Search results for: secondary jet

Authors: S. Murr, S. Phillips

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One of the biggest challenges entering a market with a carsharing or any other shared mobility (SM) service is sound investment decision-making. To support this process, the authors think that a city index evaluating different criteria is necessary. The goal of such an index is to benchmark cities along a set of external measures to answer the main two challenges: financially viability and the understanding of its specific requirements. The authors have consulted several shared mobility projects and industry experts to create such a Shared Mobility City Index (SMCI). The current proposal of the SMCI consists of 11 individual index measures: general data (demographics, geography, climate and city culture), shared mobility landscape (current SM providers, public transit options, commuting patterns and driving culture) and political vision and goals (vision of the Mayor, sustainability plan, bylaws/tenders supporting SM). To evaluate the suitability of the index, 16 cities on the East Coast of North America were selected and secondary research was conducted. The main sources of this study were census data, organisational records, independent press releases and informational websites. Only non-academic sources where used because the relevant data for the chosen cities is not published in academia. Applying the index measures to the selected cities resulted in three major findings. Firstly, density (city area divided by number of inhabitants) is not an indicator for the number of SM services offered: the city with the lowest density has five bike and carsharing options. Secondly, there is a direct correlation between commuting patterns and how many shared mobility services are offered. New York, Toronto and Washington DC have the highest public transit ridership and the most shared mobility providers. Lastly, except one, all surveyed cities support shared mobility with their sustainability plan. The current version of the shared mobility index is proving a practical tool to evaluate cities, and to understand functional, political, social and environmental considerations. More cities will have to be evaluated to refine the criteria further. However, the current version of the index can be used to assess cities on their suitability for shared mobility services and will assist investors deciding which city is a financially viable market.

Keywords: carsharing, transportation, urban planning, shared mobility city index

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Authors: D. Nagalakshmi, S. Parashuramulu K. Sadasiva Rao, G. Aruna, L. Vikram

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The zinc (Zn) is the second most abundant trace element in mammals and birds, forming structural component of over 300 enzymes, playing an important role in anti-oxidant defense, immune response and reproduction. Organic trace minerals are more readily absorbed from the digestive tract and more biologically available compared with its inorganic salt. Thus, the present study was undertaken on 60 adult female Sprague Dawley rats (275±2.04 g) for experimental duration of 12 weeks to investigate the effect of dietary Zn supplementation from various organic sources on immunity, reproduction, oxidative defense mechanism and blood biochemical profile. The rats were randomly allotted to 30 replicates (2 per replicate) which were in turn randomly allotted to 5 dietary treatments varying in Zn source i.e., one inorganic source (Zn carbonate) and 4 organic sources (Zn-proteinate, Zn-propionate, Zn-amino acid complex and Zn-methionine) so as to supply NRC recommended Zn concentration (12 ppm Zn). Supplementation of organic Zn had no effect on various haematological and serum biochemical constituents compared to inorganic Zn fed rats. The TBARS and protein carbonyls concentration in liver indicative of oxidative stress was comparable between various organic and inorganic groups. The glutathione reductase activity in haemolysate (P<0.05) and reduced glutathione concentration in liver (P<0.01) was higher when fed organic Zn and RBC catalase activity was higher (P<0.01) on Zn methionine compared to other organic sources tested and the inorganic source. The humoral immune response assessed as antibody titres against sheep RBC was higher (P<0.05) when fed organic sources of zinc compared to inorganic source. The cell mediated immune response expressed as delayed type hypersensitivity reaction was higher (P<0.05) in rats fed Zn propionate with no effect of other organic Zn sources. The serum progesterone concentration was higher (P<0.05) in rats fed organic Zn sources compared to inorganic zinc. The data on ovarian folliculogenesis indicated that organic Zn supplementation increased (P<0.05) the number of graafian follicles and corpus luteum with no effect on primary, secondary and tertiary follicle number. The study indicated that rats fed organic sources of Zn had higher antioxidant enzyme activities, immune response and serum progesterone concentration with higher number of mature follicles. Though the effect of feeding various organic sources were comparable, rats fed zinc methionine had higher antioxidant activity and cell mediated immune response was higher in rats on Zn propionate.

Keywords: organic zinc, immune, rats, reproductive

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Authors: Himali Gunasekara, Baddika Jayaratne

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Haematological abnormalities are known to cause Ischemic Stroke or Transient Ischemic Attack (TIA). The identification of haematological correlates plays an important role in a management and secondary prevention. The objective of this study was to describe haematological correlates of stroke and their association between stroke profile. The haematological correlates screened were Lupus Anticoagulant, Dysfibroginemia, Paroxysmal nocturnal haemoglobinurea (PNH), Sickle cell disease, Systemic Lupus Erythematosis (SLE) and Myeloploriferative Neoplasms (MPN). A cross sectional descriptive study was conducted in a sample of 152 stroke patients referred to haematology department of National Hospital of Sri Lanka for thrombophilia screening. Different tests were performed to assess each hematological correlate. Diluted Russels Viper Venom Test and Kaolin clotting time were done to assess Lupus anticoagulant. Full blood count (FBC), blood picture, Sickling test and High Performance Liquid Chromatography were the tests used for detection of Sickle cell disease. Paroxysmal nocturnal haemoglobinurea was assessed by FBC, blood picture, Ham test and Flowcytometry. FBC, blood picture, Janus Kinase 2 (V617F) mutation analysis, erythropoietin level and bone marrow examination were done to look for the Myeloproliferative neoplasms. Dysfibrinogenaemia was assessed by TT, fibrinogen antigen test, clot observation and clauss test. Anti nuclear antibody test was done to look for systemic lupus erythematosis. Among study sample, 134 patients had strokes and only 18 had TIA. The recurrence of stroke/TIA was observed in 13.2% of patients. The majority of patients (94.7%) have had radiological evidence of thrombotic event. One fourth of patients had past thrombotic events while 12.5% had family history of thrombosis. Out of haematological correlates screened, Lupus anticoagulant was the commonest haematological correlate (n=16 ) and dysfibrigonaemia(n=11 ) had the next high prevalence. One patient was diagnosed with Essential thrombocythaemia and one with SLE. None of the patients were positive for screening tests done for sickle cell disease and PNH. The Haematological correlates were identified in 19% of our study sample. Among stroke profile only presence of past thrombotic history was statistically significantly associated with haematological disorders (P= 0.04). Therefore, hematological disorders appear to be an important factor in etiological work-up of stroke patients particularly in patients with past thrombotic events.

Keywords: stroke, transient ischemic attack, hematological correlates, hematological disorders

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Authors: M. Walmsley, S. Elmatarri, S. Mannion

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Introduction: Self-inflicted injury is a recognised cause of major trauma in adults and is an independent indicator of a reduced functional outcome compared to non-intentional major trauma. There is little literature available on the inpatient mental health (MH) management of this vulnerable group. A retrospective review was conducted of inpatient MH management of major trauma patients admitted to a UK regional Major Trauma Centre (MTC). Their outcomes were compared to all major trauma patients. This group of patients required multiple MH interventions whilst on the Major Trauma Ward (MTW) and a had worse functional outcome compared to non-intentional trauma. Method: The national TARN (Trauma Audit and Research Network) database was used to identify patients admitted to a regional MTC over a 2-year period from June 2018 to July 2020. Patients with an ISS (Injury Severity Score) of greater than 15 with a mechanism of either self-harm or high-risk behavior were included for further analysis. Inpatient medical notes were reviewed for MH interventions on the MTW. Further outcomes, including mortality, length of stay (LOS) and Glasgow Outcome Score (GOS) were compared with all major trauma patients for the same time period. Results: A total of 60 patients were identified in the time period and of those, 27 spent time on the MTW. A total of 23 (85%) had a prior MH diagnosis, with 11 (41%) under the care of secondary MH services. Adequate inpatient records for review were available for 24 patients. During their inpatient stay, 8 (33%) were reviewed on the ward by the inpatient MH team. There were 10 interventions required for 6 (25%) patients on the MTW including, sections under the Mental Health Act, transfer to specialist MH facility, pharmacological sedation and security being called to the MTW. When compared to all major trauma patients, those admitted due to self-harm or high-risk behavior had a statistically significantly higher ISS (31.43 vs 24.22, p=0.0001) and LOS (23.51d vs 16.06d, p=0.002). Functional outcomes using the GOS were reduced in this group of patients, GOS 5 (low disability) (51.66% vs. 61.01%) and they additionally had a higher level of mortality, GOS 1 (15.00% vs 11.67%). Discussion: Intentional self-harm is a recognised cause of major trauma in adults and this patient group sustains more severe injuries, requiring a longer hospital stay with worse outcomes compared to all major trauma patients. Inpatient MH interventions are required for a significant proportion of these patients and therefore, there needs to be a close relationship with MH services. There is limited available evidence for how this patient group is best managed as an inpatient to aid their recovery and further work is needed on how outcomes in this vulnerable group can be improved.

Keywords: adult major trauma, attempted suicide, self-inflicted major trauma, inpatient management

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Authors: Amanda Watson

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The goal of this project is to create the conditions wherein every teacher, especially subjectarea experts, sees themselves as a teacher of language and vocabulary. Assessment and observational data suggest that students are not getting the support they need in vocabulary and reading comprehension, and secondary teachers do not currently have the confidence or expertise to provide this support. This study seeks to examine the impact of 10-20 minutes of daily, targeted instruction around orthography and vocabulary on student competence with the navigation of complex vocabulary and comprehension of subject-specific concepts and texts. The first phase of the pilot included 6 participating classroom teachers of grades 9 and 10 English (95 students in total) who administered an initial reading comprehension assessment. The results of this assessment indicated that the vast majority of students were reading below grade level. Teachers were then provided with a slide deck of complete lessons on orthography, vocabulary (etymology, roots and affixes) and reading comprehension strategies. For five weeks, teachers delivered lessons with their students, implementing the recommended evidence-based teaching strategies. Students and teachers completed surveys to provide feedback on the value and impact of the method. The results confirmed that this was new learning for the students and that the teaching strategies improved engagement. The lessons succeeded in providing equitable access to challenge by simultaneously offering theoretical learning to proficient readers, and exposure and practice to weaker readers. A second reading comprehension was administered after 5 weeks of daily instruction. Average scores increased by 41%, and almost every student experienced progress. The first phase was not long enough to measure the impact of the method on vocabulary acquisition or reading comprehension of subject-specific texts, however. The project will use the results of the first phase to design the second phase, and new teaching and learning strategies will be added. The goals of the second phases are to increase motivation, and to grow the daily practice beyond English class and into science and / or math. This team will continue to document a continuation of the daily lessons, Commented [E1]: Please do not use rhetorical questions in the abstract. measure the impact of the strategies, and address questions about the correlation between daily practice and improvements in the skills students need for vocabulary acquisition and disciplinary reading comprehension.

Keywords: adolescent, comprehension, orthography, reading, vocabulary, etymology, word study, disciplinary, teaching strategies

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Authors: Elvis Enowbeyang Tarkang

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Background: Since students in high schools in Cameroon fall within the age group hardest hit by HIV/AIDS, it is assumed that these students might be exposed to sexual risk behaviours. Sexual risk behaviours include engaging in unprotected sexual intercourse, early sexual debut, multiple sexual partners and coerced or forced sex, and these behaviours might predispose youth to HIV transmission. However, little has been explored on the sexual risk behaviours of high school learners in Cameroon. This study aimed at examining the sexual risk behaviours of high school students in an urban town of Cameroon. Method: A quantitative cross sectional design was adopted, using a self-administered questionnaire to collect data from a disproportional stratified simple random sample of 480 (240 male and 240 female) grade 10 to grade 12 students from two participating secondary school in Limbe in the Southwest region of Cameroon August 2014. Descriptive and Chi square statistics were calculated using statistical Package for Social Sciences (SPSS) version 20 software program at the level 0.05. Results: Majority of the respondents, 63.4% reported being sexually active, of whom only 33.2% used condoms consistently. Up to 37% of the sexually active respondents had multiple sexual partners in the past one year before the study, while 23% had multiple sexual partners during the study period. The mean age of first sex was 15.4 years. Among Christians, Pentecostals, 17 (58.6%) were more likely to have experienced sexual coercion than non-Pentecostals, 111 (42.2%) (p= 0.000). Christians, 41 (10.3%) were more likely to have been forced into first sex than Muslims, 0 (0.0%); while among the Christians, Pentecostals, 6 (15.0%) were more likely to have been forced into first sex than non-Pentecostals, 35 (10.9%) (p=0.004). Among the Christians, Pentecostals, 16 (66.7%) were more likely to have experienced sex by age 16 years than non-Pentecostals, 125 (64.1%) (p= 0.000). Students who lived in rented places, 32 (22.7%) were more likely to have had multiple sexual partners than those who lived in their parents’ houses, 35 (18.1%) (p= 0.000). Males, 36 (16.0%) were likely to have had multiple concurrent sexual partners than females, 14 (6.0%) (p=0.002). Students who used condoms consistently, 25 (33.3%) were more likely to have a higher perception of risk of contracting HIV than those who did not use condoms consistently, 38 (29.9%) (p=0.002). Students who lived in their parents’ houses, 35 (35.4%) were more likely to use condoms consistently during sex, than those who lived in rented places, 31 (29.8%) (p=0.021). Students who passed their examinations, 57 (30.9%) were more likely to have used condoms consistently than those with low academic profiles, 24 (27.9%) (p= 0.034). Conclusions and Recommendations: Gender, lack of parental control, religion, academic profile, poverty, place of residence and perception of risk of HIV infection were the main factors associated with sexual risk behaviours among students in urban Cameroon. The findings indicate that sexual risk behaviours exist among high school students in Limbe urban town of Cameroon. There is need for campaigns and interventions to bring about sexual behaviour change.

Keywords: Cameroon, high school students, HIV/AIDS, Limbe urban town, sexual risk behaviours

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Authors: T. Topór, A. Derkowski, P. Ziemiański

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Formation of organic matter (OM)-hosted nanopores upon thermal maturation are one of the key factor controlling methane storage potential in unconventional shale-gas reservoirs. In this study, the subcritical CO₂ and N₂ gas adsorption measurements combined with scanning electron microscopy and supercritical methane adsorption have been used to characterize pore system and methane storage potential in black shales from the Baltic Basin (Poland). The samples were collected from a virtually equivalent Llandovery strata across the basin and represent a complete digenetic sequence, from thermally immature to overmature. The results demonstrate that the thermal maturation is a dominant mechanism controlling the formation of OM micro- and mesopores in the Baltic Basin shales. The formation of micro- and mesopores occurs in the oil window (vitrinite reflectance; leavedVR; ~0.5-0.9%) as a result of oil expulsion from kerogenleft OM highly porous. The generated hydrocarbons then turn into solid bitumen causing pore blocking and substantial decrease in micro- and mesopore volume in late-mature shales (VR ~0.9-1.2%). Both micro- and mesopores are regenerated in a middle of the catagenesis range (VR 1.4-1.9%) due to secondary cracking of OM and gas formation. The micropore volume in investigated shales is almost exclusively controlled by the OM content. The contribution of clay minerals to micropore volume is insignificant and masked by a strong contribution from OM. Methane adsorption capacity in the Baltic Basin shales is predominantly controlled by microporous OM with pores < 1.5 nm. The mesopore volume (2-50 nm) and mesopore surface area have no effect on methane sorption behavior. The adsorbed methane density equivalent, calculated as absolute methane adsorption divided by micropore volume, reviled a decrease of the methane loading potential in micropores with increasing maturity. The highest methane loading potential in micropores is observed for OM before metagenesis (VR < 2%), where the adsorbed methane density equivalent is greater than the density of liquid methane. This implies that, in addition to physical adsorption, absorption of methane in OM may occur before metagenesis. After OM content reduction using NaOCl solution methane adoption capacity substantially decreases, suggesting significantly greater adsorption potential for OM microstructure than for the clay minerals matrix.

Keywords: maturation, methane sorption, organic matter, porosity, shales

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Authors: K. Genise, S. Murthy

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Introductory Statement: The results of this retrospective chart review suggest the effects of bacterial colonization in critically ill children with viral bronchiolitis, currently unproven, are clinically insignificant. Background: Viral bronchiolitis is one of the most prevalent causes of illness requiring hospitalization among children worldwide and one of the most common reasons for admission to pediatric intensive care. It has been hypothesized that co-infection with bacteria results in more severe clinical outcomes. Conversely, the effects of bacterial colonization in critically ill patients with bronchiolitis are poorly defined. Current clinical management of colonized patients consists primarily of supportive therapies with the role of antibiotics remaining controversial. Methods: A retrospective review of all critically ill children admitted to the BC Children’s Hospital Pediatric Intensive Care Unit (PICU) from 2014-2017 with a diagnosis of bronchiolitis was performed. Routine testing in this time frame consisted of complete pathogen testing, including PCR for Streptococcus pneumoniae. Analyses were performed to determine the impact of bacterial colonization and antibiotic use on a primary outcome of PICU length-of-stay, with secondary outcomes of hospital length-of-stay and duration of ventilation. Results: There were 92 patients with complete pathogen testing performed during the assessed timeframe. A comparison between children with detected Streptococcus pneumoniae (n=22) and those without (n=70) revealed no significant (p=0.20) differences in severity of illness on presentation as per Pediatric Risk of Mortality III scores (mean=3.0). Patients colonized with S. pneumoniae had significantly shorter PICU stays (p=0.002), hospital stays (p=0.0001) and duration of non-invasive ventilation (p=0.002). Multivariate analyses revealed that these effects on length of PICU stay and duration of ventilation do not persist after controlling for antibiotic use, presence of radiographic consolidation, age, and severity of illness (p=0.15, p=0.32). The relationship between colonization and duration of hospital stay persists after controlling for these variables (p=0.008). Conclusions: Children with viral bronchiolitis colonized with S. pneumoniae do not appear to have significantly different PICU length-of-stays or duration of ventilation compared to children who are not colonized. Colonized children appear to have shorter hospital stays. The results of this study suggest bacterial colonization is not associated with increased severity of presenting illness or negative clinical outcomes.

Keywords: bronchiolitis, colonization, critical care, pediatrics, pneumococcal, infection

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Authors: David Sudre

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Sport in cinema, like sport in society, has been mainly concerned with men and masculinity. Whether in the boxing ring, on the basketball playgrounds, or on the soccer fields, these films have mostly focused on the trials and tribulations of male athletes, for whom women have very generally played secondary, often devalued and devaluing roles, such as that of the loving and indispensable woman to the victorious athlete, that of the dangerous femme fatale, or that of the woman as a sexual object. For more than a century, this film genre has, on the contrary, symbolized the dominant values of patriotism, heroism and contributed at the same time to build an ideal of hegemonic masculinity. With the exception of films such as The Grand National (1944) and Million Dollar Baby (2004), the most commercially successful films tell the story of men's adventures in sports. Today, thanks in part to the struggles of the feminist movement and subsequent societal advances, we are seeing an increase in the number of women in increasingly prominent roles in sports films. Indeed, there seems to be a general shift in popular cinema toward women playing major characters in big-budget productions that have also achieved critical and commercial success. However, if, at first sight, the increase in the number of roles given to women suggests an evolution and a more positive image of them on the screen, it will be necessary to see how their representation is really characterized when they are young and occupy major roles in this type of film. In order to answer this question, we will rely on the results of research conducted on a corpus of 28 sports films in which a young woman plays the main role in the story. All of these productions are fictional (not documentary), mostly American, and distributed by major film studios. The chosen sports teen movies are among the biggest commercial successes of the genre and aim to make the maximum profit and occupy the most dominant positions within the "commercial pole" of the cinematic field. Therefore, this research will allow us, although a change has taken place in the last decades in the number of main roles granted to sportswomen, to decode the sociological subtext of these popular sports films for teenagers. The aim is to reveal how these sports films convey a conservative ideology that participates, on the one hand, in the maintenance of patriarchy and, on the other hand, in the dissemination of stereotyped, negative, and regressive images of young women athletes.

Keywords: cinema, sport, gender, youth, representations, inequality, stereotypes

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Authors: Barakat Adebisi Raji

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In the workplace, Artificial Intelligence has, in recent years, emerged as a transformative technology that revolutionizes how organizations operate and perform tasks. It is a technology that has a significant impact on transportation, manufacturing, education, cyber security, robotics, agriculture, healthcare, and so many other organizations. By harnessing AI technology, workplaces can enhance productivity, streamline processes, and make more informed decisions. Given the potential of AI to change the way we work and its impact on the labor market in years to come, employers understand that it entails legal challenges and risks despite the advantages inherent in it. Therefore, as AI continues to integrate into various aspects of the workplace, understanding the legal and ethical implications becomes paramount. Also central to this study is the question of who is held liable where AI makes any defaults; the person (company) who created the AI, the person who programmed the AI algorithm or the person who uses the AI? Thus, the aim of this paper is to provide a detailed overview of how AI-related liabilities are addressed under each legal tradition and shed light on potential areas of accord and divergence between the two legal cultures. The objectives of this paper are to (i) examine the ability of Common law and Islamic law to accommodate the issues and damage caused by AI in the workplace and the legality of compensation for such injury sustained; (ii) to discuss the extent to which AI can be described as a legal personality to bear responsibility: (iii) examine the similarities and disparities between Common Law and Islamic Jurisprudence on the liability of AI in the workplace. The methodology adopted in this work was qualitative, and the method was purely a doctrinal research method where information is gathered from the primary and secondary sources of law, such as comprehensive materials found in journal articles, expert-authored books and online news sources. Comparative legal method was also used to juxtapose the approach of Islam and Common Law. The paper concludes that since AI, in its current legal state, is not recognized as a legal entity, operators or manufacturers of AI should be held liable for any damage that arises, and the determination of who bears the responsibility should be dependent on the circumstances surrounding each scenario. The study recommends the granting of legal personality to AI systems, the establishment of legal rights and liabilities for AI, the establishment of a holistic Islamic virtue-based AI ethics framework, and the consideration of Islamic ethics.

Keywords: AI, health- care, agriculture, cyber security, common law, Shari'ah

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Authors: Arpit Gite

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Purpose: We have evaluated the role of Total Neoadjuvant Therapy in patients with Locally Advanced Rectal cancer by giving Chemoradiotherapy followed by consolidation chemotherapy (CRT-CNCT) and, after that, the strategy of wait and watch. Methods: In this prospective case series, we evaluated the results of three locally advanced Rectal cancers, two cases Stage II (cT3N0) and one case Stage III ( cT4aN2). All three patients' growth was 4-6 cm from the anal verge. We have treated with Chemoradiotherapy to dose of 45Gy/25 Fractions to elective nodal regions (Inguinal node in anal canal Involvement)and Primary and mesorectum (Phase I) followed by 14.4Gy/8 Fractions to Primary and Mesorectum(Phase II) to a total dose of 59.4Gy/33 Fractions with concurrent chemotherapy Tab Capecitabine 825mg/m2 PO BD with Radiation therapy. After 6 weeks of completion of Chemoradiotherapy, advised six cycles of consolidative chemotherapy, CAPEOX regimen, Oxaliplatin 130mg/m2 on day 1 and Capecitabine 1000mg/m2 PO BD on days 1-14 repeated on a 21-day cycle for a total of six cycles. The primary endpoint is Disease-free survival (DFS); the secondary endpoint is adverse events related to chemoradiotherapy. Radiation toxicity is assessed by RTOG criteria, and chemotherapy toxicity is assessed by Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0. Results: After 6 weeks of completion of Chemoradiotherapy, we did PET-CT of all three patients; all three patients had a clinically complete response and we advised 6 cycles of consolidative chemotherapy. After completion of consolidative chemotherapy, again PET-CT and sigmoidoscopy, all three patients had complete response on PET-CT and no lesions on sigmoidoscopy and kept all three patients on wait and watch.2 patients had Grade 2 skin toxicities,1 patient had Grade 1 skin toxicity, .2 patients had Grade 2 lower GI toxicities, and 1 patient had Grade lower GI toxicity, both according to RTOG criteria. 3 patients had Grade 2 diarrhea due to capecitabine, and 1 patient had Grade 1 thrombocytopenia due to oxaliplatin assessed by Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0. Conclusion: Sphincter Preservation is possible with this regimen in those who don’t want to opt for surgery or in case of low-lying rectal cancer.

Keywords: locally advanced rectal cancer, sphincter preservation, chemoradiotherapy, consolidative chemotherapy

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Authors: H.C. Chen, S. W. C. Chan, K. Cheng, A. Vathsala, H. K. Sran, H. He

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Background: End-stage renal disease (ESRD) is the last stage of chronic kidney disease. The numbers of patients with ESRD have increased worldwide due to the growing number of aging, diabetes and hypertension populations. Patients with ESRD suffer from physical illness and psychological distress due to complex treatment regimens, which often affect the patients’ social and psychological functioning. As a result, the patients may fail to perform daily self-care and self-management, and consequently experience worsening conditions. Aims: The study aims to examine the effectiveness of a self-efficacy psychoeducational programme on primary outcome (self-efficacy) and secondary outcomes (psychological wellbeing, treatment adherence, and quality of life) in patients with ESRD and haemodialysis in Singapore. Methodology: A randomised controlled, two-group pretest and repeated posttests design will be carried out. A total of 154 participants (n=154) will be recruited. The participants in the control group will receive a routine treatment. The participants in the intervention group will receive a self-efficacy psychoeducational programme in addition to the routine treatment. The programme is a two-session of educational intervention in a week. A booklet, two consecutive sessions of face-to-face individual education, and an abdominal breathing exercise are adopted in the programme. Outcome measurements include Dialysis Specific Self-efficacy Scale, Kidney Disease Quality of Life- 36 Hospital Anxiety and Depression Scale, Renal Adherence Attitudes Questionnaire and Renal Adherence Behaviour Questionnaire. The questionnaires will be used to measure at baseline, 1- and 3- and 6-month follow-up periods. Process evaluation will be conducted with a semi-structured face to face interview. Quantitative data will be analysed using SPSS21.0 software. Qualitative data will be analysed by content analysis. Significance of the study: This study will identify a clinically useful and potentially effective approach to help patients with end-stage renal disease and haemodialysis by enhancing their self-efficacy in self-care behaviour, and therefore improving their psychological wellbeing, treatment adherence and quality of life. This study will provide information to develop clinical guidelines to improve patients’ disease self-management and to enhance health-related outcomes. Hopefully it will help reducing disease burden.

Keywords: end-stage renal disease (ESRD), haemodialysis, psychoeducation, self-efficacy

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Authors: Madhvi Bhayani

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Introduction: Due to the rapid pace of urbanization, the urban health issues have become one of the significant threats to future development in India. It also poses serious repercussions on the citizen’s health. As urbanization in India is increasing at an unprecedented rate and it has generated the urban health crisis among the city dwellers especially the urban poor. The increasing proportion of the urban poor and vulnerable to the health indicators worse than the rural counterparts, they face social and financial barriers in accessing healthcare services and these conditions make human health at risk. The Local as well as the State and National governments are alike tackling with the challenges of urbanization as it has become very essential for the government to provide the basic necessities and better infrastructure that make life in cities safe and healthy. Thus, the paper argues that if no major realistic steps are taken with immediate effect, the citizens will face a huge burden of health hazards. Aim: This paper attempts to analyze the current infrastructure, government planning, and its future policy, it also discusses the challenges and outcomes of urbanization on health and its impact on it and it will also predict the future trend with regard to disease burden in the urban areas. Methods: The paper analyzes on the basis of the secondary data by taking into consideration the connection between the Rapid Urbanization and Public Health Challenges, health and health care system and its services delivery to the citizens especially to the urban poor. Extensive analyses of government census reports, health information and policy, the government health-related schemes, urban development and based on the past trends, the future status of urban infrastructure and health outcomes are predicted. The social-economic and political dimensions are also taken into consideration from regional, national and global perspectives, which are incorporated in the paper to make realistic predictions for the future. Findings and Conclusion: The findings of the paper show that India suffers a lot due to the double burden of rapidly increasing in diseases and also growing health inequalities and disparities in health outcomes. Existing tools of governance of urban health are falling short to provide the better health care services. They need to strengthen the collaboration and communication among the state, national and local governments and also with the non-governmental partners. Based on the findings the policy implications are then described and areas for future research are defined.

Keywords: health care, urbanization, urban health, service delivery

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Authors: Vipin Kumar Verma, Neeta Sehgal, Om Prakash

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Cyprinus carpio has a wide spread occurrence in the lakes and rivers of Europe and Asia. Heavy losses in natural environment due to anthropogenic activities, including pollution as well as pathogenic diseases have landed this fish in IUCN red list of vulnerable species. The significance of a suitable diet in preserving the health status of fish is widely recognized. In present study, artificial feed supplemented with leaves of two weed plants, Eichhornia crassipes and Ricinus communis were evaluated for their role on the fish immune system. To achieve this objective fish were acclimatized to laboratory conditions (25 ± 1 °C; 12 L: 12D) for 10 days prior to start of experiment and divided into 4 groups: non-challenged (negative control= A), challenged [positive control (B) and experimental (C & D)]. Group A, B were fed with non-supplemented feed while group C & D were fed with feed supplemented with 5% Eichhornia crassipes and 5% Ricinus communis respectively. Supplemented feeds were evaluated for their effect on growth, health, immune system and disease resistance in fish when challenged with Vibrio harveyi. Fingerlings of C. carpio (weight, 2.0±0.5 g) were exposed with fresh overnight culture of V. harveyi through bath immunization (concentration 2 Χ 105) for 2 hours on 10 days interval for 40 days. The growth was monitored through increase in their relative weight. The rate of mortality due to bacterial infection as well as due to effect of feed was recorded accordingly. Immune response of fish was analyzed through differential leucocyte count, percentage phagocytosis and phagocytic index. The effect of V. harveyi on fish organs were examined through histo-pathological examination of internal organs like spleen, liver and kidney. The change in the immune response was also observed through gene expression analysis. The antioxidant potential of plant extracts was measured through DPPH and FRAP assay and amount of total phenols and flavonoids were calculates through biochemical analysis. The chemical composition of plant’s methanol extracts was determined by GC-MS analysis, which showed presence of various secondary metabolites and other compounds. Investigation revealed immuno-modulatory effect of plants, when supplemented with the artificial feed of fish.

Keywords: immuno-modulation, gc-ms, Cyprinus carpio, Eichhornia crassipes, Ricinus communis

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Authors: Abderahim Ahmadou, Alfredo Napoli, Noel Durand, Didier Montet

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Biochar is a microporous and adsorbent solid carbon product obtained from the pyrolysis of various organic materials (biomass, agricultural waste). Biochar is distinguished from vegetable charcoal by its manufacture methods. Biochar is used as the amendment in soils to give them favorable characteristics under certain conditions, i.e., absorption of water and its release at low speed. Cashew nuts shell from Mali is usually discarded on land by local processors or burnt as a mean for waste management. The burning of this biomass poses serious socio-environmental problems including greenhouse gas emission and accumulation of tars and soot on houses closed to factories, leading to neighbor complaints. Some mycotoxins as aflatoxins are carcinogenic compounds resulting from the secondary metabolism of molds that develop on plants in the field and during their conservation. They are found at high level on some seeds and nuts in Africa. Ochratoxin A, member of mycotoxins, is produced by various species of Aspergillus and Penicillium. Human exposure to Ochratoxin A can occur through consumption of contaminated food products, particularly contaminated grain, as well as coffee, wine grapes. We showed that cashew shell biochars produced at 400, 600 and 800°C adsorbed aflatoxins (B1, B2, G1, G2) at 100% by filtration (rapid contact) as well as by stirring (long contact). The average percentage of adsorption of Ochratoxin A was 35% by filtration and 80% by stirring. The duration of the biochar-mycotoxin contact was a significant parameter. The effect of biochar was also tested on two strains of toxigenic molds: Aspergillus parasiticus (producers of Aflatoxins) and Aspergillus carbonarius (producers of Ochratoxins). The growth of the strain Aspergillus carbonarius was inhibited at up to 60% by the biochar at 600°C. An opposite effect to the inhibition was observed on Aspergillus parasiticus using the same biochar. In conclusion, we observed that biochar adsorbs mycotoxins: Aflatoxins and Ochratoxin A to different degrees; 100% adsorption of aflatoxins under all conditions (filtration and stirring) and adsorption of Ochratoxin A varied depending on the type of biochar and the experiment conditions (35% by filtration and 85% by stirring). The effects of biochar at 600 °C on the toxigenic molds: Aspergillus parasiticus and Aspergillus carbonarius, varied according to the experimental conditions and the strains. We observed an opposite effect on the growth with an inhibition of Aspergillus carbonarius up to 60% and a stimulated growth of Aspergillus parasiticus.

Keywords: biochar, cashew nut shell, mycotoxins, toxicogenic molds

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Authors: Grace Fangmin Tan, Elaine Yiling Tay, Elizabeth Huiwen Tham, Andrea Wei Ching Yeo

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Background: While accidental poisonings in children may seem unavoidable, knowledge of circumstances surrounding such incidents and identification of risk factors is important in the development of secondary prevention strategies. Some risk factors include age of the child, lack of adequate supervision and improper storage of substances. The aim of this study is to assess risk factors and circumstances influencing outcomes in these children. Methodology: A retrospective medical record review of all accidental poisoning cases presenting to the Children’s Emergency at National University Hospital (NUH), Singapore between January 2014 and December 2015 was conducted. Information on demographics, poisoning circumstances and clinical outcomes were collected. Results: Ninety-nine of a total of 186 poisoning cases were accidental ingestions, with a mean age of 4.7 (range 0.4 to 18.3 years). The gender distribution is rather equal with 52(52.5%) females and 47(47.5%) males. Seventy-nine (79.8%) were self-administered by the child and in 20 cases (20.2%), the substance was administered erroneously by caregivers 12/20 (60.0%) of whom were given the wrong drug dose while 8/20 (40.0%) were given the wrong substance. Self-administration was associated with presentation to the ED within 12 hours (p=0.027, OR 6.65, 95% CI 1.24-35.72). Notably, 94.9% of the cases involved substances kept within reach of the child. Sixty-nine (82.1%) had the substance kept in the original container, 3(3.6%) in food containers, 8(9.5%) in other containers and 4(4.8%) without a container. Of the 50 cases with information on labelling, 40/50(80.0%) were accurately labelled, 2/50 (4.0%) wrongly labelled, and 8/50 (16.0%) were unlabelled. Implicated substances included personal care products (11.1%), household cleaning products (3.0%), and different classes of drugs such as paracetamol (22.2%), antihistamines (17.2%) and sympathomimetics (8.1%). Children < 3 years of age were 4.8 times more likely to be poisoned by household substances than children >3 years of age (p=0.009, 95% CI 1.48-15.77). Prehospital interventions were more likely to have been done in poisoning with household substances (p=0.005, OR 6.12 95% CI 1.73-21.68). Fifty-nine (59.6%) were asymptomatic, 34 (34.3%) had a Poisoning Severity Score (PSS) grade of 1 (minor) and 6 (6.1%) grade 2 (moderate). Older children were 9.3 times more likely to be symptomatic (p<0.001, 95% CI 3.15-27.25). Thirty (32%) required admission. Conclusion: A significant proportion of accidental poisoning cases were due to medication administration errors by caregivers, which should be preventable. Risk factors for accidental poisoning included lack of adequate caregiver supervision, improper labelling and young age of the child. There is an urgent need to improve caregiver counselling during medication dispensing as well as to educate caregivers on basic child safety measures in the home to prevent future accidental poisonings.

Keywords: accidental, caregiver, paediatrics, poisoning

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Authors: Nino Naneishvili

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The study of religious minorities and their musical culture has attracted scant academic attention in Georgia. Within wider Georgian society, it would seem that the focus of discourse to date has been on the traditional orthodox religion and its musical expression, with other forms of religious expression regarded as intrinsically less valuable. The goal of this article is to study Georgia's different religious and musical picture which, this time, is presented on the example of the Pentecostals. The first signs of the Pentecostal movement originated at the end of the 19th Century in the USA, and first appeared in Georgia as early as 1914. An ethnomusicological perspective allows the use of anthropological and sociological approaches. The basic methodology is an ethnographic method. This involved attending religious services, observation, in-depth interviews and musical material analysis. This analysis, based on a combined use of various theoretical and methodological approaches, reveals that Georgian Pentecostals, apart from polyphonic singing, are characterised by “ bi-musicality.“ This phenomenon together with Georgian three part polyphony combines vocalisation within “social polyphony.“ The concept of back stage and front stage is highlighted. Chanters also try to express national identity. In some cases however it has been observed that they abandon or conceal certain musical forms of expression which are considered central to Georgian identity. The famous hymn “Thou art a Vineyard” is a case in point. The reason given for this omission within the Georgian Pentecostal church is that within Pentecostal doctrine, God alone is the object of worship. Therefore there is no veneration of Saints as representatives of the Divine. In some cases informants denied the existence of this hymn, and others explain that the meaning conveyed to the Vineyard is that of Jesus Christ and not the Virgin Mary. Others stated that they loved Virgin Mary and were therefore free to sing this song outside church circles. The results of this study illustrates that one of the religious minorities in Georgia, the Pentecostals, are characterised by a deviation in musical thinking from Homo Polyphonicus. They actively change their form of musical worship to secondary ethno hearing – bi-musicality. This outcome is determined by both new religious thinking and the process of globalization. A significant principle behind this form of worship is the use of forms during worship which are acceptable and accessible to all. This naturally leads to the development of modern forms. Obtained material does not demonstrate a connection between traditional religious music in general. Rather, it constitutes an independent domain.

Keywords: Georgia, globalization, music, pentecostal

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Authors: Mohamed Raouf Benmakrelouf, Joseph Rynkiewicz

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Targeted maximum likelihood estimation (TMLE) is well-established method for causal effect estimation with desirable statistical properties. TMLE is a doubly robust maximum likelihood based approach that includes a secondary targeting step that optimizes the target statistical parameter. A causal interpretation of the statistical parameter requires assumptions of the Rubin causal framework. The causal effect of binary variable, E, on outcomes, Y, is defined in terms of comparisons between two potential outcomes as E[YE=1 − YE=0]. Our aim in this paper is to present an adaptation of TMLE methodology to estimate the causal effect of a non-binary categorical variable, providing a large application. We propose coding on the initial data in order to operate a binarization of the interest variable. For each category, we get a transformation of the non-binary interest variable into a binary variable, taking value 1 to indicate the presence of category (or group of categories) for an individual, 0 otherwise. Such a dummy variable makes it possible to have a pair of potential outcomes and oppose a category (or a group of categories) to another category (or a group of categories). Let E be a non-binary interest variable. We propose a complete disjunctive coding of our variable E. We transform the initial variable to obtain a set of binary vectors (dummy variables), E = (Ee : e ∈ {1, ..., |E|}), where each vector (variable), Ee, takes the value of 0 when its category is not present, and the value of 1 when its category is present, which allows to compute a pairwise-TMLE comparing difference in the outcome between one category and all remaining categories. In order to illustrate the application of our strategy, first, we present the implementation of TMLE to estimate the causal effect of non-binary variable on outcome using simulated data. Secondly, we apply our TMLE adaptation to survey data from the French Political Barometer (CEVIPOF), to estimate the causal effect of education level (A five-level variable) on a potential vote in favor of the French extreme right candidate Jean-Marie Le Pen. Counterfactual reasoning requires us to consider some causal questions (additional causal assumptions). Leading to different coding of E, as a set of binary vectors, E = (Ee : e ∈ {2, ..., |E|}), where each vector (variable), Ee, takes the value of 0 when the first category (reference category) is present, and the value of 1 when its category is present, which allows to apply a pairwise-TMLE comparing difference in the outcome between the first level (fixed) and each remaining level. We confirmed that the increase in the level of education decreases the voting rate for the extreme right party.

Keywords: statistical inference, causal inference, super learning, targeted maximum likelihood estimation

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Authors: Karthik Chamari, Vasudha Rudraraju, Gaurav Chaudhari

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Background: Mantle cell lymphoma (MCL) is one of the mature B cell non-Hodgkin lymphomas (NHL). The course of MCL is moderately aggressive and variable, and it has median overall survival of 8 to 10 years. Ibrutinib, a Bruton’s tyrosine kinase inhibitor, was approved by the United States (US) Food and Drug Administration in November of 2013 for the treatment of MCL patients who have received at least one prior therapy. In this study, we aimed to evaluate whether there has been a change in survival and patterns of second primary malignancies (SPMs) among the MCL population in the US after ibrutinib approval. Methods: Using the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER)-18, we conducted a retrospective study with patients diagnosed with MCL (ICD-0-3 code 9673/3) between 2007 and 2018. We divided patients into two six-year cohorts, pre-ibrutinib approval (2007-2012) and post-ibrutinib approval (2013-2018), and compared relative survival rates (RSRs) and standardized incidence ratios (SIRs) of SPMs between cohorts. Results: We included 9,257 patients diagnosed with MCL between 2007 and 2018 in the SEER-18 survival and SIR registries. Of these, 4,205 (45%) patients were included in the pre-ibrutinib cohort, and 5052 (55%) patients were included in the post-ibrutinib cohort. The median follow-up duration for the pre-ibrutinib cohort was 54 months (range 0 to 143 months), and the post-ibrutinib cohort was 20 months (range 0 to 71 months). There was a significant difference in the five-year RSRs between pre-ibrutinib and post-ibrutinib cohorts (57.5% vs. 62.6%, p < 0.005). Out of the 9,257 patients diagnosed with MCL, 920 developed SPMs. A higher proportion of SPMs occurred in the post-ibrutinib cohort (63%) when compared with the pre-ibrutinib cohort (37%). Non-hematological malignancies comprised most of all SPMs. A higher incidence of non-hematological malignancies occurred in the post-ibrutinib cohort (SIR 1.42, 95% CI 1.29 to 1.56) when compared with the pre-ibrutinib cohort (SIR 1.14, 95% CI 1 to 1.3). There was a statistically significant increase in the incidence of cancers of the respiratory tract (SIR 1.77, 95% CI 1.43 to 2.18), urinary tract (SIR 1.61, 95% CI 1.23 to 2.06) when compared with other non-hematological malignancies in post-ibrutinib cohort. Conclusions: Our study results suggest the relative survival rates have increased since the approval of ibrutinib for mantle cell lymphoma patients. Additionally, for some unclear reasons, the incidence of SPM’s (non-hematological malignancies), mainly cancers of the respiratory tract, urinary tract, have increased in the six years following the approval of ibrutinib. Further studies should be conducted to determine the cause of these findings.

Keywords: mantle cell lymphoma, Ibrutinib, relative survival analysis, secondary primary cancers

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Authors: Elena Listo Ubeda, Miguel Marchamalo Sacristan

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The demand for water doubles every twenty years, at a rate which is twice as fast as the world´s population growth. Despite it´s great importance, water is one of the most degraded natural resources in the world, mainly because of the reduction of natural vegetation coverage, population growth, contamination and changes in the soil use which reduces its capacity to collect water. This situation is especially serious in Central America, as reflected in the Human Development reports. The objective of this project is to assist in the improvement of water production and quality in Central America. In order to do these two watersheds in Costa Rica were selected as experiments: that of the Virilla-Durazno River, located in the extreme north east of the central valley which has an Atlantic influence; and that of the Jabillo River, which flows directly into the Pacific. The Virilla river watershed is located over andisols, and that of the Jabillo River is over alfisols, and both are of great importance for water supply to the Greater Metropolitan Area and the future tourist resorts respectively, as well as for the production of agriculture, livestock and hydroelectricity. The hydrological reaction in different soil-cover complexes, varying from the secondary forest to natural vegetation and degraded pasture, was analyzed according to the evaluation of the properties of the soil, infiltration, soil compaction, as well as the effects of the soil cover complex on erosion, calculated by the C factor of the Revised Universal Soil Loss Equation (RUSLE). A water balance was defined for each watershed, in which the volume of water that enters and leaves were estimated, as well as the evapotranspiration, runoff, and infiltration. Two future scenarios, representing the implementation of reforestation and deforestation plans, were proposed, and were analyzed for the effects of the soil cover complex on the water balance in each case. The results obtained show an increase of the ground water recharge in the humid forest areas, and an extension of the study of the dry areas is proposed since the ground water recharge here is diminishing. These results are of great significance for the planning, design of Payment Schemes for Environmental Services and the improvement of the existing water supply systems. In Central America spatial planning is a priority, as are the watersheds, in order to assess the water resource socially and economically, and securing its availability for the future.

Keywords: Costa Rica, infiltration, soil, water

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Authors: Athena Daniilidou, Maria Platsidou

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Resilience is considered to greatly affect the personal and occupational wellbeing and efficacy of individuals; therefore, it has been widely studied in the social and behavioral sciences. Given its significance, several scales have been created to assess resilience of children and adults. However, most of these scales focus on examining only the internal protective or risk factors that affect the levels of resilience. The aim of the present study is to create a reliable scale that assesses both the internal and the external protective factors that affect Greek teachers’ levels of resilience. Participants were 136 secondary school teachers (89 females, 47 males) from urban areas of Greece. Connor-Davidson Resilience Scale (CD-Risc) and Resilience Scale for Adults (RSA) were used to collect the data. First, exploratory factor analysis was employed to investigate the inner structure of each scale. For both scales, the analyses revealed a differentiated factor solution compared to the ones proposed by the creators. That prompt us to create a scale that would combine the best fitting subscales of the CD-Risc and the RSA. To this end, the items of the four factors with the best fit and highest reliability were used to create the ‘Teachers' resilience scale’. Exploratory factor analysis revealed that the scale assesses the following protective/risk factors: Personal Competence and Strength (9 items, α=.83), Family Cohesion Spiritual Influences (7 items, α=.80), Social Competence and Peers Support (7 items, α=.78) and Spiritual Influence (3 items, α=.58). This four-factor model explained 49,50% of the total variance. In the next step, a confirmatory factor analysis was performed on the 26 items of the derived scale to test the above factor solution. The fit of the model to the data was good (χ2/292 = 1.245, CFI = .921, GFI = .829, SRMR = .074, CI90% = .026-,056, RMSEA = 0.43), indicating that the proposed scale can validly measure the aforementioned four aspects of teachers' resilience and thus confirmed its factorial validity. Finally, analyses of variance were performed to check for individual differences in the levels of teachers' resilience in relation to their gender, age, marital status, level of studies, and teaching specialty. Results were consistent to previous findings, thus providing an indication of discriminant validity for the instrument. This scale has the advantage of assessing both the internal and the external protective factors of resilience in a brief yet comprehensive way, since it consists 26 items instead of the total of 58 of the CD-Risc and RSA scales. Its factorial inner structure is supported by the relevant literature on resilience, as it captures the major protective factors of resilience identified in previous studies.

Keywords: protective factors, resilience, scale development, teachers

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Authors: Gwendolyn Royal-Smith

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Cocaine ranks as one of the world’s most addictive and commonly abused stimulant drugs. Recent evidence indicates that the abuse of cocaine has risen so quickly among females that this group now accounts for about 40 percent of all users in the United States. Neuropsychological studies have demonstrated that specific neural activation patterns carry higher risks for neurocognitive and executive function in cocaine addicted females thereby increasing their vulnerability for poorer treatment outcomes and more frequent post-treatment relapse when compared to males. This study examined secondary data with a convenience sample of 164 cocaine addicted male and females to assess neurocognitive and executive function. The principal objective of this study was to assess whether individual performance on the Stroop Word Color Task is predictive of treatment success by gender. A second objective of the study evaluated whether individual performance employing neurocognitive measures including the Stroop Word-Color task, the Rey Auditory Verbal Learning Test (RALVT), the Iowa Gambling Task, the Wisconsin Card Sorting Task (WISCT), the total score from the Barratte Impulsiveness Scale (Version 11) (BIS-11) and the total score from the Frontal Systems Behavioral Scale (FrSBE) test demonstrated differences in neurocognitive and executive function performance by gender. Logistic regression models were employed utilizing a covariate adjusted model application. Initial analyses of the Stroop Word color tasks indicated significant differences in the performance of males and females, with females experiencing more challenges in derived interference reaction time and associate recall ability. In early testing including the Rey Auditory Verbal Learning Test (RALVT), the number of advantageous vs disadvantageous cards from the Iowa Gambling Task, the number of perseverance errors from the Wisconsin Card Sorting Task (WISCT), the total score from the Barratte Impulsiveness Scale (Version 11) (BIS-11) and the total score from the Frontal Systems Behavioral Scale, results were mixed with women scoring lower in multiple indicators in both neurocognitive and executive function.

Keywords: cocaine addiction, gender, neuropsychology, neurocognitive, executive function

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Authors: Rooma Rani

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The education is really important for the improvement of physical and mental well-being of the school students. It is used to express inner potential, acquire knowledge, develop skills, shape habits, attitudes, values, belief, etc. along with providing strengths and resilience to people to changing situations and allowing them to develop all those capacities which will enable individual to control surrounding environment. Education has a significant effect on the behavior of individuals which helps us in the new situations of everyday life. Educating the child is directing the child’s capacities, attitudes interest, urges, and needs into the most desirable channels. We are the part of 21st century and now a day emotional intelligence is considered more important than intelligence in the success of a person. Success depends on several intelligences and on the control of emotions too. Emotional Intelligence, like general intelligence is the product of one’s heredity and its interaction with his environmental forces. There are certain methods evolved in modern researches. Keeping in view the nature and purpose of the study, the descriptive survey method is preferred. This method is one of the important methods in education research because it describes the current position of the phenomenon under study. The term descriptive survey is generally used for the type of research which proposes to condition of practices of the present time. In the present study, a systematically random sampling method was used to select a representative sample. 50 students were selected from 2 schools. Out of 50 students, 25 were boys and 25 were girls. In the study, a) it has been found a significant difference in the level of adjustment between male and female students; b) it has been found a non-significant difference in the level of emotional intelligence between male and female students; c) it has been found a non-significant relationship between adjustment and emotional intelligence among male students; d) it has been found a significant relationship between adjustment and emotional intelligence among male students. The results of the study indicated that amongst the students those who possess high scores on emotional intelligence tests are high in level of adjustment. Measures should be adopted to improve and sustain the emotional intelligence level of students throughout their studies. Adolescent students are prone to many problems like physical, social and psychological. They need a congenial home atmosphere so that they grow into full-fledged citizens of our country. After understanding these, it helps in the development of personality which leads to a better learning situation and better thinking capacities, in turn, enhances adjustment and achievement along with a better perception of self.

Keywords: adjustment, education, emotional intelligence, students

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Authors: Abdul Mutolib, Yonariza Mahdi, Hanung Ismono

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The existence of forests is essential to human lives on earth, but its existence is threatened by forest deforestations and degradations. Forest deforestations and degradations in Indonesia is not only caused by the illegal activity by the company or the like, even today many cases in Indonesia forest damage caused by human activities, one of which cut down forests for agriculture and plantations. In West Sumatra, community forest management are the result supported the enactment of customary land tenure, including ownership of land within the forest. Indigenous forest management have a positive benefit, which gives the community an opportunity to get livelihood and income, but if forest management practices by indigenous peoples is not done wisely, then there is the destruction of forests and cause adverse effects on the environment. Based on intensive field works in Dhamasraya District employing some data collection techniques such as key informant interviews, household surveys, secondary data analysis, and satellite image interpretation. This paper answers the following questions; how the impact of forest management by local communities on forest conditions (foccus in Forest Production and Limited Production Forest) and knowledge of the local community on the benefits of forests. The site is a Nagari Bonjol, Dharmasraya District, because most of the forest in Dharmasraya located and owned by Nagari Bonjol community. The result shows that there is damage to forests in Dharmasraya because of forest management activities by local communities. Damage to the forest area of 33,500 ha in Dharmasraya because forests are converted into oil palm and rubber plantations with monocultures. As a result of the destruction of forests, water resources are also diminishing, and the community has experienced a drought in the dry season due to forest cut down and replaced by oil palm plantations. Knowledge of the local community on the benefits of low forest, the people considered that the forest does not have better benefits and cut down and converted into oil palm or rubber plantations. Local people do not understand the benefits of ecological and environmental services that forests. From the phenomena in Dharmasraya on land ownership, need to educate the local community about the importance of protecting the forest, and need a strategy to integrate forests management to keep the ecological functions that resemble the woods and counts the economic benefits for the welfare of local communities. One alternative that can be taken is to use forest management models agroforestry smallholders in accordance with the characteristics of the local community who still consider the economic, social and environmental.

Keywords: community, customary land, farmer plantations, and forests

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Authors: John Hang Leung, Shyh-Yau Wang, Hei-Tung Yip, Fion, Ho Tsung-chin, Agnes LF Chan

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Objectives: Platinum-resistant ovarian cancer has a short overall survival of 9–12 months and limited treatment options. The combination of immunotherapy and targeted therapy appears to be a promising treatment option for patients with ovarian cancer, particularly to patients with platinum-resistant recurrent ovarian cancer (PRrOC). However, there are no direct head-to-head clinical trials comparing their efficacy and toxicity. We, therefore, used a network to directly and indirectly compare seven newer immunotherapies or targeted therapies combined with chemotherapy in platinum-resistant relapsed ovarian cancer, including antibody-drug conjugates, PD-1 (Programmed death-1) and PD-L1 (Programmed death-ligand 1), PARP (Poly ADP-ribose polymerase) inhibitors, TKIs (Tyrosine kinase inhibitors), and antiangiogenic agents. Methods: We searched PubMed (Public/Publisher MEDLINE), EMBASE (Excerpta Medica Database), and the Cochrane Library electronic databases for phase II and III trials involving PRrOC patients treated with immunotherapy or targeted therapy plus chemotherapy. The quality of included trials was assessed using the GRADE method. The primary outcomes compared were progression-free survival, the secondary outcomes were overall survival and safety. Results: Seven randomized controlled trials involving a total of 2058 PRrOC patients were included in this analysis. Bevacizumab plus chemotherapy showed statistically significant differences in PFS (Progression-free survival) but not OS (Overall survival) for all interested targets and immunotherapy regimens; however, according to the heatmap analysis, bevacizumab plus chemotherapy had a statistically significant risk of ≥grade 3 SAEs (Severe adverse effects), particularly hematological severe adverse events (neutropenia, anemia, leukopenia, and thrombocytopenia). Conclusions: Bevacizumab plus chemotherapy resulted in better PFS as compared with all interested regimens for the treatment of PRrOC. However, statistical differences in SAEs as bevacizumab plus chemotherapy is associated with a greater risk for hematological SAE.

Keywords: platinum-resistant recurrent ovarian cancer, network meta-analysis, immune checkpoint inhibitors, target therapy, antiangiogenic agents

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Authors: Norah Alosayl

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English is considered the most important foreign language in the Kingdom of Saudi Arabia (KSA) because of the usefulness of English as a global language compared to Arabic. As students’ desire to improve their English language skills has grown, English writing has been identified as the most difficult problem for Saudi students in their language learning. Although the English language in Saudi Arabia is taught beginning in the seventh grade, many students have problems at the university level, especially in writing, due to a gap between what is taught in secondary and high schools and university expectations- pupils generally study English at school, based on one book with few exercises in vocabulary and grammar exercises, and there are no specific writing lessons. Moreover, from personal teaching experience at King Saud bin Abdulaziz University, students face real problems with their writing. This paper revolves around the blackboard-based collaborative writing to help the undergraduate Saudi EFL students, in their first year enrolled in two sections of ENGL 101 in the first semester of 2021 at King Saud bin Abdulaziz University, practice the most difficult skill they found in their writing through a small group. Therefore, a sequential mixed methods design will be suited. The first phase of the study aims to highlight the most difficult skill experienced by students from an official writing exam that is evaluated by their teachers through an official rubric used in King Saud bin Abdulaziz University. In the second phase, this study will intend to investigate the benefits of social interaction on the process of learning writing. Students will be provided with five collaborative writing tasks via discussion feature on Blackboard to practice a skill that they found difficult in writing. the tasks will be formed based on social constructivist theory and pedagogic frameworks. The interaction will take place between peers and their teachers. The frequencies of students’ participation and the quality of their interaction will be observed through manual counting, screenshotting. This will help the researcher understand how students actively work on the task through the amount of their participation and will also distinguish the type of interaction (on task, about task, or off-task). Semi-structured interviews will be conducted with students to understand their perceptions about the blackboard-based collaborative writing tasks, and questionnaires will be distributed to identify students’ attitudes with the tasks.

Keywords: writing difficulties, blackboard-based collaborative writing, process of learning writing, interaction, participations

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Authors: Frezer Okubay Weldegebriel

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The tourism sector in Ethiopia plays a significant role in the national economy. The government is granting its pledge and readiness to develop this sector through various initiatives since to eradicate poverty and encourage economic development of the country is one of the Millennium Development plans. The tourism sector has been identified as one of the priority economic sectors by many countries, and the Government of Ethiopia has planned to make Ethiopia among the top five African destinations by 2020. Nevertheless, the international tourism demand for Ethiopia currently lags behind other African countries such as South Africa, Egypt, Morocco, Tanzania, and Kenya. Meanwhile, the number of international tourists’ arrival in Ethiopia is recently increasing even if it cannot be competitive with other African countries. Therefore, to offer demand-driven tourism products, the Ethiopian government, Tourism planners, Tour & Travel operators need to understand the important factors, which affect international tourists’ decision to visit Ethiopian destinations. This study was intended to analyze Italian Tourists Demand towards Ethiopian destination. The researcher aimed to identify the demand for Italian tourists’ preference to Ethiopian destinations comparing to the top East African countries. This study uses both qualitative and quantitative research methodology, and the data is manipulating through primary data collection method using questionnaires, interviews, and secondary data by reviewing books, journals, magazines, past researches, and websites. An active and potential Italian tourist cohort, five well-functioning tour operators based in Ethiopia for Italian tourists and professionals from Ethiopian Ministry of Tourism and Culture participated. Based on the analysis of the data collected through the questionnaire, interviews, and reviews of different materials, the study disclosed that the majority of Italian tourists have a high demand on Ethiopian Tourist destination. Historical and cultural interest, safety and security, the hospitality of the people and affordable accommodation coast are the main reason for them. However, some Italian tourists prefer to visit Kenya, Tanzania, and Uganda due to the fact that they are fascinated by adventure, safari and beaches, while Ethiopia cannot provide these attractions. Most Italian tourists have little information and practical experiences on Ethiopian tourism possibilities via a tour and travel companies. Moreover, the insufficient marketing campaign and promotion by Ethiopian Government and Ministry of Tourism could also contribute to the failure of Ethiopian tourism.

Keywords: The demand of Italian tourists, Ethiopia economy, Ethiopia tourism destination, promoting Ethiopia tourism

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Authors: Zexiao Zheng, Irene M. C. Lo

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Organic pollutants, ammonia, and bacteria are major contaminants in sewage, which may adversely impact ecosystems without proper treatment. Conventional wastewater treatment plants (WWTPs) are operated to remove these contaminants from sewage but suffer from high carbon emissions and are powerless to remove emerging organic pollutants (EOPs). Herein, we have developed a low operational carbon emissions multifunctional photoelectrochemical (PEC) system for saline sewage treatment to simultaneously remove organic compounds, ammonia, and bacteria, coupled with H2 evolution. A reduced BiVO4 (r-BiVO4) with improved PEC properties due to the construction of oxygen vacancies and V4+ species was developed for the multifunctional PEC system. The PEC/r-BiVO4 process could treat saline sewage to meet local WWTPs’ discharge standard in 40 minutes at 2.0 V vs. Ag/AgCl and completely degrade carbamazepine (one of the EOPs), coupled with significant evolution of H2. A remarkable reduction in operational carbon emissions was achieved by the PEC/r-BiVO4 process compared with large-scale WWTPs, attributed to the restrained direct carbon emissions from the generation of greenhouse gases. Mechanistic investigation revealed that the PEC system could activate chloride ions in sewage to generate reactive chlorine species and facilitate •OH production, promoting contaminants removal. The PEC system exhibited operational feasibility at different pH and total suspended solids concentrations and has outstanding reusability and stability, confirming its promising practical potential. The study combined the simultaneous removal of three major contaminants from saline sewage and H2 evolution in a single PEC process, demonstrating a viable approach to supplementing and extending the existing wastewater treatment technologies. The study generated profound insights into the in-situ activation of existing chloride ions in sewage for contaminants removal and offered fundamental theories for applying the PEC system in sewage remediation with low operational carbon emissions. The developed PEC system can fit well with the future needs of wastewater treatment because of the following features: (i) low operational carbon emissions, benefiting the carbon neutrality process; (ii) higher quality of the effluent due to the elimination of EOPs; (iii) chemical-free in the operation of sewage treatment; (iv) easy reuse and recycling without secondary pollution.

Keywords: contaminants removal, H2 evolution, multifunctional PEC system, operational carbon emissions, saline sewage treatment, r-BiVO4 photoanodes

Procedia PDF Downloads 157

Authors: Gikunda Aloise, Mjema Saida, Barasa Herbert, Wanyungu John, Kimani Maureen

Abstract:

Background: Community Health Workforce (CHW) is health care providers at the community level (Level 1) and serves as a bridge between the community and the formal healthcare system. This human resource has enormous potential to extend healthcare services and ensures that the vulnerable, marginalized, and hard-to-reach populations have access to quality healthcare services at the community and primary health facility levels. However, these cadres are neither recognized, remunerated, nor in most instances, registered in a master list. Management and supervision of CHWs is not easy if their individual demographics, training capacity and incentives is not well documented through a centralized registry. Description: In February 2022, Amref supported the Kenya Ministry of Health in developing a community health workforce database called Community Health Workers Master List Registry (CHWML), which is hosted in Kenya Health Information System (KHIS) tracker. CHW registration exercise was through a sensitization meeting conducted by the County Community Health Focal Person for the Sub-County Community Health Focal Person and Community Health Assistants who uploaded information on individual demographics, training undertaken and incentives received by CHVs. Care was taken to ensure compliance with Kenyan laws on the availability and use of personal data as prescribed by the Data Protection Act, 2019 (DPA). Results and lessons learnt: By June 2022, 80,825 CHWs had been registered in the system; 78,174 (96%) CHVs and 2,636 (4%) CHAs. 25,235 (31%) are male, 55,505 (68%) are female & 85 (1%) are transgender. 39,979. (49%) had secondary education and 2500 (3%) had no formal education. Only 27 641 (34%) received a monthly stipend. 68,436 CHVs (85%) had undergone basic training. However, there is a need to validate the data to align with the current situation in the counties. Conclusions/Next steps: The use of CHWML will unlock opportunities for building more resilient and sustainable health systems and inform financial planning, resource allocation, capacity development, and quality service delivery. The MOH will update the CHWML guidelines in adherence to the data protection act which will inform standard procedures for maintaining, updating the registry and integrate Community Health Workforce registry with the HRH system.

Keywords: community health registry, community health volunteers (CHVs), community health workers masters list (CHWML), data protection act

Procedia PDF Downloads 140

Authors: H. C. Chen, S. W. C. Chan, K. Cheng, A. Vathsala, H. K. Sran, H. He

Abstract:

Background: End-stage renal disease (ESRD) is the last stage of chronic kidney disease. The numbers of patients with ESRD have increased worldwide due to the growing number of aging, diabetes and hypertension populations. Patients with ESRD suffer from physical illness and psychological distress due to complex treatment regimens, which often affect the patients’ social and psychological functioning. As a result, the patients may fail to perform daily self-care and self-management, and consequently experience worsening conditions. Aims: The study aims to examine the effectiveness of a self-efficacy psychoeducational programme on primary outcome (self-efficacy) and secondary outcomes (psychological wellbeing, treatment adherence, and quality of life) in patients with ESRD and haemodialysis in Singapore. Methodology: A randomised controlled, two-group pretest and repeated posttests design will be carried out. A total of 154 participants (n=154) will be recruited. The participants in the control group will receive a routine treatment. The participants in the intervention group will receive a self-efficacy psychoeducational programme in addition to the routine treatment. The programme is a two-session of educational intervention in a week. A booklet, two consecutive sessions of face-to-face individual education, and an abdominal breathing exercise are adopted in the programme. Outcome measurements include Dialysis Specific Self-efficacy Scale, Kidney Disease Quality of Life- 36 Hospital Anxiety and Depression Scale, Renal Adherence Attitudes Questionnaire and Renal Adherence Behaviour Questionnaire. The questionnaires will be used to measure at baseline, 1- and 3- and 6-month follow-up periods. Process evaluation will be conducted with a semi-structured face to face interview. Quantitative data will be analysed using SPSS21.0 software. Qualitative data will be analysed by content analysis. Significance of the study: This study will identify a clinically useful and potentially effective approach to help patients with end-stage renal disease and haemodialysis by enhancing their self-efficacy in self-care behaviour, and therefore improving their psychological well-being, treatment adherence and quality of life. This study will provide information to develop clinical guidelines to improve patients’ disease self-management and to enhance health-related outcomes and it will help reducing disease burden.

Keywords: end-stage renal disease (ESRD), haemodialysis, psychoeducation, self-efficacy

Procedia PDF Downloads 319