Search results for: Darren J. Mann

Authors: Julia Wong, Hua Beng Lim, Petrina Goh, Johanna Foo, Caleb Ng, Nurul ‘Aqilah Bte Mohd Taufek

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Animal-assisted therapy (AAT) utilizes human-animal interaction to achieve specific therapeutic goals, and its efficacy has been demonstrated across various settings overseas. The use of AAT in Singapore, however, is still limited. Ang Mo Kio-Thye Hua Kwan (AMKH) is one of the first community hospitals in Singapore to use AAT to complement its occupational therapy services with elderly patients. This study explored the perspectives of AMKH’s occupational therapists (OTs) in relation to AAT to understand barriers and enablers in implementing and practising AAT. We also examined how OTs at-large across practice settings perceive AAT. A mixed method design was used. 64 OTs at-large participated in on online survey, and 7 AMKH OTs were interviewed individually via Zoom. Survey results were analysed with descriptive and Mann-Whitney U tests. Interviews were thematically analysed. AMKH OTs perceived various benefits of AAT articulated in overseas studies in domains such as motivation and participation, emotional, social interaction, sensory tactile stimulation, and cognition. Interestingly, this perception was also supported by 67% of OTs who had responded to the survey, even though most of the OTs who had participated in the survey had no experience in AAT. Despite the perceived benefits of AAT, both OTs from AMKH and those at-large articulated concerns on risks pertaining to AAT (e.g., allergies, unexpected animal behaviour, infections, etc). However, AMKH OTs shared several ways to mitigate these risks, demonstrating their ability to develop a safe program. For e.g., volunteers and their dogs must meet specific recruitment criteria, stringent protocols are used to screen and match dogs with patients, and there are strict exclusion criteria for patients participating in AAT. AMKH OTs’ experience suggests that additional skills and knowledge are required to implement AAT, therefore, healthcare institutions should first consider improving their staff training and risk mitigation knowledge before implementing AAT. They can also refer to AMKH’s AAT protocols and those found in overseas studies, but institutions must adapt the protocols to fit their institutional settings and patients’ profiles.

Keywords: animal-assisted therapy, dog-assisted therapy, occupational therapy, complementary therapy

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Authors: Priyanka Tiwari, Uma Devi Ranjit, Ritesh Thapa

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Background and Significance: Cerebral Palsy (CP) influences not only the child's everyday functioning but also the functioning of whole family. Application of study findings can be used in clinical or community setting to screen the parents of children with cerebral palsy in order to identify the compromised domain of stress which in turn will help to improve the interaction between parent and child with disability and thus ultimately affect the progress that a child makes in his or her therapeutic or educational programs. Objective: The objective of the study was to assess the level of stress in mothers of children with CP by adopting mixed method design. Methodology: Cross-sectional descriptive design was adopted in the quantitative design where Parental Stress Scale (PSS) was utilized to collect data from a convenient sample of 40 mothers of children with CP who were under regular follow-up by home visitor of Self-help Group for Cerebral Palsy while embedded qualitative design was used to explore the stress of mothers of CP affected children. From the parent population of quantitative sample 4 mothers were chosen for in-depth exploration, regarding their stress by means of case study method. Descriptive statistics like frequency, percentage, mean, median, standard deviation, correlation and inferential statistics like Mann-Whitney U test and Kruskal-Wallis H test were used to describe and assess relationship between variables. Findings: The mean stress experienced by mothers of children with cerebral palsy was 53.62±9.53 with 15% percent of the mothers experiencing severe stress. There was significant association between age group of mother and total stress score and negative themes of stress. Similarly, signification association was found between educational status of the mother and positive themes of stress which was convergent with the qualitative finding as well, where literate mothers had more positive view of their child's disability which could be attributed to their educational level as education provides us with a broad perspective to look at a situation. Conclusions: Still one-sixth of the mothers experienced severe stress so if we want to ensure the well-being of the children affected by cerebral palsy, then parents caring for them need to be looked after as well.

Keywords: stress, cerebral palsy, mothers, mixed method

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Authors: Ayse Inel Manav, Nuray Simsek

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The number of people with dementia and the problems that are experienced by these people are increasing along with aging world population. This study was carried out to assess the effects of reminiscence therapy using internet videos on the cognitive condition and apathy levels of elderly people who had mild dementia and lived in nursing homes. This randomly controlled experimental study was conducted between 25 May-25 August 2016 in the nursing home, elderly care and rehabilitation centers in Adana and Seyhan, Turkey. A total of 32 individuals participated in this study, 16 in the experimental group and 16 in the control group. Data were collected using a personal information form developed on the basis of the published literature, the Standardized Mini Mental Test (SMMT) and the Apathy Rating Scale (ARS). The Clinical Research Ethics Committee's approval, written institutional permission, and the written consent of the participants were obtained before data collection. The individuals in the experimental group received reminiscence therapy using internet videos for 60 minutes one day a week for three months. During the same period, 25-30 minutes of unstructured interviews on subjects unrelated to reminiscence were carried out with individuals in the control group. The SMMT and ARS were administered before the applications in the experimental group and at the end of the third month. The collected data were analyzed using descriptive statistics (means, standard deviations, and frequencies) as well as Student's t-test, the Mann-Whitney U-test, and Wilcoxon's signed ranks test. In this study, the total SMMT post-test scores of the experimental group were higher than those of the control group (p = 0.001; p < 0.01). There was a difference between experimental and control groups' total SMMT post-test scores (p = 0.001; p < 0.01). The experimental group's ARS total post-test scores were higher than those of the control group (p = 0.001; p < 0.01). This study found that group reminiscence therapy using internet videos improved the cognitive functions and apathy levels of elderly individuals with mild dementia.

Keywords: apaty, cognitive testing, dementia, elderly, reminisence threapy

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Authors: Gaye Demi̇rtaş Adli

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Research: It was conducted to determine the factors affecting the fear of self-injection and self-pricking of fingers of diabetic individuals.The study was conducted as a cross-sectional, relation-seeking, and descriptive study. The study was conducted on 122 patients who had just started insulin therapy. Data were obtained through The Descriptive Patient Form, The Diabetic Self-Injection, and the Fear of Testing Questionnaire Form (D-FISQ). Descriptive statistical methods used in the evaluation of data are the Mann-Whitney U test, Kruskal-Wallis H test, and the Spearman correlation. The factors affecting the scale scores were evaluated with multiple linear regression analysis. The value of P<0.05 was considered statistically significant. Study group: 56.6% of the patients are male patients. Fear of self-injection (injection), fear of self-testing (test), and total fear (total) scores of women were found to be statistically higher than men (p<0.001). Age, gender, and pain experience were important variables that affected patients' fear of injections. With a one-unit increase in age, the injection fear score decreased by 0.13 points, and the mean injection fear score of women was 2.11 points higher than that of men. It was determined that the patient's age, gender, living with whom, and blood donation history were important variables affecting the fear of self-testing. It is seen that the fear test score decreases by 0.18 points with an increase in age by one unit, and the fear test scores of women compared to men are on average 3,358 points, the fear test scores of those living alone are 4,711 points compared to those living with family members, and the fear test scores of those who do not donate blood are 2,572 compared to those who donate blood score, it was determined that those with more pain experience were 3,156 points higher on average than those with less fear of injection. As a result, it was seen that the most important factors affecting the fear of insulin injection and finger punching in individuals with diabetes were age, gender, pain experience, living with whom, and blood donation history.

Keywords: diabetes, needle phobia, fear of injection, insulin injection

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Authors: Chaudhary Itisha, Shankar Manu

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Patient satisfaction represents a crucial aspect in the evaluation of health care services. Preoperative teaching provides the patient with pertinent information concerning the surgical process and the intended surgical procedure as well as anticipated patient behavior (anxiety, fear), expected sensation, and the probable outcomes. Although patient education is part of Accreditation protocols, it is not uniform at most places. The aim of this study was to try to assess the benefit of preoperative patient education on selected post-operative outcome parameters; mainly, post-operative pain scores, requirement of additional analgesia, return to activity of daily living and overall patient satisfaction, and try to standardize few education protocols. Dependent variables were measured before and after the treatment on a study population of 302 volunteers. Educational intervention was provided by the Investigator in the preoperative period to the study group through personal counseling. An information booklet contained detailed information was also provided. Statistical Analysis was done using Chi square test, Mann Whitney u test and Fischer Exact Test on a total of 302 subjects. P value <0.05 was considered as level of statistical significance and p<0.01 was considered as highly significant. This study suggested that patients who are given a structured, individualized and elaborate preoperative education and counseling have a better ability to cope up with postoperative pain in the immediate post-operative period. However, there was not much difference when the patients have had almost complete recovery. There was no difference in the requirement of additional analgesia among the two groups. There is a positive effect of preoperative counseling on expected return to the activities of daily living and normal work schedule. However, no effect was observed on the activities in the immediate post-operative period. There is no difference in the overall satisfaction score among the two groups of patients. Thus this study concludes that there is a positive benefit as suggested by the results for pre-operative patient education. Although the difference in various parameters studied might not be significant over a long term basis, they definitely point towards the benefits of preoperative patient education. 

Keywords: patient education, post-operative pain, postoperative outcomes, patient satisfaction

Procedia PDF Downloads 339

Authors: L. Musak, J. Valachova, T. Vasicko, O. Osina

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Stainless steel is resistant to electrochemical corrosion by passivation. Welders are greatly exposed to welding fumes of toxic metals, which added to this steel. The content of chromium (Cr) is above 11.5%, Ni and Mo from 2 to 6.5%. The aim of the study was the evaluation of occupational exposure to Cr, chromosome analysis and valuation of individual susceptibility polymorphism of gene CCND1 c.870 G>A. The exposed group was consisted from 117 welders of stainless steels. The average age was 38.43 years and average exposure time 7.14 years. Smokers represented 40.17%. The control group consisted of 123 non-exposed workers with an average age of 39.74 years and time employment 16.67 years. Smokers accounted for 22.76%. Analysis of Cr in blood and urine was performed by atomic absorption spectrophotometry (AAS Varian SpectraAA 30P) with electrothermal decomposition of the sample in the graphite furnace. For the evaluation of chromosomal aberrations (CA) cytogenetic analysis of peripheral blood lymphocytes was used. Gene polymorphism was determined by PCR-RFLP reaction using appropriate primers and restriction enzymes. For statistic analysis the Mann-Whitney U-test was used. The mean Cr level in blood of exposed group was 0.095 µmol/l (0.019 min - max 0.504). No value exceeds the average normal value. The mean value Cr in urine was 7.9 µmol/mol creatinine (min 0.026 to max 19.26). The total number of CA was 1.86% in compared to 1.70% controls. (CTA-type 0.90% vs. 0.80% and CSA-type 0.96% vs. 0.90%). In the number of total CA statistical difference was observed between smokers and non-smokers of exposed group (S-1.57% vs. NS-2.04%, P<0.05). In CCND1 gene polymorphisms was observed the increasing of the total CA with wild-type allele (WT) via heterozygous to the VAR genotype (1.44% <1.82% <2.13%). A statistically higher incidence of CTA-type aberrations in variant genotypes between exposed and control groups was observed (1.22% vs. 0.59%, P <0.05). The work place is usually higher source of exposure to harmful factors. Workers need consistent and frequent health control. In assessing the risk of adverse effects of metals it is important to consider their persistence, behavior and bioavailability. Prolonged exposure to carcinogens may not manifest symptoms of poisoning, but delayed effects may occur, which resulted in a higher incidence of malignant tumors.

Keywords: CCND1, genotoxicity, polymorphism, stainless steel, welders

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Authors: Alemayehu Muluneh, Saskia Keesstra, Leo Stroosnijder, Woldeamlak Bewket, Ashenafi Burka

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There are some scientific evidences and a belief by many that forests attract rain and deforestation contributes to a decline of rainfall. However, there is still a lack of concrete scientific evidence on the role of forests in rainfall amount. In this paper, we investigate the forest-rainfall relationships in the environmentally hot spot area of the Central Rift Valley (CRV) of Ethiopia. Specifically, we evaluate long term (1970-2009) rainfall variability and its relationship with historical forest cover and the relationship between existing forest cover and topographical variables and rainfall distribution. The study used 16 long term and 15 short term rainfall stations. The Mann-Kendall test, bi variate and multiple regression models were used. The results show forest and wood land cover continuously declined over the 40 years period (1970-2009), but annual rainfall in the rift valley floor increased by 6.42 mm/year. But, on the escarpment and highlands, annual rainfall decreased by 2.48 mm/year. The increase in annual rainfall in the rift valley floor is partly attributable to the increase in evaporation as a result of increasing temperatures from the 4 existing lakes in the rift valley floor. Though, annual rainfall is decreasing on the escarpment and highlands, there was no significant correlation between this rainfall decrease and forest and wood land decline and also rainfall variability in the region was not explained by forest cover. Hence, the decrease in annual rainfall on the escarpment and highlands is likely related to the global warming of the atmosphere and the surface waters of the Indian Ocean. Spatial variability of number of rainy days from systematically observed two-year’s rainfall data (2012-2013) was significantly (R2=-0.63) explained by forest cover (distance from forest). But, forest cover was not a significant variable (R2=-0.40) in explaining annual rainfall amount. Generally, past deforestation and existing forest cover showed very little effect on long term and short term rainfall distribution, but a significant effect on number of rainy days in the CRV of Ethiopia.

Keywords: elevation, forest cover, rainfall, slope

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Authors: Erna Judith Roach, Nalini Bhaskaranand

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Background & Significance: Asthma is the most common chronic disease among children. Education is the cornerstone of management of asthma to help the affected children. In India there are about 1.5- 3.0 million asthmatic children in the age group of 5-11 years. Many parents face management dilemmas in administration of medications to their children. Mothers being primary caregivers of children are often responsible for administering medications to them. The purpose of the study was to develop an educational package on techniques of drug administration for mothers of asthmatic children and determine its effectiveness in terms of improvement in skill in drug administration. Methodology: A quasi- experimental time series pre-test post -test control group design was used. Mothers of asthmatic children attending paediatric outpatient departments of selected hospitals along with their children between 5 and 12 years were included. Sample size consisted of 40 mothers in the experimental and 40 mothers in the control groups. Block randomization was used to assign samples to both the groups. The data collection instruments used were Baseline Proforma, Clinical Proforma, Daily asthma drug intake and symptoms diary and Observation Rating Scales on technique of using a metered dose inhaler with spacer; metered dose inhaler with facemask; metered dose inhaler alone and dry powder inhaler. The educational package consisted of a video and booklet on techniques of drug administration. Data were collected at baseline, 1, 3 and 6 months. Findings: The mean post-test scores in techniques of drug administration were higher than the mean pre-test scores in the experimental group in all techniques. The Friedman test (p < 0.01), Wilcoxon Signed Rank test (p < 0.008) and Mann Whitney U (p < 0.01) showed statistically significant difference in the experimental group than the control group. There was significant decrease in the average number of symptom days (11 Vs. 4 days/ month) and hospital visits (5 to 1 per month) in the experimental group when compared to the control group. Conclusion: The educational package was found to be effective in improving the skill of mothers in drug administration in all the techniques, especially with using the metered dose inhaler with spacer.

Keywords: childhood asthma, drug administration, mothers of children, inhaler

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Authors: Farzad Shirzad, Bohlol Alijani, Mehry Akbary, Mohammad Saligheh

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Climate change and global warming are very important issues today. The process of climate change, especially changes in temperature and precipitation, is the most important issue in the environmental sciences. Climate change means changing the averages in the long run. Iran is located in arid and semi-arid regions due to its proximity to the equator and its location in the subtropical high pressure zone. In this respect, the Hyrcanian forest is a green necklace between the Caspian Sea and the south of the Alborz mountain range. In the forty-third session of UNESCO, it was registered as the second natural heritage of Iran. Beech is one of the most important tree species and the most industrial species of Hyrcanian forests. In this research, using dendroclimatology, the width of the tree ring, and climatic data of temperature and precipitation from Shanderman meteorological station located in the study area, And non-parametric Mann-Kendall statistical method to investigate the trend of climate change over a time series of 202 years of growth ringsAnd Pearson statistical method was used to correlate the growth of "ring" growth rings of beech trees with climatic variables in the region. The results obtained from the time series of beech growth rings showed that the changes in beech growth rings had a downward and negative trend and were significant at the level of 5% and climate change occurred. The average minimum, medium, and maximum temperatures and evaporation in the growing season had an increasing trend, and the annual precipitation had a decreasing trend. Using Pearson method during fitting the correlation of diameter of growth rings with temperature, for the average in July, August, and September, the correlation is negative, and the average temperature in July, August, and September is negative, and for the average The average maximum temperature in February was correlation-positive and at the level of 95% was significant, and with precipitation, in June the correlation was at the level of 95% positive and significant.

Keywords: climate change, dendroclimatology, hyrcanian forest, beech

Procedia PDF Downloads 104

Authors: Florenda B. Cardinoza

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This study was conducted to determine the determinants of Grade III and grade VI pupils’ performance in the National Achievement Test in the Division of Cavite City, School Year 2011-2012. Specifically, the research aimed to: (1) describe the demographic profile of the respondents in terms of age, sex, birth order, family size, family income, and occupation of parents; (2) determine the level of attitude towards NAT; and (3) describe the degree of relationship between the following variables: school support, teachers’ support, and lastly family support for the pupils’ performance in 2012 NAT. The study used the descriptive-correlation research method to investigate the determinants of pupils’ performance in the National Achievement Test of Public Elementary Schools in the Division of Cavite City. The instrument used in data gathering was a self-structured survey. The NAT result for SY 2011-2012 provided by NETRC and DepEd Cavite City was also utilized. The statistical tools used to process and analyze the data were frequency distribution, percentage, mean, standard deviation, Kruskall Wallis, Mann-Whitney, t-test for independent samples, One-way ANOVA, and Spearman Rank Correlational Coefficient. Results revealed that there were more female students than males in the Division of Cavite City; out of 659 respondents, 345 were 11 years old and above; 390 were females; 283 were categorized as first child in the family; 371 of the respondents were from small family; 327 had Php5000 and below family income; 450 of the fathers’ respondents were non professionals; and 431 of the mothers respondents had no occupation. The attitude towards NAT, with a mean of 1.65 and SD of .485, shows that respondents considered NAT important. The school support towards NAT, with a mean of 1.89 and SD of .520, shows that respondents received school support. The pupils had a very high attitude towards teachers’ support in NAT with a mean of 1.60 and SD of .572. Family support, with t-test of 16.201 with a p-value of 0.006, shows significant at 5 percent level. Thus, the determinants of pupils’ performance in NAT in terms of family support for NAT preparation is not significant according to their family income. The grade level, with the t-test is 4.420 and a p-value of 0.000, is significant at 5 percent level. Therefore, the determinants of pupils’ performance in NAT in terms of grade level for NAT preparation vary according to their grade level. For the determinants of pupils’ performance of NAT sample test for attitude towards NAT, school support, teachers’ support, and family support were noted highly significant with a p value of 0.000.

Keywords: achievement, determinants, national, performance, public, pupils', test

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Authors: Nepton Kiani

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Dental decay is one of the most common chronic diseases worldwide and imposes significant costs annually on people and healthcare systems. Addressing this issue is among the important programs of the World Health Organization in the field of oral and dental disease prevention and health promotion. In this context, oral and dental health in vulnerable groups, especially pregnant women, is of greater importance due to the health maintenance of the mother and fetus. The aim of this study is to investigate the DMFT index and various factors affecting it in order to identify different factors influencing the process of dental decay and to take an effective step in reducing the progression of this disease, control, and prevention. In this cross-sectional descriptive study, 120 pregnant women attending Nepton Policlinica clinic in Malaga, Spain, were evaluated for the DMFT index and oral and dental hygiene. In this regard, interviews, precise observations, and data collection were used. Subsequently, data analysis was performed using SPSS software and employing correlation tests, Kruskal-Wallis, and Mann-Whitney tests. The DMFT index for pregnant women in three age groups 22-26, 27- 31, and 32-36 years was respectively 2.8, 4.5, and 5.6. The results of logistic regression analysis showed that demographic variables (age, education, job, economic status) and the frequency of brushing and flossing lead to preventive behavior up to 49.58 percent (P<0.05). Generally, the results indicated that oral and dental care during pregnancy is poor. Only a small number of pregnant women regularly used toothbrush and dental floss or visited the dentist regularly. On the other hand, poor performance in adopting oral and dental care was more observed in pregnant women with lower economic and educational status. The present study showed that raising the level of awareness and education on oral and dental health in pregnant women is essential. In this field, it is necessary to focus on conducting educational-care courses at the level of healthcare centers for midwives, healthcare personnel, and at the community level for families, to prevent and perform dental treatments before the pregnancy period

Keywords: Malaga, oral and dental health, pregnant women, Spain

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Authors: Sima Modirkhamene, Arezoo Khezri

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The purpose of the present investigation was to probe the main motivational strategies Iranian school vs. institute teachers use in virtual and in-person classes to motivate students in learning the English language. Yet another purpose was to understand teachers’ perceptions about any modifications in their use of motivational strategies before and during/after the pandemic. For the purpose of this investigation, a total of 63 EFL teachers (35 female, 28 male) were conveniently sampled from schools and institutes in the cities of Mahabad and Sardasht. Moreover, for the interview phase of the study, 20 percent (n=16) of the sample was selected conveniently. The required data was gathered through a modified questionnaire (Cheng & Dornyei, 2007) consisting of 42 items and a set of semi-structured interviews. The outcomes of a set of non-parametric Mann-Whitney U tests demonstrated that presenting tasks properly in online classes and familiarizing learners with L2- related values in in-person classes came out as the most influential source of motivational strategies practiced by EFL school teachers. Additionally, it was found that proper teacher behavior(showing enthusiasm) in both in-person and virtual classes and presenting tasks properly in in-person classes were overwhelmingly endorsed by EFL institute teachers. The study also portrayed no statistically significant mean difference between school and institute EFL teachers’ overall use of motivational strategies in virtual and in-person classes. The interview results indicated that the strategies of designing tasks through technological aids, provision of videos, gamification techniques, assigning projects, and delivering formative online feedback were held in high regard during/after the pandemic due to the high reliance of teaching on the Internet connection. Meanwhile, the research has indicated that the spread of COVID-19 was the main reason for teachers’ modifications in motivational strategies, in response to the crisis of the pandemic, all educational contexts at all levels resorted to online education as a result their strategies were adapted to the new situation. The findings brought to light through this investigation provided initial evidence of the unintended consequences of the pandemic on teachers’ strategic choices. Therefore, to deliver a better education for the future, the study suggests more concentration on the quality of teaching as well as reframing the status quo of teaching .

Keywords: virtual teaching, motivational teaching strategies, teaching context, online education

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Authors: Aneena Suresh, C. S. Sidharth

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Drug related problems (DRPs) are common in chronic kidney disease (CKD) patients and end stage patients undergoing hemodialysis. To treat the co-morbid conditions of the patients, more complex therapeutic regimen is required, and it leads to development of DRPs. So, this calls for frequent monitoring of the patients. Due to the busy work schedules, physicians are unable to deliver optimal care to these patients. Addition of a clinical pharmacist in the team will improve the standard of care offered to CKD patients by minimizing DRPs. In India, the role of clinical pharmacists in the improving the health outcomes in CKD patients is poorly recognized. Therefore, this study is conducted to put an insight on the role of clinical pharmacist in improving Drug Related Problems in patients with chronic kidney disease, thereby helping them to achieve desired therapeutic outcomes in the patients. A prospective interventional study was conducted for a year in a 620 bedded tertiary care hospital in India. Data was collected using an unstructured questionnaire, medication charts, etc. DRPs were categorized using Hepler and Strand classification. Relationships between the age, weight, GFR, average no of medication taken, average no of comorbidities, and average length of hospital days with the DRPs were identified using Mann Whitney U test. The study population primarily constituted of patients above the age of 50 years with a mean age of 59.91±13.59. Our study showed that 25% of the population presented with DRPs. On an average, CKD patients are prescribed at least 8 medications for the treatment in our study. This explains the high incidence of drug interactions in patients suffering from CKD (45.65%). The least common DRPs in our study were found to be sub therapeutic dose (2%) and adverse drug reactions (2%). Out of this, 60 % of the DRPs were addressed successfully. In our study, there is an association between the DRPs with the average number of medications prescribed, the average number of comorbidities, and the length of the hospital days with p value of 0.022, 0.004, and 0.000, respectively. In the current study, 86% of the proposed interventions were accepted, and 41 % were implemented by the physician, and only 14% were rejected. Hence, it is evident that clinical pharmacist interventions will contribute significantly to diminish the DRPs in CKD patients, thereby decreasing the economic burden of healthcare costs and improving patient’s quality of life.

Keywords: chronic kidney disease, clinical pharmacist, drug related problem, intervention

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Authors: Anna Hadamus, Patryk Wasowski, Anna Mosiolek, Zbigniew Wronski, Sebastian Wojtowicz, Dariusz Bialoszewski

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Introduction: Kinesiology Taping is a very popular physiotherapy method, often used for healthy people, especially athletes, in order to stimulate the muscles and improve their performance. The aim of this study was to determine the effect of the muscle application of Kinesiology Taping on the joint position sense in active motion. Material and Methods: The study involved 50 healthy people - 30 men and 20 women, mean age was 23.2 years (range 18-30 years). The exclusion criteria were injuries and operations of the knee, which could affect the test results. The participants were divided randomly into two equal groups. The first group consisted of individuals with the applied Kinesiology Taping muscle application (KT group), whereas in the rest of the individuals placebo application from red adhesive tape was used (placebo group). Both applications were to enhance the effects of quadriceps muscle activity. Joint position sense (JPS) was evaluated in this study. Error of Active Reproduction of the Joint Position (EARJP) of the knee was measured in 45° flexion. The test was performed prior to applying the patch, with the applied application, then 24 hours after wearing, and after removing the tape. The interval between trials was not less than 30 minutes. Statistical analysis was performed using Statistica 12.0. We calculated distribution characteristics, Wilcoxon test, Friedman‘s ANOVA and Mann-Whitney U test. Results. In the KT group and the placebo group average test score of JPS before applying application KT were 3.48° and 5.16° respectively, after its application it was 4.84° and 4.88°, then after 24 hours of experiment JPS was 5.12° and 4.96°, and after application removal we measured 3.84° and 5.12° respectively. Differences over time in any of the groups were not statistically significant. There were also no significant differences between the groups. Conclusions: 1. Applying Kinesiology Taping to quadriceps muscle had no significant effect on the knee joint proprioception. Its use in order to improve sensorimitor skills seems therefore to be unreasonable. 2. No differences between applications of KT and placebo indicates that the clinical effect of stretch tape is minimal or absent. 3. The results are the basis for the continuation of prospective, randomized trials of numerous study groups.

Keywords: joint position sense, kinesiology taping, kinesiotaping, knee

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Authors: Mike T. Wei, Douglas N. Mintz, Lisa A. Mandl, Arielle W. Fein, Jayme C. Burket, Yuo-Yu Lee, Wei-Ti Huang, Vivian P. Bykerk, Mark P. Figgie, Edward F. Di Carlo, Bruce N. Cronstein, Susan M. Goodman

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Background/Purpose: Rheumatoid arthritis (RA) patients have excellent total hip arthroplasty (THA) survival, and methotrexate (MTX), an anti-inflammatory disease modifying drug which may affect bone reabsorption, may play a role. The purpose of this study is to determine the diagnosis leading to revision THA (rTHA) in RA patients and to assess the association of radiographic lucency with MTX use. Methods: All patients with validated diagnosis of RA in the institution’s THA registry undergoing rTHA from May 2007 - February 2011 were eligible. Diagnosis leading to rTHA and medication use was determined by chart review. Osteolysis was evaluated on available radiographs by measuring maximum lucency in each Gruen zone. Differences within RA patients with/without MTX in osteolysis, demographics, and medications were assessed with chi-squared, Fisher's exact tests or Mann-Whitney U tests as appropriate. The error rate for multiple comparisons of lucency in the different Gruen zones was corrected via false discovery rate methods. A secondary analysis was performed to determine differences in diagnoses leading to revision between RA and matched OA controls (2:1 match by sex age +/- 5 years). OA exclusion criteria included presence of rheumatic diseases, use of MTX, and lack of records. Results: 51 RA rTHA were identified and compared with 103 OA. Mean age for RA was 57.7 v 59.4 years for OA (p = 0.240). 82.4% RA were female v 83.5% OA (p = 0.859). RA had lower BMI than OA (25.5 v 28.2; p = 0.166). There was no difference in diagnosis leading to rTHA, including infection (RA 3.9 v OA 6.8%; p = 0.719) or dislocation (RA 23.5 v OA 23.3%; p = 0.975). There was no significant difference in the length of time the implant was in before revision: RA 11.0 v OA 8.8 years (p = 0.060). Among RA with/without MTX, there was no difference in use of biologics (30.0 v 43.3%, p = 0.283), steroids (47.6 v 50.0%, p = 0.867) or bisphosphonates (23.8 v 33.3%, p = 0.543). There was no difference in rTHA diagnosis with/without MTX, including loosening (52.4 v 56.7%, p = 0.762). There was no significant difference in lucencies with MTX use in any Gruen zone. Patients with MTX had femoral stem subsidence of 3.7mm v no subsidence without MTX (p = 0.006). Conclusion: There was no difference in the diagnosis leading to rTHR in RA and OA, although RA trended longer prior to rTHA. In this small retrospective study, there were no significant differences associated with MTX exposure or radiographic lucency among RA patients. The significance of subsidence is not clear. Further study of arthroplasty survival in RA patients is warranted.

Keywords: hip arthroplasty, methotrexate, revision arthroplasty, rheumatoid arthritis

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Authors: Renato Morbidelli, Carla Saltalippi, Alessia Flammini, Marco Cifrodelli, Corrado Corradini

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The trend of magnitude and frequency of extreme rainfalls seems to be different depending on the investigated area of the world. In this work, the impact of climate change on extreme rainfalls in Umbria, an inland region of central Italy, is examined using data recorded during the period 1921-2015 by 10 representative rain gauge stations. The study area is characterized by a complex orography, with altitude ranging from 200 to more than 2000 m asl. The climate is very different from zone to zone, with mean annual rainfall ranging from 650 to 1450 mm and mean annual air temperature from 3.3 to 14.2°C. Over the past 15 years, this region has been affected by four significant droughts as well as by six dangerous flood events, all with very large impact in economic terms. A least-squares linear trend analysis of annual maximums over 60 time series selected considering 6 different durations (1 h, 3 h, 6 h, 12 h, 24 h, 48 h) showed about 50% of positive and 50% of negative cases. For the same time series the non-parametrical Mann-Kendall test with a significance level 0.05 evidenced only 3% of cases characterized by a negative trend and no positive case. Further investigations have also demonstrated that the variance and covariance of each time series can be considered almost stationary. Therefore, the analysis on the magnitude of extreme rainfalls supplies the indication that an evident trend in the change of values in the Umbria region does not exist. However, also the frequency of rainfall events, with particularly high rainfall depths values, occurred during a fixed period has also to be considered. For all selected stations the 2-day rainfall events that exceed 50 mm were counted for each year, starting from the first monitored year to the end of 2015. Also, this analysis did not show predominant trends. Specifically, for all selected rain gauge stations the annual number of 2-day rainfall events that exceed the threshold value (50 mm) was slowly decreasing in time, while the annual cumulated rainfall depths corresponding to the same events evidenced trends that were not statistically significant. Overall, by using a wide available dataset and adopting simple methods, the influence of climate change on the heavy rainfalls in the Umbria region is not detected.

Keywords: climate changes, rainfall extremes, rainfall magnitude and frequency, central Italy

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Authors: Gashaw Gismu Chakilu

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Climate and land cover change are very important issues in terms of global context and their responses to environmental and socio-economic drivers. The dynamic of these two factors is currently affecting the environment in unbalanced way including watershed hydrology. In this paper individual and combined impacts of climate change and land use land cover change on hydrological processes were evaluated through applying the model Soil and Water Assessment Tool (SWAT) in Gumara watershed, Upper Blue Nile basin Ethiopia. The regional climate; temperature and rainfall data of the past 40 years in the study area were prepared and changes were detected by using trend analysis applying Mann-Kendall trend test. The land use land cover data were obtained from land sat image and processed by ERDAS IMAGIN 2010 software. Three land use land cover data; 1973, 1986, and 2013 were prepared and these data were used for base line, model calibration and change study respectively. The effects of these changes on high flow and low flow of the catchment have also been evaluated separately. The high flow of the catchment for these two decades was analyzed by using Annual Maximum (AM) model and the low flow was evaluated by seven day sustained low flow model. Both temperature and rainfall showed increasing trend; and then the extent of changes were evaluated in terms of monthly bases by using two decadal time periods; 1973-1982 was taken as baseline and 2004-2013 was used as change study. The efficiency of the model was determined by Nash-Sutcliffe (NS) and Relative Volume error (RVe) and their values were 0.65 and 0.032 for calibration and 0.62 and 0.0051 for validation respectively. The impact of climate change was higher than that of land use land cover change on stream flow of the catchment; the flow has been increasing by 16.86% and 7.25% due to climate and LULC change respectively, and the combined change effect accounted 22.13% flow increment. The overall results of the study indicated that Climate change is more responsible for high flow than low flow; and reversely the land use land cover change showed more significant effect on low flow than high flow of the catchment. From the result we conclude that the hydrology of the catchment has been altered because of changes of climate and land cover of the study area.

Keywords: climate, LULC, SWAT, Ethiopia

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Authors: L. Musak, J. Valachova, T. Vasicko, O. Osina

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Introduction: Stainless steel is resistant to electrochemical corrosion by passivation. Welders are greatly exposed to welding fumes of toxic metals, which added to this steel. The content of chromium (Cr) in steel was above 11.5%, Ni and Mo from 2 to 6.5%. The aim of the study was the evaluation of occupational exposure to Cr, chromosome analysis and valuation of individual susceptibility polymorphism of gene CCND1 c.870 G>A. Materials and Methods: The exposed group was consisted from 117 welders of stainless steels. The average age was 38.43 years and average exposure time 7.14 years. Smokers represented 40.17%. The control group consisted of 123 non-exposed workers with an average age of 39.74 years and time employment 16.67 years. Smokers accounted for 22.76%. Analysis of Cr in blood and urine was performed by atomic absorption spectrophotometry (AAS Varian SpectraAA 30P) with electrothermal decomposition of the sample in the graphite furnace. For the evaluation of chromosomal aberrations (CA) was used cytogenetic analysis of peripheral blood lymphocytes, gene polymorphism was determined by PCR-RFLP reaction using appropriate primers and restriction enzymes. For statistical analysis was used the Mann-Whitney U-test. Results: The mean Cr level in exposed group was 0.095 mmol/l (0.019 min-max 0.504). No value does exceed the average normal value. The average value Cr in urine was 7.9 mmol/mol creatinine (min 0.026 to max 19.26). The total number of CA was 1.86% in compared to 1.70% controls. (CTA-type 0.90% vs 0.80% and CSA-type 0.96% vs 0.90%). In the number of total CA was observed statistical difference between smokers and non-smokers of exposed group (S-1.57% vs. NS-2.04%, P<0.05). In CCND1 gene polymorphisms was observed the increasing of the total CA with wild-type allele (WT) via heterozygous to the VAR genotype (1.44%<1.82%<2.13%). There was observed a statistically higher incidence of CTA-type aberrations in variant genotypes between exposed and control groups (1.22% vs. 0.59%, P<0.05). Discussion and conclusions: The work place is usually higher source of exposure to harmful factors. Workers need consistently and checked frequently health control. In assessing the risk of adverse effects of metals is important to consider their persistence, behavior and bioavailability. Prolonged exposure to carcinogens may not manifest symptoms of poisoning, but delayed effects may occur, which resulted in a higher incidence of malignant tumors.

Keywords: genotoxicity, chromium, stainless steels, welders

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Authors: Novita Linda Akbar, Elmeida Effendy, Mustafa M. Amin

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Background: The most common of psychotic disorders is schizophrenia. Vitamin D is made from sunlight, and in the skin from UVB radiation from sunlight. If people with Vitamin D deficiency is common severe mental illness such as schizophrenia.Schizophrenia is a chronic mental illness characterised by positive symptoms and negatives symptoms, such as hallucinations and delusions, flat affect and lack of motivation we can found. In patients with Schizophrenia maybe have several environmental risk factors for schizophrenia, such as season of birth, latitude, and climate has been linked to vitamin D deficiency. There is also relationship between the risk of schizophrenia and latitude, and with an increased incidence rate of schizophrenia seen at a higher latitude. Methods: This study was an analytical study, conducted in BLUD RS Jiwa Propinsi Sumatera Utara and RSUD Deli Serdang, the period in May 2016 and ended in June 2016 with a sample of the study 60 sample (20 patients live in the Highland and Lowland, 20 healthy controls). Inclusion criteria were schizophrenic patients both men and women, aged between 18 to 60 years old, acute phase no agitation or abstinence antipsychotic drugs for two weeks, live in the Highland and Lowland, and willing to participate this study. Exclusion criteria were history of other psychotic disorders, comorbidities with other common medical condition, a history of substance abuse. Sample inspection for serum vitamin D using ELFA method. Statistical analysis using numeric comparative T-independent test. Results: The results showed that average levels of vitamin D for a group of subjects living in areas of high land was 227.6 ng / mL with a standard deviation of 86.78 ng / mL, the lowest levels of vitamin D is 138 ng / mL and the highest 482 ng / mL. In the group of subjects who settled in the low lands seem mean vitamin D levels higher than the mountainous area with an average 237.8 ng / mL with a standard deviation of 100.16 ng / mL. Vitamin D levels are lowest and the highest 138-585 ng / mL. Conclusion and Suggestion: The results of the analysis using the Mann Whitney test showed that there were no significant differences between the mean for the levels of vitamin D based on residence subject with a value of p = 0.652.

Keywords: latitude, schizophrenia, Vitamin D, Sumatera Utara

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Authors: Sumitra Sharma, Christina Parker, Kathleen Finlayson, Clint Douglas, Niall Higgins

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Background: Telehealth services have potential to increase accessibility, utilization, and effectiveness of healthcare services. As the telehealth services are yet to integrate within regular hospital services in Nepal, the use of the telehealth services among adults with diabetes is scarce. Prior to implementation of telehealth services for adults with diabetes, it is necessary to examine influencing factors of telehealth services. Objective: This study aimed to investigate factors influencing telehealth services for diabetes care in Nepal. Methods: This study used a mixed-method study design which included a cross-sectional survey among adults with diabetes and semi-structured interviews among key healthcare professionals of Nepal. The study was conducted in a medical out-patient department of a tertiary hospital of Nepal. The survey adapted a previously validated questionnaire, while semi-structured questions for interviews were developed from literature review and experts consultation. All interviews were audio-recorded, and inductive content analysis was used to code transcripts and develop themes. For a survey, a descriptive analysis, chi-square test, and Mann Whitney U test were used to analyze the data. Results: One hundred adults with diabetes were participated in a survey, and seven healthcare professionals were recruited for interviews. In a survey, just over half of the participants (53%) were male, and others were female. Almost all participants (98%) owned a mobile phone, and 67% of them had a computer with internet access at home. Majority of participants had experience in using Facebook messenger (95%), followed by Viber (60%) and Zoom (26%). Almost all of the participants (96%) were willing to use telehealth services. There were significant associations between female sex and participants living 10 km away from the hospital with their willingness to use telehealth services. There was a significant association between participants' self-perception of good health status with their willingness to use video-conference calls and phone calls to use telehealth services. Seven themes were developed from interview data which are related to predisposing, reinforcing, and enabling factors influencing telehealth services for diabetes care in Nepal. Conclusion: In summary, several factors were found to influence the use of telehealth services for diabetes care in Nepal. For effective implementation of a sustainable telehealth services for adults with diabetes in Nepal, these factors need to be considered.

Keywords: contributing factors, diabetes mellitus, developing countries, telemedicine, telecare

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Authors: Zuzanna Miodonska, Michal Krecichwost, Pawel Badura

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Sigmatism (lisping) is a speech disorder in which sibilant consonants are mispronounced. The diagnosis of this phenomenon is usually based on the auditory assessment. However, the progress in speech analysis techniques creates a possibility of developing computer-aided sigmatism diagnosis tools. The aim of the study is to statistically verify whether specific acoustic features of sibilant sounds may be related to pronunciation correctness. Such knowledge can be of great importance while implementing classifiers and designing novel tools for automatic sibilants pronunciation evaluation. The study covers analysis of various speech signal measures, including features proposed in the literature for the description of normative sibilants realization. Amplitudes and frequencies of three fricative formants (FF) are extracted based on local spectral maxima of the friction noise. Skewness, kurtosis, four normalized spectral moments (SM) and 13 mel-frequency cepstral coefficients (MFCC) with their 1st and 2nd derivatives (13 Delta and 13 Delta-Delta MFCC) are included in the analysis as well. The resulting feature vector contains 51 measures. The experiments are performed on the speech corpus containing words with selected sibilant sounds (/ʃ, ʒ/) pronounced by 60 preschool children with proper pronunciation or with natural pathologies. In total, 224 /ʃ/ segments and 191 /ʒ/ segments are employed in the study. The Mann-Whitney U test is employed for the analysis of stigmatism and normative pronunciation. Statistically, significant differences are obtained in most of the proposed features in children divided into these two groups at p < 0.05. All spectral moments and fricative formants appear to be distinctive between pathology and proper pronunciation. These metrics describe the friction noise characteristic for sibilants, which makes them particularly promising for the use in sibilants evaluation tools. Correspondences found between phoneme feature values and an expert evaluation of the pronunciation correctness encourage to involve speech analysis tools in diagnosis and therapy of sigmatism. Proposed feature extraction methods could be used in a computer-assisted stigmatism diagnosis or therapy systems.

Keywords: computer-aided pronunciation evaluation, sigmatism diagnosis, speech signal analysis, statistical verification

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Authors: Marko Jankovic, Aleksandra Knezevic, Maja Cupic, Dragana Vujic, Zeljko Zecevic, Borko Gobeljic, Marija Simic, Tanja Jovanovic

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The human cytomegalovirus (CMV) is a notorious pathogen in the pediatric transplant setting. Although studies on factors in complicity with CMV infection abound, the role of age, gender, allogeneic hematopoietic stem cell transplantation (alloHSCT) modality, and underlying disease as regards CMV infection and viral load in children are poorly explored. We examined the significance of various factors related to the risk of CMV infection and viral load in Serbian children and adolescents undergoing alloHSCT. This was a prospective single centre study of thirty two pediatric patients in receipt of alloHSCT for various malignant and non-malignant disorders. Screening for active viral infection was performed by regular weekly monitoring. The Real-Time PCR method was used for CMV DNA detection and quantitation. Statistical analysis was performed using the IBM SPSS Statistics v20 software. Chi-square test was used to evaluate categorical variables. Comparison between scalar and nominal data was done by Wilcoxon-Mann-Whitney test. Pearson correlation was applied for studying the association between patient age and viral load. CMV was detected in 23 (71.9%) patients. Infection occurred significantly more often (p=0.015) in patients with haploidentical donors. The opposite was noted for matched sibling grafts (p=0.006). The viral load was higher in females (p=0.041) and children in the aftermath of alloHSCT with malignant diseases (p=0.019). There was no significant relationship between the viral infection dynamics and overt medical consequences. This is the first study of risk factors for CMV infection in Serbian pediatric alloHSCT patients. Transplanted patients presented with a high incidence of CMV viremia. The HLA compatibility of donated graft is associated with the frequency of CMV positive events. Age, gender, underlying disease, and medically relevant events were not conducive to occurrences of viremia. Notably, substantial viral burdens were evidenced in females and patients with neoplastic diseases. Studies comprising larger populations are clearly needed to scrutinize current results.

Keywords: allogeneic hematopoietic stem cell transplantation, children, cytomegalovirus, risk factors, viral load

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Authors: Khosro Barkhordari, Fateme Sadr, Mina Pashang

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Back ground: Blood transfusion is one of the major issues in cardiac surgery patients. Transfusing patients based on fixed cut-off points of hemoglobin is the current protocol in most institutions. The hemoglobin level of 7- 10 has been suggested for blood transfusion in cardiac surgery patients. We aimed to evaluate if blood transfusion based on change in percentage of hematocrit has different outcomes. Methods: In this retrospective cohort study, we investigated the early postoperative outcome of cardiac surgery patients who received blood transfusions at Tehran Heart Center Hospital, IRAN. We reviewed and analyzed the basic characteristics and clinical data of 700 patients who met our exclusion and inclusion criteria. The two groups of blood transfused patients were compared, those who have 30-50 percent decrease in basal hematocrit versus those with 10 -29 percent decrease. Results: This is ongoing study, and the results would be completed in two weeks after analysis of the date. Conclusion: Early analysis has shown no difference in early post-operative outcomes between the two groups, but final analysis will be completed in two weeks. 1-Department of Anesthesiology and Critical Care, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, IRAN 2- Department of Research, Tehran Heart Center, Tehran, IRAN Quantitative variables were compared using the Student t-test or the Mann‐Whitney U test, as appropriate, while categorical variables were compared using the χ2 or the Fisher exact test, as required. Our intention was to compare the early postoperative outcomes between the two groups, which include 30 days mortality, Length of ICU stay, Length of hospital stay, Intubation time, Infection rate, acute kidney injury, and respiratory complications. The main goal was to find if transfusing blood based on changes in hematocrit from a basal level was better than to fixed cut-off point regarding early post-operative outcomes. This has not been studied enough and may need randomized control trials.

Keywords: post-operative, cardiac surgery, outcomes, blood transfusion

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Authors: Anna Tokajuk, Agnieszka Zakrzeska, Ewa Chabielska, Halina Car

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Whey is a by-product generated mainly in the production of cheese and casein. Powder forms of whey are used widely in the food industry as well as a high-protein food for infants, for convalescents, by athletes and especially by bodybuilders to increase muscle mass during exercise. Whey protein concentrate-80 (WPC-80) is a source of bioactive peptides with beneficial effects on the cardiovascular system. It is known that whey proteins health beneficial properties include antidiabetic, blood pressure lowering, improving cardiovascular system function, antibacterial, antiviral and other effects. To study its influence on the development of thrombosis, venous thrombosis model was performed according to the protocol featured by Reyers with modification by Chabielska and Gromotowicz. Male Wistar-Crl: WI (Han) rats from researched groups were supplemented with two doses of WPC-80 (0.3 or 0.5 g/kg) for 7, 14 or 21 days and after these periods, one-hour venous thrombosis model was performed. Control group received 0.9 % NaCl solution and was sham operated. The statistical significance of results was computed by Mann – Whitney’s test. We observed that thrombus weight was decreased in animals obtaining WPC-8080 and that was statistically significant in 14 and 21-day supplemented groups. Blood count parameters did not differ significantly in rats with and without thrombosis induction whether they were fed with WPC-80 or not. Moreover, the number of platelets (PLT) was within the normal range in each group. The examined coagulation parameters in rats of the control groups were within normal limits. After WPC-80 supplementation there was the tendency to prolonged activated partial thromboplastin time (aPTT), but in comparison, the results did not turn out significant. In animals that received WPC-80 0.3 g·kg-1 for 21 days with and without induced thrombosis, prothrombin time (PT) and an international normalized ratio (INR) was somewhat decreased, remaining within the normal range, but the nature and significance of this observation are beyond the framework of the current study. Additionally, fibrinogen and thrombin time (TT) did not differ significantly between groups. Therefore the exact effect of WPC-80 on coagulation system is still elusive and requires further thorough research including mechanisms of action. Determining the potential clinical application of WPC-80 requires the selection of the optimal dose and duration of supplementation.

Keywords: antithrombotic, rats, venous thrombosis, WPC-80

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Authors: A. Dean, M. Pitcher, L. Storer, K. Shanahan, I. Rio, B. Mann

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Purpose: Breast cancer survivors are at risk of specific physical and psycho-social issues, such as arm swelling, fatigue, and depression. Firstly, we investigate symptoms reported by Australia breast cancer survivors upon completion of definitive treatment. Secondly, we evaluate the appropriateness and effectiveness of a multi-centre pilot program nurse-led clinic to identify these issues and make timely referrals to available services. Methods: Patients post-definitive treatment (excluding ongoing hormonal therapy) for early breast cancer or ductal carcinoma in situ were invited to participate. An hour long appointment with a breast care nurse (BCN) was scheduled. In preparation, patients completed validated quality-of-life surveys (FACT-B, Menopause Rating Scale, Distress Thermometer). During the appointment, issues identified in the surveys were addressed and referrals to appropriate services arranged. Results: 183 of 274 (67%) eligible patients attended a nurse-led clinic. Mean age 56.8 years (range 29-87 years), 181/183 women, 105/183 post-menopausal. 96 (55%) participants reported significant level of distress; 31 (18%) participants reported extreme distress or depression. Distress stemmed from a lack of energy (56/175); poor quality of sleep (50/176); inability to work or participate in household activities (35/172) and problems with sex life (28/89). 166 referrals were offered; 94% of patients accepted the referrals. 65% responded to a follow-up survey: the majority of women either strongly agreed or agreed that the BCN was overwhelmingly supportive, helpful in making referrals, and compassionate towards them. 39% reported making lifestyle changes as a result of the BCN. Conclusion: Breast cancer survivors experience a unique set of challenges, including low mood, difficulty sleeping, problems with sex life and fear of disease recurrence. The nurse-led clinic model is an appropriate and effective method to ensure physical and psycho-social issues are identified and managed in a timely manner. This model empowers breast cancer survivors with information about their diagnosis and available services.

Keywords: early breast cancer, survivorship, breast care nursing, oncology nursing and cancer care

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Authors: P. Ghosh, S. B. Sharma

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The growing problem of food waste is causing unacceptable economic, environmental and social impacts across the globe. In Australia, food waste is estimated at about AU$8 billion per year; however, information on the extent of wastage at different stages of the food value chain from farm to fork is very limited. This study aims to identify causes for and extent of food waste at wholesaler stage of the food value chain in the state of Western Australia. It also explores approaches applied to reduce and utilize food waste by the wholesalers. The study was carried out at Perth city market in Caning Vale, the main wholesale distribution centre for fruits and vegetables in Western Australia. A survey questionnaire was prepared and shared with 51 wholesalers and their responses to 10 targeted questions on quantity of produce (fruits and vegetables) delivery received and further supplied, reasons for waste generation and innovations applied or being considered to reduce and utilize food waste. Data were computed using the Statistical Package for the Social Sciences (SPSS version 21). Among the wholesalers 52% were primary wholesalers (buy produce directly from growers) and 48% were secondary wholesalers (buy produce in bulk from major wholesalers and supply to the local retail market, caterers, and customers with specific requirements). Average fruit and vegetable waste was 180 Kilogram per week per primary wholesaler and 30 Kilogram per secondary wholesaler. Based on this survey, the fruit and vegetable waste at wholesaler stage was estimated at about 286 tonnes per year. The secondary wholesalers distributed pre-ordered commodities, which minimized the potential to cause waste. Non-parametric test (Mann Whitney test) was carried out to assess contributions of wholesalers to waste generation. Over 56% of secondary wholesalers generally had nothing to bin as waste. Pearson’s correlation coefficient analysis showed positive correlation (r = 0.425; P=0.01) between the quantity of produce received and waste generated. Low market demand was the predominant reason identified by the wholesalers for waste generation. About a third of the wholesalers suggested that high cosmetic standards for fruits and vegetables - appearance, shape, and size - should be relaxed to reduce waste. Donation of unutilized fruits and vegetables to charity was overwhelmingly (95%) considered as one of the best options for utilization of discarded produce. The extent of waste at other stages of fruit and vegetable supply chain is currently being studied.

Keywords: food waste, fruits and vegetables, supply chain, waste generation

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Authors: Yuri V. Bykov, V. A. Baturin

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Aim of the study: The aim of the study was to perform a comparative analysis of the levels of autoantibodies (AAB) to the S-100 protein as well as to the dopamine and NMDA receptors in children with type 1 diabetes mellitus (DM) in therapeutic remission. Materials and methods: Blood serum obtained from 42 children ages 4 to 17 years (20 boys and 22 girls) was analyzed. Twenty-one of these children had a diagnosis of type 1 DM and were in therapeutic remission (study group). The mean duration of disease in children with type 1 DM was 9.6±0.36 years. Children without DM were included in a group of "apparently healthy children" (21 children, comparison group). AAB to the S-100 protein, the dopamine, and NMDA receptors were measured by ELISA. The normal range of IgG AAB was specified as up to 10 µg/mL. In order to compare the central parameters of the groups, the following parametric and non-parametric methods were used: Student's t-test or Mann-Whitney U test. The level of significance for inter-group comparisons was set at p<0.05. Results: The mean levels of AAB to the S-100B protein were significantly higher (p=0.0045) in children with DM (16.84±1.54 µg/mL) when compared with "apparently healthy children" (2.09±0.05 µg/mL). The detected elevated levels of AAB to NMDA receptors may indicate that in children with type 1 DM, there is a change in the activity of the glutamatergic system, which in its turn suggests the presence of excitotoxicity. The mean levels of AAB to dopamine receptors were higher (p=0.0082) in patients comprising the study group than in the children of the comparison group (40.47±2.31 µg/mL and 3.91±0.09 µg/mL). The detected elevated levels of AAB to dopamine receptors suggest an altered activity of the dopaminergic system in children with DM. This can also be viewed as indirect evidence of altered activity of the brain's glutamatergic system. The mean levels of AAB to NMDA receptors were higher in patients with type 1 DM compared with the "apparently healthy children," at 13.16±2.07 µg/mL and 1.304±0.05 µg/mL, respectively (p=0.0021). The elevated mean levels of AAB to the S-100B protein may indicate damage to brain tissue in children with type 1 DM. A difference was also detected between the mean values of the measured AABs, and this difference depended on the duration of the disease: mean AAB values were significantly higher in patients whose disease had lasted more than five years. Conclusions: The elevated mean levels of AAB to the S-100B protein may indicate damage to brain tissue in the setting of excitotoxicity in children with type 1 DM. The discovered elevation of the levels of AAB to NMDA and dopamine receptors may indicate the activation of the glutamatergic and dopaminergic systems. The observed abnormalities indicate the presence of central nervous system damage in children with type 1 DM, with a tendency towards the elevation of the levels of the studied AABs with disease progression.

Keywords: autoantibodies, brain damage, children, diabetes mellitus

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Authors: Betul Altinok

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The aim of this study is researching servant leadership behaviors of sports managers. For this purpose, Servant Leadership behaviors of Sport Managers (N=69) working as Dean, School Principal and Head of Department in Sport Sciences Faculties, Physical Education and Sport Schools and Departments educating Physical Education and Sport investigated via questionnaires applied to academicians (N=1185) working in these institutions. Servant Leadership Questionnaire sent via e-mail to all Academicians working in Physical Education and Sport educating Faculties, Schools of Universities and Departments in Turkey. 406 survey which is responded and accurately completed by Academicians were evaluated. In this study, Servant Leadership Questionnaire developed and conducted validity and reliability analysis by Barbuto and Wheeler (2006) used to investigate sports managers servant leadership behaviors. Scale translated into Turkish then validity and reliability analysis were conducted. After measurement model of servant leadership questionnaire verified, Shapiro Wilk normality test was applied to obtained data to determine whether has got a normal distribution or not, depending on gender, job title, profession time, department and evaluated manager. Results of practiced normality test showed that data has not got a normal distribution (nonparametric). After normality test, Mann Whitney-U test applied at 0.05 value for determining whether there is a difference between servant leadership scores according to gender and Kruskal Wallis Test applied at 0.05 value for determining whether there is a difference between servant leadership scores according to job title, profession time, department and evaluated manager. Test results showed that there were not differences between Altruistic Calling (p>0.05), Emotional Healing (p>0.05), Wisdom (p>0.05), Persuasive Mapping (p>0.05) and (p>0.05), Organizational Stewardship sub-dimensions according to gender. Test results showed that there were not differences between Altruistic Calling (p>0.05), Emotional Healing (p>0.05), Wisdom (p>0.05), Persuasive Mapping (p>0.05) and (p>0.05), Organizational Stewardship sub-dimensions according to job title, profession time, department and evaluated manager. In the light of study results, it can be said that applied survey is objective and unfurls evaluated managers servant leadership behaviors. Empirical and practical contribution of this study is to test sports managers servant leadership behaviors in Turkey for the very first time.

Keywords: academicians, management, servant leadership, sport

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Authors: Emil Iskandarov, Nazrin Agayeva

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Background: The effectiveness of hormone suppressive therapy (HST) in patients with nodular goiter (NG) is controversial. The aim of this study was to identify the impact of long-time HST on the Quality of Life (QoL) of patients with NG. Material and Methods: A retrospective analysis of 146 patients with NG showed treated with HST showed that in 38,4% of cases, HST was not effective. Nodules were increased in size and moreover, and new nodules were developed. Statistical procedure identified the predictors of resistant nodules: only one nodule in the left lobe; nodule size >17mm; calcinate within the nodule. 174 patients with NG, by whom predictors of resistant nodules were established, were informed about the results of previous research and surgery was suggested. Eighty-eight patients (the basic group) agreed with surgery and thyroidectomy was led. 86 patients (control group) ignored the suggestion and wished to receive HST. 3, 6 and 12 months after starting HST; control group patients were examined. HST was non-effective and patients, due to developing symptoms, were operated on. Patients in both groups were followed up 3, 6 and 12 months after thyroidectomy. Quality of Life was checked with the SF-36 survey form and compared between groups. The statistical analysis was performed with the non-parametric Mann–Whitney U test and with the Student t-test. P values ＜0.05 were considered statistically significant. Results and Discussions: QoL of patients in the basic and control groups 3 months after surgery was almost the same. However, Emotional problems severely interfered with patients in a control group with normal social activities with family, friends, and neighbors. The causes were related to the non-effective HST treatment before surgery: stress for forgetting to take drugs timely every day for a long time; blood tests for thyroid hormone level; needle biopsies of nodules for cancer screening and regular ultrasound investigations, which showed that nodules not diminished in size. Changing the treatment method after 1-year non-effective HST and delayed surgery negatively impacted patient's QoL. Social role functioning and mental health in the control group were also impaired and the difference between the results in the basic group was statistically significant (p <0.05). Conclusion: Predictors, such as only one nodule, the width of nodules more than 17mm, and the existence of calcinate within the nodule, are able to forecast the resistant nodules. HST in patients with resistant nodules is non-effective and surgery is suggested in patients with resistant nodules in the thyroid gland. Long time HST has a negative impact on the QoL patient after surgery.

Keywords: thyroid gland, nodule, hormone suppressive therapy, quality of life

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Authors: Agnieszka Zalejska-Jonsson

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The Swedish Green Building Council (SGBC) was established in 2009. Since then, over 1000 buildings have been certified, of which approximately 600 are newly produced and 340 are residential buildings. During that time, approximately 2000 apartment buildings have been built in Sweden. This means that over a five- year period 17% of residential buildings have been certified according to the environmental building scheme. The certification of the building is not a guarantee of environmental progress but it gives us an indication of the extent of the progress. The overarching aim of this study is to investigate the factors behind the relatively slow evolution of the green residential housing market in Sweden. The intention is to examine stated willingness to pay (WTP) for green and low energy apartments, and to explore which factors have a significant effect on stated WTP among apartment owners. A green building was defined as a building certified according to the environmental scheme and a low energy building as a building designed and constructed with high energy efficiency goals. Data for this study were collected through a survey conducted among occupants of comparable apartment buildings: two green and one conventional. The total number of received responses was 429: green A (N=160), response rate 42%; green B (N=138) response rate 35%, and conventional (N=131) response rate 43%. The study applied a quasi-experimental method. Survey responses regarding factors affecting purchase of apartment, stated WTP and environmental literacy have been analysed using descriptive statistics, the Mann–Whitney (rank sum) test and logistic models. Comments received from respondents have been used for further interpretation of results. Results indicate that environmental education has a significant effect on stated WTP. Occupants who declared higher WTP showed a higher level of environmental literacy and indicated that energy efficiency was one of the important factors that affected their decision to buy an apartment. Generally, the respondents were more likely to pay more for low energy buildings than for green buildings. This is to a great extent a consequence of rational customer behaviour and difficulty in apprehending the meaning of green building certification. The analysis shows that people living in green buildings indicate higher WTP for both green and low energy buildings, the difference being statistically significant. It is concluded that growth in the green housing market in Sweden might be achieved if policymakers and developers engage in active education in the environmental labelling system. The demand for green buildings is more likely to increase when the difference between green and conventional buildings is easily understood and information is not only delivered by the estate agent, but is part of an environmental education programme.

Keywords: consumer, environmental education, housing market, stated WTP, Sweden

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