Search results for: Mary Rosa Espinosa-Ochoa
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 347

Search results for: Mary Rosa Espinosa-Ochoa

107 A Qualitative Exploration of How Brazilian Immigrant Mothers Living in the United States Obtain Information about Physical Activity and Screen-Viewing for Their Young Children

Authors: Ana Cristina Lindsay, Mary L. Greaney

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Background: Racial/ethnic minority children of low-income immigrant families remain at increased risk of obesity. Consistent with high rates of childhood obesity among racial/ethnic minority children are high rates of physical inactivity and increased levels of sedentary behaviors (e.g., TV and other screen viewing). Brazilians comprise a fast-growing immigrant population group in the US, yet little research has focused on the health issues affecting Brazilian immigrant children. The purpose of this qualitative study was to explore how Brazilian-born immigrant mothers living in the United States obtain information about physical activity and screen-time for their young children. Methods: Qualitative research including focus groups with Brazilian immigrant mothers of preschool-age children living in the U.S. Results: Results revealed that Brazilian immigrant mothers obtain information on young children’s physical activity and screen-time from a variety of sources including interpersonal communication, television and magazines, government health care programs (WIC program) and professionals (e.g., nurses and pediatricians). A noteworthy finding is the significant role of foreign information sources (Brazilian TV shows and magazines) on mothers’ access to information about these early behaviors. Future research is needed to quantify and better understanding Brazilian parents’ access to accurate and sound information related to young children’s physical activity and screen-viewing behaviors. Conclusions: To our knowledge, no existing research has examined how Brazilian immigrant mothers living in the United States obtain information about these behaviors. This information is crucial for the design of culturally appropriate early childhood obesity prevention interventions tailored to the specific needs of this ethnic group.

Keywords: physical activity, scree-time, information, immigrant, mothers, Brazilian, United States

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106 Physicochemical and Microbiological Assessment of Source and Stored Domestic Water from Three Local Governments in Ile-Ife, Nigeria

Authors: Mary A. Bisi-Johnson, Kehinde A. Adediran, Saheed A. Akinola, Hamzat A. Oyelade

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Some of the main problems man contends with are the quantity (source and amount) and quality of water in Nigeria. Scarcity leads to water being obtained from various sources and microbiological contaminations of the water may thus occur between the collection point and the point of usage. Thus, this study aims to assess the general and microbiological quality of domestic water sources and household stored water used within selected areas in Ile-Ife, South-Western part of Nigeria for microbial contaminants. Physicochemical and microbiological examination were carried out on 45 source and stored water samples collected from well and spring in three different local government areas i.e. Ife east, Ife-south, and Ife-north. Physicochemical analysis included pH value, temperature, total dissolved solid, dissolved oxygen, and biochemical oxygen demand. Microbiology involved most probable number analysis, total coliform, heterotrophic plate, faecal coliform, and streptococcus count. The result of the physicochemical analysis of samples showed anomalies compared to acceptable standards with the pH value of 7.20-8.60 for stored and 6.50-7.80 for source samples as the total dissolved solids (TDS of stored 20-70mg/L, source 352-691mg/L), dissolved oxygen (DO of stored 1.60-9.60mg/L, source 1.60-4.80mg/L), biochemical oxygen demand (BOD stored 0.80-3.60mg/L, source 0.60-5.40mg/L). General microbiological quality indicated that both stored and source samples with the exception of a sample were not within acceptable range as indicated by analysis of the MPN/100ml which ranges (stored 290-1100mg/L, source 9-1100mg/L). Apart from high counts, most samples did not meet the World Health Organization standard for drinking water with the presence of some pathogenic bacteria and fungi such as Salmonella and Aspergillus spp. To annul these constraints, standard treatment methods should be adopted to make water free from contaminants. This will help identify common and likely water related infection origin within the communities and thus help guide in terms of interventions required to prevent the general populace from such infections.

Keywords: domestic, microbiology, physicochemical, quality, water

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105 Memory Retrieval and Implicit Prosody during Reading: Anaphora Resolution by L1 and L2 Speakers of English

Authors: Duong Thuy Nguyen, Giulia Bencini

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The present study examined structural and prosodic factors on the computation of antecedent-reflexive relationships and sentence comprehension in native English (L1) and Vietnamese-English bilinguals (L2). Participants read sentences presented on the computer screen in one of three presentation formats aimed at manipulating prosodic parsing: word-by-word (RSVP), phrase-segment (self-paced), or whole-sentence (self-paced), then completed a grammaticality rating and a comprehension task (following Pratt & Fernandez, 2016). The design crossed three factors: syntactic structure (simple; complex), grammaticality (target-match; target-mismatch) and presentation format. An example item is provided in (1): (1) The actress that (Mary/John) interviewed at the awards ceremony (about two years ago/organized outside the theater) described (herself/himself) as an extreme workaholic). Results showed that overall, both L1 and L2 speakers made use of a good-enough processing strategy at the expense of more detailed syntactic analyses. L1 and L2 speakers’ comprehension and grammaticality judgements were negatively affected by the most prosodically disrupting condition (word-by-word). However, the two groups demonstrated differences in their performance in the other two reading conditions. For L1 speakers, the whole-sentence and the phrase-segment formats were both facilitative in the grammaticality rating and comprehension tasks; for L2, compared with the whole-sentence condition, the phrase-segment paradigm did not significantly improve accuracy or comprehension. These findings are consistent with the findings of Pratt & Fernandez (2016), who found a similar pattern of results in the processing of subject-verb agreement relations using the same experimental paradigm and prosodic manipulation with English L1 and L2 English-Spanish speakers. The results provide further support for a Good-Enough cue model of sentence processing that integrates cue-based retrieval and implicit prosodic parsing (Pratt & Fernandez, 2016) and highlights similarities and differences between L1 and L2 sentence processing and comprehension.

Keywords: anaphora resolution, bilingualism, implicit prosody, sentence processing

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104 Machine Learning Model to Predict TB Bacteria-Resistant Drugs from TB Isolates

Authors: Rosa Tsegaye Aga, Xuan Jiang, Pavel Vazquez Faci, Siqing Liu, Simon Rayner, Endalkachew Alemu, Markos Abebe

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Tuberculosis (TB) is a major cause of disease globally. In most cases, TB is treatable and curable, but only with the proper treatment. There is a time when drug-resistant TB occurs when bacteria become resistant to the drugs that are used to treat TB. Current strategies to identify drug-resistant TB bacteria are laboratory-based, and it takes a longer time to identify the drug-resistant bacteria and treat the patient accordingly. But machine learning (ML) and data science approaches can offer new approaches to the problem. In this study, we propose to develop an ML-based model to predict the antibiotic resistance phenotypes of TB isolates in minutes and give the right treatment to the patient immediately. The study has been using the whole genome sequence (WGS) of TB isolates as training data that have been extracted from the NCBI repository and contain different countries’ samples to build the ML models. The reason that different countries’ samples have been included is to generalize the large group of TB isolates from different regions in the world. This supports the model to train different behaviors of the TB bacteria and makes the model robust. The model training has been considering three pieces of information that have been extracted from the WGS data to train the model. These are all variants that have been found within the candidate genes (F1), predetermined resistance-associated variants (F2), and only resistance-associated gene information for the particular drug. Two major datasets have been constructed using these three information. F1 and F2 information have been considered as two independent datasets, and the third information is used as a class to label the two datasets. Five machine learning algorithms have been considered to train the model. These are Support Vector Machine (SVM), Random forest (RF), Logistic regression (LR), Gradient Boosting, and Ada boost algorithms. The models have been trained on the datasets F1, F2, and F1F2 that is the F1 and the F2 dataset merged. Additionally, an ensemble approach has been used to train the model. The ensemble approach has been considered to run F1 and F2 datasets on gradient boosting algorithm and use the output as one dataset that is called F1F2 ensemble dataset and train a model using this dataset on the five algorithms. As the experiment shows, the ensemble approach model that has been trained on the Gradient Boosting algorithm outperformed the rest of the models. In conclusion, this study suggests the ensemble approach, that is, the RF + Gradient boosting model, to predict the antibiotic resistance phenotypes of TB isolates by outperforming the rest of the models.

Keywords: machine learning, MTB, WGS, drug resistant TB

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103 Assessing the Self-Directed Learning Skills of the Undergraduate Nursing Students in a Medical University in Bahrain: A Quantitative Study

Authors: Catherine Mary Abou-Zaid

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This quantitative study discusses the concerns with the self-directed learning (SDL) skills of the undergraduate nursing students in a medical university in Bahrain. The nursing undergraduate student SDL study was conducted taking all 4 years and compiling data collected from the students themselves by survey questionnaire. The aim of the study is to understand and change the attitudes of self-directed learning among the undergraduate students. The SDL of the undergraduate student nurses has been noticed to be lacking and motivation to actually perform without supervision while out-with classrooms are very low. Their use of the resources available on the virtual learning environment and also within the university is not as good as it should be for a university student at this level. They do not use them to their own advantage. They are not prepared for the transition from high school to an academic environment such as a university or college. For some students it is the first time in their academic lives that they have faced sharing a classroom with the opposite sex. For some this is a major issue and we as academics need to be aware of all issues that they come to higher education with. Design Methodology: The design methodology that was chosen was a quantitative design using convenience sampling of the students who would be asked to complete survey questionnaire. This sampling method was chosen because of the time constraint. This was completed by the undergraduate students themselves while in class. The questionnaire was analyzed by the statistical package for social sciences (SPSS), the results interpreted by the researcher and the findings published in the paper. The analyzed data will also be reported on and from this information we as educators will be able to see the student’s weaknesses regarding self-directed learning. The aims and objectives of the research will be used as recommendations for the improvement of resources for the students to improve their SDL skills. Conclusion: The results will be able to give the educators an insight to how we can change the self-directed learning techniques of the students and enable them to embrace the skills and to focus more on being self-directed in their studies rather than having to be put on to a SDL pathway from the educators themselves. This evidence will come from the analysis of the statistical data. It may even change the way in which the students are selected for the nursing programme. These recommendations will be reported to the head of school and also to the nursing faculty.

Keywords: self-directed learning, undergraduate students, transition, statistical package for social sciences (SPSS), higher education

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102 Pathway Linking Early Use of Electronic Device and Psychosocial Wellbeing in Early Childhood

Authors: Rosa S. Wong, Keith T.S. Tung, Winnie W. Y. Tso, King-Wa Fu, Nirmala Rao, Patrick Ip

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Electronic devices have become an essential part of our lives. Various reports have highlighted the alarming usage of electronic devices at early ages and its long-term developmental consequences. More sedentary screen time was associated with increased adiposity, worse cognitive and motor development, and psychosocial health. Apart from the problems caused by children’s own screen time, parents today are often paying less attention to their children due to hand-held device. Some anecdotes suggest that distracted parenting has negative impact on parent-child relationship. This study examined whether distracted parenting detrimentally affected parent-child activities which may, in turn, impair children’s psychosocial health. In 2018/19, we recruited a cohort of preschoolers from 32 local kindergartens in Tin Shui Wai and Sham Shui Po for a 5-year programme aiming to build stronger foundations for children from disadvantaged backgrounds through an integrated support model involving medical, education and social service sectors. A comprehensive set of questionnaires were used to survey parents on their frequency of being distracted while parenting and their frequency of learning and recreational activities with children. Furthermore, they were asked to report children’s screen time amount and their psychosocial problems. Mediation analyses were performed to test the direct and indirect effects of electronic device-distracted parenting on children’s psychosocial problems. This study recruited 873 children (448 females and 425 males, average age: 3.42±0.35). Longer screen time was associated with more psychosocial difficulties (Adjusted B=0.37, 95%CI: 0.12 to 0.62, p=0.004). Children’s screen time positively correlated with electronic device-distracted parenting (r=0.369, p < 01). We also found that electronic device-distracted parenting was associated with more hyperactive/inattentive problems (Adjusted B=0.66, p < 0.01), fewer prosocial behavior (Adjusted B=-0.74, p < 0.01), and more emotional symptoms (Adjusted B=0.61, p < 0.001) in children. Further analyses showed that electronic device-distracted parenting exerted influences both directly and indirectly through parent-child interactions but to different extent depending upon the outcome under investigation (38.8% for hyperactivity/inattention, 31.3% for prosocial behavior, and 15.6% for emotional symptoms). We found that parents’ use of devices and children’s own screen time both have negative effects on children’s psychosocial health. It is important for parents to set “device-free times” each day so as to ensure enough relaxed downtime for connecting with children and responding to their needs.

Keywords: early childhood, electronic device, psychosocial wellbeing, parenting

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101 Exploration of the Possible Link Between Emotional Problems and Cholesterol Levels Among Children Diagnosed with Attention-Deficit Hyperactivity Disorder

Authors: Rosa S. Wong, Keith T.S. Tung, H.W. Tsang, Frederick K. Ho, Patrick Ip

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Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention and hyperactive-impulsive behavior. Evidence shows that ADHD and mood problems such as depression and anxiety often co-occur and yet not everyone with ADHD reported elevated emotional problems. Given that cholesterol is essential for healthy brain development including the regions governing emotion regulation, reports found lower cholesterol levels in patients with major depressive disorder and those with suicide attempt behavior compared to healthy subjects. This study explored whether ADHD adolescents experienced more emotional problems and whether emotional problems correlated with cholesterol levels in these adolescents. This study used a portion of data from the longitudinal cohort study which was designed to investigate the long-term impact of family socioeconomic status on child development. In 2018/19, parents of 300 adolescents (average age: 12.57+/-0.49 years) were asked to rate their children’s emotional problems and report whether their children had doctor-diagnosed psychiatric diseases. We further collected blood samples from 263 children to study their lipid profile (total cholesterol, high-density lipoprotein (HDL)-cholesterol, and low-density lipoprotein (LDL)-cholesterol). Regression analyses were performed to test the relationships between variables of interest. Among 300 children, 27 (9%) had ADHD diagnosis. Analysis based on overall sample found no association between ADHD and emotional problems, but when investigating the relationship by gender, there was a significant interaction effect of ADHD and gender on emotional problems (p=0.037), with ADHD males displaying more emotional problems than ADHD females. Further analyses based on 263 children (21 with ADHD diagnosis) found significant interaction effect of ADHD and gender on total cholesterol (p=0.038) and low LDL-cholesterol levels (p=0.013) after adjusting for the child’s physical disease history. Specifically, ADHD males had significantly lower total cholesterol and low lipoprotein-cholesterol levels than ADHD females. In ADHD males, more emotional problems were associated with lower LDL-cholesterol levels (B = -4.26, 95%CI (-7.46, -1.07), p=0.013). We found preliminary support for the association between more emotional problems and lower cholesterol levels in ADHD children, especially among males. Although larger prospective studies are needed to substantiate these claims, the evidence highlights the importance of healthy lifestyle to keep cholesterol levels in normal range which can have positive effects on physical and mental health.

Keywords: attention-deficit hyperactivity disorder, cholesterol, emotional problems, adolescents

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100 Emily Dickinson's Green Aesthetics: Mode Gakuen Cocoon Tower as the Anthropomorphic Architectural Representation in the Age of Anthropocene

Authors: Chia-Wen Kuo

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Jesse Curran states that there is a "breath awareness" that "facilitates a present-minded capability" to catalyse an "epistemological rupture" in Emily Dickinson's poetry, particularly in the age of Anthropocene. In Dickinson's "Nature", non-humans are subjectified as nature ceases to be subordinated to human interests, and Dickinson's Eco-humility has driven us, readers, into mimicking nature for the making of a better world. In terms of sustainable architecture, Norman Foster is among the representatives who utilise BIM to reduce architectural waste while satiating the users' aesthetic craving for a spectacular skyline. Notably, the Gherkin - 30 St. Mary Axe in east-end London. In 2019, Foster and his team aspired to savour the London skyline with his new design - the Tulip, which has been certified by the LEED as a legitimate green building as well as a complementary extension of the Gherkin. However, Foster's proposition had been denied for numerous times by the mayor Sadiq Khan and the city council as the Tulip cannot blend in the public space around while its observatory functions like a surveillance platform. The Tulip, except for its aesthetic idiosyncrasy, fails to serve for the public good other than another ostentatious tourist attraction in London. The architectural team for Mode Gakuen Cocoon tower, completed in 2008, intended to honour Nature with the symbolism in the building's aesthetic design. It serves as an architectural cocoon that nurtures the students of "Special Technology and Design College" inside. The building itself turns into a Dickinsonian anthropomorphism, where humans are made humble to learn from the entomological beings for self-betterment in the age of Anthropocene. Despite bearing resemblance to a tulip as well as its LEED credential, Norman Foster’s Tulip merely pays tribute to the Nature in a relatively superficial manner without constructing an apparatus that substantially benefit the Londoners as all green cities should embrace Emily Dickinson’s “breath awareness” and be built and treated as an extensive as well as expansive form of biomimicry.

Keywords: green city, sustianable architecture, London, Tokyo

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99 Dogs Chest Homogeneous Phantom for Image Optimization

Authors: Maris Eugênia Dela Rosa, Ana Luiza Menegatti Pavan, Marcela De Oliveira, Diana Rodrigues De Pina, Luis Carlos Vulcano

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In medical veterinary as well as in human medicine, radiological study is essential for a safe diagnosis in clinical practice. Thus, the quality of radiographic image is crucial. In last year’s there has been an increasing substitution of image acquisition screen-film systems for computed radiology equipment (CR) without technical charts adequacy. Furthermore, to carry out a radiographic examination in veterinary patient is required human assistance for restraint this, which can compromise image quality by generating dose increasing to the animal, for Occupationally Exposed and also the increased cost to the institution. The image optimization procedure and construction of radiographic techniques are performed with the use of homogeneous phantoms. In this study, we sought to develop a homogeneous phantom of canine chest to be applied to the optimization of these images for the CR system. In carrying out the simulator was created a database with retrospectives chest images of computed tomography (CT) of the Veterinary Hospital of the Faculty of Veterinary Medicine and Animal Science - UNESP (FMVZ / Botucatu). Images were divided into four groups according to the animal weight employing classification by sizes proposed by Hoskins & Goldston. The thickness of biological tissues were quantified in a 80 animals, separated in groups of 20 animals according to their weights: (S) Small - equal to or less than 9.0 kg, (M) Medium - between 9.0 and 23.0 kg, (L) Large – between 23.1 and 40.0kg and (G) Giant – over 40.1 kg. Mean weight for group (S) was 6.5±2.0 kg, (M) 15.0±5.0 kg, (L) 32.0±5.5 kg and (G) 50.0 ±12.0 kg. An algorithm was developed in Matlab in order to classify and quantify biological tissues present in CT images and convert them in simulator materials. To classify tissues presents, the membership functions were created from the retrospective CT scans according to the type of tissue (adipose, muscle, bone trabecular or cortical and lung tissue). After conversion of the biologic tissue thickness in equivalent material thicknesses (acrylic simulating soft tissues, bone tissues simulated by aluminum and air to the lung) were obtained four different homogeneous phantoms, with (S) 5 cm of acrylic, 0,14 cm of aluminum and 1,8 cm of air; (M) 8,7 cm of acrylic, 0,2 cm of aluminum and 2,4 cm of air; (L) 10,6 cm of acrylic, 0,27 cm of aluminum and 3,1 cm of air and (G) 14,8 cm of acrylic, 0,33 cm of aluminum and 3,8 cm of air. The developed canine homogeneous phantom is a practical tool, which will be employed in future, works to optimize veterinary X-ray procedures.

Keywords: radiation protection, phantom, veterinary radiology, computed radiography

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98 Awareness about Authenticity of Health Care Information from Internet Sources among Health Care Students in Malaysia: A Teaching Hospital Study

Authors: Renjith George, Preethy Mary Donald

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Use of internet sources to retrieve health care related information among health care professionals has increased tremendously as the accessibility to internet is made easier through smart phones and tablets. Though there are huge data available at a finger touch, it is doubtful whether all the sources providing health care information adhere to evidence based practice. The objective of this survey was to study the prevalence of use of internet sources to get health care information, to assess the mind-set towards the authenticity of health care information available via internet sources and to study the awareness about evidence based practice in health care among medical and dental students in Melaka-Manipal Medical College. The survey was proposed as there is limited number of studies reported in the literature and this is the first of its kind in Malaysia. A cross sectional survey was conducted among the medical and dental students of Melaka-Manipal Medical College. A total of 521 students including medical and dental students in their clinical years of undergraduate study participated in the survey. A questionnaire consisting of 14 questions were constructed based on data available from the published literature and focused group discussion and was pre-tested for validation. Data analysis was done using SPSS. The statistical analysis of the results of the survey proved that the use of internet resources for health care information are equally preferred over the conventional resources among health care students. Though majority of the participants verify the authenticity of information from internet sources, there was considerable percentage of candidates who feels that all the information from the internet can be utilised for clinical decision making or were not aware about the need of verification of authenticity of such information. 63.7 % of the participants rely on evidence based practice in health care for clinical decision making while 34.2 % were not aware about it. A minority of 2.1% did not agree with the concept of evidence based practice. The observations of the survey reveals the increasing use of internet resources for health care information among health care students. The results warrants the need to move towards evidence based practice in health care as all health care information available online may not be reliable. The health care person should be judicious while utilising the information from such resources for clinical decision making.

Keywords: authenticity, evidence based practice, health care information, internet

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97 A Gendered Perspective of the Influence of Public Transport Infrastructural Design on Accessibility

Authors: Ajeni Ari, Chiara Maria Leva, Lorraine D’Arcy, Mary Kinahan

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In addressing gender and transport, considerations of mobility disparities amongst users are important. Public transport (PT) policy and design do not efficiently account for the varied mobility practices between men and women, with literature only recently showing a movement towards gender inclusion in transport. Arrantly, transport policy and designs remain gender-blind to the variation of mobility needs. The global movement towards sustainability highlights the need for expeditious strategies that could mitigate biases within the existing system. At the forefront of such a plan of action, in part, may be mandated inclusive infrastructural designs that stimulate user engagement with the transport system. Fundamentally access requires a means or an opportunity for the entity, which for PT is an establishment of its physical environment and/or infrastructural design. Its practicality may be utilised with knowledge of shortcomings in tangible or intangible aspects of the service offerings allowing access to opportunities. To inform on existing biases in PT planning and design, this study analyses qualitative data to examine the opinions and lived experiences among transport users in Ireland. Findings show that infrastructural design plays a significant role in users’ engagement with the service. Paramount to accessibility are service provisions that cater to both user interactions and those of their dependents. Apprehension to use the service is more so evident in women in comparison to men, particularly while carrying out household duties and caring responsibilities at peak times or dark hours. Furthermore, limitations are apparent with infrastructural service offerings that do not accommodate the physical (dis)ability of users, especially universal design. There are intersecting factors that impinge on accessibility, e.g., safety and security, yet essentially; the infrastructural design is an important influencing parameter to user perceptual conditioning. Additionally, data discloses the need for user intricacies to be factored in transport planning geared towards gender inclusivity, including mobility practices, travel purpose, transit time or location, and system integration.

Keywords: infrastructure design, public transport, accessibility, women, gender

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96 Family Medicine Residents in End-of-Life Care

Authors: Goldie Lynn Diaz, Ma. Teresa Tricia G. Bautista, Elisabeth Engeljakob, Mary Glaze Rosal

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Introduction: Residents are expected to convey unfavorable news, discuss prognoses, and relieve suffering, and address do-not-resuscitate orders, yet some report a lack of competence in providing this type of care. Recognizing this need, Family Medicine residency programs are incorporating end-of-life care from symptom and pain control, counseling, and humanistic qualities as core proficiencies in training. Objective: This study determined the competency of Family Medicine Residents from various institutions in Metro Manila on rendering care for the dying. Materials and Methods: Trainees completed a Palliative Care Evaluation tool to assess their degree of confidence in patient and family interactions, patient management, and attitudes towards hospice care. Results: Remarkably, only a small fraction of participants were confident in performing independent management of terminal delirium and dyspnea. Fewer than 30% of residents can do the following without supervision: discuss medication effects and patient wishes after death, coping with pain, vomiting and constipation, and reacting to limited patient decision-making capacity. Half of the respondents had confidence in supporting the patient or family member when they become upset. Majority expressed confidence in many end-of-life care skills if supervision, coaching and consultation will be provided. Most trainees believed that pain medication should be given as needed to terminally ill patients. There was also uncertainty as to the most appropriate person to make end-of-life decisions. These attitudes may be influenced by personal beliefs rooted in cultural upbringing as well as by personal experiences with death in the family, which may also affect their participation and confidence in caring for the dying. Conclusion: Enhancing the quality and quantity of end-of-life care experiences during residency with sufficient supervision and role modeling may lead to knowledge and skill improvement to ensure quality of care. Fostering bedside learning opportunities during residency is an appropriate venue for teaching interventions in end-of-life care education.

Keywords: end of life care, geriatrics, palliative care, residency training skill

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95 Formulation of Suppositories Using Allanblackia Floribunda Butter as a Base

Authors: Mary Konadu

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The rectal route for drug administration is becoming attractive to drug formulators because it can avoid hepatic first-pass effects, decrease gastrointestinal side effects and avoid undesirable effects of meals on drug absorption. Suppositories have been recognized as an alternative to the oral route in situations such as when the patient is comatose, unable to swallow, or when the drug produces nausea or vomiting. Effective drug delivery with appropriate pharmaceutical excipient is key in the production of clinically useful preparations. The high cost of available excipients coupled with other disadvantages have led to the exploration of potential excipients from natural sources. Allanblackia floribunda butter, a naturally occurring lipid, is used for medicinal, culinary, and cosmetic purposes. Different extraction methods (solvent (hexane) extraction, traditional/hot water extraction, and cold/screw press extraction) were employed to extract the oil. The different extracts of A. floribunda oil were analyzed for their physicochemical properties and mineral content. The oil was used as a base to formulate Paracetamol and Diclofenac suppositories. Quality control test were carried out on the formulated suppositories. The %age oil yield for hexane extract, hot water extract, and cold press extract were 50.40 ±0.00, 37.36±0.00, and 20.48±0.00, respectively. The acid value, saponification value, iodine value and free fatty acid were 1.159 ± 0.065, 208.51 ± 8.450, 49.877 ± 0.690 and 0.583 ± 0.032 respectively for hexane extract; 3.480 ± 0.055, 204.672±2.863, 49.04 ± 0.76 and 1.747 ± 0.028 respectively for hot water/traditional extract; 4.43 ± 0.055, 192.05±1.56, 49.96 ± 0.29 and 2.23 ± 0.03 respectively for cold press extract. Calcium, sodium, magnesium, potassium, and iron were minerals found to be present in the A. floribunda butter extracts. The uniformity of weight, hardness, disintegration time, and uniformity of content were found to be within the acceptable range. The melting point ranges for all the suppositories were found to be satisfactory. The cumulative drug release (%) of the suppositories at 45 minutes was 90.19±0.00 (Hot water extract), 93.75±0.00 (Cold Pres Extract), and 98.16±0.00 (Hexane Extract) for Paracetamol suppositories. Diclofenac sodium suppositories had a cumulative %age release of 81.60±0.00 (Hot water Extract), 95.33±0.00 (Cold Press Extract), and 99.20±0.00 (Hexane Extract). The physicochemical parameters obtained from this study shows that Allanblackia floribunda seed oil is edible and can be used as a suppository base. The suppository formulation was successful, and the quality control tests conformed to Pharmacopoeia standard.

Keywords: allanblackia foribunda, paracetamol, diclofenac, suppositories

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94 Comparative Analysis of Political Parties and Political Behavior: The Trend for Democratic Principles

Authors: Mary Edokpa Fadal, Frances Agweda

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Considering the volatile and evolving nature of the political environment in the developing countries, it is important that the subject of effective leadership practices that focus on transformational and systematic political development and values be reviewed. If the attitude towards partisan politics and the played politics by political parties is relatively deviated from expected adherence to acceptance, safe, efficient and practical standard, the political parties will continue to struggle endlessly in an effort to maintain a system that works. The analysis is situated in the context of political parties and partisan political behavior in contemporary societies and developing nations. Recent research of empirical evidence shows that most of the political parties are more or less, not too active in playing their instrumental role in the political system, such as unifying, simplifying and stabilizing the political process. This is however traced to the problem of ethnic politics that have been dominated by tribalism. The rising clamor for political development needs re-structuring and correcting the abnormalities in the center of the polity to address the flaws in our political system. The paper argues that political parties and political actors are some of the vital instrument of attaining societal goals of democratic principles for peace and durability. Issues of ethnic and partisan politics are also discussed, as it relates to question pertaining to political ideologies. It is in the findings that this paper examines some of the issues that have been seen revolving the true practice of political parties and its activities towards the democratic trend of a society, that help to resolve questions surrounding the issues of politics and governance in developing countries. These issues are seen as an aberration that have characterized politics and political behavior especially in the aspect of transparency and fulfilling its purpose of existence. The paper argues that the transition of the developing nature of states largely depends on the political structures and party politics and the nature of constitutionalism following the democratic awakening. The paper concludes that politics and political behavior are all human factors that play a vital role in the development of contemporary societies. They drive the wheel of nations towards its goal attainment. This paper relies on documentary, primary sources of data collection and empirical analysis.

Keywords: development, ethnicity, partisan politics, political behavior, political parties

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93 Evaluation of Occupational Doses in Interventional Radiology

Authors: Fernando Antonio Bacchim Neto, Allan Felipe Fattori Alves, Maria Eugênia Dela Rosa, Regina Moura, Diana Rodrigues De Pina

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Interventional Radiology is the radiology modality that provides the highest dose values to medical staff. Recent researches show that personal dosimeters may underestimate dose values in interventional physicians, especially in extremities (hands and feet) and eye lens. The aim of this work was to study radiation exposure levels of medical staff in different interventional radiology procedures and estimate the annual maximum numbers of procedures (AMN) that each physician could perform without exceed the annual limits of dose established by normative. For this purpose LiF:Mg,Ti (TLD-100) dosimeters were positioned in different body regions of the interventional physician (eye lens, thyroid, chest, gonads, hand and foot) above the radiological protection vests as lead apron and thyroid shield. Attenuation values for lead protection vests were based on international guidelines. Based on these data were chosen as 90% attenuation of the lead vests and 60% attenuation of the protective glasses. 25 procedures were evaluated: 10 diagnostics, 10 angioplasty, and 5-aneurysm treatment. The AMN of diagnostic procedures was 641 for the primary interventional radiologist and 930 for the assisting interventional radiologist. For the angioplasty procedures, the AMN for primary interventional radiologist was 445 and for assisting interventional radiologist was 1202. As for the procedures of aneurism treatment, the AMN for the primary interventional radiologist was 113 and for the assisting interventional radiologist were 215. All AMN were limited by the eye lens doses already considering the use of protective glasses. In all categories evaluated, the higher dose values are found in gonads and in the lower regions of professionals, both for the primary interventionist and for the assisting, but the eyes lens dose limits are smaller than these regions. Additional protections as mobile barriers, which can be positioned between the interventionist and the patient, can decrease the exposures in the eye lens, providing a greater protection for the medical staff. The alternation of professionals to perform each type of procedure can reduce the dose values received by them over a period. The analysis of dose profiles proposed in this work showed that personal dosimeters positioned in chest might underestimate dose values in other body parts of the interventional physician, especially in extremities and eye lens. As each body region of the interventionist is subject to different levels of exposure, dose distribution in each region provides a better approach to what actions are necessary to ensure the radiological protection of medical staff.

Keywords: interventional radiology, radiation protection, occupationally exposed individual, hemodynamic

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92 The Relationship between the Social Entrepreneur and the Social Dimension of Sustainability: A Bibliometric Survey of the Last Twelve Years

Authors: Leticia Lengler, Jefferson Oliveira, Vania Estivalete, Jordana Marques Kneipp, Lucia Regina Da Rosa Gama Madruga

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The way social entrepreneurs act and can positively impact on our society engages the interest of academics, companies and governments, who seek solutions to solve or alleviate issues related to the abuse of natural resources, as well as the increase of poverty (social aspects). Studies on social entrepreneurship have been characterized by diverse ramifications and their transdisciplinary character, permeating various disciplines and approaches. Different bibliometric studies were conducted within the theme of social entrepreneurship. In this context, because it is a topic in development and multifaceted, the aim of this article is to present the main interfaces of the studies on the Social Entrepreneur figure in relation to the social concern of sustainability, highlighting the relevant researches and their trends, as well as their relationship with the organizations. Aiming to achieve this purpose, the specific goals are: to identify the most cited authors and articles, to verify the authors and journals with the greatest number of publications and their approaches and to point out their affiliations, countries, and languages of publications. It is still a secondary objective to identify the emerging trends in relation to the social entrepreneur and his social concern stemming from the discussions on sustainability. This way, we analyzed articles from two international databases (Scopus and Web of Science), from 2004 to 2016. The main results were the increase in the number of publications, with most of them in English language, coming mainly from the United States institutions (such as Indiana University and Harvard University) and the United Kingdom (whose main institutions are University of London and Robert Gordon University). Although publications in Spanish and Portuguese are the least expressive in quantity, some tendencies point to publications that discuss the social entrepreneur in terms of gender (that relates to female entrepreneurship) and social class (that relates to the need of building communities that contemplate the Social entrepreneur at the base of the pyramid). It should be noted that the trends of the themes emerged from the analysis of the publication titles only in Portuguese, since this is the native language of the authors who carry out their studies mainly in Brazil. When considering articles in Portuguese (57 indicated by WOS and 9 by Scopus), a previous analysis of the titles was carried out to identify how researchers were approaching the theme social entrepreneur in a joint way to the social dimension of sustainability. However, the analysis of the titles themselves brought a limitation to our study, since it was felt a need to carry out a qualitative study, in which it could be possible to consider the abstracts of the available articles.

Keywords: base of pyramid, social dimension, social entrepreneur, sustainability

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91 Cord Blood Hematopoietic Stem Cell Expansion Ability of Mesenchymal Stem Cells Isolated From Different Sources

Authors: Ana M. Lara, Manuela Llano, Felipe Gaitán, Rosa H. Bustos, Ana Maria Perdomo-Arciniegas, Ximena Bonilla

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Umbilical cord blood is used as a source of progenitor and stem cells for the regeneration of the hematopoietic and immune system to treat patients with different hematological or non-hematological diseases. This stem cell source represents an advantage over the use of bone marrow or mobilized peripheral blood because it has a lower incidence rate of graft-versus-host disease, probably due to fewer immunological compatibility restrictions. However, its low cellular dose limits its use in pediatric patients. This work proposes the standardization of a cell expansion technique to compensate for the dose of infused cells through the ex-vivo manipulation of hematopoietic progenitor cells from umbilical cord blood before transplantation. The expansion model is carried out through co-cultures with mesenchymal stem cells (MSC) from bone marrow (BM) and less explored fetal tissues such as Wharton's jelly (WJ) and umbilical cord blood (UCB). Initially, a master cell bank of primary mesenchymal stem cells isolated from different sources was established and characterized following International Society of Cell Therapies (ISCT) indications. Additionally, we assessed the effect of a short 25 Gy cycle of gamma irradiation on cell cycle arrest of mesenchymal cells over the support capacity for the expansion of hematopoietic stem cells from umbilical cord blood was evaluated. The results show that co-cultures with MSC from WJ and UCB allow the cellular dose of HSPC to be maximized between 5 and 16 times having a similar support capacity as BM. In addition, was evaluated the hematopoietic stem progenitor cell's HSPC functionality through the evaluation of migration capacity, their differentiation capacity during culture time by flow cytometry to evaluate the expression of membrane markers associated with lineage-committed progenitors, their clonogenic potential, and the evaluation of secretome profile in the expansion process was evaluated. So far, the treatment with gamma irradiation maintains the hematopoietic support capacity of mesenchymal stem cells from the three sources studied compared to treatments without irradiation, favoring the use of fetal tissues that are generally waste to obtain mesenchymal cell lines for ex-vivo expansion systems. With the results obtained, a standardized protocol that will contribute to the development of ex-vivo expansion with MSC on a larger scale will be achieved, enabling its clinical use and expanding its application in adults.

Keywords: ex-vivo expansion, hematopoietic stem cells, hematopoietic stem cell transplantation, mesenchymal stem cells, umbilical cord blood

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90 Opinions and Perceptions of Clinical Staff towards Caring for Obese Patients: A Qualitative Research Study in a Cardiac Centre in Bahrain

Authors: Catherine Mary Abou-Zaid, Sandra Goodwin

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This study was conducted in a cardiac center in Bahrain. The rise in the amount of obese patients’ both men and women, being admitted for surgical procedures has become an issue to the nurses and doctors as these patients pose a high risk of major complications arising from their problem. The cessation of obesity in the country is very high and obesity-related diseases has been the cause of concern among men and women, also related individual diseases such as cardiovascular, diabetes and chronic respiratory diseases are rising dramatically within Bahrain in the last 10 years. Rationale for the Study: The ontological approach will help to understand and assess the true nature of the social world and how the world looks at obesity. Obesity has to be looked at as being a realistic ongoing issue. The epistemological approach will look at the theory of the origins of the nature of knowledge, set the rule of validating and learning in the social world of what can be done to curb this concept and how this can help prevent otherwise preventable diseases. Design Methodology: The qualitative design methodology took the form of an ontological/epistemological approach using phenomenology as a framework. The study was based on a social research issue, therefore, ontological ‘realism and idealism’ will feature as the nature of the world from a social and natural context. Epistemological positions of the study will be how we as researchers will find the actual social world and the limiting of that knowledge. The one-to-one interviews will be transcribed and the taped verbatim will be coded and charted giving the thematic analytic results. Recommendations: The significance of the research brought many recommendations. These recommendations were taken from the themes and sub-themes and were presented to the centers management and the necessary arrangements for updating knowledge and attitudes towards obesity in cardiac patients was then presented to the in-service education department. Workshops and training sessions on promoting health education were organized and put into the educational calendar for the next academic year. These sessions would look at patient autonomy, the patients’ rights, healthy eating for patients and families and the risks associated with obesity in cardiac disease processes.

Keywords: cardiac patients, diabetes, education & training, obesity cessation, qualitative

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89 Modelling for Roof Failure Analysis in an Underground Cave

Authors: M. Belén Prendes-Gero, Celestino González-Nicieza, M. Inmaculada Alvarez-Fernández

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Roof collapse is one of the problems with a higher frequency in most of the mines of all countries, even now. There are many reasons that may cause the roof to collapse, namely the mine stress activities in the mining process, the lack of vigilance and carelessness or the complexity of the geological structure and irregular operations. This work is the result of the analysis of one accident produced in the “Mary” coal exploitation located in northern Spain. In this accident, the roof of a crossroad of excavated galleries to exploit the “Morena” Layer, 700 m deep, collapsed. In the paper, the work done by the forensic team to determine the causes of the incident, its conclusions and recommendations are collected. Initially, the available documentation (geology, geotechnics, mining, etc.) and accident area were reviewed. After that, laboratory and on-site tests were carried out to characterize the behaviour of the rock materials and the support used (metal frames and shotcrete). With this information, different hypotheses of failure were simulated to find the one that best fits reality. For this work, the software of finite differences in three dimensions, FLAC 3D, was employed. The results of the study confirmed that the detachment was originated as a consequence of one sliding in the layer wall, due to the large roof span present in the place of the accident, and probably triggered as a consequence of the existence of a protection pillar insufficient. The results allowed to establish some corrective measures avoiding future risks. For example, the dimensions of the protection zones that must be remained unexploited and their interaction with the crossing areas between galleries, or the use of more adequate supports for these conditions, in which the significant deformations may discourage the use of rigid supports such as shotcrete. At last, a grid of seismic control was proposed as a predictive system. Its efficiency was tested along the investigation period employing three control equipment that detected new incidents (although smaller) in other similar areas of the mine. These new incidents show that the use of explosives produces vibrations which are a new risk factor to analyse in a next future.

Keywords: forensic analysis, hypothesis modelling, roof failure, seismic monitoring

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88 Maternal and Child Health Care: A Study among the Rongmeis of Manipur, India

Authors: Lorho Mary Maheo, Arundhati Maibam Devi

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Background: Maternal and child health (MCH) cares are the health services provided to mothers and children. It includes the health promotion, preventive, curative and rehabilitation health care for mothers and children. Materials and method: The present study sample comprises of 208 women within the age range 15-69 years from two remote villages of Tamenglong District in Manipur. They were randomly chosen for assessing their health as well as the child’s health adopting an interview schedule method. Results: The findings of the study revealed that majority (80%) of the women have their first conception in their first year of married life. A decadal change has been observed with regard to the last pregnancy i.e., antenatal check-up, place of delivery as well as the service provider. However, irrespective of age of the women, home delivery is still preferred though very few are locally trained. Pre- and post-delivery resting period vary depending on the busy schedule of the agricultural works as the population under study is basically agriculturist. Postnatal care remains to be traditional as they are strongly associated with cultural beliefs and practices that continue to prevail in the studied community. Breast feeding practices such as colostrums given, initiation of breastfeeding, weaning was all taken into account.  Immunization of children has not reached the expected target owing to a variety of reasons. Maternal health care also includes use of birth control measures. The health status of women would invariably improve if family planning is meaningfully adopted. Only 10.1% of the women adopted the modern birth control implying its deep-rooted value attached to the children. Based on the self-assessment report on their health treatment a good number of the respondents resorted to self-medication even to the extent of buying allopathic medicine without a doctor’s prescription. One important finding from the study is the importance attributed to the traditional health care system which is easily affordable and accessible to the villagers. Conclusion: The overall condition of maternal and child care is way behind till now as no adequate/proper health services are available.

Keywords: antenatal, breastfeeding, child health, maternal, Tamenglong District

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87 Semi-Autonomous Surgical Robot for Pedicle Screw Insertion on ex vivo Bovine Bone: Improved Workflow and Real-Time Process Monitoring

Authors: Robnier Reyes, Andrew J. P. Marques, Joel Ramjist, Chris R. Pasarikovski, Victor X. D. Yang

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Over the past three decades, surgical robotic systems have demonstrated their ability to improve surgical outcomes. The LBR Med is a collaborative robotic arm that is meant to work with a surgeon to streamline surgical workflow. It has 7 degrees of freedom and thus can be easily oriented. Position and torque sensors at each joint allow it to maintain a position accuracy of 150 µm with real-time force and torque feedback, making it ideal for complex surgical procedures. Spinal fusion procedures involve the placement of as many as 20 pedicle screws, requiring a great deal of accuracy due to proximity to the spinal canal and surrounding vessels. Any deviation from intended path can lead to major surgical complications. Assistive surgical robotic systems are meant to serve as collaborative devices easing the workload of the surgeon, thereby improving pedicle screw placement by mitigating fatigue related inaccuracies. Moreover, robotic spinal systems have shown marked improvements over conventional freehanded techniques in both screw placement accuracy and fusion quality and have greatly reduced the need for screw revision, intraoperatively and post-operatively. However, current assistive spinal fusion robots, such as the ROSA Spine, are limited in functionality to positioning surgical instruments. While they offer a small degree of improvement in pedicle screw placement accuracy, they do not alleviate surgeon fatigue, nor do they provide real-time force and torque feedback during screw insertion. We propose a semi-autonomous surgical robot workflow for spinal fusion where the surgeon guides the robot to its initial position and orientation, and the robot drives the pedicle screw accurately into the vertebra. Here, we demonstrate feasibility by inserting pedicle screws into ex-vivo bovine rib bone. The robot monitors position, force and torque with respect to predefined values selected by the surgeon to ensure the highest possible spinal fusion quality. The workflow alleviates the strain on the surgeon by having the robot perform the screw placement while the ability to monitor the process in real-time keeps the surgeon in the system loop. The approach we have taken in terms of level autonomy for the robot reflects its ability to safely collaborate with the surgeon in the operating room without external navigation systems.

Keywords: ex vivo bovine bone, pedicle screw, surgical robot, surgical workflow

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86 Human Rights in the United States: Challenges and Lessons from the Period 1948-2018

Authors: Mary Carmen Peloche Barrera

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Since its early years as an independent nation, the United States has been one of the main promoters regarding the recognition, legislation, and protection of human rights. In the matter of freedom, the founding father Thomas Jefferson envisioned the role of the U.S. as a defender of freedom and equality throughout the world. This founding ideal shaped America’s domestic and foreign policy in the 19th and the 20th century and became an aspiration of the ideals of the country to expand its values and institutions. The history of the emergence of human rights cannot be studied without making reference to leaders such as Woodrow Wilson, Franklin, and Eleanor Roosevelt, as well as Martin Luther King. Throughout its history, this country has proclaimed that the protection of the freedoms of men, both inside and outside its borders, is practically the reason for its existence. Although the United States was one of the first countries to recognize the existence of inalienable rights for individuals, as well as the main promoter of the Universal Declaration of Human Rights of 1948, the country has gone through critical moments that had led to questioning its commitment to the issue. Racial segregation, international military interventions, national security strategy, as well as national legislation on immigration, are some of the most controversial issues related to decisions and actions driven by the United States, which at the same time mismatched with its role as an advocate of human rights, both in the Americas and in the rest of the world. The aim of this paper is to study the swinging of the efforts and commitments of the United States towards human rights. The paper will analyze the history and evolution of human rights in the United States, to study the greatest challenges for the country in this matter. The paper will focus on both the domestic policy (related to demographic issues) and foreign policy (about its role in a post-war world). Currently, more countries are joining the multilateral efforts for the promotion and protection of human rights. At the same time, the United States is one of the least committed countries in this respect, having ratified only 5 of the 18 treaties emanating from the United Nations. The last ratification was carried out in 2002 and, since then, the country has been losing ground, in an increasingly vertiginous way, in its credibility and, even worse, in its role as leader of 'the free world'. With or without the United States, the protection of human rights should remain the main goal of the international community.

Keywords: United States, human rights, foreign policy, domestic policy

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85 Medial Temporal Tau Predicts Memory Decline in Cognitively Unimpaired Elderly

Authors: Angela T. H. Kwan, Saman Arfaie, Joseph Therriault, Zahra Azizi, Firoza Z. Lussier, Cecile Tissot, Mira Chamoun, Gleb Bezgin, Stijn Servaes, Jenna Stevenon, Nesrine Rahmouni, Vanessa Pallen, Serge Gauthier, Pedro Rosa-Neto

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Alzheimer’s disease (AD) can be detected in living people using in vivo biomarkers of amyloid-β (Aβ) and tau, even in the absence of cognitive impairment during the preclinical phase. [¹⁸F]-MK-6420 is a high affinity positron emission tomography (PET) tracer that quantifies tau neurofibrillary tangles, but its ability to predict cognitive changes associated with early AD symptoms, such as memory decline, is unclear. Here, we assess the prognostic accuracy of baseline [18F]-MK-6420 tau PET for predicting longitudinal memory decline in asymptomatic elderly individuals. In a longitudinal observational study, we evaluated a cohort of cognitively normal elderly participants (n = 111) from the Translational Biomarkers in Aging and Dementia (TRIAD) study (data collected between October 2017 and July 2020, with a follow-up period of 12 months). All participants underwent tau PET with [¹⁸F]-MK-6420 and Aβ PET with [¹⁸F]-AZD-4694. The exclusion criteria included the presence of head trauma, stroke, or other neurological disorders. There were 111 eligible participants who were chosen based on the availability of Aβ PET, tau PET, magnetic resonance imaging (MRI), and APOEε4 genotyping. Among these participants, the mean (SD) age was 70.1 (8.6) years; 20 (18%) were tau PET positive, and 71 of 111 (63.9%) were women. A significant association between baseline Braak I-II [¹⁸F]-MK-6240 SUVR positivity and change in composite memory score was observed at the 12-month follow-up, after correcting for age, sex, and years of education (Logical Memory and RAVLT, standardized beta = -0.52 (-0.82-0.21), p < 0.001, for dichotomized tau PET and -1.22 (-1.84-(-0.61)), p < 0.0001, for continuous tau PET). Moderate cognitive decline was observed for A+T+ over the follow-up period, whereas no significant change was observed for A-T+, A+T-, and A-T-, though it should be noted that the A-T+ group was small.Our results indicate that baseline tau neurofibrillary tangle pathology is associated with longitudinal changes in memory function, supporting the use of [¹⁸F]-MK-6420 PET to predict the likelihood of asymptomatic elderly individuals experiencing future memory decline. Overall, [¹⁸F]-MK-6420 PET is a promising tool for predicting memory decline in older adults without cognitive impairment at baseline. This is of critical relevance as the field is shifting towards a biological model of AD defined by the aggregation of pathologic tau. Therefore, early detection of tau pathology using [¹⁸F]-MK-6420 PET provides us with the hope that living patients with AD may be diagnosed during the preclinical phase before it is too late.

Keywords: alzheimer’s disease, braak I-II, in vivo biomarkers, memory, PET, tau

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84 Mechanisms Underlying the Effects of School-Based Internet Intervention for Alcohol Drinking Behaviours among Chinese Adolescent

Authors: Keith T. S. Tung, Frederick K. Ho, Rosa S. Wong, Camilla K. M. Lo, Wilfred H. S. Wong, C. B. Chow, Patrick Ip

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Objectives: Underage drinking is an important public health problem both locally and globally. Conventional prevention/intervention relies on unidirectional knowledge transfer such as mail leaflets or health talks which showed mixed results in changing the target behaviour. Previously, we conducted a school internet-based intervention which was found to be effective in reducing alcohol use among adolescents, yet the underlying mechanisms have not been properly investigated. This study, therefore, examined the mechanisms that explain how the intervention produced a change in alcohol drinking behaviours among Chinese adolescent as observed in our previous clustered randomised controlled trial (RCT) study. Methods: This is a cluster randomised controlled trial with parallel group design. Participating schools were randomised to the Internet intervention or the conventional health education group (control) with a 1:1 allocation ratio. Secondary 1–3 students of the participating schools were enrolled in this study. The Internet intervention was a web-based quiz game competition, in which participating students would answer 1,000 alcohol-related multiple-choice quiz questions. Conventional health education group received a promotional package on equivalent alcohol-related knowledge. The participants’ alcohol-related attitude, knowledge, and perceived behavioural control were self-reported before the intervention (baseline) and one month and three months after the intervention. Results: Our RCT results showed that participants in the Internet group were less likely to drink (risk ratio [RR] 0.79, p < 0.01) as well as in lesser amount (β -0.06, p < 0.05) compared to those in the control group at both post-intervention follow-ups. Within the intervention group, regression analyses showed that high quiz scorer had greater improvement in alcohol-related knowledge (β 0.28, p < 0.01) and attitude (β -0.26, p < 0.01) at 1 month after intervention, which in turn increased their perceived behavioural control against alcohol use (β 0.10 and -0.26, both p < 0.01). Attitude, compared to knowledge, was found to be a stronger contributor to the intervention effect on perceived behavioural control. Conclusions: Our internet-based intervention has demonstrated effectiveness in reducing the risk of underage drinking when compared with conventional health education. Our study results further showed an attitude to be a more important factor than knowledge in changing health-related behaviour. This has an important implication for future prevention/intervention on an underage drinking problem.

Keywords: adolescents, internet-based intervention, randomized controlled trial, underage drinking

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83 A Meta Analysis of the Recent Work-Related Research of BEC-Teachers in the Graduate Programs of the Selected HEIs in Region I and CAR

Authors: Sherelle Lou Sumera Icutan, Sheila P. Cayabyab, Mary Jane Laruan, Paulo V. Cenas, Agustina R. Tactay

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This study critically analyzed the recent theses and dissertations of the Basic Education Curriculum (BEC) teachers who finished their graduate programs in selected higher educational institutions in Region I and CAR to be able to come up with a unified result from the varied results of the analyzed research works. All theses and dissertations completed by the educators/teachers/school personnel in the secondary and elementary public and private schools in Region 1 and CAR from AY 2003–2004 to AY 2007–2008 were classified first–as to work or non-work related; second–as to the different aspects of the curriculum: implementation, content, instructional materials, assessment instruments, learning, teaching, and others; third–as to being eligible for meta-analysis or not. Only studies found eligible for meta-analysis were subjected to the procedure. Aside from documentary analysis, the statistical treatments used in meta-analysis include the standardized effect size, Pearson’s correlation (r), the chi-square test of homogeneity and the inverse of the Fisher transformation. This study found out that the BEC-teachers usually probe on work-related researchers with topics that are focused on the learning performances of the students and on factors related to teaching. The development of instructional materials and assessment of implemented programs are also equally explored. However, there are only few researches on content and assessment instrument. Research findings on the areas of learning and teaching are the only aspects that are meta-analyzable. The research findings across studies in Region I and CAR of BEC teachers that focused on similar variables correlated to teaching do not vary significantly. On the contrary, research findings across studies in Region I and CAR that focused on variables correlated to learning performance significantly vary. Within each region, variations on the findings of research works related to learning performance that considered similar variables still exist. The combined finding on the effect size or relationship of the variables that are correlated to learning performance are low which means that effect is small but definite while the combined findings on the relationship of the variables correlated to teaching are slight or almost negligible.

Keywords: meta-analysis, BEC teachers, work-related research,

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82 Assessment of Health Literacy and Awareness of Female Residents of Barangay Dagatan, Sabang, and Marauoy Lipa, Batangas on Polycystic Ovarian Syndrome: A Cross-Sectional Study

Authors: Jean Gray C. Achapero, Mary Margareth P. Ancheta, Patricia Anjelika A. Angeles, Shannon Denzel S. Ao Tai, Carl Brandon C. Barlis, Chrislen Mae B. Benavidez

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Health literacy and awareness of Polycystic ovarian syndrome (PCOS) is a global issue that is under-addressed in the Philippines. Conducting a thorough review of the country's ability to recognize and comprehend the severity of the syndrome should be undertaken, as early treatment is essential to avoid further disorder complications. This research aims to assess the health literacy and awareness of the female residents of Barangay Dagatan, Sabang, and Marauoy Lipa, Batangas on PCOS. It followed a cross-sectional study, and data gathering was done through a pre-assessment using the Single Item Literacy Screener (SILS) and an online population-based survey questionnaire about PCOS awareness. The participants, as based on the objectives and purposive sampling method, were females aged 18-45 years old. Data were analyzed statistically using STATA 13.1 software. The study showed that 339 (76%) out of 444 respondents passed the SILS meaning the residents have proficient health literacy. Among the 339 respondents, 87% (287) had previous knowledge about PCOS. The respondents showed minimal awareness of PCOS symptoms which could be attributed to its broad spectrum of information. Respondents were shown to be most knowledgeable about PCOS physiology, treatment, beliefs, and its remedies. The respondents’ age had no significant association with their health literacy (p=0.31) and PCOS awareness (p=0.60). A significant association was noted, however, in their educational attainment linked with their health literacy (p=<0.0001) and PCOS awareness (p=0.001). It is suggested that reproductive health education even in the lower year levels must be optimized and Local Government Unit (LGU)/Non-Government Organization (NGO)-held seminars should be conducted for knowledge reinforcement. Reliable health information should be more accessible to the public and clinicians must emphasize the importance of the majority of early screening as part of routine physical examination for women of reproductive age to increase health literacy and awareness about PCOS and actively engage in the management of the disease.

Keywords: age, awareness, educational attainment, health literacy, polycystic ovarian syndrome

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81 Textile-Based Sensing System for Sleep Apnea Detection

Authors: Mary S. Ruppert-Stroescu, Minh Pham, Bruce Benjamin

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Sleep apnea is a condition where a person stops breathing and can lead to cardiovascular disease, hypertension, and stroke. In the United States, approximately forty percent of overnight sleep apnea detection tests are cancelled. The purpose of this study was to develop a textile-based sensing system that acquires biometric signals relevant to cardiovascular health, to transmit them wirelessly to a computer, and to quantitatively assess the signals for sleep apnea detection. Patient interviews, literature review and market analysis defined a need for a device that ubiquitously integrated into the patient’s lifestyle. A multi-disciplinary research team of biomedical scientists, apparel designers, and computer engineers collaborated to design a textile-based sensing system that gathers EKG, Sp02, and respiration, then wirelessly transmits the signals to a computer in real time. The electronic components were assembled from existing hardware, the Health Kit which came pre-set with EKG and Sp02 sensors. The respiration belt was purchased separately and its electronics were built and integrated into the Health Kit mother board. Analog ECG signals were amplified and transmitted to the Arduino™ board where the signal was converted from analog into digital. By using textile electrodes, ECG lead-II was collected, and it reflected the electrical activity of the heart. Signals were collected when the subject was in sitting position and at sampling rate of 250 Hz. Because sleep apnea most often occurs in people with obese body types, prototypes were developed for a man’s size medium, XL, and XXL. To test user acceptance and comfort, wear tests were performed on 12 subjects. Results of the wear tests indicate that the knit fabric and t-shirt-like design were acceptable from both lifestyle and comfort perspectives. The airflow signal and respiration signal sensors return good signals regardless of movement intensity. Future study includes reconfiguring the hardware to a smaller size, developing the same type of garment for the female body, and further enhancing the signal quality.

Keywords: sleep apnea, sensors, electronic textiles, wearables

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80 Strawberry Productivity of Peri-Urban and Urban Locations across Southeast Michigan, USA

Authors: Maria E. Laconi, Kyla D. Scherr, Mary A. Jamieson

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Human populations in urban environments have rapidly grown in recent decades. Consequently, the intensity of land-use and development has also increased in many urban and peri-urban environments. Some cities, such as Detroit, Michigan, USA, have embraced urban agriculture and local food production. Little is known, however, about how the local and landscape scale environmental factors influence crop productivity on urban farms. Our study aims to evaluate factors influencing the productivity of strawberries on community farms and gardens in the Detroit metropolitan area. Strawberries are one of few fruits that can provide an abundant harvest just after the first season of being planted, which is ideal for urban gardeners in developed areas. In the spring of 2016, we planted six different strawberry cultivars (three everbearing and three June bearing varieties) at five farm sites in Wayne and Oakland County (six replicate plants per cultivar per site). We surveyed flower and fruit phenology and production for everbearing varieties weekly (flowers for June bearing varieties were removed to enhance productivity in the coming growing season). Additionally, we conducted one initial 36hr pollinator survey in mid-September during peak fruit production and characterized local and landscape scale land-cover data. Preliminary results and observations from this first year of our study revealed that strawberry production varied significantly by site. Specifically, productivity at our most northern site appeared to suffer from delayed phenology and early frost damage to ripening strawberries. Bee abundance and diversity also differed among farms, though further surveys are needed to adequately inventory the pollinator community. Finally, strawberry cultivars demonstrated significant differences in the number and size of fruits produced. We plan to continue this study in the coming years, increasing the number of sites surveyed and number of pollinator sampling events. Our study aims to inform strategies for enhancing crop productivity on urban and peri-urban farms.

Keywords: insect pollination, strawberry productivity, sustainable agriculture, urban gardening

Procedia PDF Downloads 273
79 Women Bodies and Images in Funerary Landscapes of the Late Antique Oecumene: An Analysis of Women Representation Between Idealized Pagan Antecedents and Concrete Female Power Within Christian Communities

Authors: Camilla Marraccini

Abstract:

The sarcophagus of Adelphia represents an iconographic unicum compared to female representations on sarcophagi. From the time of its discovery in 1872 until recent studies , the figurative program of the sarcophagus' lid has been the subject of extensive debate. Critics have been divided between those who have interpreted the scene as the life of Mary , those who have interpreted it as a depiction of Adelphia , those who saw it as a traditional representation of Moses and Christ , and those who read a particular philosophical doctrine depicting Sophia dei . Indeed, next to the female orans, Maries on the throne and female servants of Christ, the distinctiveness of the sarcophagus becomes evident and a unique scene stands out on the lid: a procession of nine women culminating with a frontal woman on the throne. Using an iconographic analysis that questions 1.the traces of the typologies of christian women found in sarcophagi and 2.the pagan models used by the artisans of Christianity, this paper aims to investigate an interpretation of the scene based on the discoveries of meaning and semantic shifts that can be understood once the model used for this iconography is found, whilst conducting a comparative analysis that underlines the importance of understanding the reasons behind this commission. Searching for the commissioner's will needs to be an interdisciplinary quest: from iconographical analysis to epigraphical and archaeological data. Considering, that several recent studies have emphasized the important female presence in the catacomb of St.Giovanni (perhaps a burial dedicated exclusively to female monastic cults?) , where the sarcophagus was found, the local development of the cult of St. Lucia, and the fact that Adelfia is referred to as clarissima femina in her inscription, the present paper will try to make a transition between art and social context. Thus, this paper aims to understand whether this iconography can be an ulterior source, next to the epigraphical ones, to reconstruct the concrete role of Adelfia in local women's communities. In summary, by tracing different forms of continuity between pagan and christian practices, this paper aims to understand what the relationship between actual hierarchical power, funerary self-representations and the inherited semantics of images could tell us about the life and death of late antique Christian women.

Keywords: early Christian art, female bodies, iconography, female communities, sarcophagi

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78 One Decade Later: The Conundrum of Unrecognized Asherman Syndrome

Authors: Maria Francesca Lavadia-Gumabao, Mary Antoinette Salvamante-Torallo

Abstract:

Introduction: The fibrous intrauterine adhesions forming inside the uterus and/or cervix in Asherman syndrome can obstruct the internal cervical orifice and may present as a case of outflow tract obstruction. Asherman syndrome is often overlooked since it has no specific presentation and is undetectable by routine physical examinations or diagnostic procedures such as an ultrasound. This paper highlights the delay and elusive diagnosis of Asherman syndrome which negatively impacted the patient’s fertility and quality of life. Case presentation: A 33-year-old woman (gravida 3, para 3) who presented with secondary amenorrhea for thirteen years associated with cyclic pelvic pain and secondary infertility sought a consultation at our institution for evaluation and specialty management. The patient had no other well-established risk factors for Asherman syndrome aside from pregnancy. For more than a decade, she delayed seeking medical care. At presentation, history taking, physical examination, and ultrasound were not helpful in identifying the cause of outflow tract obstruction. Diagnostic hysteroscopy was then performed, during which extensive scarring and fibrosis completely obscured the internal cervical orifice were observed, consistent with the diagnosis of Asherman syndrome (Grade 5B). The patient then underwent ultrasound guided hysteroscopy outflow tract dilatation and responded well to the treatment as she had her menstrual period a month after the procedure and no longer had cyclic pelvic pain with a repeat ultrasound finding of an unremarkable uterus. The hispathology result of the tissues retrieved revealed myometrial fragments with associated old hemorrhage benign endometrial stromal tissues, which failed to show endometrial glands. Conclusion: The delay and elusive diagnosis of Asherman syndrome can be brought about by poor health seeking behavior of patients and difficulty in detecting this condition by routine physical examinations or diagnostic procedures such as an ultrasound. It is, therefore, necessary to include Asherman syndrome in the differential diagnosis of secondary amenorrhea and secondary infertility. With expertise in hysteroscopy, early diagnosis, proper classification in the advent of hysteroscopy, and optimal management can improve patient outcomes.

Keywords: Asherman syndrome, outflow tract obstruction, secondary amenorrhea, infertility, hysteroscopy

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