Search results for: primary%20health%20care

Authors: Bhagwant Singh, Sikander Singh Cheema

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This paper examines firewall mechanisms routinely implemented for network security in depth. A firewall can't protect you against all the hazards of unauthorized networks. Consequently, many kinds of infrastructure are employed to establish a secure network. Firewall strategies have already been the subject of significant analysis. This study's primary purpose is to avoid unnecessary connections by combining the capability of the firewall with the use of additional firewall mechanisms, which include packet filtering and NAT, VPNs, and backdoor solutions. There are insufficient studies on firewall potential and combined approaches, but there aren't many. The research team's goal is to build a safe network by integrating firewall strength and firewall methods. The study's findings indicate that the recommended concept can form a reliable network. This study examines the characteristics of network security and the primary danger, synthesizes existing domestic and foreign firewall technologies, and discusses the theories, benefits, and disadvantages of different firewalls. Through synthesis and comparison of various techniques, as well as an in-depth examination of the primary factors that affect firewall effectiveness, this study investigated firewall technology's current application in computer network security, then introduced a new technique named "tight coupling firewall." Eventually, the article discusses the current state of firewall technology as well as the direction in which it is developing.

Keywords: firewall strategies, firewall potential, packet filtering, NAT, VPN, proxy services, firewall techniques

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Authors: Rashedul Islam

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A firmly-validated aim of teaching science is to support student enthusiasm for science learning with an outspread interest in scientific issues in future life. This is in keeping with the recent development in Gifted and Talented Education statement which instructs that gifted students have a renewed interest and natural aptitude in science. Yet, the practice of science teaching leaves many students with the feeling that science is difficult and compared to other school subjects, students interest in science is declining at the final years of the primary school. As a curriculum guides the teaching-learning activities in school, where significant consequences may result from the context of the curricula and syllabi, are a major feature of certain educational jurisdictions in NSW, Australia. The purpose of this study was an exploration of the curriculum sets the context to identify how science education is practiced through primary schools in Sydney, Australia. This phenomenon was explored through document review from two publicly available documents namely: the NSW Science Syllabus K-6, and Australian Curriculum: Foundation - 10 Science. To analyse the data, this qualitative study applied themed content analysis at three different levels, i.e., first cycle coding, second cycle coding- pattern codes, and thematic analysis. Preliminary analysis revealed the phenomenon of teaching-learning practices drawn from eight themes under three phenomena aligned with teachers’ practices and gifted student’s learning characteristics based on Gagné’s Differentiated Model of Gifted and Talent (DMGT). From the results, it appears that, overall, the two documents are relatively well-placed in terms of identifying the context of teaching and learning primary science to gifted students. However, educators need to make themselves aware of the ways in which the curriculum needs to be adapted to meet gifted students learning needs in science. It explores the important phenomena of teaching-learning context to provide gifted students with optimal educational practices including inquiry-based learning, problem-solving, open-ended tasks, creativity in science, higher order thinking, integration, and challenges. The significance of such a study lies in its potential to schools and further research in the field of gifted education.

Keywords: teaching primary science, gifted student learning, curriculum context, science syllabi, Australia

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Authors: Caiwei Zhu, Remke Klapwijk

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Spatial thinking, a way of thinking based on the understanding and reasoning of spatial concepts and representations, is embedded in science, technology, engineering, arts, and mathematics (STEAM) learning. Aside from many studies that successfully used targeted training to improve students’ spatial thinking skills, few have closely examined how spatial thinking can be trained in classroom settings. Design and technology education, which receives increasing attention towards its integration into formal curriculums, inherently encompasses a wide range of spatial activities, such as constructing mental representations of design ideas, mentally transforming objects and materials to form designs, visually communicating design plans through annotated drawings, and creating 2D and 3D design artifacts. Among different design topics, biomimicry offers a unique avenue for students to recognize and analyze the shapes and structures in nature. By mapping the forms of plants and animals onto functions, students gain inspiration to solve human design challenges. This study is one of the first to highlight opportunities for training spatial thinking in a biomimicry design project for primary school students. Embracing methodological principles of educational design-based research, this case study is conducted along with iterations in the design of the intervention and collaboration with teachers. Data are harvested from small groups of 10- to 12-year-olds at an international school in the Netherlands. Classroom videos, semi-structured interviews with students, design drawings and artifacts, formative assessment, and the pre- and post-intervention spatial test triangulate evidence for students' spatial thinking. In addition to contributing to a theory of integrating spatial thinking in the primary curriculum, mechanisms underlying such improvement in spatial thinking are explored and discussed.

Keywords: biomimicry, design and technology education, primary education, spatial thinking

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Authors: Branka Milicic Stanic, Romana Mijovic

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In primary hyperparathyroidism, an increased risk of developing cardiovascular disease may exist due to increased activity of the renin-angiotensin-aldosterone system (RAAS). In adenomatous altered tissue of parathyroid gland, compared to normal tissue, there are two to fourfold increase in the expression of type 1 angiotensin II receptors. As there is a clear evidence of the independent role of aldosterone on the cardiovascular system, the aim of this study was to evaluate the existence of an association between aldosterone secretion and parathyroid hormone in patients with primary hyperparathyroidism. This study included 48 patients with elevated parathyroid hormone who had come to the Departement of Nuclear Medicine, Clinical Center of Vojvodina, for Parathyroid Scintigraphy. The control group consisted of 30 healthy subjects who matched age and gender to the study group. All the results were statistically processed by statistical package STATISTICA 14 (Statsoft Inc,Tulsa, OK, USA). The survey was conducted between February 2017 and April 2018 at the Departement of Nuclear Medicine and at the Departement for Endocinology Diagnoistics, in Clinical Center of Vojvodina, Novi Sad. Compared to the control group, the study group had statistically significantly higher values of aldosterone (p=0.028), total calcium (p=0.01), ionized calcium (p=0.003) and parathyroid hormone (N-TACT PTH) (p=0.00), while statistically a significant lower levels in the study group were for phosphorus (p=0.003) and vitamin D (p=0.04). A linear correlation analysis in the study group revealed a statistically significant degree of positive correlation between renin and N-TACT PTH (r=0.688, p<0.05); renin and calcium (r=0.673, p<0.05) and renin and ionized calcium (r=0.641, p<0.05). Serum aldosterone and parathyroid hormone levels (N-TACT) were correlated positively in patients with primary hyperparathyroidism (r=0.509, p<0.05). According to the linear correlation analysis in the control group, aldosterone showed no positive correlation with N-TACT PTH (r=-0.285, p>0.05), as well as total and ionized calcium (r=-0.200, p>0.05; r=-0.313, p>0.05). In multivariate regression analysis of the study group, the strongest predictive variable of aldosterone secretion was N-TACT PTH (p=0.011). Aldosterone correlated positively to PTH levels in patients with primary hyperparathyroidism, and the fact is that in these patients aldosterone might be a key mediator of cardiovascular symptoms. All this knowledge should help to find new treatments to prevent cardiovascular disease.

Keywords: aldosterone, hyperparathyroidism, parathyroid hormone, parathyroid gland

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Authors: Abhishek Oswal

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Background: Inconsistencies between the guidelines for childhood asthma can pose a diagnostic challenge to clinicians. NICE guidelines are the most commonly followed guidelines in primary care in the UK; they state that to be diagnosed with asthma, a child must be more than 5 years old and must have objective evidence of the disease. When diagnoses are coded in general practice (GP), these guidelines may be superseded by communications from secondary care. Hence it is imperative that diagnoses are correct, as per up to date guidelines and evidence, as this affects follow up and management both in primary and secondary care. Methods: A snapshot audit at a general practice surgery was undertaken of children (less than 16 years old) with a coded diagnosis of 'asthma', to review the age at diagnosis and whether any objective evidence of asthma was documented at diagnosis. 50 cases of asthma in children presenting to the emergency department (ED) were then audited to review the age at presentation, whether there was evidence of previous asthma diagnosis and whether the patient was discharged from ED. A repeat audit is planned in ED this winter. Results: In a GP surgery, there were 83 coded cases of asthma in children. 51 children (61%) were diagnosed under 5, with 9 children (11%) who had objective evidence of asthma documented at diagnosis. In ED, 50 cases were collected, of which 4 were excluded as they were referred to the other services, or for incorrect coding. Of the 46 remaining, 27 diagnoses confirmed to NICE guidelines (59%). 33 children (72%) were discharged from ED. Discussion: The most likely reason for the apparent low rate of a correct diagnosis is the significant challenge of obtaining objective evidence of asthma in children. There were a number of patients who were diagnosed from secondary care services and then coded as 'asthma' in GP, without having objective documented evidence. The electronic patient record (EPR) system used in our emergency department (ED) did not allow coding of 'suspected diagnosis' or of 'viral induced wheeze'. This may have led to incorrect diagnoses coded in primary care, of children who had no confirmed diagnosis of asthma. We look forward to the re-audit, as the EPR system has been updated to allow suspected diagnoses. In contrast to the NICE guidelines used here, British Thoracic Society (BTS) guidelines allow for a trial of treatment and subsequent confirmation of diagnosis without objective evidence. It is possible that some of the cases which have been classified as incorrect in this audit may still meet other guidelines. Conclusion: The diagnosis of asthma in children is challenging. Incorrect diagnoses may be related to clinical pressures and the provision of services to allow compliance with NICE guidelines. Consensus statements between the various groups would also aid the decision-making process and diagnostic dilemmas that clinicians face, to allow more consistent care of the patient.

Keywords: asthma, diagnosis, primary care, emergency department, guidelines, audit

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Authors: Alfia Sari

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The implementation of the Content Language Integrated Learning (CLIL) approach in Indonesia has shown positive impacts in several educational institutions. Several studies have proven the benefits of implementing the CLIL approach, including the development of students’ language and content subject knowledge. Interestingly, one primary school in Surabaya, Indonesia, has been successfully implementing the CLIL approach. The students achieved high content and language subject scores, and the school was accredited A. A study on how the CLIL approach was practiced is important to investigate how teachers implemented it and how students benefited from it. Therefore, this present study attempted to investigate the implementation of the CLIL approach in this school to characterize good practices that can be implemented in other schools. A case study was conducted to observe its implementation in the third-grade classes (English, Science, and Math) by using the Protocol for Language Arts Teaching Observation (PLATO). The findings indicated that the CLIL teaching in this school accommodated the content and language well (scores 3-4). The content and language were clearly integrated, and the teachers successfully carried out the subjects in English. Teachers offered students opportunities to listen, speak, read, and write using the target language. This study described some characteristics of CLIL teaching in primary school that can be used as examples for future CLIL teachers to integrate the content and language in their teaching practices.

Keywords: CLIL, ELT, young learners, case study

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Authors: Garima Singh, Kunal Malhotra

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Objective: The expansion of telehealth has been instrumental in increasing access to medical services, especially for underserved and rural communities. In 2020, 14 million patients received virtual care through telemedicine and the global telemedicine market is expected to reach up to $185 million by 2023. It provides a platform and allows a patient to receive primary care as well as specialized care using technology and the comfort of their homes. Telemedicine was particularly useful during COVID-pandemic and the number of telehealth visits increased by 5000% during that time. It continues to serve as a significant resource for patients seeking care and to bridge the gap between the disease and the treatment. Method: As per APA (American Psychiatric Association), Telemedicine is the process of providing health care from a distance through technology. It is a subset of telemedicine, and can involve providing a range of services, including evaluations, therapy, patient education and medication management. It can involve direct interaction between a physician and the patient. It also encompasses supporting primary care providers with specialist consultation and expertise. It can also involve recording medical information (images, videos, etc.) and sending this to a distant site for later review. Results: In our organization, we are using telepsychiatry and serving 25 counties and approximately 1.4 million people. We provide multiple services, including inpatient, outpatient, crisis intervention, Rehab facility, autism services, case management, community treatment and multiple other modalities. With project ECHO (Extension for Community Healthcare Outcomes) it has been used to advise and assist primary care providers in treating mental health. It empowers primary care providers to treat patients in their own community by sharing knowledge. Conclusion: Telemedicine has shown to be a great medium in meeting patients’ needs and accessible mental health. It has been shown to improve access to care in both urban and rural settings by bringing care to a patient and reducing barriers like transportation, financial stress and resources. Telemedicine is also helping with reducing ER visits, integrating primary care and improving the continuity of care and follow-up. There has been substantial evidence and research about its effectiveness and its usage.

Keywords: telehealth, telemedicine, access to care, medical technology

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Authors: Charity Okeke, Elizabeth Venter

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Verbal discipline is one of the most regularly used disciplinary strategies to deal with classroom misconduct in schools globally. This study provides effective verbal discipline strategies to deal with classroom misconduct in primary schools. The study was qualitative research of ten teachers that took place in two South African primary schools. Data were collected through recorded semi-structured face-to-face interviews. The interview recordings were transcribed and analysed using content analysis. Findings from the study show that talking to learners in a calm and polite manner, raising one’s voice occasionally to show seriousness and disapproval of misconduct, engaging misbehaved learners in private talk to understand the reasons behind their unruly actions, verbal praise and rewards are effective in dealing with classroom misconduct. The study recommends that teachers should avoid shouting at learners and talk to them politely to get them to behave well in class. Teachers should avoid embarrassing misbehaving learners in the classroom but engage them privately to understand the reasons behind their unruly activities. Teachers should also use verbal praise and rewards such as well-done stickers to motivate learners to keep behaving well, as reinforcement is very important in the classroom. The study concludes that the verbal disciplining strategies mentioned above are effective in achieving a conducive teaching and learning atmosphere in the classroom.

Keywords: classroom discipline, classroom misconduct, verbal discipline, verbal discipline strategies

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Authors: Georgia H. Mega

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Art street, a category of artwork displayed in public spaces, has been recognized as a potential tool for promoting reflective thinking in both adult and primary education. Educational techniques that encourage critical and creative thinking, as well as deeper reflection, have been developed and applied in educational curricula. This paper aims to explore the potential of art street in cultivating learners' reflective awareness toward multiculturalism. The main objective of this case study is to investigate the possibilities that art street offers in terms of developing learners' critical reflection, regardless of their age. The study compares two art street works from Greece and Norway, focusing on their common theme of multiculturalism. The study adopts a qualitative methodology, specifically a case study approach. This approach allows for an in-depth analysis of the two selected art street works and their impact on learners' reflective thinking. The study demonstrates that art street can effectively cultivate learners' reflective awareness of multiculturalism. The selected works of art, despite being created by different artists and displayed in different cities, share similar content and convey messages that facilitate reflective dialogue on cultural osmosis. Both adult and primary education approaches utilize the same art street works to achieve reflective awareness. This paper contributes to the existing literature on reflective learning processes by highlighting the potential of art street as a means for encouraging reflective thinking. It builds upon the theoretical frameworks of adult education theorists such as Freire and Mezirow, as well as those of primary education theorists such as Perkins and Project Zero. Data for this study were collected through observation and analysis of two art street works, one from Greece and one from Norway. These works were selected based on their common theme of multiculturalism. Analysis Procedures: The collected data were analyzed using qualitative analysis techniques. The researchers examined the content and messages conveyed by the selected art street works and explored their impact on learners' reflective thinking. The central question addressed in this study is whether art street can develop learners' critical reflection toward multiculturalism, regardless of their age. The findings of this study support the notion that art street can effectively cultivate learners' reflective awareness toward multiculturalism. The selected art street works, despite their differences in origin and location, share common themes that encourage reflective dialogue. The use of art street in both adult and primary education approaches showcases its potential as a tool for promoting reflective learning processes. Overall, this paper contributes to the understanding of art street as a means for reflective thinking in the field of adult and primary education.

Keywords: art street, educational techniques, multiculturalism, observation of artworks, reflective awareness

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Authors: Mohammed Hassan Alshaikhi

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Teaching vocabulary is a fundamental step in helping students to develop a good grasp of language. Exploring new strategies is an essential part of improving the teaching of vocabulary. The study aimed to explore the teaching vocabulary strategies in Saudi primary classrooms (aged 11 and 12 years old) in Jeddah, Saudi Arabia. The study was based on qualitative data collected from a large-scale case study, which utilised observations at eight male state and private primary schools during the academic year 2016-2017. The observations were transcribed, coded and entered into Nvivo software to be organised and analysed. Varying teaching vocabulary strategies were explored, and then they were circulated to many English teachers to be used in their classes.

Keywords: case study, English language, Saudi teachers, teaching vocabulary strategies

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Authors: Sarayu Agarwal

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This paper aims to teach English (secondary language) by bridging the understanding between the Regional language (primary language) and the English Language (secondary language). Here primary language is the one a person has learned from birth or within the critical period, while secondary language would be any other language one learns or speaks. The paper also focuses on evolving old teaching methods to a contemporary participatory model of learning and teaching. Pilot studies were conducted to gauge an understanding of student’s knowledge of the English language. Teachers and students were interviewed and their academic curriculum was assessed as a part of the initial study. Extensive literature study and design thinking principles were used to devise a solution to the problem. The objective is met using a holistic learning kit/card game to teach children word recognition, word pronunciation, word spelling and writing words. Implication of the paper is a noticeable improvement in the understanding and grasping of English language. With increasing usage and applicability of English as a second language (ESL) world over, the paper becomes relevant due to its easy replicability to any other primary or secondary language. Future scope of this paper would be transforming the idea of participatory learning into self-regulated learning methods. With the upcoming govt. learning centres in rural areas and provision of smart devices such as tablets, the development of the card games into digital applications seems very feasible.

Keywords: English as a second language, vocabulary-building card games, learning through gamification, rural education

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Authors: Hannah Wamaitha Irungu

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Educational reforms have been made from time to time since independence in Kenya. Kenya previously had a curriculum system coined as 8.4.4, where learners go through 8 years of primary, 4 years of secondary, and 4 years of tertiary or college education. The 8.4.4 system was very theoretical, examinational oriented, lacked career guidance, lacked I.C.T. infrastructure and had the pressure for exam grading results to move to the next level. Kenya is now implementing a Competency Based Curriculum (C.B.C) system of education. C.B.C, on the other hand, is learner based. It focuses mainly on the ability of the learners, their strengths/likings, not what they are systematically trained to pass exams only for progression. The academic pressure will be eased, which gives a chance to all learners to pursue their fields of strength and not only those endowed academically/theoretically. With C.B.C., each learner’s progress is nurtured and monitored over a period of 14 years that are divided into four major levels (2-6-3-3): 1. Pre-primary education [pp1 and pp2]-2 years; 2. Lower-primary [grades 1 - 6]-6 years; 3. Junior-secondary [grades 7 - 9]-3 years; 4. Senior secondary [grades 10 - 12]-3 years. In this paper, we look at these aspects with regards to C.B.C.: What necessitates it, its key strengths/benefits and application in a developing country; Implementation, what has worked and what is not working with the approach taken by Kenya education stakeholders during this process; Stakeholders, who should be involved/own the process; Conclusion, lessons learned, current status and recommendations going forward.

Keywords: benefits, challenges, competency, curricula, Kenya, successes

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Authors: Shantam Gupta

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The objective of this study is to address the critical need for automation in the domestic food processing sector and study its impact. Food is the one of the most basic physiological needs essential for the survival of a living being. Some of them have the capacity to prepare their own food (like most plants) and henceforth are designated as primary food producers; those who depend on these primary food producers for food form the primary consumers’ class (herbivores). Some of the organisms relying on the primary food are the secondary food consumers (carnivores). There is a third class of consumers called tertiary food consumers/apex food consumers that feed on both the primary and secondary food consumers. Humans form an essential part of the apex predators and are generally at the top of the food chain. But still further disintegration of the food habits of the modern human i.e. Homo sapiens, reveals that humans depend on other individuals for preparing their own food. The old notion of eating raw/brute food is long gone and food processing has become very trenchant in lives of modern human. This has led to an increase in dependence on other individuals for ‘processing’ the food before it can be actually consumed by the modern human. This has led to a further shift of humans in the classification of food chain of consumers. The effects of the shifts shall be systematically investigated in this paper. The processing of food has a direct impact on the economy of the individual (consumer). Also most individuals depend on other processing individuals for the preparation of food. This dependency leads to establishment of a vital link of dependency in the food web which when altered can adversely affect the food web and can have dire consequences on the health of the individual. This study investigates the challenges arising out due to this dependency and the impact of food processing on the economy of the individual. A comparison of Industrial food processing and processing at domestic platforms (households and restaurants) has been made to provide an idea about the present scenario of automation in the food processing sector. A lot of time and energy is also consumed while processing food at home for consumption. The high frequency of consumption of meals (greater than 2 times a day) makes it even more laborious. Through the medium of this study a pressing need for development of an automatic cooking machine is proposed with a mission to reduce the inter-dependency & human effort of individuals required for the preparation of food (by automation of the food preparation process) and make them more self-reliant The impact of development of this product has also further been profoundly discussed. Assumption used: The individuals those who process food also consume the food that they produce. (They are also termed as ‘independent’ or ‘self-reliant’ modern human beings.)

Keywords: automation, food processing, impact on economy, processing individual

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Authors: Wai-Ming Ng

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Nowadays Umeya Shokichi has been commonly regarded as the symbol of Sino-Japanese friendship and a close friend of Sun Yatsen. The images of Umeya have been largely built on contemporary political needs rather than historical sources. Based on Japanese and Chinese primary sources, this paper will challenge existing views of Umeya Shokichi in regard to his role in the 1911 Revolution and his relationship with Sun Yatsen. The study of Umeya Shokichi is handicapped by the accessibility and creditability of primary sources. Records of Umeya are largely kept in his family collection. Scholars are relatively difficult to get access to these materials. In addition, Umeya’s records can hardly be cross-checked as he is seldom mentioned in the writings of Sun Yatsen, Miyazaki Toten, James Cantlie and others. Heretofore, studies about Umeya are few and most are not critical enough to provide a balanced historical account of Umeya. This article will reexamine the role of Umeya Shokichi in the 1911 Revolution by highlighting his relationship with Sun Yatsen in Hong Kong from 1886 to 1911. It demonstrates that the role of Umeya in the 1911 Revolution and his relationship with Sun Yatsen are exaggerated by Chinese and Japanese officials as well as Umeya’s family members. The fact is that Sun did not play a direct role in the 1911 Revolution, not to mention his sponsors. To Sun, Umeya was perhaps merely one of his many sponsors rather than an intimate friend. This study will be a thought-provoking and iconoclast piece of scholarship based on critical reading of primary sources.

Keywords: Umeya Shokichi, Sun Yatsen, 1911 Revolution, Sino-Japanese friendship

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Authors: Felix Lankester, Alicia Davis, Safari Kinung'hi, Catherine Bunga, Shayo Alkara, Imam Mzimbiri, Jonathan Yoder, Sarah Cleaveland, Guy H. Palmer

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Achieving the London Declaration goal of a 90% reduction in neglected tropical diseases (NTDs) by 2030 requires cost-effective strategies that attain high and comprehensive coverage. The first objective of this trial was to assess the impact on cost and coverage of employing a novel integrative One Health approach linking two NTD control programs: mass drug administration (MDA) for soil-transmitted helminths in humans (STH) and mass dog rabies vaccination (MDRV). The second objective was to compare the coverage achieved by the MDA, a community-wide deworming intervention, with that of the existing national primary school-based deworming program (NSDP), with particular focus on the proportion of primary school-age children reached and their school enrolment status. Our approach was unconventional because, in line with the One Health approach to disease control, it coupled the responsibilities and resources of the Ministries responsible for human and animal health into one program with the shared aim of preventing multiple NTDs. The trial was carried out in hard-to-reach pastoral communities comprising 24 villages of the Ngorongoro District, Tanzania, randomly allocated to either Arm A (MDA and MDRV), Arm B (MDA only) or Arm C (MDRV only). Objective one: The percentage of people in each target village that received treatment through MDA in Arms A and B was 63% and 65%, respectively (χ2 = 1, p = 0.32). The percentage of dogs vaccinated in Arm A and C was 70% and 81%, respectively (χ2 =9, p = 0.003). It took 33% less time for a single person and a dog to attend the integrated delivery than two separate events. Cost per dose (including delivery) was lower under the integrated strategy, with delivery of deworming and rabies vaccination reduced by $0.13 (54%) and $0.85 (19%) per dose, respectively. Despite a slight reduction in the proportion of village dogs vaccinated in the integrated event, both the integrated and non-integrated strategies achieved the target threshold of 70% required to eliminate rabies. Objective two: The percentages of primary school age children enrolled in school that was reached by this trial (73%) and the existing NSDP (80%) were not significantly different (F = 0.9, p = 0.36). However, of the primary school age children treated in this trial, 46% were not enrolled in school. Furthermore, 86% of the people treated would have been outside the reach of the NSDP because they were not primary school age or were primary school age children not enrolled in school. The comparable reach, the substantial reductions in cost per dose delivered and the decrease in participants’ time support this integrated One Health approach to control multiple NTDs. Further, the recorded level of non-enrolment at primary school suggests that, in remote areas, school-based delivery strategies could miss a large fraction of school-age children and that programs that focus delivery solely at the level of the primary school will miss a substantial proportion of both primary school age children as well as other individuals from the community. We have shown that these populations can be effectively reached through extramural programs.

Keywords: canine mediated human rabies, integrated health interventions, mass drug administration, neglected tropical disease, One Health, soil-transmitted helminths

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Authors: Happy Kumar Das, Md. Shahriar Shafiq

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This paper portrays an assumed change in the primary teacher education program in Bangladesh. An initiative has been taken with a vision to ensure an integrated approach to developing trainee teachers’ knowledge and understanding about learning at a deeper level, and with that aim, the Diploma in Primary Education (DPEd) program replaces the Certificate-in-Education (C-in-Ed) program in Bangladeshi context for primary teachers. The stated professional values of the existing program such as ‘learner-centered’, ‘reflective’ approach to pedagogy tend to contradict the practice exemplified through the delivery mechanism. To address the challenges, through the main two components (i) Training Institute-based learning and (ii) School-based learning, the new program tends to cover knowledge and value that underpin the actual practice of teaching. These two components are given approximately equal weighting within the program in terms of both time, content and assessment as the integration seeks to combine theoretical knowledge with practical knowledge and vice versa. The curriculum emphasizes a balance between the taught modules and the components of the practicum. For example, the theories of formative and summative assessment techniques are elaborated through focused reflection on case studies as well as observation and teaching practice in the classroom. The key ideology that is reflected through this newly developed program is teacher’s belief in ‘holistic education’ that can lead to creating opportunities for skills development in all three (Cognitive, Social and Affective) domains simultaneously. The proposed teacher education program aims to address these areas of generic skill development alongside subject-specific learning outcomes. An exploratory study has been designed in this regard where 7 Primary Teachers’ Training Institutes (PTIs) in 7 divisions of Bangladesh was used for experimenting DPEd program. The analysis was done based on document analysis, periodical monitoring report and empirical data gathered from the experimental PTIs. The findings of the study revealed that the intervention brought positive change in teachers’ professional beliefs, attitude and skills along with improvement of school environment. Teachers in training schools work together for collective professional development where they support each other through lesson study, action research, reflective journals, group sharing and so on. Although the DPEd program addresses the above mentioned factors, one of the challenges of the proposed program is the issue of existing capacity and capabilities of the PTIs towards its effective implementation.

Keywords: Bangladesh, effective implementation, primary teacher education, reflective approach

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Authors: Caglayan Pinar Demirtas, Mustafa Koc

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Objective: This study was carried out in order to find out; the methods which are used by primary school teachers to cope with stress, their psychological health, and the direction of controlling focus. The study was carried out by using the ‘school survey’ and ‘society survey’ methods. Method: The study included primary school teachers. The study group was made up of 1066 people; 511 women and 555 men who accepted volunteerly to complete; ‘the inventory for collecting data, ‘the Scale for Attitude of Overcoming Stress’ (SBTE / SAOS), ‘Rotter’s Scale for the Focus of Inner- Outer Control’ (RİDKOÖ / RSFIOC), and ‘the Symptom Checking List’ (SCL- 90). The data was collected by using ‘the Scale for Attitude of Overcoming Stress’, ‘the Scale for the Focus of Inner- Outer Control’, ‘the Symptom Checking List’, and a personal information form developed by the researcher. SPSS for Windows packet programme was used. Result: The age variable is a factor in interpersonal sensitivity, depression, anxciety, hostality symptoms but it is not a factor in the other symptoms. The variable, gender, is a factor in emotional practical escaping overcoming method but it is not a factor in the other overcoming methods. Namely, it has been found out that, women use emotional practical escaping overcoming method more than men. Marital status is a factor in methods of overcoming stress such as trusting in religion, emotional practical escaping and biochemical escaping while it is not a factor in the other methods. Namely, it has been found out that married teachers use trusting in religion method, and emotional practical escaping method more than single ones. Single teachers generally use biochemical escaping method. In primary school teachers’ direction of controlling focus, gender variable is a factor. It has been found out that women are more inner controlled while the men are more outer controlled. The variable, time of service, is a factor in the direction of controlling focus; that is, teachers with 1-5 years of service time are more inner controlled compared with teachers with 16-20 years of service time. The variable, age, is a factor in the direction of controlling focus; that is, teachers in 26-30 age groups are more outer controlled compared with the other age groups and again teachers in 26-30 age group are more inner controlled when compared with the other age groups. Direction of controlling focus is a factor in the primary school teachers’ psychological health. Namely, being outer controlled is a factor but being inner controlled is not. The methods; trusting in religion, active plannıng and biochemical escaping used by primary school teachers to cope with stress act as factors in the direction of controlling focus but not in the others. Namely, it has been found out that outer controlled teachers prefer the methods of trusting in religion and active planning while the inner controlled ones prefer biochemical escaping.

Keywords: coping with, controlling focus, psychological health, stress

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Authors: Tareq Oshan

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Facility location and size decisions are important to any company because they affect profitability and success. However, warehouses are exposed to various risks of failure that affect their activity. This paper presents a mixed-integer non-linear mathematical model that can be used to determine optimal warehouse locations and sizes, which warehouses to fortify, and which branches should be assigned to specific warehouses when there is a risk of warehouse failure. Every branch is assigned to a fortified primary warehouse or a nonfortified primary warehouse and a fortified backup warehouse. The standard method and an introduced method, based on the average probabilities, for linearizing this mathematical model were used. A Canadian case study was used to demonstrate the developed mathematical model, followed by some sensitivity analysis.

Keywords: supply chain network design, fortified warehouse, mixed-integer mathematical model, warehouse failure risk

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Authors: Marwa Hanafy

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The objective of linking the museum with school curriculum is to focus on the values and principles of the educational standards of the fourth grade as "equality, cooperation, allegiance, belonging, participation, peace, tolerance, pride and patriotism, etc." through activities, discussion, exhibits, etc., which can help the students to develop their characters and be useful for their society. For example, there is a lesson in Module 3 assess the role of women as mothers and queens, here this research will focus on the value of women and respect them through statues or images of women which support and affect positively on the students who will apply these Morals to themselves and to the community by dependency. It cannot be denied that the students have to be a part of the museum educational programs which have designed for them, by giving them the opportunity to participate, talk, discuss and express their opinions and hear them in the museums, this may be an effective way to confirm that the interests of children are taken into account.

Keywords: museum education, primary school education, school curriculum, informal learning

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Authors: Thandeka Y. S. Jwara, Paul Musonge

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Traditionally, the complexity associated with implementing and controlling biological nutrient removal (BNR) in wastewater works (WWW) has been primarily in terms of balancing competing requirements for nitrogen and phosphorus removal, particularly with respect to the use of influent chemical oxygen demand (COD) as a carbon source for the microorganisms. Successful BNR optimization and modelling using WEST (Worldwide Engine for Simulation and Training) depend largely on the accurate fractionation of the influent COD. The different COD fractions have differing effects on the BNR process, and therefore, the influent characteristics need to be well understood. This study presents the fractionation results of primary wastewater effluent COD at one of South Africa’s wastewater works treating 65ML/day of mixed industrial and domestic effluent. The method used for COD fractionation was the oxygen uptake rate/respirometry method. The breakdown of the results of the analysis is as follows: 70.5% biodegradable COD (bCOD) and 29.5% of non-biodegradable COD (iCOD) in terms of the total COD. Further fractionation led to a readily biodegradable soluble fraction (SS) of 75%, a slowly degradable particulate fraction (XS) of 24%, a particulate non-biodegradable fraction (XI) of 50.8% and a non-biodegradable soluble fraction (SI) of 49.2%. The fractionation results demonstrate that the primary effluent has good COD characteristics, as shown by the high level of the bCOD fraction with Ss being higher than Xs. This means that the microorganisms have sufficient substrate for the BNR process and that these components can now serve as inputs to the WEST Model for the plant under study.

Keywords: chemical oxygen demand, COD fractionation, wastewater modelling, wastewater optimization

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Authors: Ayman Hegab

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Increasing evidence supports the use of platelet-rich plasma (PRP) combined with hyaluronic acid (HA) for the treatment of knee osteoarthritis, which effectively promotes cartilage repair. This study aimed to determine whether injection of PRP+HA following arthrocentesis reduces pain and improves maximum incisal opening. This was a single-blind, prospective, randomized control study. The patients were selected based on the Hegab classification: Group I: patients treated with arthrocentesis followed by a single PRP injection; Group II (Control): patients treated with arthrocentesis followed by a single HA injection; and Group III: patients treated with arthrocentesis followed by a single PRP+HA combination injection. The primary predictor variable was the medication used for injection. The primary outcome variables were the maximum voluntary mouth opening and pain index scores. The secondary outcome variable was joint sounds. All outcome variables were assessed and compared among the three groups at baseline and at 1-, 3-, 6-, and 12-month intervals. Other variables, including patients’ age and sex, were evaluated in relation to the patient outcomes. Injecting PRP+HA showed statistically significant improvement in the primary and secondary treatment outcomes over PRP or HA injection throughout the study period (P<0.005). Injection of PRP+HA following arthrocentesis had significant long-term clinical efficacy regarding pain relief that was considered the main concern of both the patient and clinician.

Keywords: TMJ, HA, PRP, osteoarthritis

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Authors: Shyamani Hettiarachchi, Gopi Kitnasamy

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Background: The potentially high level of physical need and dependency experienced by children with cerebral palsy could affect the quality of life (QOL) of the child, the caregiver and his/her family. Poor QOL in children with cerebral palsy is associated with the parent-child relationship, limited opportunities for social participation, limited access to healthcare services, psychological well-being and the child's physical functioning. Given that children experiencing disabilities have little access to remedial support with an inequitable service across districts in Sri Lanka, and given the impact of culture and societal stigma, there may be differing viewpoints across respondents. Objectives: The aim of this study was to evaluate the psychometric properties of the Tamil version of the Cerebral Palsy Quality of Life for Children (CPQOL-Child) Questionnaire. Design: An instrument development and validation study. Methods: Forward and backward translations of the CPQOL-Child were undertaken by a team comprised of a physiotherapist, speech and language therapist and two linguists for the primary caregiver form and the child self-report form. As part of a pilot phase, the Tamil version of the CPQOL was completed by 45 primary caregivers with children with cerebral palsy and 15 children with cerebral palsy (GMFCS level 3-4). In addition, the primary caregivers commented on the process of filling in the questionnaire. The psychometric properties of test-retest reliability, internal consistency and construct validity were undertaken. Results: The test-retest reliability and internal consistency were high. A significant association (p < 0.001) was found between limited motor skills and poor QOL. The Cronbach's alpha for the whole questionnaire was at 0.95.Similarities and divergences were found between the two groups of respondents. The child respondents identified limited motor skills as associated with physical well-being and autonomy. Akin to this, the primary caregivers associated the severity of motor function with limitations of physical well-being and autonomy. The trend observed was that QOL was not related to the level of impairment but connected to environmental factors by the child respondents. In addition to this, the main concern among primary caregivers about the child's future and on the child's lack of independence was not fully captured by the QOL questionnaire employed. Conclusions: Although the initial results of the CPQOL questionnaire show high test-retest reliability and internal consistency of the instrument, it does not fully reflect the socio-cultural realities and primary concerns of the caregivers. The current findings highlight the need to take child and caregiver perceptions of QOL into account in clinical practice and research. It strongly indicates the need for culture-specific measures of QOL.

Keywords: cerebral palsy, CPQOL, culture, quality of life

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Authors: Chih-Wen Fan

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Backgrounds/ Research goals : School improvement requires change leadership, which often means discomfort. Principals are the key people that determine the effectiveness of schools. In an era of organization’s pursuit of speed and effectiveness, school administration has to be accountable and innovative. Effective principals work to improve achievement by focusing on the administrative and teaching quality of improvement. However, there is a lack of literature addressing the relevant case studies on school change leadership. This article explores how principals can use change leadership to drive school change. It analyze the driving factors of principal changes in the case school, the beliefs of change leadership, specific methods, and what impact they have. Methods: This study applies the case study research method to the selected primary school located in an urban area for case study, which has achieved excellent performance after reform and innovation. The researchers selected an older primary school located in an urban area that was transformed into a high-performance primary school after changes were enacted by the principal. The selected case was recommended by three supervisors of the Education Department. The case school underwent leadership change by the new principal during his term, and won an award from the Ministry of Education. Total of 8 teachers are interviewed. The data encoding includes interviews and documents. Expected results/ conclusions: The conclusions of the study are, as follows: (1) The influence for Principal Lin's change leadership is from internal and external environmental development and change pressures. (2) The principal's belief in change leadership is to recognize the sense of crisis, and to create a climate of change and demand for change. (3) The principal's specific actions are intended to identify key members, resolve resistance, use innovative thinking, and promote organizational learning. (4) Principal Lin's change leadership can enhance the professional functions of all employees through appropriate authorization. (5) The effectiveness of change leadership lies in teachers' participation in decision-making; the school's reputation has been enhanced through featured courses.

Keywords: change leadership, empowerment, crisis awareness, case study

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Authors: Randa M. Ali, Naguiba F. Loutfy, Osama M. Awad

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Background: Leishmaniasis is a worldwide disease, affecting 88 countries, it is estimated that about 350 million people are at risk of leishmaniasis. Overall prevalence is 12 million people with annual mortality of about 60,000. Annual incidence is 1,500,000 cases of cutaneous leishmaniasis (CL) worldwide and half million cases of visceral Leishmaniasis (VL). Objectives: The objective of this study was to assess primary health care physicians knowledge (PHP) and attitude about leishmaniasis and to assess awareness of local inhabitants about the disease and its vector in four areas in west Alexandria, Egypt. Methods: This study was a cross sectional survey that was conducted in four PHC units in west Alexandria. All physicians currently working in these units during the study period were invited to participate in the study, only 20 PHP completed the questionnaire. 60 local inhabitant were selected randomly from the four areas of the study, 15 from each area; Data was collected through two different specially designed questionnaires. Results: 11(55%) percent of the physicians had satisfactory knowledge, they answered more than 9 (60%) questions out of a total 14 questions about leishmaniasis and sandfly. The second part of the questionnaire is concerned with attitude of the primary health care physicians about leishmaniasis, 17 (85%) had good attitude and 3 (15%) had poor attitude. The second questionnaire showed that the awareness of local inhabitants about leishmaniasis and sandly as a vector of the disease is poor and needs to be corrected. Most of the respondents (90%) had not heard about leishmaniasis, Only 3 (5%) of the interviewed inhabitants said they know sandfly and its role in transmission of leishmaniasis. Conclusions: knowledge and attitudes of physicians are acceptable. However, there is, room for improvement and could be done through formal training courses and distribution of guidelines. In addition to raising the awareness of primary health care physicians about the importance of early detection and notification of cases of lesihmaniasis. Moreover, health education for raising awareness of the public regarding the vector and the disease is necessary because related studies have demonstrated that if the inhabitants do not perceive mosquitoes to be responsible for diseases such as malaria they do not take enough measures to protect themselves against the vector.

Keywords: leishmaniasis, PHP, knowledge, attitude, local inhabitants

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Authors: Kim Kennedy, Daren Gibson, Stephanie Flukes, Chandra Diwakarla, Lisa Spalding, Leanne Pilkington, Andrew Redfern

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Introduction: It is well known that patients with Head and Neck Cancer (HNC) are at increased risk of subsequent head and neck cancers due to various aetiologies. Aim: We sought to determine the factors contributing to an increased risk of subsequent HNC primaries, and also to evaluate whether Aboriginal patients are at increased risk. Methods: We performed a retrospective cohort analysis of 320 HNC patients from a single centre in Western Australia, identifying 80 Aboriginal patients and 240 non-Aboriginal patients matched on a 1:3 ratio by site, histology, rurality, and age. We collected patient data including smoking and alcohol consumption, tumour and treatment data, and data on subsequent HNC primaries. Results: A subsequent HNC primary was seen in 37 patients (11.6%) overall. There was no significant difference in the rate of second primary HNCs between Aboriginal patients (12.5%) and nonAboriginal patients (11.2%) (p=0.408). Subsequent HNCs, were strongly associated with smoking and alcohol consumption however, with 95% of patients with a second primary being ever-smokers, and 54% of patients with a second primary having a history of excessive alcohol consumption. In the 37 patients with multiple HNC primaries, there were a total of 57 HNCs, with 29 patients having two primaries, six patients having 3 HNC primaries, one patient with four, and one with six. 54 out of the 57 cancers were in ever smokers (94.7%). There were only two multiple HNC primaries in a never smoker, non-drinker, and these cases were of unknown etiology with HPV/p16 status unknown in both cases. In the whole study population, there were 32 HPV-positive HNCs, and 67 p16-positive HNCs, with only two 2 nd HNCs in a p16-positive case, giving a rate of 3% in the p16+ population, which is actually much lower than the rate of second primaries seen in the overall population (11.6%), and was highest in the p16-negative population (15.7%). This suggests that p16-positivity is not a strong risk factor for subsequent primaries, and in fact p16-negativity appeared to be associated with increased risk, however this data is limited by the large number of patients without documented p16 status (45.3% overall, 12% for oropharyngeal, and 59.6% for oral cavity primaries had unknown p16 status). Summary: Subsequent HNC primaries were strongly associated with smoking and alcohol excess. Second and later HNC primaries did not appear to occur at increased rates in Aboriginal patients compared with non-Aboriginal patients, and p16-positivity did not predict increased risk, however p16-negativity was associated with an increased risk of subsequent HNCs.

Keywords: head and neck cancer, multiple primaries, aboriginal, p16 status, smoking, alcohol

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Authors: Chizzoniti Domenico, Beggiora Klizia, Cattani Letizia, Moscatelli Monica

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This paper concerns the study of sustainable construction materials applied on the "Health Post", a prototype for the primary health care situated in alienated areas of the world. It's suitable for social and climatic Sub-Saharan context; however, it could be moved in other countries of the world with similar urgent needs. The idea is to create a Health Post with local construction materials that have a low environmental impact and promote the local workforce allowing reuse of traditional building techniques lowering production costs and transport. The aim of Primary Health Care Centre is to be a flexible and expandable structure identifying a modular form that can be repeated several times to expand its existing functions. In this way it could be not only a health care centre but also a socio-cultural facility.

Keywords: low costs building, sustainable construction materials, green construction system, prototype, health care, emergency

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Authors: Seyed Abolhassan Naeini, Maedeh Akhavan Tavakkoli

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Evaluating the shear wave velocity (V_s) and primary wave velocity (Vₚ) is necessary to identify the ground type of the site. Identifying the soil type based on different codes can affect the dynamic analysis of geotechnical properties. This study aims to separate the underground layers at the project site based on the shear wave and primary wave velocity (Sₚ) in different depths and determine dynamic elastic modulus based on the shear wave velocity. Bandar Anzali is located in a tectonically very active area. Several active faults surround the study site. In this case, a field investigation of downhole testing is conducted as a geophysics method to identify the ground type.

Keywords: downhole, geophysics, shear wave velocity, case-study

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Authors: Arunas Emeljanovas, Brigita Mieziene, Vida Cesnaitiene, Ingunn Fjortoft, Lise Kjonniksen

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Background: Gender differences in physical fitness were tracked in many studies with lower effect in preschool children and increasing difference among genders across age. In Lithuania, on a population level, secular trends in physical fitness were regularly observed each ten years for the last two decades for 11-18 years old students. However, there is apparently a lack of such epidemiological studies among primary school students. Assessing and monitoring physical fitness from an early age is of particular importance seeking to develop and strengthen physical abilities of youths for future health benefits. The goal of the current study was to indicate age and gender differences in anthropometric measures, musculoskeletal, motor and cardiorespiratory fitness in Lithuanian primary school children. Methods: The study included 3456 1-4th grade students from 6 to 10 years. The data reliably represents the population of primary school children in Lithuania. Among them, 1721 (49.8 percent) were boys. Physical fitness was measured by the 9-item test battery, developed by Fjørtoft and colleagues (2011). Height and weight were measured and body mass index was calculated. Student t test evaluated differences in physical fitness between boys and girls, ANOVA was performed to indicate differences across age. Results: All anthropometric and fitness means that were identified as significantly different were better in boys than in girls and in older than younger students (p < .05). Among anthropometric measures, height was higher in boys aged 7 through 9 years. Weight and BMI differed among boys and girls only at 8 years old. Means of height and weight increased significantly across all ages. Among musculoskeletal fitness tests, means of standing broad jump, throwing a tennis ball and pushing a medicine ball were different between genders within each age group and across all ages. Differences between genders were less likely in motor fitness than in musculoskeletal or cardiorespiratory fitness. Differences in means of shuttle run 10 x 5 test between genders occurred at age 6, 9 and 10 years; running 20 m at age 6 and 9 years, and climbing wall bars at age 9 and 10. Means of Reduced Cooper test representing cardiorespiratory fitness were different between genders within each age group but did not differ among age 6 and 8 as well as 7 and 8 years in boys, and among age 7 and 8 years in girls. Conclusion: In general, the current study confirms gender differences in musculoskeletal, motor and cardiorespiratory fitness found in other studies across the world in primary school and older children. Observed gender differences might be explained by higher physical activity in boys rather than girls. As it is explained by previous literature, older boys and girls had better performances than younger ones, because of the components of fitness change as a function of growth, maturation, development, and interactions among the three processes.

Keywords: primary school children, motor fitness, musculoskeletal fitness, cardiovascular fitness

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Authors: Danilo López, Edwin Rivas, Fernando Pedraza

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Currently, one of the major challenges in wireless networks is the optimal use of radio spectrum, which is managed inefficiently. One of the solutions to existing problem converges in the use of Cognitive Radio (CR), as an essential parameter so that the use of the available licensed spectrum is possible (by secondary users), well above the usage values that are currently detected; thus allowing the opportunistic use of the channel in the absence of primary users (PU). This article presents the results found when estimating or predicting the future use of a spectral transmission band (from the perspective of the PU) for a chaotic type channel arrival behavior. The time series prediction method (which the PU represents) used is ANFIS (Adaptive Neuro Fuzzy Inference System). The results obtained were compared to those delivered by the RNA (Artificial Neural Network) algorithm. The results show better performance in the characterization (modeling and prediction) with the ANFIS methodology.

Keywords: ANFIS, cognitive radio, prediction primary user, RNA

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Authors: Athanasia Chatzifotiou, Karen Tait

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Eco-school is an international initiative that offers schools the opportunity to develop practices on education for sustainable development (EfSD). Such practices need to focus on nine areas, namely: energy, water, biodiversity, school grounds, healthy living, transport, litter, waste and global citizenship. Acquiring the green flag status is the ultimate stage (silver and bronze are the other two) that is awarded by a committee external to the school and it lasts for two years. Our project focused on two such primary schools that had acquired the green flag status. The aim of our project is to describe the schools’ approach of becoming an eco-school, the practitioners’ role in promoting the values and principles of such endeavors, thus identifying the impact of EfSD. We chose the eco-schools initiative as it gives a clear and straightforward way to identify a school with an interest in EfSD. The project is important because even though EfSD attracts high attention in rhetoric, there is evidence indicating that EfSD may be neglected in practice. This paper presents part of a bigger project that aims to compare how primary schools and early years settings have approached EfSD via the eco-school initiative in the North East of England. This is a qualitative project that used a case study design to focus on the practices of two particular primary schools to gain a green flag status. A semi-structured interview was used with the lead teachers/practitioners of the schools; an audit was also conducted as part of a tour of the schools’ premises highlighting the initiatives, curriculum work, projects undertaken as well as resources available to school. A content analysis of the interview transcripts was conducted with the creation of response categories and response narratives by the two researchers first working individually and then collaboratively; the findings of the project reflected issues that concerned: a) pupils’ cognitive, physical and socio-emotional development, b) the wider community and c) the lead practitioners’ role and status in school. In relation to EfSD, our findings indicated that its impact upon these two eco-schools was rather minimal; a mismatch was identified between the eco-school practices and a holistic understanding of issues that EfSD aims to achieve. This mismatch between eco-school practices and EfSD is discussed with regard to: a) pupils’ understanding of the sustainability dimension in the topics they addressed; and b) teachers’ knowledge of sustainability and willingness to keep on such work in schools.

Keywords: eco-schools, environment, primary schools, sustainability education

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