Search results for: clinical psychology training

Authors: Netasha Shaikh, Bryony Wood, Demitra Tsivos, Michael Knight, Risto Kauppinen, Elizabeth Coulthard

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Background: Effective treatment of dementia will require early diagnosis, before significant brain damage has accumulated. Memory loss is an early symptom of Alzheimer’s disease (AD). The hippocampus, a brain area critical for memory, degenerates early in the course of AD. The hippocampus comprises several subfields. In contrast to healthy aging where CA3 and dentate gyrus are the hippocampal subfields with most prominent atrophy, in AD the CA1 and subiculum are thought to be affected early. Conventional clinical structural neuroimaging is not sufficiently sensitive to identify preferential atrophy in individual subfields. Here, we will explore the sensitivity of new magnetic resonance imaging (MRI) sequences designed to interrogate medial temporal regions as an early marker of Alzheimer’s. As it is likely a combination of tests may predict early Alzheimer’s disease (AD) better than any single test, we look at the potential efficacy of such imaging alone and in combination with standard and novel cognitive tasks of hippocampal dependent memory. Methods: 20 patients with mild cognitive impairment (MCI), 20 with mild-moderate AD and 20 age-matched healthy elderly controls (HC) are being recruited to undergo 3T MRI (with sequences designed to allow volumetric analysis of hippocampal subfields) and a battery of cognitive tasks (including Paired Associative Learning from CANTAB, Hopkins Verbal Learning Test and a novel hippocampal-dependent abstract word memory task). AD participants and healthy controls are being tested just once whereas patients with MCI will be tested twice a year apart. We will compare subfield size between groups and correlate subfield size with cognitive performance on our tasks. In the MCI group, we will explore the relationship between subfield volume, cognitive test performance and deterioration in clinical condition over a year. Results: Preliminary data (currently on 16 participants: 2 AD; 4 MCI; 9 HC) have revealed subfield size differences between subject groups. Patients with AD perform with less accuracy on tasks of hippocampal-dependent memory, and MCI patient performance and reaction times also differ from healthy controls. With further testing, we hope to delineate how subfield-specific atrophy corresponds with changes in cognitive function, and characterise how this progresses over the time course of the disease. Conclusion: Novel sequences on a MRI scanner such as those in route in clinical use can be used to delineate hippocampal subfields in patients with and without dementia. Preliminary data suggest that such subfield analysis, perhaps in combination with cognitive tasks, may be an early marker of AD.

Keywords: Alzheimer's disease, dementia, memory, cognition, hippocampus

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Authors: Antarip Bhattacharya, Dhritiman Maitra

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Primary hyperparathyroidism (PHPT) is the most common cause of hypercalcemia due to autonomous production of parathormone (PTH) and the third most common endocrine disorder. Upto 2% of postmenopausal women could have this condition. Primary hyperparathyroidism is characterized by hypercalcemia with a high or insufficiently suppressed level of parathyroid hormone and is caused by a solitary parathyroid adenoma in 85-90% of patients. PHPT may also be caused by parathyroid hyperplasia (involving multiple glands) or parathyroid carcinoma. Associated morbidities and sequelae include decreased bone mineral density, fractures, kidney stones, hypertension, cardiac comorbidities and psychiatric disorder which entail huge costs for treatment. In the year 2021, by virtue of running a Breast and Endocrine Surgery clinic in a Tier 1 city at a tertiary care hospital, the opportunity to be associated with patients of hyperparathyroidism came our way. Here, we shall describe the spectrum of clinical presentations and customisation of treatment for parathyroid diseases with reference to the above patients. A retrospective analysis of the data of all patients presenting with symptoms of parathyroid diseases was made and classified according to the cause. 13 patients had presented with symptoms of hyperparathyroidism and each case presented with unique symptoms and necessitated detailed evaluation. The treatment or surgery offered to each patient was tailored to his/her individual disease and led to favourable outcomes. Diseases affecting parathyroid are not as rare as we believe. Each case merits detailed clinical evaluation, investigations and tailoring of suitable treatment with regard to medical management and extent of surgery. Intra-operative frozen section/iOPTH monitoring are really useful adjuncts for intra-operative decision making.

Keywords: hyperparathyroidism, parathyroid adenoma, parathyroid surgery, PTH

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Authors: Mumtaz Ali, Hamzullah Khan, Khalid Khanzada, Shahid Ayub, Aurangzeb Wazir

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Objective: To analyse the death of patients treated in neuro-surgical ICU for severe head injuries from different perspectives. The evaluation of the data so obtained to help improve the health care delivery to this group of patients in ICU. Study Design: It is a descriptive study based on retrospective analysis of patients presenting to neuro-surgical ICU in Lady Reading Hospital, Peshawar. Study Duration: It covered the period between 1st January 2009 to 31st December 2009. Material and Methods: The Clinical record of all the patients presenting with the clinical radiological and surgical features of severe head injuries, who expired in neuro-surgical ICU was collected. A separate proforma which mentioned age, sex, time of arrival and death, causes of head injuries, the radiological features, the clinical parameters, the surgical and non surgical treatment given was used. The average duration of stay and the demographic and domiciliary representation of these patients was noted. The record was analyzed accordingly for discussion and recommendations. Results: Out of the total 112 (n-112) patients who expired in one year in the neuro-surgical ICU the young adults made up the majority 64 (57.14%) followed by children, 34 (30.35%) and then the elderly age group: 10 (8.92%). Road traffic accidents were the major cause of presentation, 75 (66.96%) followed by history of fall; 23 (20.53%) and then the fire arm injuries; 13 (11.60%). The predominant CT scan features of these patients on presentation was cerebral edema, and midline shift (diffuse neuronal injuries). 46 (41.07%) followed by cerebral contusions. 28 (25%). The correctable surgical causes were present only in 18 patients (16.07%) and the majority 94 (83.92%) were given conservative management. Of the 69 (n=69) patients in which CT scan was repeated; 62 (89.85%) showed worsening of the initial CT scan abnormalities while in 7 cases (10.14%) the features were static. Among the non surgical cases both ventilatory therapy in 7 (6.25%) and tracheostomy in 39 (34.82%) failed to change the outcome. The maximum stay in the neuro ICU leading upto the death was 48 hours in 35 (31.25%) cases followed by 31 (27.67%) cases in 24 hours; 24 (21.42%) in one week and 16 (14.28%) in 72 hours. Only 6 (5.35%) patients survived more than a week. Patients were received from almost all the districts of NWFP except. The Hazara division. There were some Afghan refugees as well. Conclusion: Mortality following the head injuries is alarmingly high despite repeated claims about the professional and administrative improvement. Even places like ICU could not change the out come according to the desired aims and objectives in the present set up. A rethinking is needed both at the individual and institutional level among the concerned quarters with a clear aim at the more scientific grounds. Only then one can achieve the desired results.

Keywords: Glasgow Coma Scale, pediatrics, geriatrics, Peshawar

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Authors: Sudhir Kumar Singh, Debashish Chakravarty

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Slope stability analysis is an important aspect in the field of geotechnical engineering. It is also important from safety, and economic point of view as any slope failure leads to loss of valuable lives and damage to property worth millions. This paper aims at mitigating the risk of slope failure by studying the effect of different joint sets on the stability of mine pit slopes under the influence of various external factors, namely degree of saturation, rainfall intensity, and seismic coefficients. Supervised machine learning approach has been utilized for making accurate and reliable predictions regarding the stability of slopes based on the value of Factor of Safety. Numerous cases have been studied for analyzing the stability of slopes using the popular Finite Element Method, and the data thus obtained has been used as training data for the supervised machine learning models. The input data has been trained on different supervised machine learning models, namely Random Forest, Decision Tree, Support vector Machine, and XGBoost. Distinct test data that is not present in training data has been used for measuring the performance and accuracy of different models. Although all models have performed well on the test dataset but Random Forest stands out from others due to its high accuracy of greater than 95%, thus helping us by providing a valuable tool at our disposition which is neither computationally expensive nor time consuming and in good accordance with the numerical analysis result.

Keywords: finite element method, geotechnical engineering, machine learning, slope stability

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Authors: Myriam Roy

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The perspectives of the Togolese public towards mental illness were assessed, looking at religious affiliation, personal knowledge of someone with a mental illness, and education level as influencers. The goal was to observe which factors influenced most strongly the general public’s attitudes towards mental illness. The Togolese population was surveyed within the context of mental health awareness workshops and involved college and university students, rural community members, and company employees. Taylor and Dear’s Community Attitudes towards the Mentally Ill (CAMI) questionnaire was used to assess these influencers and includes four dimensions of community attitudes towards mental illness: authoritarianism, benevolence, social restrictiveness, and community mental health ideology (CMHI). Demographic questions were also included, tailored to the various realities of the Togolese population. These questions looked, among others, at religious, ethnical (region of origin within Togo), and educational background. It was found that religious affiliation and personal knowledge did not correlate significantly with changes in the four dimensions of the CAMI scale. It suggests that public perspectives towards mental illness might not be as associated with these variables as was previously thought. The dimensions, however, did correlate with themselves as was expected. Authoritarianism was associated positively with social restrictiveness, benevolence was associated negatively with social restrictiveness and positively with CMHI, and CMHI was associated negatively with social restrictiveness, indicating the CAMI did not suffer from reliability and validity issues when used with this population. Interestingly, level of education significantly impacted authoritarianism level, with higher education associated with a decrease in authoritarianism. This finding would support the notion that education is likely to provide access to a wide array of information as well as interaction with people from various backgrounds and situations. Providing increased awareness regarding mental health and illness in schools could be beneficial to favor the impact that education appears to have on public perspectives towards mental illness in Togo. Future studies could assess which mental health interventions in schools would be the most useful in Togo.

Keywords: CAMI questionnaire, cross-cultural psychology, stigma towards mental illness, West African psychology

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Authors: Gulam Anwer Khan, A. Gautam

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Background: The arch of aorta is a large artery that arches over the root of the left lung and connects the ascending aorta and descending aorta. It is situated in the superior mediastinum behind the manubrium sterni. It gives off three major branches i.e. brachiocephalic trunk, left common carotid artery and left subclavian artery arising from the superior surface of arch of aorta from right to left. Material and Methods: This was a descriptive study. It was carried out in 44 cadavers, obtained during dissections for undergraduates of Department of Anatomy, Chitwan Medical College, Bharatpur, Chitwan, between March 2015 to October 2016. Cadavers of both sexes were included in the present study. The arch of aorta was dissected and exposed according to the methods described by Romanes in Cunningham’s manual of practical anatomy. Results: Out of 44 dissected cadavers, 35 (79.54%) were male and 9 (20.46%) were female cadavers. The normal branching pattern of the arch of aorta was encountered in 28 (63.64%) cadavers and the remaining 16 (36.36%) cadavers showed variations in the branching pattern of arch of aorta. Two different types of variations on the branching pattern of arch of aorta were noted in the present study, in which 12 (27.27%) cadavers had common trunk of the Arch of Aorta. In 3 (5.00%) male cadavers, we found the origin of the Thyroid ima artery. This variation was noted in 1(1.66%) female cadaver. Conclusion: The present study carried out on adult human cadavers’ revealed wide variations in the branching pattern of the arch of ao rta. These variations are of clinical significance and also very useful for the anatomists, radiologists, anesthesiologists, surgeons for practice during angiography, instrumentation, supra-aortic thoracic, head and neck surgery.

Keywords: arch of aorta, brachiocephalic trunk, left common carotid artery, left subclavian artery, Thyroidea ima artery

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Authors: Soudeh Tabashi, Mohammadreza Moshari, Parisa Sezari

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Introduction: Postoperative analgesia in Orthotopic Liver Transplantation (OLT) surgery is challenging for anesthesiologists. Although OLT is one of the most extensive abdominal operations, it seems that patients don’t suffer from severe post operative pain. On the other hands drug metabolism is unpredictable due to unknown graft function. The aim of this study was to compare intraoperative infusion of remifentanil versus fentanyl in postoperative opioid demand in patients with OLT and evaluating the complications in two groups. Method: In this double-blind clinical trial 34 patients who had OLT were included. They divided randomly in two groups of Remifentanil (R) and Fentanyl (F). Patients in group R and F received infusion of Remifentanil 0.3-1 µg/Kg/min and Fentanyl 0.3-1 µg/Kg/min during maintenance of anesthesia. Post operative pain were measured in 6, 12, 18, 24 hours and second and third days after surgery with Numeric Rate Scale (NRS). Patients had received intravenous acetaminophen as rescue therapy with NRS of 3 or more. In addition to demographic information, post operative opioid consumption were recorded as the primary outcome. Intraoperative blood transfusion, intraoperative inotropic drugs consumption, weaning time and intensive care unit stay were also evaluated. Results: Total dose of acetaminophen consumption in first 3 days after surgery did not have significant difference between two groups (Pvalue=0.716). intraoperative inotrope consumption, blood transfusion and post operative weaning time and ICU stay were also similar in both groups. Conclusion: This study demonstrates that intraoperative infusion of remifentanil in OLT have the same effect on post operative pain management as fentanyl. Despite the complications of operation were not increased by remifentanil.

Keywords: liver transplantation, postoperative pain, remifentanil, fentanyl

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Authors: Asmaa M. El-Bandrawy, Afaf M. Botla, Ghada E. El-Refaye, Hassan O. Ghareeb

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Background: Urinary incontinence is a common problem among adults. Its incidence increases with age and it is more frequent in women. Pelvic floor muscle training (PFMT) is the first-line therapy in the treatment of pelvic floor dysfunction (PFD) either alone or combined with biofeedback-assisted PFMT. The aim of the work: The purpose of this study is to evaluate the efficacy of biofeedback-assisted PFMT in postoperative stress urinary incontinence. Settings and Design: A single blind controlled trial design was. Methods and Material: This study was carried out in 30 volunteer patients diagnosed as severe degree of stress urinary incontinence and they were admitted to surgical treatment. They were divided randomly into two equal groups: (Group A) consisted of 15 patients who had been treated with post-operative biofeedback-assisted PFMT and home exercise program (Group B) consisted of 15 patients who had been treated with home exercise program only. Assessment of all patients in both groups (A) and (B) was carried out before and after the treatment program by measuring intra-vaginal pressure in addition to the visual analog scale. Results: At the end of the treatment program, there was a highly statistically significant difference between group (A) and group (B) in the intra-vaginal pressure and the visual analog scale favoring the group (A). Conclusion: biofeedback-assisted PFMT is an effective method for the symptomatic relief of post-operative female stress urinary incontinence.

Keywords: stress urinary incontinence, pelvic floor muscles, pelvic floor exercises, biofeedback

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Authors: Ubaka Chukwuemeka Michael, Ukwe Chinwe Victoria

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Background: The use of antipsychotic monotherapy remains the standard for schizophrenic disorders so also a prescription switch from older typical to newer atypical classes of antipsychotics on the basis of better efficacy and tolerability. However, surveys on the quality of antipsychotic drug use and substitution in developing countries are very scarce. This study was intended to evaluate quality and factors that drive the prescription and substitution of antipsychotic drugs among schizophrenic patients visiting a regional psychiatric hospital. Methods: Case files of patients visiting a federal government funded Neuropsychiatric Hospital between July 2012 and July 2014 were systematically retrieved. Patient demographic characteristics, clinical details and drug management data were collected and subjected to descriptive and inferential data analysis to determine quality and predictors of utilization. Results: Of the 600 case files used, there were more male patients (55.3%) with an overall mean age of 33.7±14.4 years. Typical antipsychotic agents accounted for over 85% of prescriptions, with majority of the patients receiving more than 2 drugs in at least a visit (80.9%). Fluphenazine (25.2%) and Haloperidol (18.8%) were mostly given as antipsychotics for treatment initiation while Olazenpine (23.0%) and Benzhexol (18.3%) were the most currently prescribed antipsychotics. Nearly half (42%, 252/600) of these patients were switched from one class to another, with 34.5% (207/600) of them switched from typical to atypical drug classes. No demographic or clinical factors influenced drug substitutions but a younger age and being married influenced being prescribed a polypharmacy regimen (more than 2 drugs) and an injectable antipsychotic agent. Conclusion: The prevalence of antipsychotic polypharmacy and use of typical agents among these patients was high. However, only age and marital status affected the quality of antipsychotic prescriptions among these patients.

Keywords: antipsychotics, drug substitution, pharmacoepidemiology, polypharmacy

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Authors: A. Dinelka Panagoda, Bathiya Bandara, Chamod Wijetunga, Chathura Malinda, Lakmal Rupasinghe, Chethana Liyanapathirana

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This research takes us forward with the concepts of Federated Learning and Software-Defined Networking (SDN) to introduce an efficient malware detection technique and provide a mitigation mechanism to give birth to a resilient and automated healthcare sector network system by also adding the feature of extended privacy preservation. Due to the daily transformation of new malware attacks on hospital Integrated Clinical Environment (ICEs), the healthcare industry is at an undefinable peak of never knowing its continuity direction. The state of blindness by the array of indispensable opportunities that new medical device inventions and their connected coordination offer daily, a factor that should be focused driven is not yet entirely understood by most healthcare operators and patients. This solution has the involvement of four clients in the form of hospital networks to build up the federated learning experimentation architectural structure with different geographical participation to reach the most reasonable accuracy rate with privacy preservation. While the logistic regression with cross-entropy conveys the detection, SDN comes in handy in the second half of the research to stack up the initial development phases of the system with malware mitigation based on policy implementation. The overall evaluation sums up with a system that proves the accuracy with the added privacy. It is no longer needed to continue with traditional centralized systems that offer almost everything but not privacy.

Keywords: software-defined network, federated learning, privacy, integrated clinical environment, decentralized learning, malware detection, malware mitigation

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Authors: Hamzeh Awad

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Disability is considered to be a worldwide complex phenomenon which rising at a phenomenal rate and caused by many different factors. Chronic diseases such as cardiovascular disease and diabetes can lead to mobility disability in particular and disability in general. The ICF is an integrative bio-psycho-social model of functioning and disability and considered by the World Health Organization (WHO) to be a reference for disability classification using its categories and core set to classify disorder’s functional limitations. Specialist programs at Sultan Bin Abdul Aziz Humanitarian City (SBAHC) are providing both inpatient and outpatient services have started to implement the ICF and use it as a problem solving tool in Rehab. Diabetes is leading contributing factor for disability and considered epidemic in several Gulf countries including the Kingdom of Saudi Arabia (KSA), where its prevalence continues to increase dramatically. Metabolic disorders, mainly diabetes are not well covered in Rehab field. The purpose of this study is present to research and clinical rehabilitation field of DREAM and ICF as a framework in clinical and research setting in Rehab service. Also, shed the light on using the ICF as problem solving tool at SBAHC. There are synergies between disability causes and wider public health priorities in relation to both chronic disease and disability prevention. Therefore, there is a need for strong advocacy and understanding of the role of ICF as a reference in Rehab settings in Middle East if we wish to seize the opportunity to reverse current trends of acquired disability in the region.

Keywords: international classification of functioning, disability and health (ICF), prototype, rehabilitation and diabetes

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Authors: Muhammet Baldan, Emel Timuçin

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Molecular solubility prediction plays a crucial role in various fields, such as drug discovery, environmental science, and material science. In this study, we compare the performance of five machine learning algorithms—linear regression, support vector machines (SVM), random forests, gradient boosting machines (GBM), and neural networks—for predicting molecular solubility using the AqSolDB dataset. The dataset consists of 9981 data points with their corresponding solubility values. MACCS keys (166 bits), RDKit properties (20 properties), and structural properties(3) features are extracted for every smile representation in the dataset. A total of 189 features were used for training and testing for every molecule. Each algorithm is trained on a subset of the dataset and evaluated using metrics accuracy scores. Additionally, computational time for training and testing is recorded to assess the efficiency of each algorithm. Our results demonstrate that random forest model outperformed other algorithms in terms of predictive accuracy, achieving an 0.93 accuracy score. Gradient boosting machines and neural networks also exhibit strong performance, closely followed by support vector machines. Linear regression, while simpler in nature, demonstrates competitive performance but with slightly higher errors compared to ensemble methods. Overall, this study provides valuable insights into the performance of machine learning algorithms for molecular solubility prediction, highlighting the importance of algorithm selection in achieving accurate and efficient predictions in practical applications.

Keywords: random forest, machine learning, comparison, feature extraction

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Authors: Marta Czechowska-Bieluga

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Social work education in Poland focuses mostly on developing competencies that address the needs of individuals and families affected by a variety of life's problems. As a result of the ageing of the Polish population, much attention is equally devoted to adults, including the elderly. However, social work with children and young people is the area of education which should be given more consideration. Social work students are mostly trained to cater to the needs of families and the competencies aimed to respond to the needs of children and young people do not receive enough attention and are only offered as elective classes. This paper strives to review the social work programmes offered by the selected higher education institutions in Poland in terms of social work training aimed at helping children and young people to address their life problems. The analysis conducted in this study indicates that university education for social work focuses on training professionals who will provide assistance only to adults. Due to changes in the social and political situation, including, in particular, changes in social policy implemented for the needy, it is necessary to extend this area of education to include the specificity of the support for children and young people; especially, in the light of the appearance of new support professions within the area of social work. For example, family assistants, whose task is to support parents in performing their roles as guardians and educators, also assist children. Therefore, it becomes necessary to equip social work professionals with competencies which include issues related to the quality of life of underage people living in families. Social work curricula should be extended to include the issues of child and young person development and the patterns governing this phase of life.

Keywords: social work education, social work programmes, social worker, university

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Authors: Fatima Faraz

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BACKGROUND: While Artificial intelligence (AI) provides new opportunities across a wide variety of industries, healthcare is no exception. AI can lead to advancements in how the healthcare system functions and improves the quality of patient care. Developing countries like Pakistan are lagging in the implementation of AI-based solutions in healthcare. This demands increased knowledge and AI literacy among health care professionals. OBJECTIVES: To assess the level of awareness among medical students and faculty about AI in preparation for teaching AI basics and data science applications in clinical practice in an integrated medical curriculum. METHODS: An online 15-question semi-structured questionnaire, previously tested and validated, was delivered among participants through convenience sampling. The questionnaire composed of 3 parts: participant’s background knowledge, AI awareness, and attitudes toward AI applications in medicine. RESULTS: A total of 182 students and 39 faculty members from Rawalpindi Medical University, Pakistan, participated in the study. Only 26% of students and 46.2% of faculty members responded that they were aware of AI topics in clinical medicine. The major source of AI knowledge was social media (35.7%) for students and professional talks and colleagues (43.6%) for faculty members. 23.5% of participants answered that they personally had a basic understanding of AI. Students and faculty (60.1%) were interested in AI in patient care and teaching domain. These findings parallel similar published AI survey results. CONCLUSION: This survey concludes interest among students and faculty in AI developments and technology applications in healthcare. Further studies are required in order to correctly fit AI in the integrated modular curriculum of medical education.

Keywords: medical education, data science, artificial intelligence, curriculum

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Authors: Israel B. Bitton

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“Memory” is associated with various phenomena, from physical to mental, personal to collective and historical to cultural. As part of a broader exploration of memory studies in philosophy and science (slated for academic publication October 2021), this specific study employs analytical methods of cognitive psychology and philosophy of memory to theorize that A) the primary human will (drive) is to significance, in that every human action and expression can be rooted in a most primal desire to be cosmically significant (however that is individually perceived); and B) that the will to significance manifests as the will to memorability, an innate desire to be remembered by others after death. In support of these broad claims, a review of various popular culture “touchpoints”—historic and contemporary records spanning literature, film and television, traditional news media, and social media—is presented to demonstrate how this very theory is repeatedly and commonly expressed (and has been for a long time) by many popular public figures as well as “everyday people.” Though developed before COVID, the crisis only increased the theory’s relevance: so many people were forced to die alone, leaving them and their loved ones to face even greater existential angst than what ordinarily accompanies death since the usual expectations for one’s “final moments” were shattered. To underscore this issue of, and response to, what can be considered a sociocultural “memory gap,” this study concludes with a summary of several projects launched by journalists at the height of the pandemic to document the memorable human stories behind COVID’s tragic warped speed death toll that, when analyzed through the lens of Viktor E. Frankl’s psychoanalytical perspective on “existential meaning,” shows how countless individuals were robbed of the last wills and testaments to their self-significance and memorability typically afforded to the dying and the aggrieved. The resulting insight ought to inform how government and public health officials determine what is truly “non-essential” to human health, physical and mental, at times of crisis.

Keywords: cognitive psychology, covid, neuroscience, philosophy of memory

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Authors: Rana S. Alghamdi

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

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

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Authors: Sonal Sethi, Mukesh Yadav, Abhimanyu Gupta

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The upcoming field of radiogenomics has the potential to upgrade the role of imaging in lung cancer management by noninvasive characterization of tumor histology and genetic microenvironment. Receptor positivity like epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) genotyping are critical in lung adenocarcinoma for treatment. As conventional identification of receptor positivity is an invasive procedure, we analyzed the features on non-invasive computed tomography (CT), which predicts the receptor positivity in lung adenocarcinoma. Retrospectively, we did a comprehensive study from 77 proven lung adenocarcinoma patients with CT images, EGFR and ALK receptor genotyping, and clinical information. Total 22/77 patients were receptor-positive (15 had only EGFR mutation, 6 had ALK mutation, and 1 had both EGFR and ALK mutation). Various morphological characteristics and metastatic distribution on CT were analyzed along with the clinical information. Univariate and multivariable logistic regression analyses were used. On multivariable logistic regression analysis, we found spiculated margin, lymphangitic spread, air bronchogram, pleural effusion, and distant metastasis had a significant predictive value for receptor mutation status. On univariate analysis, air bronchogram and pleural effusion had significant individual predictive value. Conclusions: Receptor positive lung cancer has characteristic imaging features compared with nonreceptor positive lung adenocarcinoma. Since CT is routinely used in lung cancer diagnosis, we can predict the receptor positivity by a noninvasive technique and would follow a more aggressive algorithm for evaluation of distant metastases as well as for the treatment.

Keywords: lung cancer, multidisciplinary cancer care, oncologic imaging, radiobiology

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Authors: Shosh Kazaz, Shmuel Banai, Vered Zilberberg

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Optimizing high business performance and employee's well-being simultaneously often challenges organizations. 'TIP' intervention enables achieving them both as the given project demonstrates. Increasing outcomes and improving performance were the initial motivators for this explorative project, followed by a request of the head of the Cardiology department: 'I know we are the best at our clinical practice, but we need to take it further and break our own glass ceiling.' Two guided interventions were conducted in two different units within the department, designed to implement advanced managerial and business-oriented tools, along with 'soft tools' based on coaching psychology and particularly wellness coaching. The organ department multi-disciplinary teams were assembled, aiming to manage and lead the process: mapping the patients' flow, creating solutions, implementing, assessing, improving and assimilating them. Approximately four months later, without additional external resources, meaningful results emerged by the teams in terms of business and performance: shortening the hospitalization length at a given procedure (from 7 to 2.1 days); increasing the availability of Catheterization laboratory by 16% daily – resulting profitability raise; improving patients' journey and experience. A year later, those results are maintained. Furthermore, interviews with the participants revealed positive perceptions regarding the department; a higher sense of joyfulness, connectedness, belonging and a better department climate were reported. Additionally, participants reported a higher sense of fulfillment as opposed to their earliest skepticism and cynicism about their ability to enhance outcomes without more resources (budget and/or manpower), experiencing a mindset change toward the possibility of leading personal and professional growth processes. These reports were supported by analyzing a set of questionnaires that the participants completed, parallel to a control group of non-participating colleagues. Although the assessment was taken a year after the completion of the project and during 'covid-19th-3rd national quarantine, the results indicated a significant impact on several personal parameters associated with wellness, compared to the control group. The participants were higher in self-efficacy and organizational commitment; men were higher in resilience and optimism and women were higher in well-being. In conclusion, the 'TIP' relatively short intervention integrates advanced managerial and wellness coaching tools, empowers organizational resources: Team, Individual and Process and by that generates multi-impact measurable results in terms of employee's wellness parameters along with business performance and patient care.

Keywords: coaching, health and wellness, health management, leadership and well-being

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Authors: Ervin Meqikukiqi

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It is difficult to assess how athletes can best modify their movements to prevent non contact ACL injuries. Speaking with an athletic trainer, physical therapist, or sports medicine specialist is a good place to start. Recent research has allowed therapists and clinicians to easily identify and target weak muscle areas (e.g., weak hips, which leads to knock-kneed landing positions) and identify ways to improve strength and thus help prevent injury. In addition, other risk factors such as reduced hamstring strength and increased joint range of motion can be further assessed by a physical therapist or athletic trainer to improve performance-or rehabilitation efforts after an injury has occurred. Current studies also demonstrate that specific types of training, such as jump routines and learning to pivot properly, help athletes prevent ACL injuries. These types of exercises and training programs are more beneficial if athletes start when they are young. It may be optimal to integrate prevention programs during early adolescence, prior to when young athletes develop certain habits that increase the risk of an ACL injury. This is a 20 minute program designed to reduce the risk of tears of the Anterior Cruciate Ligament. It should be started at least four and preferably six weeks prior to start of competition.Ideally it is done five times per week preseason and three times per week in season.The coach or trainer must constantly observe athletes during these exercises to correct and maintain proper technique. Once the athletes understand the principles, they can monitor and coach each other. Four phases: Warm-up, Strengthening, Plyometrics, Agility and Balance.

Keywords: athletes, acl, prevention, injuries, plyoemtric, proprioception, agillity

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Authors: Thakur Pushpawati, Singh Vinita, Agrawal Sarita, Mohapatra Eli

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Polycystic ovary syndrome (PCOS) is a disease of endocrine and frequently encountered in women in their reproductive period, and it is characterized by clinical features of anovulation, clinical and biochemical features of hyperandrogenism, and PCOS morphology on ultrasonographic examination. In Indian scenario, only a few studies are available on the correlation of serum 25-dihydroxy vitamin D3 level and insulin level. The present study is a prospective case-control study and aims to estimate the concentration of serum 25-dihydroxy vitamin D3 and insulin resistance and determine the association of serum 25-dihydroxy vitamin D3 with insulin resistance in PCOS women of 18-40 years age group. In this study, the primary objective is to estimate the concentration of 25-dihydroxy vitamin D3, insulin, glycaemic status, calcium and phosphorus levels in 18-40 year age women with polycystic ovary syndrome and to compare these parameters with age and BMI matched healthy control of same age group women. The secondary objective is to determine the association between 25-dihydroxy vitamin D3 concentration and insulin resistance among PCOS cases in 18-40 years age group women. This study was carried on at outpatient Department of Obstetrics & Gynaecology, Aiims Raipur. It took one year from the date of approval. In case, 32 women were diagnosed (Diagnosed PCOS cases as per Rotterdoms criteria among women of 18-40 years of age), as control group 32 women of 18-40 years of age were diagnosed As a result, serum insulin level was elevated among PCOS women along with 25-dihydroxy vitamin D3 deficiency.Conclude up, PCOS is more common in the age group of 20-40 years. There is a strong correlation between vitamin D deficiency and insulin resistance among PCOS patients.

Keywords: vitamin D, insulin resistance, PCOS, reproductive age group

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Authors: Redie Bezabih Hailu

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Unemployment is a problem of nations that needs a continuous research. This study aimed to determine the collaborations and challenges of public employment service (PES) with special emphasis of stakeholders, employers and job seekers. The researcher used pragmatic philosophy, exploratory design and inductive approach to collect data from the respondents using interview and focused group discussion techniques. PES provides job market information, vocational counseling, and training. As PES is not fully furnished with man power, budget, modern technologies, it is providing less adequate services to the employers and job seekers. Matching job seekers with job vacancies is the major challenge for the center and using paper-based data management system too. There is also a number of job seekers in spite of very limited number of vacancies that the service provision is poor due to the fact that there is low level of vacancies and high level of job seekers. The center has collaboration with AFE, AYA, BoTVED, BoWCY, and CETU. The major challenges with this collaborations was the absence of operational guidelines to evaluate effectiveness and performance, lottery method of selecting candidates for vacancies and nepotism or favoritism were challenges for job seekers. On the other hand, (COVID-19) pandemic, inability to get skilled labor, absence of standardized payment, expectation of job seekers and less educational quality and mass graduation were another challenges for employment services. The study recommended quality education and training, operational guideline for collaboration, technology based labor market information system and suggested further studies on quality of PES.

Keywords: public employment service, collaborations, stakeholders, employers, job seekers

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Authors: M. Khordadmehr, V. R. Ranjbar, R. Norouzi, M. Zeinoddin

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Coccidiosis is recognized as a serious parasitic disease problem limiting quail industry recently. But the data on incidence, clinical signs, species of coccidia and pathological changes in Japanese quail are rare, especially in Iran in spite of the significant improvement of commercial quail breeding in this country in recent decades. Therefore, in the present paper was studied natural infection of quail coccidiosis in three commercial rearing farms with 80% morbidity and 3% mortality rate. For this purpose, fecal sample, oocyst examination, and morphological study were performed beside necropsy, histopathology, and PCR to confirm the diagnosis. In the affected birds, clinical signs included brown diarrhea, weakness, and pale face. In the fecal examination, three species of the genus Eimeria were identified including E. uzura, E. bateri, and E. tsunodai. At necropsy, the main gross lesions were edema, congestion and small blood spots in the small intestine. In histopathologic examination, endogenous stages of the parasites associated with hyperplasia of the intestinal glands, mild congestion, infiltration of mononuclear cells, and edema were observed in the intestine. The molecular study using BSEF and BSER specific primers confirmed the presence of the genus Eimeria in the affected birds. Interestingly, phylogenetic analysis showed relatively high bootstrap values in Japanese quail Eimeria with E. acervuline and E. maxima strains in the chicken. The present study is the first phylogenetic findings on Eimeria of quail which could be valuable for further research on Japanese quail coccidiosis.

Keywords: coccidiosis, Japanese Quail, pathomorphology, phylogenetic analysis

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Authors: Wilailuk Meepracha

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The results of the study on the project evaluation to develop the competencies, capabilities, and skills in repairing computers of people in Jompluak Local Municipality, Bang Khonthi District, Samut Songkram Province showed that the overall result was good (4.33). When considering on each aspect, it was found that the highest one was on process evaluation (4.60) followed by product evaluation (4.50) and the least one was on feeding factor (3.97). When considering in details, it was found that: 1) the context aspect was high (4.23) with the highest item on the arrangement of the training situation (4.67) followed by the appropriateness of the target (4.30) and the least aspect was on the project cooperation (3.73). 2) The evaluation of average overall primary factor or feeding factor showed high value (4.23) while the highest aspect was on the capability of the trainers (4.47) followed by the suitable venue (4.33) while the least aspect was on the insufficient budget (3.47). 3) The average result of process evaluation was very high (4.60). The highest aspect was on the follow-op supervision (4.70) followed by responsibility of each project staffs (4.50) while the least aspect was on the present situation and the problems of the community (4.40). 4) The overall result of the product evaluation was very high (4.50). The highest aspect was on the diversity of the activities and the community integration (4.67) followed by project target achievement (4.63) while the least aspect was on continuation and regularity of the activities (4.33). The trainees reported high satisfaction on the project management at very high level (43.33%) while 40% reported high level and 16.67% reported moderate level. Suggestions for the project were on the additional number of the computer sets (37.78%) followed by longer training period especially on computer skills (43.48%).

Keywords: project evaluation, competency development, the capability on computer repairing and computer skills

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Authors: Bernardita Tornero

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Cognitive Acceleration in Mathematics Education (CAME) programmes have been used successfully for promoting the development of thinking skills in school students for the last 30 years. Given that the approach has had a tremendous impact on the thinking capabilities of participating students, this study explored the experience of using the programme with prospective primary teachers in Chile. Therefore, this study not only looked at the experience of prospective primary teachers during the CAME course as learners, but also examined how they perceived the approach from their perspective as future teachers, as well as how they could transfer the teaching strategies they observed to their future classrooms. Given the complexity of the phenomenon under study, this research used a mixed methods approach. For this reason, the impact that the CAME course had on prospective teachers’ thinking skills was not only approached by using a test that assessed the participants’ improvements in these skills, but their learning and teaching experiences were also recorded through qualitative research tools (learning journals, interviews and field notes). The main findings indicate that, at the end of the CAME course, prospective teachers not only demonstrated higher thinking levels, but also showed positive attitudinal changes towards teaching and learning in general, and towards mathematics in particular. The participants also had increased confidence in their ability to teach mathematics and to promote thinking skills in their students. In terms of the CAME methodology, prospective teachers not only found it novel and motivating, but also commented that dealing with the thinking skills topic during a university course was both unusual and very important for their professional development. This study also showed that, at the end of the CAME course, prospective teachers felt they had developed strategies that could be used in their classrooms in the future. In this context, the relevance of the study is not only that it described the impact and the positive results of the first experience of using a CAME approach with prospective teachers, but also that some of the conclusions have significant implications for the teaching of thinking skills and the training of primary school teachers.

Keywords: cognitive acceleration, formal reasoning, prospective teachers, initial teacher training

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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: M. J. Pourvaghar, Sh. Khoshemehry

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Adopting inappropriate body posture during addiction can cause muscular and skeletal deformities. This study is aimed at investigating the effects of a program of the selected corrective exercises on the kyphosis of addicted male patients. Materials and methods: This was a quasi-experimental study. This study has been carried out using the semi-experimental method. The subjects of the present study included 104 addicted men between 25 to 45 years of age. In 2014, these men were referred to one of the NA (Narcotic Anonymous) centres in Kashan in 2015. A total of 24 people suffering from drug withdrawal, who had abnormal kyphosis, were purposefully selected as a sample. The sample was randomly divided into two groups, experimental and control; each group consisted of 12 people. The experimental group participated in a training program for 12 weeks consisting of three 60 minute sessions per week. That includes strengthening, stretching and PNF exercises (deep stretching of the muscle). The control group did no exercise or corrective activity. The Kolmogorov-Smirnov test was used to assess normal distribution of data; and a paired t-test and covariance analysis test were used to assess the effectiveness of the exercises, with a significance level of P≤0.05 by using SPSS18. The results showed that three months of the selected corrective exercises had a significant effect (P≤ 0.005) on the correction of the kyphosis of the addicted male patients after three months of rehabilitation (drug withdrawal) in the experimental group, while there was no significant difference recorded in the control group (P≥0.05). The results show that exercise and corrective activities can be used as non-invasive and non-pharmacological methods to rehabilitate kyphosis abnormalities after drug withdrawal and treatment for addiction.

Keywords: kyphosis, exercise-rehabilitation, addict, addiction

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Authors: Malalage Mudara Peiris

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Objectives of the study are: the biosynthesis of silver nanoparticles (AgNPs) using Escherichia coli, Acinetobacter baumannii and Staphylococcus aureus, characterization of silver nanoparticles and determination of antimicrobial activity against E. coli, P. aeruginosa, S. aureus, MRSA, and C. Albicans. Methods: E. coli (ATCC 25922), A. baumanii (clinical strain), S. aureus (clinical strain) cultured in nutrient broth medium were used for biosynthesis of AgNPs. Culture conditions (AgNO3 concentration, pH, incubation time and temperature) were optimized. Characterization of synthesized NPs was done by UV-Visible spectroscopy. The antimicrobial activity of the synthesized NPs was studied using the good diffusion assay against E. coli, S. aureus, MRSA (Methicillin-resistant Staphylococcus aureus), P. aeruginosa and C. Albicans. Results: All the selected bacteria produced silver nanoparticles at alkaline pH above 0.3 g/L AgNO3 concentration. The optimum reaction temperature was 60oC. According to the UV-Visible spectroscopy, the maximum absorbance was found to be around 420 - 430 nm indicating the presence of AgNPs. According to the good diffusion results, AgNPs produced by S. aureus resulted in the larger zone of inhibition (ZOI) against the selected pathogens, while AgNPs produced by E. coli showed comparatively smaller ZOI. In general, biosynthesized AgNPs were highly effective against gram-negative bacteria compared to gram-positive bacterial and fungal species. Conclusions: Green AgNPs produced by each bacterium show antimicrobial activity against the selected pathogens. AgNPs produced by S. aureus are the most effective NPs among tested AgNPs, while AgNPs produced by E. coli are the least effective. Further characterization of NPs is required to study the physical properties of silver NPs.

Keywords: green nanotechnology, silver nanoparticles, bacteria, antimicrobial activity

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Authors: Mirriam M. Moleko, Sekanse A. Ntsala

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Language in mathematics instruction enables the teacher to communicate mathematical knowledge to the learners with precision. It also enables the learner to deal with mathematical activities effectively. This scholarly piece was motivated by the fact that mathematics performance in the South African primary classrooms has not been satisfactory, and English, which is a Language of Learning and Teaching (LoLT) for the majority of the learners, has been singled out as one of the major impediments. This is not only on the part of the learners, but also on the part of the teachers as well. The study thus focused on the lack of competency in English among the primary school teachers as one of the possible causes of poor performance in mathematics in primary classrooms. The qualitative processes, which were premised on the social interaction theory as a lens, sourced the narratives of 10 newly qualified primary school mathematics teachers from the disadvantaged schools on the matter. This was achieved through the use of semi-structured interviews and focus group discussions. The data, which were analyzed thematically, highlighted the actuality that the challenges cut across the pre-service stage to the in-service stage. The findings revealed that the undergraduate mathematics courses in the number of the institutions neglect the importance of language. The study further revealed that the in-service mathematics teachers lack adequate linguistic command, thereby finding it difficult to successfully teach some mathematical concepts, or even to outline instructions clearly. The study thus suggests the need for training institutions to focus on improving the teachers’ English language competency. The need for intensive in-service training targeting the problem areas was also highlighted. The study thus contributes to the body of knowledge by providing suggestions on how the mathematics teachers’ language incompetency can be mitigated.

Keywords: Competency, English language proficiency, language of learning and teaching, primary mathematics teachers

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Authors: Sara atibi, Azzeddine Atibi, Salim Ahmed, Khadija El Kababi

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Given the crucial impact of entrepreneurship on socio-economic development, nations are making various efforts to support and encourage it. Entrepreneurship education has proven to be a vital lever in stimulating business creation. This research is part of this dynamic, which is increasingly attracting the attention of educational policymakers. Indeed, entrepreneurship education provides students with the skills, knowledge, and motivation needed to succeed in various entrepreneurial contexts. it objective is to demonstrate the impact of entrepreneurship education on the development of entrepreneurial intention among students at Al Akhawayn University and to determine whether introducing this discipline at the secondary school level can strengthen this intention, with the aim of proposing measures to foster entrepreneurship. To achieve this objective, it conducted a literature review on entrepreneurship, entrepreneurial intention, and entrepreneurship education to draw from existing experiences in the field. it then carried out an exploratory study through a qualitative survey. it collected real data via an online questionnaire hosted on Google Drive. This questionnaire was tested on a sample of 100 students, adjusted, and validated by three university professors who are experts in the field, and then administered to the students of Al Akhawayn University. The results of our survey among students at Al Akhawayn University clearly show that the development of entrepreneurial intention increases among students who have taken entrepreneurship courses or participated in seminars, thus promoting business creation and entrepreneurship. A minority of these students still choose to work in the private or public sector; however, the majority express a strong desire to become entrepreneurs. We also noted that some students believe entrepreneurship depends solely on entrepreneurial training, while others think it relies on a combination of training, resources, and personal will.

Keywords: entrepreneurship education, entrepreneurial intention, business creation, al akhawayn university, secondary school curriculum

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Authors: I. Ramalho, S. Campos, M. Dias

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Introduction: Endometriosis may play a role in the pathogenesis of ovarian cancer (OC), however, the risk and prognosis have not been well established. The association between these two pathologies could have an important impact on prevention and early diagnosis of OC. Objective: To analyze the prevalence of endometriosis associated ovarian cancer and related clinical, epidemiological and histopathological issues. Design: We conducted a retrospective case series analysis of patients diagnosed with endometriosis and ovarian cancer in the Gynecology Department of Coimbra University Hospital Center since 2006 to 2015. Methods: We collected data from women diagnosed with ovarian cancer, with anatomopathology records reporting findings of endometriosis in ovarian cancer patients. Patients were retrieved from the pathological records and appropriate medical records were retrospectively reviewed. Statistical analysis was performed using SPSS 22.0. Results: Histological evidence of endometriosis was found in 17 out of 261 patients diagnosed with ovarian cancer (OC) (6.51%). The most usual symptoms were pelvic pain, abdominal distension, asthenia, ascites, weight loss and nausea. Mean age at diagnosis was 61.2 ± 15.1, 41-86 years old, 33.3% were pre-menopausal patients and cancer stage distribution was predominantly stage I (31.3%) and stage III (56.3%). OC occurred unilaterally in 14 patients and 2 patients were diagnosed with a synchronous ovarian and endometrial cancer. Regarding histological type, 10 OC were classified as clear cell carcinoma (CCC), 4 endometrioid carcinomas (EC) and 3 mixed type (clear cell and endometrioid). Four ovarian carcinomas presumably arose from endometriomas: 3 CCC and 1 EC. Conclusions: In accordance with previous studies, clear cell was the most common pathological type in endometriotic patients, followed by endometrioid carcinomas, and two rare synchronous ovarian and endometrial carcinomas were registered. Although endometriosis association to OC is uncommon, endometriosis should be managed with special care in order to early diagnosis.

Keywords: endometriosis, histology, observational study, ovarian cancer

Procedia PDF Downloads 222