of the work supervisors employed at the department of community-based corrections. This study based on reflective practice illustrated the effectiveness of curriculum of in-service training programme as a tool to enhance the capacities of the relevant officers in Sri Lanka. The data for the study was obtained from participants and coordinator through classroom discussions and key informant interviews. This study showed that use of appropriate tailor-made curriculum and field practice manual by the officers during the training was very much dependent on the provision of appropriate administrative facilities, passion, teaching methodology that promote capacity to involve best practices. It also demonstrated further the fact that professional social work response, strengthening families within legal framework was very much grounded in the adoption of proper skills imbibed through training in appropriate methodology practiced in the field under guided supervision.

Keywords: capacity building, community-based corrections, in-service training, paraprofessionals

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1419 Internal Evaluation of Architecture University Department in Architecture Engineering Bachelor's Level: A Case from Iran

Authors: Faranak Omidian

Abstract:

This study has been carried out to examine the status of architecture department at bachelor's level of engineering architecture in Islamic Azad University of Dezful in 2012-13 academic year. The present research is a descriptive cross sectional study and in terms of measurement, it is descriptive and analytical, which was done based on 7 steps and in 7 areas with 32 criteria and 169 indicators. The sample includes 201 students, 14 faculty members, 72 graduates and 39 employers. Simple random sampling method, complete enumeration method, network sampling (snowball sampling) were used for students, faculty members and graduates respectively. All sample responded to the questions. After data collection, the findings were ranked on Likert scale from desirable to undesirable with the scores ranging from 1 to 3.The results showed that the department with a score of 1.88 in regard to objectives, organizational status, management and organizations, with a score of 2 in relation to students, with a score of 1.8 in regard to faculty members was in a relatively desirable status. Regarding training courses and curriculum, it gained a score of 2.33 which indicates the desirable status of the department in this regard. It gained scores of 1.75, 2, and 1.8 with respect to educational and research facilities and equipment, teaching and learning strategies, and graduates respectively, all of which shows the relatively desirable status of the department. The results showed that the department of architecture, with an average score of 2.14 in all evaluated areas, was in a desirable situation. Therefore, although the department generally has a desirable status, it needs to put in more effort to tackle its weaknesses and shortages and corrects its defects in order to promote educational quality, taking to the desirable level.

Keywords: internal evaluation, architecture department in Islamic, Azad University, Dezful

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1418 Ultra-Reliable Low Latency V2X Communication for Express Way Using Multiuser Scheduling Algorithm

Authors: Vaishali D. Khairnar

Abstract:

The main aim is to provide lower-latency and highly reliable communication facilities for vehicles in the automobile industry; vehicle-to-everything (V2X) communication basically intends to increase expressway road security and its effectiveness. The Ultra-Reliable Low-Latency Communications (URLLC) algorithm and cellular networks are applied in combination with Mobile Broadband (MBB). This is particularly used in express way safety-based driving applications. Expressway vehicle drivers (humans) will communicate in V2X systems using the sixth-generation (6G) communication systems which have very high-speed mobility features. As a result, we need to determine how to ensure reliable and consistent wireless communication links and improve the quality to increase channel gain, which is becoming a challenge that needs to be addressed. To overcome this challenge, we proposed a unique multi-user scheduling algorithm for ultra-massive multiple-input multiple-output (MIMO) systems using 6G. In wideband wireless network access in case of high traffic and also in medium traffic conditions, moreover offering quality-of-service (QoS) to distinct service groups with synchronized contemporaneous traffic on the highway like the Mumbai-Pune expressway becomes a critical problem. Opportunist MAC (OMAC) is a way of proposing communication across a wireless communication link that can change in space and time and might overcome the above-mentioned challenge. Therefore, a multi-user scheduling algorithm is proposed for MIMO systems using a cross-layered MAC protocol to achieve URLLC and high reliability in V2X communication.

Keywords: ultra-reliable low latency communications, vehicle-to-everything communication, multiple-input multiple-output systems, multi-user scheduling algorithm

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1417 The Causes and Effects of Delinquent Behaviour among Students in Juvenile Home: A Case Study of Osun State

Authors: Baleeqs, O. Adegoke, Adeola, O. Aburime

Abstract:

Juvenile delinquency is fast becoming one of the largest problems facing many societies due to many different factors ranging from parental factors to bullying at schools all which had led to different theoretical notions by different scholars. Delinquency is an illegal or immoral behaviour, especially by the young person who behaves in a way that is illegal or that society does not approve of. The purpose of the study was to investigate causes and effects of delinquent behaviours among adolescent in juvenile home in Osun State. A descriptive survey research type was employed. The random sampling technique was used to select 100 adolescents in Juvenile home in Osun State. Questionnaires were developed and given to them. The data collected from this study were analyzed using frequency counts and percentage for the demographic data in section A, while the two research hypotheses postulated for this study were tested using t-test statistics at the significance level of 0.05. Findings revealed that the greatest school effects of delinquent behaviours among adolescent in juvenile home in Osun by respondents were their aggressive behaviours. Findings revealed that there was a significant difference in the causes and effects of delinquent behaviours among adolescent in juvenile home in Osun State. It was also revealed that there was no significant difference in the causes and effects of delinquent behaviours among secondary school students in Osun based on gender. These recommendations were made in order to address the findings of this study: More number of teachers should be appointed in the observation home so that it will be possible to provide teaching to the different age group of delinquents. Developing the infrastructure facilities of short stay homes and observation home is a top priority. Proper counseling session’s interval is highly essential for these juveniles.

Keywords: behaviour, delinquency, juvenile, random sampling, statistical techniques, survey

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1416 Safety and Efficacy of Laparoscopic D2 Gastrectomy for Advanced Gastric Cancers Single Unit Experience

Authors: S. M. P Manjula, Ishara Amarathunga, Aryan Nath Koura, Jaideepraj Rao

Abstract:

Background: Laparoscopic D2 Gastrectomy for non metastatic advanced Gastric cancer (AGC) has become a controversial topic as there are confronting ideas from experts in the field. Lack of consensus are mainly due to non feasibility of the dissection and safety and efficacy. Method: Data from all D2 Gastrectomies performed (both Subtotal and Total Gastrectomies) in our unit from 2009 December to 2013 December were retrospectively analysed. Computor database was prospectively maintained. Pathological stage two A (iiA) and above considered advanced Gastric cancers, who underwent curative intent D2 Gastrectomy were included for analysis(n=46). Four patients excluded from the study as peritoneal fluid cytology came positive for cancer cells and one patient exempted as microscopic resection margin positive(R1) after curative resection. Thirty day morbidity and mortality, operative time, lymph nodes harvest and survival (disease free and overall) analyzed. Results: Complete curative resection achieved in 40 patients. Mean age of the study population was 62.2 (32-88) and male to female ratio was 23: 17. Thirty day mortality (1/40) and morbidity (6/40). Average operative time 203.7 minutes (185- 400) and average lymphnodes harvest was 40.5 (18-91). Disease free survival of the AGC in this study population was 16.75 months (1-49). Average hospital stay was 6.8 days (3-31). Conclusion: Laparoscopic dissection is effective feasible and safe in AGC.

Keywords: laparoscopy, advanced gastric cancer, safety, efficacy

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1415 Fate of Sustainability and Land Use Array in Urbanized Cities

Authors: Muhammad Yahaya Ubale

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Substantial rate of urbanization as well as economic growth is the tasks and prospects of sustainability. Objectives of the paper are: to ascertain the fate of sustainability in urbanized cities and; to identify the challenges of land use array in urbanized cities. Methodology engaged in this paper employed the use of secondary data where articles, conference proceedings, seminar papers and literature materials were effectively used. The paper established the fact that while one thinks globally, it is reciprocal to act locally if at all sustainability should be achieved. The speed and scale of urbanization must be equal to natural and cost-effective deliberations. It also discovered a podium that allows a city to work together as an ideal conglomerate, engaging all city departments as a source of services, engaging residents, businesses, and contractors. It also revealed that city should act as a leader and partner within an urban region, engaging senior government officials, utilities, rural settlements, private sector stakeholders, NGOs, and academia. Cities should assimilate infrastructure system design and management to enhance efficiency of resource flows in an urban area. They should also coordinate spatial development; integrate urban forms and urban flows, combine land use, urban design, urban density, and other spatial attributes with infrastructural development. Finally, by 2050, urbanized cities alone could be consuming 140 billion tons of minerals, ores, fossil fuels and biomass annually (three times its current rate of consumption), sustainability can be accomplished through land use control, limited access to finite resources, facilities, utilities and services as well as property right and user charge.

Keywords: sustainability, land use array, urbanized cities, fate of sustainability and perseverance

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1414 Enhancing Students’ Performance in Basic Science and Technology in Nigeria Using Moodle LMS

Authors: Olugbade Damola, Adekomi Adebimbo, Sofowora Olaniyi Alaba

Abstract:

One of the major problems facing education in Nigeria is the provision of quality Science and Technology education. Inadequate teaching facilities, non-usage of innovative teaching strategies, ineffective classroom management, lack of students’ motivation and poor integration of ICT has resulted in the increase in percentage of students who failed Basic Science and Technology in Junior Secondary Certification Examination for National Examination Council in Nigeria. To address these challenges, the Federal Government came up with a road map on education. This was with a view of enhancing quality education through integration of modern technology into teaching and learning, enhancing quality assurance through proper monitoring and introduction of innovative methods of teaching. This led the researcher to investigate how MOODLE LMS could be used to enhance students’ learning outcomes in BST. A sample of 120 students was purposively selected from four secondary schools in Ogbomoso. The experimental group was taught using MOODLE LMS, while the control group was taught using the conventional method. Data obtained were analyzed using mean, standard deviation and t-test. The result showed that MOODLE LMS was an effective learning platform in teaching BST in junior secondary schools (t=4.953, P<0.05). Students’ attitudes towards BST was also enhanced through MOODLE LMS (t=15.632, P<0.05). The use of MOODLE LMS significantly enhanced students’ retention (t=6.640, P<0.05). In conclusion, the Federal Government efforts at enhancing quality assurance through integration of modern technology and e-learning in Secondary schools proved to have yielded good result has students found MOODLE LMS to be motivating and interactive. Attendance was improved.

Keywords: basic science and technology, MOODLE LMS, performance, quality assurance

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1413 Winning the Future of Education in Africa through Project Base Learning: How the Implementation of PBL Pedagogy Can Transform Africa’s Educational System from Theory Base to Practical Base in School Curriculum

Authors: Bismark Agbemble

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This paper talks about how project-based learning (PBL) is being infused or implemented in the educational sphere of Africa. The paper navigates through the liminal aspects of PBL as a pedagogical approach to bridge the divide between theoretical knowledge and its application within school curriculums. Given that contextualized learning can be embodied, the abstract vehemently discusses that PBL creates an opportunity for students to work on projects that are of academic relevance in their local settings. It presents PBL’s growth of critical thinking, problem-solving, cooperation, and communications, which is vital in getting young citizens to prepare for the 21st-century revolution. In addition, the abstract stresses the possibility that PBL could become a stimulus to creativity and innovation wherein learning becomes motivated from within by intrinsic motivations. The paper advocates for a holistic approach that is based on teacher’s professional development with the provision of adequate infrastructural facilities and resource allocation, thus ensuring the success and sustainability of PBLs in African education systems. In the end, the paper positions this as a transformative educational methodology that has great potential in helping to shape an African generation that is prepared for a great future.

Keywords: student centered pedagogy, constructivist learning theory, self-directed learning, active exploration, real world challenges, STEM, 21st century skills, curriculum design, classroom management, project base learning curriculum, global intelligence, social and communication skills, transferable skills, critical thinking, investigatable learning, life skills

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1412 Need for a National Newborn Screening Programme in India: Pilot Study Data

Authors: Sudheer Moorkoth, Leslie Edward Lewis, Pragna Rao

Abstract:

Newborn screening (NBS) is a part of routine newborn care in many countries worldwide to detect early any rare treatable conditions and inborn errors of metabolism (IEM). India has not started this program yet. In an attempt to understand the challenges in implementing a national newborn screening program in India, we initiated a pilot newborn screening project funded by the Government of Canada. Along with initiating the newborn screening at Kasturba Hospital, Manipal in South India, for screening six disorders (Congenital Hypothyroidism(CH), Congenital Adrenal Hyperplasia (CAH), Galactosemia, Biotinidase deficiency, Glucose-6-Phosphate Dehydrogenase deficiency (G-6PD) and Phenylketonurea), we also studied the awareness of various stakeholders on the newborn screening. In a period of nine months from August 2017 to March 2018 we could screen 1915 newborns (999 male and 916 female). The result showed that there were seven babies screened positive. This interim result points to an incidence rate of 1 in 270 children for these rare disorders collectively. This includes three confirmed cases of CH, two cases of G-6PD deficiency, and one case each for Galctosemia and CAH. A questionnaire based study to understand the awareness among various stakeholders revealed that there is little awareness among parents, adolescents and anganwadi workers (public health worker). The interim data points to the need for a national newborn screening programme in India. There is also an immediate need to undertake large-scale awareness programme to create knowledge on NBS among the various stakeholders.

Keywords: awareness, inborn errors of metabolism (IEM), newborn screening, rare disease

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