Search results for: intervention plan

Authors: Tulsi Ram Bhusal

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Global climate change is known to have a huge impact on agriculture due to changing in rainfall pattern and elevated air temperature that lead to drought and/or flooding. This systematic study has focused on agriculture in Nepal. The study has shown that the trend of current climatic change is affecting rice production, while the farmers with technological access have tried to adapt to the changing conditions at their level. There is insufficient intervention from the government side in terms of policies and schemes. The lack of sufficient funds is one of the significant reasons in terms of governance. The climatic trends and the way it is affecting the annual riceyieldinNepal has been discussed in this study thoroughly. This study has reviewed published studies and ferred important points regarding the Nepal’s status on rice production. Mainly due to the increasing graph of average temperature and other physical conditions needed for the proper cultivation of ricearechanging due to which there is significant dropofannual rice production. Although from corners of the country, many farmers have attempted to adapt the methods of cultivation to the changing climatic conditions, lack of access to technologies, and fund allocation from the governmental level, it is difficult for the mtobringchanges in rice production by the crown without any institutional help. This systematic study effectively presents the magnitude of the impact on rice cultivation due to climatic changes inrecenttimesinNepal. This review aims to bring the current scenarioofNepal’sricefarming, and it impacts due to changing climate, which can subsequently contribute in devising plans for proper governance, formulating policies, and allocation of funds for the betterment.

Keywords: rice, climate change, rice production, nepal, agriculture

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Authors: Polycarp Igbojekwe

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The main objective of this study was to determine if emotional labour has become a criterion in performance appraisal, job description, selection, and training schemes in the hotel industry in Nigeria. Our main assumption was that majority of hotel organizations have not built emotional labour into their human resources management schemes. Data were gathered by the use of structured questionnaires designed in Likert format, and interviews. The focus group was managers of the selected hotels. Analyses revealed that majority of the hotels have not built emotional labour into their human resources schemes particularly in the 1, 2, and 3-star hotels. It was observed that service employees of 1, 2, and 3-star hotels have not been adequately trained to perform emotional labour; a critical factor in quality service delivery. Managers of 1, 2, and 3-star hotels have not given serious thought to emotional labour as a critical factor in quality service delivery. The study revealed that suitability of an individual’s characteristics is not being considered as a criterion for selection and performance appraisal for service employees. The implication of this is that, person-job-fit is not seriously considered. It was observed that there has been a disconnect between required emotional competency, its recognition, evaluation, and training. Based on the findings of this study, it is concluded that selection, training, job description and performance appraisal instruments in use in hotels in Nigeria are inadequate. Human resource implications of the findings in this study are presented. It is recommended that hotel organizations should re-design and plan the emotional content and context of their human resources practices to reflect the emotional demands of front line jobs in the hotel industry and the crucial role emotional labour plays during service encounters.

Keywords: emotional labour, employee selection, job description, performance appraisal, person-job-fit, employee compensation

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Authors: Eli Maria Forti-Pazzianotto, Carolina Moraes Da Costa, Daniela Faleiros Berteli Merino, Maura Rigoldi Simões Da Rocha, Irineu Rasera-Junior

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There is no conclusive evidence to support the use of one type or brand of incentive espirometry over others. The decision as to which equipment is best, have being based on empirical assessment of patient acceptance, ease of use, and cost. The aim was to evaluate the effects of use of two methodologies of breathing exercises, performed by flow-oriented incentive spirometry, in the reversal of diaphragmatic dysfunction in postoperative bariatric surgery. 38 morbid obese women were selected. Respiratory muscle strength was evaluated through the nasal inspiratory pressure (NIP), and the respiratory muscles endurance, through incremental test by measurement of sustained maximal inspiratory pressure (SMIP). They were randomized in 2 groups: 1- Respiron® Classic (RC) the inspirations were slow, deep and sustained for as long as possible (5 sec). 2- Respiron® Athletic1 (RA1) - the inspirations were explosive, quick and intense, raising balls by the explosive way. 6 sets of 15 repetitions with intervals of 30 to 60 seconds were performed in groups. At the end of the intervention program (second PO), the volunteers were reevaluated. The groups were homogeneous with regard to initial assessment. However on reevaluating there was a significant decline of the variable PIN (p= < 0.0001) and SMIP (p=0.0004) in RC. In the RA1 group there was a maintenance of SMIP (p=0.5076) after surgery. The use of the Respiron Athletic 1, as well as the methodology of application used, can contribute positively to preserve the inspiratory muscle endurance and improve the diaphragmatic dysfunction in postoperative period.

Keywords: bariatric surgery, incentive spirometry, respiratory muscle, physiotherapy

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Authors: Belaynesh Tsegay, Teklay Gebrecherkos, Atsebaha Gebrekidan Kahsay, Mahmud Abdulkader

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Background: Hepatitis B and C viruses are important health and socioeconomic problem across the globe, with a remarkable number of diseases and deaths in sub-Saharan African countries. The burden of hepatitis is unknown in the prison settings of Tigray. Therefore, we aimed to describe the seroprevalence and associated factors of hepatitis B and C viruses among prisoners in Tigray, Ethiopia. Methods: A cross-sectional study was carried out from February 2020 to May 2020 at the prison facilities of Tigray. Demographics and associated factors were collected from 315 prisoners prospectively. Five milliliters of blood were collected and tested using rapid tests kits of HBsAg (Zhejiang orient Gene Biotech Co., Ltd., China) and HCV antibodies (Volkan Kozmetik Sanayi Ve Ticaret Ltd. STI, Turkey). Positive samples were confirmed using ELISA (Beijing Wantai Biological Pharmacy Enterprise Co. Ltd). Data were analyzed using the SPSS version 20, and p<0.05 was considered statistically significant. Results: The overall seroprevalence of HBV and HCV were 25 (7.9%) and 1 (0.3%), respectively. The majority of hepatitis B viral infections were identified from the age groups of 18–25 years (10.7%) and unmarried prisoners (11.8%). Prisoners greater than 100 per cell (AOR=3.95, 95% CI=1.15–13.6, p=0.029) and with a history of alcohol consumption (AOR=3.01, 95% CI=1.17–7.74, p=0.022) were significantly associated with HBV infections. Conclusion: The seroprevalence of HBV among prisoners was nearly high or borderline, with a very low HCV prevalence. HBV was most prevalent among young adults, those housed with a large number of prisoners per cell, and those who had a history of alcohol consumption. This study recommends that there should be prison-focused intervention, including regular health education, with the emphasis on the mode of transmission and introducing HBV screening policy for prisoners, especially when they enter the prison.

Keywords: seroprevalence, HBV, HCV, prisoners, tigray

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Authors: Dilliram Paudyal

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The history of taxation in Nepal dates back to antiquity. However, the modern tax system gained its momentum after the establishment of democracy in 1951, which initially focused only land tax and tariff on foreign trade. In the due time, several taxes were introduced, such as direct taxes, indirect taxes, and non-taxes. However, the tax structure in Nepal is heavily dominated by indirect taxes that contribute more than 60 % of the total revenue. The government has been mobilizing revenues through a series of tax reforms during the Tenth Five-year Plan (2002 – 2007) and successive Three-year Interim Development Plans by introducing several tax measures. However, these reforms are regressive in nature, which does not lead the overall economy towards short-run stability as well as in the long run development. Based on the literature review and discussion among government officials and few taxpayers individually and groups, this paper aims to major issues and challenges that hinder the tax reform effective in Nepal. Additionally, this paper identifies potential way and process of tax reform in Nepal. The results of the study indicate that transparency in a major problem in Nepalese tax system in Nepal, where serious structural constraints with administrative and procedural complexities envisaged in the Income Tax Act and taxpayers are often unaware of the specific size of tax which is to comply them. Some other issues include high tax rate, limited tax base, leakages in tax collection, rigid and complex Income Tax Act, inefficient and corrupt tax administration, limited potentialities of direct taxes and negative responsiveness of land tax with higher administrative costs. In the context, modality of tax structure and mobilize additional resources is to be rectified on a greater quantum by establishing an effective, dynamic and highly power driven Autonomous Revenue Board.

Keywords: corrupt, development, inefficient, taxation

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Authors: Enjie Xu, Zhen Huang, Kunpeng Zhu, Jianping Hu, Xiaolong Ma, Yongjie Wang, Jiazhuang Zhu, Chunlin Zhang

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Abstract: Hypoxia and dedifferentiation of osteosarcoma (OS) cells leads to poor prognosis. We plan to identify the role of hypoxia on dedifferentiation and the associated signaling pathways. We performed a sphere formation assay and determined spheroid cells as dedifferentiated cells by detecting stem cell-like markers. RNAi assay was used to explore the expression relationship between hypoxia inducible factor 1 subunit alpha (HIF1A) and platelet derived growth factor receptor beta (PDGFRB). We obtained PDGFRB knockdown and overexpression cells through lentiviral infection experiments and the effects of PDGFRB on cytoskeleton rearrangement and cell adhesion were explored by immunocytochemistry. Wound-healing experiments, transwell assays, and animal trials were employed to investigate the effect of PDGFRB on OS metastasis. Dedifferentiated OS cells were found to exhibit high expression of HIF1A and PDGFRB, and HIF1A promoted the expression of PDGFRB, subsequently activated ras homolog family member A (RhoA), and increased the phosphorylation of myosin light chain (MLC). PDGFRB also enhanced the phosphorylation of focal adhesion kinase (FAK). The OS cell morphology and vinculin distribution were altered by PDGFRB. PDGFRB also promoted cell dedifferentiation and had a significant impact on the metastasis of OS cells both in vitro and in vivo. Our results demonstrated that HIF1A up-regulated PDGFRB under hypoxic conditions, and PDGFRB regulated the actin cytoskeleton by activating RhoA and subsequently phosphorylating MLC, thereby promoting OS dedifferentiation and pulmonary metastasis.

Keywords: osteosarcoma, dedifferentiation, metastasis, cytoskeleton rearrangement, PDGFRB, hypoxia

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Authors: Diego Carrasco, Catarina Freitas, Hugo Rio Tinto, Ricardo Rio Tinto, Nuno Couto, Joaquim Gago, Carlos Carvalho

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Introduction: Endoscopic ultrasound-guided choledochoduodenostomy (EUS-CD) to drain the gallbladder can be a palliative care procedure for non-surgical oncologic patients with cholelithiasis and cholangitis process. Case description: A 59-years old Caucasian male diagnosed with extrahepatic cholangiocarcinoma with multiple liver, lung and peritoneum metastasis, unresponsive to treatment with gemcitabine/cisplatin, presented in the institution with fever, hypotension, and severe upper right abdominal pain secondary to cholelithiasis and cholangitis process. The patient was admitted and started on large spectrum antibiotics plus fluid-challenge. Afterward, a percutaneous transhepatic biliary drainage (PTBD) was performed to drain the gallbladder. This procedure temporarily stabilized the patient. However, the definitive solution required gallbladder removal. Since the patient exhibited an advanced oncologic disease and poor response to the chemotherapy, he was not a candidate for surgical intervention. Diagnostic Pathways: A self-expanding metal stent was placed from the duodenum into the bile duct by endoscopic ultrasound-guided. The stent allowed efficient drainage of the contrast from the gallbladder at the end of the endoscopic procedure. Conclusion and Discussion: The stent allowed efficient drainage of the contrast from the gallbladder at the end of the endoscopic procedure and successfully reversed the cholangitis process. EUS-CD is an effective and safe technique and can be used as a palliative care procedure for non-surgical oncologic patients.

Keywords: palliative care, cholangiocarcinoma, choledochoduodenostomy, endoscopic ultrasound-guided

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Authors: Ivan Yudianto

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The research objectives are to analyze the factors that impede the Parking Tax and Parking Retribution collection in Bekasi City Government, analyzing the factors that can increase local own revenue from the tax sector of parking tax and parking retribution, analyze monitoring the parking retribution collection by the Bekasi City Government, analyze strategies Bekasi City Government through the preparation of a roadmap and action plan to increase parking tax and parking retribution revenues. The approach used in this research is a qualitative approach. Qualitative research is used because the problem is not yet clear and the object to be studied will be holistic, complex, and dynamic, and the relationship will be interactive symptoms. Methods of data collection and technical analysis of the data was in-depth interviews, participant observation, documentary materials, literature, and triangulation, as well as new methods such as the methods of visual materials and internet browsing. The results showed that there are several factors that become an obstacle such as the parking taxpayer does not disclose the actual parking revenue, the parking taxpayer are late or do not pay Parking Tax, many parking locations controlled by illegal organizations, shortage of human resources in charge levy and supervise the parking tax and parking retribution collection in the Bekasi City Government, surveillance parking tax and parking retribution are not scheduled on a regular basis. Several strategic priorities in order to develop the potential of the Parking Tax and Parking Retribution in the Bekasi City Government, namely through increased controling and monitoring of the Parking Taxpayer, forming a team of auditors to audit the Parking Taxpayer, seek law enforcement persuasive and educative to reduce Parking Taxpayer wayward, providing strict sanctions against the Parking Taxpayer disobedient, revised regulations mayors about locations of parking in Bekasi City, rationalize revenues target of Parking Retribution, conducting takeover attempts parking location on the roadside of the individual or specific group, and drafting regional regulations on parking subscribe.

Keywords: local own revenue, parking retribution, parking tax, parking taxpayer

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Authors: Julia Wong, Hua Beng Lim, Cheryl Ho, Gin Jen Gwee, Rachel Tay

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In Singapore, a few hospitals and non-governmental social service agencies have been utilising animal-assisted therapy (AAT) in their practice in recent years, although the animals used (e.g., dogs, cats, and horses) and program modality may differ due to the different practice settings, client profiles, and intervention goals. This pilot study explores dog owners’ perceptions of AAT with a focus on examining the enablers and barriers towards volunteering with their dogs in AAT programs in Singapore. A qualitative, thematic analysis study was conducted using in-depth, semi-structured interviews with 16 dog owners. 3 of the dog owners had previous experience volunteering with their dogs serving elderly patients in a community hospital, while the rest of the dog owners had no previous experience volunteering with their dogs. The former group was recruited with the help of the hospital, while the latter group was recruited via word-of-mouth. Dog owners who had volunteering experiences in AAT program versus those who had none differed in their perceptions towards AAT. Dog owners who had volunteered with their dogs in an AAT program in a hospital felt that their volunteering experience were meaningful to patients and to themselves, as they were intrinsically motivated by the desire to serve the community. Those who had not volunteered were hesitant to volunteer with their dogs as they were not comfortable with strangers touching their dogs. They also felt that it would be a huge commitment in terms of time and money; most of them do not own a car as it is uneconomical, and pets are not allowed on Singapore’s public transport systems. This study is limited by its small sample size, and its findings are not generalisable. However, given that volunteers are an invaluable resource in healthcare settings, future studies can examine more stakeholders’ perceptions towards AAT.

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

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Authors: Mangala M. Pai, B. V. Murlimanju, Latha V. Prabhu, P. J. Jiji , Vandana Blossom

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Background:To study the morphological parameters of the axis vertebra in anatomical specimens. Methods: The present study was designed to obtain the morphometric data of axis vertebra. The superior and inferior articular facets of the axis were macroscopically observed for their shapes and the different parameters were measured using the digital Vernier caliper. It included 20 dried axis bones, which were obtained from the anatomy laboratory. Results: The morphometric data obtained in the present study are represented in the tables. The side wise comparison of the length and width of the articular facets of the axis vertebra were done. The present study observed that, there is no statistically significant difference observed among the parameters of right and left side articular facets (p>0.05). The superior and inferior articular facets were observed to have variable shapes. The frequencies of different shapes of superior and inferior articular facets are represented in figures. All the shapes of the inferior and superior articular facets were symmetrical over the right and left sides. Among the superior articular facets, the constrictions were absent in 13 cases (65%), 2 (10%) exhibited a single constriction, 3 (15%) had 2 constrictions and 2 (10%) were having 3 constrictions. The constrictions were absent in 11 (55%) of the inferior articular facets, 3 (15%) of them had 1 constriction, 3 (15%) were having 2 constrictions, 2 (10%) exhibited 3 constrictions and 1 (5%) of them had 4 constrictions. The constrictions of the inferior and superior articular facets were symmetrical over the right and left sides. Conclusion: We believe that the present study has provided additional information on the morphometric data of the axis vertebra. The data are important to the neurosurgeons, orthopedic surgeons and radiologists. The preoperative assessment of the axis vertebra may prevent dangerous complications like spinal cord and nerve root compression during the surgical intervention.

Keywords: axis, articular facet, morphology, morphometry

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Authors: Shahryar Eslamitabar

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Currently, the internet plays an important role in the various scientific, commercial and service practices. Thanks to information and communication technology, the healthcare industry via the internet, generally known as cyber-medicine, can offer professional medical service in a wider geographical area. Having some appealing benefits such as convenience in offering healthcare services, improved accessibility to the services, enhanced information exchange, cost-effectiveness, time-saving, etc. Tele-health has increasingly developed innovative models of healthcare delivery. However, it presents many potential hazards to cyber-patients, inherent in the use of the system. First, there are legal issues associated with the communication and transfer of information on the internet. These include licensure, malpractice, liabilities and jurisdictions as well as privacy, confidentiality and security of personal data as the most important challenge brought about by this system. Additional items of concern are technological and ethical. Although, there are some rules to deal with pitfalls associated with cyber-medicine practices in the USA and some European countries, yet for all developments, it is being practiced in a legal vacuum in many countries. In addition to the domestic legislations to deal with potential problems arisen from the system, it is also imperative that some international or regional agreement should be developed to achieve the harmonization of laws among countries and states. This article discusses some implications posed by the practice of cyber-medicine in the healthcare system according to the experience of some developed countries using a comparative study of laws. It will also review the status of tele-health laws in Iran. Finally, it is intended to pave the way to outline a plan for countries like Iran, with newly-established judicial system for health laws, to develop appropriate regulations through providing some recommendations.

Keywords: tele-health, cyber-medicine, telemedicine, criminal laws, legislations, time-saving

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Authors: Suleiman Hassan Otuoze, Dexter Vernon Lloyd Hunt, Ian Jefferson

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Urbanization has continued to widen the gap between demand and resources available to provide resilient and sustainable transport services in many fast-growing developing countries' cities. Transport demand management is a decision-based optimization concept for both benchmarking and ensuring efficient use of transport resources. This study assesses the service quality of infrastructure and mobility services in the Nigerian cities of Kano and Lagos through five dimensions of quality (i.e., Tangibility, Reliability, Responsibility, Safety Assurance and Empathy). The methodology adopts a hybrid AHP-SERVQUAL model applied on questionnaire surveys to gauge the quality of satisfaction and the views of experts in the field. The AHP results prioritize tangibility, which defines the state of transportation infrastructure and services in terms of satisfaction qualities and intervention decision weights in the two cities. The results recorded ‘unsatisfactory’ indices of quality of performance and satisfaction rating values of 48% and 49% for Kano and Lagos, respectively. The satisfaction indices are identified as indicators of low performances of transportation demand management (TDM) measures and the necessity to re-order priorities and take proactive steps towards infrastructure. The findings pilot a framework for comparative assessment of recognizable standards in transport services, best ethics of management and a necessity of quality infrastructure to guarantee both resilient and sustainable urban mobility.

Keywords: transportation demand management, multi-criteria decision support, transport infrastructure, service quality, sustainable transport

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Authors: Zena Ebrahim, Susan Woodhouse

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Previous research shows that mothers’ experiences of trauma are linked to their child’s later socioemotional functioning. However, the mechanisms involved are not well understood. One potential mediator is maternal insensitive responses to child distress. This study examined the link between maternal trauma, mothers’ responses to toddler distress, and toddlers’ socioemotional outcomes among a socioeconomically diverse sample of 110 mothers and their 12- to 35-month-old toddlers. It was hypothesized that a mother’s difficulty in responding sensitively to her child’s distress would mediate the relations between maternal trauma and child internalizing and externalizing behaviors. Two mediational models were tested to examine non-supportive responses to distress as a potential mediator of the relation between maternal trauma and toddler mental health outcomes; one model focused on predicting child internalizing symptoms and the other focused on predicting child externalizing symptoms. Measures included assessment of maternal trauma (Life Stressor Checklist-Revised), mothers’ responses to child distress (Coping with Toddlers’ Negative Emotions Scale), and toddler socioemotional functioning (Infant-Toddler Social and Emotional Assessment). Results revealed that the relations between maternal trauma and toddler symptoms (internalizing and externalizing symptoms) were mediated by maternal non-supportive response to child distress for both internalizing and externalizing domains of child mental health. Findings suggest the importance of early intervention for trauma-exposed mothers and target areas for parenting interventions.

Keywords: trauma, parenting, child mental health, transgenerational effects of trauma

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Authors: Naim Izet Kajtazi

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Context: Although rare, glomus tumor (i.e., nonchromaffin chemodectomas and paragan¬gliomas) is the most common middle ear tumor, with female predominance. Pre-operative embolization is often required to devascularize the hypervascular tumor for better surgical outcomes. Process: A 35-year-old female presented with episodes of frequent dizziness, ear fullness, and right ear tinnitus for 12 months. Head imaging revealed a right glomus tympanicum tumor. She underwent pre-operative endovascular embolization of the glomus tympanicum tumor with surgical, cyanoacrylate-based glue. Immediately after the procedure, she developed drowsiness and severe pain in the right temporal region. Further investigations revealed a right cerebellar stroke in the posterior inferior cerebellar artery territory. She was treated with intravenous heparin, followed by one year of oral anticoagulation. With rehabilitation, she significantly recovered from her post embolization stroke. However, the tumor was resected at another institution. Ten years later, follow-up imaging indicated a gradual increase in the size of the glomus jugulare tumor, compressing the nearby critical vascular structures. She subsequently received radiation therapy to treat the residual tumor. Outcome: Currently, she has no neurological deficit, but her mild dizziness, right ear tinnitus, and hearing impairment persist. Relevance: This case highlights the complex nature of these tumors, which often bring challenges to the patients as well as treatment teams. The multi-disciplinary team approach is necessary to tailor the management plan for individual tumors. Although embolization is a safe procedure, careful attention and thoughtful anatomic knowledge regarding dangerous anastomosis are essential to avoid devastating complications. Complications occur due to encountered vessel anomalies and new anastomoses formed during the gluing and changes in hemodynamics.

Keywords: stroke, embolization, MRI brain, cerebral angiogram

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Authors: Meryem Imane Babaghayou, Abdelhafidi Asma

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This study deals with the ageing of Blown extruded films of low-density polyethylene (LDPE), used for greenhouse covering. The LDPE have been subjected to climatic ageing in a sub-Saharan facility at Laghouat (Algeria) with direct exposure to sun. The microstructural changes in the films were analyzed by IRFT for different states of ageing. The mechanical characterization was performed on a uniaxial tensile apparatus. The mechanical properties such as Young's modulus, strain at break, and stress at break have been followed for different states of exposure time (0 to 6 months). The Climatic ageing of LDPE films shows the effect of ageing on the microstructural Plan which leads to: i) To an oxidation of the molecular chains. ii) To the formation of cross-linkings and breaking chains, which both of them are responsible for the mechanical behavior’s modifications of the material. Cross-links are in favor of strengthening of the mechanical properties at break (the increase of σr and εr). In other side, the chains breaking leads to a decrease of these properties. The increase in the Young's modulus also seems to be related to those structural changes since the cross-links increase the average molecular weight. Branchings and tangles are favorable pairs for the ductile nature of the material. And in other side, the chains breaking reduces the average molecular weight and therefore promotes the stiffening (following to morphological changes) so the material becomes fragile. The post-mortem analysis of the samples shows that the mechanical stress has an effect on the molecular structure of the material. Although if quantitatively the concentrations of different chemical species exchanges, from a quantitative point of view only the unsaturations raises the polemics of a possible microstructural modification induced by mechanical stress applied during the tensile test. Also, we recommend a more rigorous analysis with other means of investigation.

Keywords: low-density polyethylene, ageing, mechanical properties, IRTF

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Authors: Didem Kepir Savoly, Selen Demirtas Zorbaz

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This research focuses on the unique developmental stage of university students, known as emerging adulthood, which can be filled with stressors relating to academics, career aspirations, and relationships. The impact of these factors on the wellbeing and mental health of students is not well understood and requires further investigation. The aim of this study is to investigate the influence of career optimism and relationship status on the wellbeing/life satisfaction of university students. The specific hypotheses being tested are: 1) University students with higher career optimism will exhibit a higher level of life satisfaction, and 2) University students in relationships will report a higher level of life satisfaction. This research adopts a quantitative approach, utilizing scales and questionnaires to collect data from university students in Turkey. The data was collected from university students in Turkey through the administration of the Career Optimism Scale, The Satisfaction with Life Scale, and the Perceived Romantic Relationship Quality Scale. The data is then analyzed using scale implementation, correlational analysis, and group comparison. One-way ANOVA, regression, and t-test analysis techniques are employed. The research findings provide insights into the relationship between career optimism and university students’ life satisfaction, as well as the influence of relationship status on their life satisfaction. The results suggest that life satisfaction was predicted by career optimism but not by relationship status. Moreover, significant relationships between life satisfaction and relationship quality were found among the university students who were in a relationship. These results can be utilized by practitioners, particularly those in counseling centers and career services at universities, to develop tailored psychoeducational and intervention programs aimed at promoting the mental health of university students.

Keywords: career optimism, relationship status, university students, wellbeing

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Authors: Jiayan Gou, Kexin He, Xin Zhang, Fei Wang, Liuni Zou

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Background: Homocysteine is a high-risk factor for cognitive decline, and folic acid supplementation can lower homocysteine levels. However, current clinical research results are inconsistent, and the effects of folic acid on homocysteine levels and cognitive function in older people are inconsistent. Objective: The objective of this study is to systematically evaluate the effects of folic acid alone or in combination with other nutrients on homocysteine levels and cognitive function in older adults. Methods: Systematic searches were conducted in five databases, including PubMed, Embase, the Cochrane Library, Web of Science, and CINAHL, from inception to June 1, 2023. Randomized controlled trials were included investigating the effects of folic acid alone or in combination with other nutrients on cognitive function in older people. Results: 17 articles were included, with six focusing on the effects of folic acid alone and 11 examining folic acid in combination with other nutrients. The study included 3,100 individuals aged 60 to 83.2 years, with a relatively equal gender distribution (approximately 51.82% male). Conclusion: Folic acid alone or combined with other nutrients can effectively lower homocysteine level and improve cognitive function in patients with mild cognitive impairment. But for patients with Alzheimer's disease and dementia, the intervention only can reduce the homocysteine level, but the improvement in cognitive function is not significant. In healthy older people, high baseline homocysteine levels (>11.3 μmol/L) and good ω-3 fatty acid status (>590 μmol/L) can enhance the improvement effect of folic acid on cognitive function. This trial has been registered on PROSPERO as CRD42023433096.

Keywords: B-complex vitamins, cognitive function, folic acid, homocysteine

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Authors: Beatrix Faragó, Zsolt Szakály, Ágnes Kovácsné Tóth, Csaba Konczos, Norbert Kovács, Zsófia Pápai, Tamás Kertész

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The future of the nation is the embodiment of a healthy society. A key segment of government policy is the development of health and a health-oriented environment. As a result, sport as an activator of health is an important area for development. In Hungary, sport is a strategic sector with the aim of developing a sports nation. The function of sport in the global society is multifaceted, which is manifested in both social and economic terms. The economic importance of sport is gaining ground in the world, with implications for Central and Eastern Europe. Smaller states, such as Hungary, cannot ignore the economic effects of exploiting the effects of sport. The relationship between physical activity and health is driven by the health economy towards the nation's economic factor. In our research, we analyzed sport as a national strategy sector and its impact on age groups. By presenting the current state of health behavior, we get an idea of the directions where development opportunities require even more intervention. The foundation of the health of a nation is the young age group, whose shaping of health will shape the future generation. Our research was attended by university students from the Faculty of Health and Sports Sciences who will be experts in the field of health in the future. The other group is the elderly, who are a growing social group due to demographic change and are a key segment of the labor market and consumer society. Our study presents the health behavior of the two age groups, their differences, and similarities. The survey also identifies gaps in the development of a health management strategy that national strategies should take into account.

Keywords: competitiveness, health behavior, health economy, health management, sports nation

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Authors: Mohammed Alassim

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In 2014, a UN survey stated that: "The greatest challenge to the adoption of whole-of government, which fundamentally rests on increased collaboration, is resistance to change among government actors". Change management has experienced both theoretically and practically many transformation over the years. When organizations have to implement radical changes, they have to encounter a plethora of issues which leads to ineffective or inefficient implementation of change in most cases. 70% of change projects fail because of human issues. It has been cited that” most studies still show a 60-70% failure rate for organizational change projects — a statistic that has stayed constant from the 1970’s to the present.”. E-government involves not just technical change but cultural, policy, social and organizational evolution. Managing change and overcoming resistance to change is seen as crucial in the success of E-government projects. Resistance can be from different levels in the organization (top management, middle management or employees at operational levels). There can be many reasons for resistance including fear of change and insecurity, lack of knowledge and absence of commitment from management to implement the change. The purpose of this study is to conduct in-depth research to understand the process of change and to identify the critical factors that have led to resistance from employees at different levels (top management, Middle management and operational employees) during e-government initiatives in the public sector in Saudi Arabia. The study is based on qualitative and empirical research methods conducted in the public sector in the Kingdom of Saudi Arabia. This research will use triangulation in data method (interview, group discussion and document review). This research will contribute significantly to knowledge in this field and will identify the measures that can be taken to reduce resistance to change, Upon analysis recommendations or model will be offered which can enable decision makers in public sector in Saudi Arabia how to plan, implement and evaluate change in e-government initiatives via change management strategy.

Keywords: change management, e-government, managing change, resistance to change

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Authors: Hasan Frookh Jamal

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This is a case of a 36-year-old Bahraini gentleman diagnosed to have Cushing's Syndrome with a large anterior mediastinal mass. He was sent abroad to the Speciality hospital in Jordan, where he underwent diagnostic video-assisted thoracoscopy, partial thymectomy and pericardial fat excision. Histopathology of the mass was reported to be an Atypical carcinoid tumor with a low Ki67 proliferation index of 5%, the mitotic activity of 4 MF/10HPF and pathological stage classification(pTNM): pT1aN1. MRI of the pituitary gland showed an ill-defined non-enhancing focus of about 3mm on the Rt side of the pituitary on coronal images, with a similar but smaller one on the left side, which could be due to enhancing pattern rather than a real lesion as reported. The patient underwent Ga68 Dotate PET/CT scan post-operatively, which showed multiple somatostatin receptor-positive lesions seen within the tail, body and head of the pancreas and positive somatostatin receptor lymph nodes located between the pancreatic head and IVC. There was no uptake detected at the anterior mediastinum nor at the site of thymic mass resection. There was no evidence of any positive somatostatin uptake at the soft tissue or lymph nodes. The patient underwent IPSS, which proved that the source is, in fact, an ectopic source of ACTH secretion. Unfortunately, the patient's serum cortisol remained elevated after surgery and failed to be suppressed by 1 mg ODST and by 2 days LLDST with a high ACTH value. The patient was started on Osilodrostat for treatment of hypercortisolism for the time being and his future treatment plan with Lutetium-177 Dotate therapy vs. bilateral adrenalectomy is to be considered in an MDT meeting.

Keywords: cushing syndrome, neuroendocrine tumur, carcinoid tumor, Thymoma

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Authors: J. Mano Ranjini

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Each and every child is special, born with a unique talent to explore this world. The word Dyslexia is derived from the Greek language in which “dys” meaning poor or inadequate and “lexis” meaning words or language. Dyslexia describes about a different kind of mind, which is often gifted and productive, that learns the concept differently. The main aim of the study is to bring the positive outcome of the reading level by examining the effectiveness of Visual Auditory Kinesthetic Tactile technique on Reading Level among Dyslexic Children at Helikx Open School and Learning Centre. A Quasi experimental one group pretest post test design was adopted for this study. The Reading Level was assessed by using the Schonell Graded Word Reading Test. Thirty subjects were drawn by using purposive sampling technique and the intervention Visual Auditory Kinesthetic Tactile technique was implemented to the Dyslexic Children for 30 consecutive days followed by the post Reading Level assessment revealed the improvement in the mean score value of reading level by 12%. Multi-sensory (VAKT) teaching uses all learning pathways in the brain (visual, auditory, kinesthetic-tactile) in order to enhance memory and learning and the ability in uplifting emotional, physical and societal dimensions. VAKT is an effective method to improve the reading skill of the Dyslexic Children that ensures the enormous significance of learning thereby influencing the wholesome of the child’s life.

Keywords: visual auditory kinesthetic tactile technique, reading level, dyslexic children, Helikx Open School

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Authors: Najla Alhkalaf

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The focus of this study is answering the following question: How do e-government services in Bahrain support the productivity of SMEs? This study examines the current E-government function in enhancing SME productivity in Bahrain through analysing the efficiency of e- government by viewing its facilitators and barriers from the perspective of different stakeholders. The study aims to identify and develop best practice guidelines with the end-goal of creating a standardised channel of communication between e-government and SMEs that fulfil the requirement of SME owners, and thus achieve the prime objective of e-government. E-government services for SMEs have been offered in Bahrain since 2005. However, the current services lack the required mechanism for SMEs to fully take advantage of these services because of lagging communication between service provider and end-user. E-government employees believe that a lack of awareness and trust are the main stumbling block, whereas the SME owners believe that there is a lack of sufficiency in the content and efficiency provided through e- services. A questionnaire has been created based on a pilot study that highlighted the main indicators of e-government efficiency and SMEs productivity as well as previous studies conducted on this subject. This allowed for quantitative data to be extracted. Also interviews were conducted with SME owners and government employees from both case studies, which formed the qualitative data for this study. The findings portray that both the service provider and service receiver largely agree on the existence of most of the technical and administrative barriers. However, the data reflects a level of dissatisfaction from the SME side, which contradicts with the perceived level of satisfaction from the government employees. Therefore, the data supports the argument that assures the existence of a communication gap between stakeholders. To this effect, this research would help build channels of communication between stakeholders, and then induces a plan unlocking the potential of e-government application. The conclusions of this study will help devise an optimised E-government strategy for Bahrain.

Keywords: e-government, SME, e-services, G2B, government employees' perspective, entrepreneurs' perspective, enterprise

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Authors: Veysel Çelik, Aynur Aker, Ebru Güç

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Developments in information and communication technologies have increased both the speed of producing information and the speed of accessing new information. Accordingly, the daily lives of individuals have started to change. New concepts such as e-mail, e-government, e-school, e-signature have emerged. For this reason, prospective teachers who will be future teachers or school administrators are expected to have a high awareness of digital data security. The aim of this study is to reveal the effect of the digital storytelling technique on the data security awareness of pre-service teachers of computer and instructional technology education departments. For this purpose, participants were selected based on the principle of volunteering among third-grade students studying at the Computer and Instructional Technologies Department of the Faculty of Education at Siirt University. In the research, the pretest/posttest half experimental research model, one of the experimental research models, was used. In this framework, a 6-week lesson plan on digital data security awareness was prepared in accordance with the digital narration technique. Students in the experimental group formed groups of 3-6 people among themselves. The groups were asked to prepare short videos or animations for digital data security awareness. The completed videos were watched and evaluated together with prospective teachers during the evaluation process, which lasted approximately 2 hours. In the research, both quantitative and qualitative data collection tools were used by using the digital data security awareness scale and the semi-structured interview form consisting of open-ended questions developed by the researchers. According to the data obtained, it was seen that the digital storytelling technique was effective in creating data security awareness and creating permanent behavior changes for computer and instructional technology students.

Keywords: digital storytelling, self-regulation, digital data security, teacher candidates, self-efficacy

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Authors: Duran Fiack, Jeremy Cumberbatch, Michael Sutherland, Nadine Zerphey

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Civic leaders have increasingly relied upon local climate adaptation plans to identify vulnerabilities, prioritize goals, and implement actions in order to prepare cities for the present and projected effects of global climate change. The concept of sustainability is central to these efforts, as climate adaptation discussions are often framed within the context of economic resilience, environmental protection, and the distribution of climate change impacts across various socioeconomic groups. For urban centers, the climate change issue presents unique challenges for each of these dimensions; however, its potential impacts on marginalized populations are extensive. This study draws from the ‘just sustainabilities’ framework to perform a qualitative analysis of climate adaptation plans prepared by 22 of the 100 largest U.S. cities and examine whether, and to what extent, such initiatives prioritize social equity improvements. Past research has found that the integration of sustainability in urban policy and planning often produces outcomes that favor environmental and economic objectives over social equity improvements. We find that social equity is a particularly prominent theme in local-level climate adaptation efforts, relative to environmental quality and economic development. The findings contribute to the literature on climate adaptation and sustainability within the urban context and offer practical insight for local-level stakeholders concerning potential obstacles and opportunities for the integration of social equity initiatives into climate adaptation planning. Given the likelihood that climate changes will continue to impose unique challenges for marginalized communities in urban areas, advancing our understanding of how social equity concerns are integrated into adaptation efforts is likely to become an increasingly critical area of inquiry.

Keywords: climate adaptation plan, climate change, social equity, sustainability

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Authors: Atitallah Sofien, Bouyahia Olfa, Krifi Farah, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

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Introduction: Cutis marmorata telangiectatica congenita (CMTC) is a rare cutaneous vascular malformation. It most often appears at birth or during the first days of life. Its origin is still unknown. It associates a livedo with telangiectasias of diffuse or segmental topography. In rare cases, it can be associated with neurological disorders such as macrocephaly and, less frequently, with epilepsy. Methodology: We report a case of an infant with Macrocephaly- Cutis marmorata telangiectatica congenita syndrome associated with epilepsy. Results: This is the case of a one month and 15 days old female infant from a non-consanguineous marriage, admitted for a status epilepticus in the context of apyrexia. Infectious and metabolic causes had been eliminated. Physical examination had shown non-infiltrated and reticular livedoid erythematous patches affecting the left upper limb and atrophic on the back of the left hand. Cerebral magnetic resonance imaging (MRI) showed thin layers of bifrontal, temporal, and left parietal hygromas associated with the widening of the bifrontal subarachnoid spaces. The electroencephalogram showed a well-organized sleep tracing with a single right occipital paroxysmal abnormality. Antiepileptic treatment has been administered with good clinical evolution and regression of the skin lesion and a control electroencephalogram without abnormality. Conclusion: This observation illustrates an association of CMTC with both macrocephaly and epilepsy. This pathology, which is relatively benign and has a good prognosis, generally does not require treatment. However, a detailed examination must be carried out, and a follow-up plan must be put in place for each patient presenting with CMTC, given the risk of association with other abnormalities, which can be potentially serious.

Keywords: cutis marmorata telangiectatica congenita, macrocephaly, epilepsy, children

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Authors: Michael R. Taber, Kristin Stanec

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This paper presents year-two of a longitudinal study on implementing Possibility Books into undergraduate courses to develop a student's creativity mindset: tolerating ambiguity, willingness to risk failure, curiosity, and openness to embrace possibility thinking through unexpected connections. Courses involved in this research span disciplines in the natural and social sciences and the humanities. Year one of the project developed indices from which baseline data could be analyzed. The two significant indices ( > 0.7) were "creativity mindset" and "intentional interactions." Preliminary qualitative and quantitative data analysis indicated that students found the new pedagogical intervention as a safe space to learn new strategies, recognize patterns, and define structures through innovative notetaking forms. Possibility Books in Natural Science courses were designed to develop students' conceptualization of science and math. Using Possibility Books in all disciplines provided a space for students to practice divergent thinking (i.e.,Possibilities), convergent thinking (i.e., forms that express meaning), and risk-taking (i.e., the vulnerability associated with expression). Qualitative coding of open responses on a post-survey revealed two major themes: 1) Possibility Books provided a mind space for learning about self, and 2) provided a calming opportunity to connect concepts. Quantitative analysis indicated significant correlations between focused headspace and notetaking (r = 0.555, p < 0.001), focused headspace, and connecting with others (r = 0.405, p < 0.001).

Keywords: pedagogy, science education, learning methods, creativity mindsets

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Authors: R. Santos Alimi

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Using time-series techniques, this study empirically tested the validity of existing theory which stipulates there is a nonlinear relationship between government size and economic growth; such that government spending is growth-enhancing at low levels but growth-retarding at high levels, with the optimal size occurring somewhere in between. This study employed three estimation equations. First, for the size of government, two measures are considered as follows: (i) share of total expenditures to gross domestic product, (ii) share of recurrent expenditures to gross domestic product. Second, the study adopted real GDP (without government expenditure component), as a variant measure of economic growth other than the real total GDP, in estimating the optimal level of government expenditure. The study is based on annual Nigeria country-level data for the period 1970 to 2012. Estimation results show that the inverted U-shaped curve exists for the two measures of government size and the estimated optimum shares are 19.81% and 10.98%, respectively. Finally, with the adoption of real GDP (without government expenditure component), the optimum government size was found to be 12.58% of GDP. Our analysis shows that the actual share of government spending on average (2000 - 2012) is about 13.4%.This study adds to the literature confirming that the optimal government size exists not only for developed economies but also for developing economy like Nigeria. Thus, a public intervention threshold level that fosters economic growth is a reality; beyond this point economic growth should be left in the hands of the private sector. This finding has a significant implication for the appraisal of government spending and budgetary policy design.

Keywords: public expenditure, economic growth, optimum level, fully modified OLS

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Authors: Jiashu Shen

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With the increase in the prevalence of divorce, the impact of divorce on children’s sexual and reproductive health has received wide attention, while few studies have investigated parent marital relationship. This study aims to study the relation of both parent divorce and perceived parental marital relationship with children’s sexual behaviors among Chinese university or vocational college students. The study used data from “National College Student Survey on Sexual and Reproductive Health 2019”, an internet-based survey conducted from November 2019 to February 2020, in 241 universities or vocational colleges in China. Statistical analyses were conducted to assess the relationship of perceived parental marital relationship and parents’ divorce of distinct occurrence time with sexual intercourse, risky sexual behaviors, unintended health outcomes and sexual abuse. Among 51,124 university or vocational college students, those whose parents had divorced accounted for 10.72%. Better perceived parental relationship was associated with a lower likelihood to have sexual intercourse (male: OR: 0.83, 95%CI: 0.80-0.86; female: OR: 0.73, 95%CI: 0.70-0.75), sexual abuse, risky sexual behaviors and unintended health outcomes. Divorce was also found to be associated with higher risk of sexual abuse, risky sexual behaviors and unintended health outcomes. The findings highlight the importance of parental marital relationship and divorce in risky sexual behavior among young adults. The findings may provide implications on intervention programs targeting at children with divorced parents from an early stage.

Keywords: college students, divorce, family relationship, sexual behavior

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Authors: Hsien Hua Kuo, Wen Chun Lin, Chia Chi Hsu, Hsien Wen Kuo

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Objective: Despite the high prevalence of musculoskeletal disorders (MSDs) among nurses, which has been consistently observed in the studies of Western countries, very little information regarding intensity of workload and work-related quality of life (WRQOL) related to MSDs among nurses is available in Taiwan. The objective of this study is to investigate the factors affecting musculoskeletal disorders in nurses from a hospital. Methods: 550 nurses from a hospital in Taoyuan were interviewed using a modified standardized Nordic Musculoskeletal (NMQ) questionnaire which contained the demographic information, workplace condition and musculoskeletal disorders. Results: Response rate of nurses were 92.5% from a teaching hospital. Based on medical diagnosis by physician, neck of musculoskeletal disorders had the highest percentage in nine body portions. The higher percentage of musculoskeletal disorders in nurses found from wards of internal and surgery. Severity and symptoms of musculoskeletal disorders diagnosed by self-reported questionnaire significantly correlated with WRQOL, job satisfaction and intensity of workload among nurses based on the logistic regression model. Conclusion: The severity and symptoms of musculoskeletal disorders among nurses showed a dose-dependent with WRQOL and workload. When work characteristics in hospital were modified, the severity of musculoskeletal disorders among nurses will be decreased and alleviated. Comment: Multifaceted ergonomic intervention programme to reduce the prevalence of MSDs among nurses was by encouraging nurses to do more physical activity which will make them more flexible and increase their strength. Therefore, the head nurse should encourage nurses to regularly physical activity and to modify unfitting ergonomic environment in order to reduce the prevalence of MSDs.

Keywords: musculoskeletal disorders, nurse, WRQOL, job satisfaction

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Authors: Beng Zhen Yeow

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In most work that involves children, the voice of the children is often not heard. This is ironic since a lot of discussions might involve their welfare and safety. It might seem natural that the professionals should hear from them about what they wish for instead of deciding what is best for them. However, this, unfortunately, might be more the exception than the norm in most case and hence in many instances, children are merely 'subjects' in conversations about safety instead of active participants in the construction or creation of safety in the family. There might be many reasons why it does not happen in our work. Firstly, professionals have learnt how to 'socialise' into their professional roles and hence in the process become 'un-childlike'. Secondly, there is also a lack of professional training with regards to how to talk with children. Finally, there might be also a lack of concrete tools and techniques that are developed to facilitate the process. In this paper, the case study method is used to show how the idea of safety could be concretised and discussed with children and their family members, and hence making them active participants and co-creators of their own safety. Specific skills and techniques are highlighted through the case study. In this case, there was improvement in outcomes like no repeated offence or abuse. In addition, children were also able to advocate for their own safety after six months of intervention and how the family members were able to explicitly say what they can do to improve safety. The professionals in the safety network reported significant improvements. On top of that, the abused child who was removed due to child protection concerns, had verbalized observations of change in mother’s parenting abilities, and has requested for home leave to begin due to ownership of safety planning and having confidence to co-create safety for her siblings and herself together with the professionals in the safety network. Children becoming active participants in the co-creation of safety not only serve the purpose in allowing them to own a 'voice' but at the same time, give them greater confidence to protect themselves at home and in other contexts outside of home.

Keywords: partnering for safety, collaborative social work, family and systemic psychotherapy, child protection

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