Search results for: CBR centres

Authors: Ilim Moses Msughter

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The study was carried out to examine the availability of Ante-natal care services and the socio-cultural factors affecting the utilization of these services in Dutsin-Ma Local Government Area of Katsina State. Four specific objectives were outlined as thus to examine the availability of antenatal care services in Dutsin-Ma local government area, to identify the socio-cultural factors affecting the utilisation of ante-natal care services, to ascertain the challenges affecting utilisation of ante-natal care services and suggest strategies to improve efficiency in ante-natal service delivery and utilisation of same services. Data were collected from 110 respondents using a questionnaire and through the use of the interview. Data were analysed quantitatively and qualitatively. The findings revealed that ante-natal care services are available in the study area, but access to such services is hindered by several factors, which include religious and traditional beliefs, cost of services and poor attitudes of health care workers which has an adverse effect on people’s desire to visit ante-natal centres. The study recommended that Traditional Birth Attendants (TBA) need to be trained on how to handle pregnancy-related complications. It is also recommended that essential ante-natal drugs and services should be subsidised or made free by the government, and this must be closely monitored to ensure efficiency. Finally, human relation training should be organised for nurses and midwives to improve their attitudes towards patients during ante-natal visits.

Keywords: utilisation, religion, traditional birth attendant, ante-natal

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Authors: Zeinab Haji Abolhasani, Romeo Marian, Lee Luong

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This paper and its companions (Part II, Part III) will concentrate on optimizing a class of supply chain problems known as Multi- Commodities Consumer Supply Chain (MCCSC) problem. MCCSC problem belongs to production-distribution (P-D) planning category. It aims to determine facilities location, consumers’ allocation, and facilities configuration to minimize total cost (CT) of the entire network. These facilities can be manufacturer units (MUs), distribution centres (DCs), and retailers/end-users (REs) but not limited to them. To address this problem, three major tasks should be undertaken. At the first place, a mixed integer non-linear programming (MINP) mathematical model is developed. Then, system’s behaviors under different conditions will be observed using a simulation modeling tool. Finally, the most optimum solution (minimum CT) of the system will be obtained using a multi-objective optimization technique. Due to the large size of the problem, and the uncertainties in finding the most optimum solution, integration of modeling and simulation methodologies is proposed followed by developing new approach known as GASG. It is a genetic algorithm on the basis of granular simulation which is the subject of the methodology of this research. In part II, MCCSC is simulated using discrete-event simulation (DES) device within an integrated environment of SimEvents and Simulink of MATLAB® software package followed by a comprehensive case study to examine the given strategy. Also, the effect of genetic operators on the obtained optimal/near optimal solution by the simulation model will be discussed in part III.

Keywords: supply chain, genetic algorithm, optimization, simulation, discrete event system

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Authors: Sandipika Gupta

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Objective: Due to admirably low 30-day mortality rates for paediatric cardiac surgery, it is now pertinent to turn towards more intermediate-length outcomes such as morbidities closely associated with these surgeries. One such morbidity, major adverse events (MAE) comprises a group of adverse outcomes associated with paediatric cardiac surgery (e.g. cardiac arrest, major haemorrhage). Methods: This is a retrospective study that analysed the incidence and impact of MAE which was the primary outcome in the UK population. The data was collected in 5 centres between October 2015 and June 2017, amassing 3090 surgical episodes. The incidence and risk factors for MAE, were assessed through descriptive statistical analyses and multivariate logistic regression. The secondary outcomes of life status at 6 months and the length of hospital stay were also evaluated to understand the impact of MAE on patients. Results: Out of 3090 episodes, 134 (4.3%) had a postoperative MAE. The majority of the episodes were in: neonates (47%, P<0.001), high-risk cardiac diagnosis groups (20.1%, P<0.001), episodes with longer 5mes on the bypass (72.4%, P<0.001) and urgent surgeries (57.9%, P<0.001). Episodes reporting MAE also reported longer lengths of stay in hospital (29 days vs 9 days, P<0.001). Furthermore, patients experiencing MAE were at a higher risk of mortality at the 6-month life status check (mortality rates: 29.2% vs 2%, P<0.001).Conclusions: Key risk factors were identified. An important negative impact of MAE was found for patients. The identified risk factors could be used to profile and flag at-risk patients. Monitoring of MAE rates and closer investigation into the care pathway before and after individual MAEs in children’s heart units may lead to a reduction in these terrible events.

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Authors: Oluwatayo Isijola

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The destructive influence of Europe on Africa has also taken a tow on the aesthetic essence of the African Art, which centres on morality and value for human life. In a parallel vein, the adverse turn of this influence on the dramaturgy of some contemporary African plays, poses impedance to audience consciousness in performance engagements. Through the spectrum of African Aesthetics, this study attempts a performance appraisal of A Husband’s wife; an unpublished play written by Tyrone Terence for the African audience. The researcher proffers two variant textual interpretations of the play to evaluate performance engagement in its default realistic mode, which holds an unresolved 'Medean-impulse', and another wherein the resolution is treated to a paradigm shift for aesthetic preference. The investigation employs the mixed method, which combines the quantitative and qualitative methodologies. Keen observation on the reactions and responses of audience members that were engaged in both performances, and on-the-spot interview with selected audience members, were the primary sources for the qualitative data. However, quantitative data was captured in an on-the-spot survey with the instrument of the questionnaire served to a sample population of the audience. The study observes that the preference for African aesthetics as exemplified in the second performance which deployed a paradigm shift did enhance audience consciousness. Hinging on performance aesthetic theory, the paper recommends that all such African plays bestowed with the shortcoming of African aesthetics, should be appropriately treated to paradigm shifts for performance engagement, in the interest of enhancing audience consciousness in the Nigerian Theatre.

Keywords: African aesthetics, audience consciousness, paradigm shift, median-impulse

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Authors: K. Hinde, R. Bookun, P. Tran

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Percutaneous CT guided biopsies provide a fast, minimally invasive, cost effective and safe method for obtaining tissue for histopathology and culture. Standards for diagnostic yield vary depending on whether the tissue is being obtained for histopathology or culture. We present a retrospective audit from Western Health in Melbourne Australia over a 12-month period which aimed to determine the diagnostic yield, technical success and complication rate for CT guided bone biopsies and identify factors affecting these results. The digital imaging storage program (Synapse Picture Archiving and Communication System – Fujifilm Australia) was analysed with key word searches from October 2015 to October 2016. Nineteen CT guided bone biopsies were performed during this time. The most common referring unit was oncology, work up imaging included CT, MRI, bone scan and PET scan. The complication rate was 0%, overall diagnostic yield was 74% with a technical success of 95%. When performing biopsies for histologic analysis diagnostic yield was 85% and when performing biopsies for bacterial culture diagnostic yield was 60%. There was no significant relationship identified between size of lesion, distance of lesion to skin, lesion appearance on CT, the number of samples taken or gauge of needle to diagnostic yield or technical success. CT guided bone biopsy at Western Health meets the standard reported at other major clinical centres for technical success and safety. It is a useful investigation in identification of primary malignancy in distal bone metastases.

Keywords: bone biopsy, computed tomography, core biopsy, histopathology

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Authors: Khitam Ibrahem Shlash Mohammad

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Background: Postnatal depression is a focus of considerable research attention, but little is known about the pattern of stress across this period. Objective: to investigate the prevalence of stress after childbirth for Jordanian women and identify associated risk factors. Method: Design: A descriptive cross-sectional study. Participants were recruited six to eight weeks postpartum, provided personal, social and obstetric information, and completed the stress subscale of Depression Anxiety and Stress Scale (DASS-S), the Maternity Social Support Scale (MSSS), and Perceived Self-Efficacy Scale (PSES). Setting: maternal and child health care clinics in four health care centres in Maan city in Southern Jordan. Participants: Arabic speaking women (n = 324) between the ages of 18 and 45 years, six to eight weeks postpartum, primiparous or multiparous at low risk for obstetric complications. Data collection took place between October 2015 and January 2016. Ethical clearance was obtained prior to data collection. Results: The prevalence of postpartum stress among Jordanian women was 39.8 %. A regression analysis revealed that occupation, low social support, financial problems, difficult marital relationships, difficult relationship with family-in-law, giving birth to a female baby, difficult childbirth, and low self-efficacy were associated with postpartum stress. Conclusions and implications for practice: Jordanian women need support during pregnancy, during and after childbirth. Postpartum emotional support and assessment of symptoms of stress need to be incorporated into routine practice. The opportunity for open discussion along with increased awareness and clarification of common misconceptions about postpartum stress is necessary.

Keywords: prevalence, postpartum, stress, Jordanian women

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Authors: Ayeshmanthe Rathnayake, Ashutosh Hardikar

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Introduction: Lung cancer is the most common cause of cancer death in Australia, with more than 13000 cases per year. Until now, there has been a major deficiency of national comprehensive thoracic surgery data. The thoracic workload for surgeons as well as caseload per unit, is highly variable, with some centres performing less than 15 cases per annum, thus raising concerns about optimal care at low-volume sites. This is an attempt to review the outcomes of lung cancer surgery in Tasmania. Method: The objective of this study is to determine the surgical outcomes of lung cancer surgery at Royal Hobart Hospital (RHH) with the primary outcome of surgical mortality. Four hundred fifty-one cases were analysed retrospectively from 2010 to May 2022. Results: A total of 451 patients underwent thoracic surgery with a primary diagnosis of lung cancer. The primary outcome of 30-day mortality was <0.5%. The mean age was 65.3 years, with male predominance and a 4.2% prevalence of Indigenous Australians. The mean LOS was 7.5 days. The surgical approach was either VATS (50.3%) or Thoracotomy (49.7%), with a trend towards the former in recent years with an increase in the proportion of VATS from 18.2% to 51% (p<0.05) in complex resections since 2019. A corresponding reduction in conversion rate to open was observed (18% vs. 5.5%), and there were no deaths within this subgroup. Lung resections were divided into lobectomy (55.4%), wedge resection (36.8%), segmentectomy (2.9%) and pneumonectomy (4.9%). The RHH demonstrates good surgical outcomes for lung cancer and provides a sustainable service for Tasmania. Conclusion: This retrospective study reports the surgical outcomes of lung cancer surgery at the Royal Hobart Hospital, thereby providing insight into the surgical management of lung cancer in the state thus far. The state has been slow to catch up on the minimally invasive program, but the overall results have been comparable to most peers.

Keywords: lung cancer, thoracic surgery, lung resection, surgical outcomes

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Authors: Ahmad Khoirul Umam, Iin Mayasari

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Indonesia is blessed with rich natural resources and frequently dubbed as the 6th richest country in the world in terms of mining resources, including minerals and coal. Mining can contribute to the socio-economic development by generating state revenue for development, elevating poverty through employment, opening and developing remote areas, putting in basic infrastructure and creating new centres of developments. However, favouritism and rent-seeking behaviour committed by government officials, politicians, and business players in licensing and permit giving in mining and forestry sectors have resisted reforms. Even though Indonesia’s Corruption Eradication Commission (KPK) successfully targeted untouchable actors, public criticism continues to focus on questions of why corruption apparently remains systemic in mining industry in the country? This paper revealed that structural anomalies, as well as legacies of the Soeharto era’s power inequities, have severely inhibited Indonesia’s bureaucratic arrangements that continue to influence adversely the elements of transparency and accountability in mining industry governance. In the more liberalized and decentralized political system, the deficiencies have gradually assisted vested interest groups to band together, thus creating a coalition that can challenge, resist, and contain anti-graft actions. Therefore, Indonesia needs much more serious anti-corruption actions that would require eliminating the monopoly over power, enhancing competition, limiting discretion, and clarifying the rules of business and political competition in the mining sector in the country.

Keywords: anti-corruption, public integrity, private integrity, mining industry, democratization

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Authors: Francisco Pedroza-Montero, Jesús Naín Pedroza-Montero, Diego Soto-Puebla, Osiris Alvarez-Bajo, Beatriz Castaneda, Sofía Navarro-Espinoza, Martín Pedroza-Montero

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Nanodiamonds have been widely studied for their physical properties, including chemical inertness, biocompatibility, optical transparency from the ultraviolet to the infrared region, high thermal conductivity, and mechanical strength. In this work, we studied how the fluorescence spectrum of nanodiamonds quenches concerning the concentration in aqueous solutions systematically ranging from 0.1 to 10 mg/mL. Our results demonstrated a non-linear fluorescence quenching as the concentration increases for both of the NV zero-phonon lines; the 5 mg/mL concentration shows the maximum fluorescence emission. Furthermore, this behaviour is theoretically explained as an electronic recombination process that modulates the intensity in the NV centres. Finally, to gain more insight, the FRET methodology is used to determine the fluorescence efficiency in terms of the fluorophores' separation distance. Thus, the concentration level is simulated as follows, a small distance between nanodiamonds would be considered a highly concentrated system, whereas a large distance would mean a low concentrated one. Although the 5 mg/mL concentration shows the maximum intensity, our main interest is focused on the concentration of 0.5 mg/mL, which our studies demonstrate the optimal human cell viability (99%). In this respect, this concentration has the feature of being as biocompatible as water giving the possibility to internalize it in cells without harming the living media. To this end, not only can we track nanodiamonds on the surface or inside the cell with excellent precision due to their fluorescent intensity, but also, we can perform thermometry tests transforming a fluorescence contrast image into a temperature contrast image.

Keywords: nanodiamonds, fluorescence spectroscopy, concentration, bioimaging, thermometry

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Authors: S. S. Adamu, H. S. Muhammad, D. S. Shuaibu

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Poor power quality in electrical power systems can lead to medical equipment at healthcare centres to malfunction and present wrong medical diagnosis. Equipment such as X-rays, computerized axial tomography, etc. can pollute the system due to their high level of harmonics production, which may cause a number of undesirable effects like heating, equipment damages and electromagnetic interferences. The conventional approach of mitigation uses passive inductor/capacitor (LC) filters, which has some drawbacks such as, large sizes, resonance problems and fixed compensation behaviours. The current trends of solutions generally employ active power filters using suitable control algorithms. This work focuses on assessing the level of Total Harmonic Distortion (THD) on medical facilities and various ways of mitigation, using radiology unit of an existing hospital as a case study. The measurement of the harmonics is conducted with a power quality analyzer at the point of common coupling (PCC). The levels of measured THD are found to be higher than the IEEE 519-1992 standard limits. The system is then modelled as a harmonic current source using MATLAB/SIMULINK. To mitigate the unwanted harmonic currents a shunt active filter is developed using synchronous detection algorithm to extract the fundamental component of the source currents. Fuzzy logic controller is then developed to control the filter. The THD without the active power filter are validated using the measured values. The THD with the developed filter show that the harmonics are now within the recommended limits.

Keywords: power quality, total harmonics distortion, shunt active filters, fuzzy logic

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Authors: Elhussaien Elshiekh

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A study was performed to management and compare radiation doses and image quality during Lumbar spine PA and Lumbar spine LAT, x- ray radiography using Computed Radiography (CR) and Digital Radiography (DR). Standard exposure factors such as kV, mAs and FFD used for imaging the Lumbar spine anthropomorphic phantom obtained from average exposure factors that were used with CR in five radiology centres. Lumbar spine phantom was imaged using CR and DR systems. Entrance surface air kerma (ESAK) was calculated X-ray tube output and patient exposure factor. Images were evaluated using visual grading system based on the European Guidelines on Quality Criteria for diagnostic radiographic images. The ESAK corresponding to each image was measured at the surface of the phantom. Six experienced specialists evaluated hard copies of all the images, the image score (IS) was calculated for each image by finding the average score of the Six evaluators. The IS value also was used to determine whether an image was diagnostically acceptable. The optimum recommended exposure factors founded here for Lumbar spine PA and Lumbar spine LAT, with respectively (80 kVp,25 mAs at 100 cm FFD) and (75 kVp,15 mAs at 100 cm FFD) for CR system, and (80 kVp,15 mAs at100 cm FFD) and (75 kVp,10 mAs at 100 cm FFD) for DR system. For Lumbar spine PA, the lowest ESAK value required to obtain a diagnostically acceptable image were 0.80 mGy for DR and 1.20 mGy for CR systems. Similarly for Lumbar spine LAT projection, the lowest ESAK values to obtain a diagnostically acceptable image were 0.62 mGy for DR and 0.76 mGy for CR systems. At standard kVp and mAs values, the image quality did not vary significantly between the CR and the DR system, but at higher kVp and mAs values, the DR images were found to be of better quality than CR images. In addition, the lower limit of entrance skin dose consistent with diagnostically acceptable DR images was 40% lower than that for CR images.

Keywords: image quality, dosimetry, radiation protection, optimization, digital radiography, computed radiography

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Authors: Yasin I. Tayem, Jamil Ahmed, Mahmood Bahzad, Abdullah Alnama, Fahad Al Asfoor, Mahmood A. Jalil, Mohammed Radhi, Ahmed Alenezi, Khalid A. J. Al-Khaja

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Drug-drug interactions (DDIs) represent a significant cause of patient’s morbidity and mortality. The rate of DDIs is rapidly increasing worldwide with the increasing proportion of ageing population and frequent requirement of polypharmacy-prescription of multiple drugs to treat comorbidities. Prescribing physicians are responsible for checking their prescriptions for the presence and severity of DDIs. However, since a large number of new drugs are approved and marketed every year, new interactions between medications are increasingly reported. Consequently, it is no longer practical for physicians to rely only upon their previous knowledge of medicine to avoid potential DDIs. The aim of this study was to explore the perceptions of physicians working at primary healthcare centers in Bahrain towards DDIs and how they manage them during their practice. Methodology: In this cross-sectional study, physicians working at all governmental primary healthcare centers in Bahrain were invited to voluntarily, privately and anonymously respond to a self-administered questionnaire. The questionnaire aims to assess their self-reported knowledge of DDIs and how they check for them in their practice. The participants were requested to provide socio demographic data and information related to their attitudes towards DDIs including strategies they employ for detecting and managing them, and their awareness of drugs which commonly cause DDIs. At the end of the questionnaire, an open-ended item was added to allow participants to further add any comment. Findings and Conclusions: The study is going on currently, and the results and conclusions will be presented at the conference.

Keywords: awareness, drug interactions, health centres, physicians

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Authors: Raad Nari, Maura Moriaty, Maha T. Barakat

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Introduction: Sodium-glucose co-transporter-2 (SGLT2) inhibitors are a new class of oral anti-diabetic drugs with a unique mechanism of action. They are used to improve glycaemic control in adults with type 2 diabetes by enhancing urinary glucose excretion. In the UAE, there has been certainly an increased use of these medications. As with any new medication, there are safety considerations related to their use in patients with type two diabetes. A retrospective study was conducted at the three main centres of the Imperial College London Diabetes Centre. Methodology: All patients in electronic database (Diamond) from October 2014 to October 2017 were included with a minimum of six months usage of sodium glucose co-transporter inhibitors that comprise canagliflozin, dapagliflozin and empagliflozin. There were 15 paired sample biochemical and clinical correlations. The analysis was done at the start of the study, three months and six months apart. SPSS version 24 was used for this study. Conclusion: This study of sodium glucose co-transporter-2 inhibitors used showed significant reductions in weight, glycated haemoglobin A1C, systolic and diastolic blood pressures. As the case with systematic reviews, there were similar changes in liver enzymes, raised total cholesterol, low density lipopoptein and high density lipoprotein. There was slight improvement in estimated glomerular filtration rate too. Our analysis also showed that they increased in the incidence of urinary tract symptoms and incidence of urinary tract infections.

Keywords: SGLT2 inhibitors dapagliflozin empagliflozin canagliflozin, adverse effects, amputation diabetic ketoacidosis DKA, urinary tract infection

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Authors: Endalew Fufa Kufi

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The research investigated the role of stakeholders such as students, teachers and administrators in the practices of good governance in higher education by looking into the special contributions of top-officials, teachers and students in ensuring workable ties and productive interchanges in Adama Science and Technology University. Attention was given to participation, fairness and exemplariness as key indicators of good governance. The target university was chosen for its familiarity for the researcher to get dependable data, access to respondent and management of the processing of data. Descriptive survey design was used for the purpose of describing concerned roles the stakeholders in the university governance in order to reflect on the nature of participation of the practices. Centres of the research were administration where supportive groups such as central administrators and underlying service-givers had parts and academia where teachers and students were target. Generally, 60 teachers, 40 students and 15 administrative officers were referents. Data were collected in the form of self-report through open-ended questionnaires. The findings indicated that, while vertical interchanges in terms of academic and administrative routines were had normal flow on top-down basis, planned practices of stakeholders in decision-making and reasonably communicating roles and changes in decisions with top-officials were not efficiently practiced. Moreover, the practices of good modelling were not witnessed to have existed to the fullest extent. Rather, existence of a very wide gap between the academic and administrative staffs was witnessed as was reflected the case between teachers and students. The implication was such that for shortage in participative atmosphere and weaning of fairness in governance, routine practices have been there as the vicious circles of governance.

Keywords: governance, participative, stakeholders, transformative, role-assumption

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Authors: Engida Yisma, Berhanu Dessalegn, Ayalew Astatkie, Nebreed Fesseha

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Background: The use of the partograph is a well-known best practice for quality monitoring of labour and subsequent prevention of obstructed and prolonged labour. However, a number of cases of obstructed labour do happen in health facilities due to poor quality of intrapartum care. Methods: A cross-sectional quantitative study assessed knowledge and utilization of partograph among obstetric care givers in public health institutions of Addis Ababa, Ethiopia using a structured interviewer administered questionnaire. The collected data was analyzed using SPSS version 16.0. Logistic regression analysis was used to identify factors associated with knowledge and use of partograph among obstetric care givers. Results: Knowledge about the partograph was fair: 189 (96.6%) of all the respondents correctly mentioned at least one component of the partograph, 104 (53.3%) correctly explained the function of alert line and 161 (82.6%) correctly explained the function of action line. The study showed that 112 (57.3%) of the obstetric care givers at public health institutions reportedly utilized partograph to monitor mothers in labour. The utilization of the partograph was significantly higher among obstetric care givers working in health centres (67.9%) compared to those working in hospitals (34.4%) [Adjusted OR = 3.63(95%CI: 1.81, 7.28)]. Conclusions: A significant percentage of obstetric care givers had fair knowledge of the partograph and why it is necessary to use it in the management of labour and over half of obstetric care givers reported use of the partograph to monitor mothers in labour. Pre-service and on-job training of obstetric care givers on the use of the partograph should be given emphasis. Mandatory health facility policy is also recommended to ensure safety of women in labour in public health facilities in Addis Ababa, Ethiopia.

Keywords: partograph, knowledge, utilization, obstetric care givers, public health institutions

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Authors: Jemini Vyas, Oluwatobi Adeyoe, Jenny Branagan, Chandran Tanabalan, Aakash Pai

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Introduction: Radical prostatectomy and radiotherapy are both viable options for the treatment of localised prostate cancer. Over the years medicine has evolved towards a patient-centred approach. Patient decision-making is not motivated by clinical outcomes alone. Geographical location and ease of access to treating clinician are contributory factors. With the development of robotic surgery, prostatectomy has been centralised into tertiary centres. This has impacted on the distances that patients and their families are expected to travel. Methods: A single centre retrospective study was undertaken over a five-year period. All patients with localised prostate cancer, undergoing radical radiotherapy or prostatectomy were collected pre-centralisation. This was compared to the total number undergoing these treatments post centralisation. Results: Pre-centralisation, both radiotherapy and prostatectomy groups had to travel a median of less than five miles for treatment. Post-centralisation of pelvic surgery, prostatectomy patients had to travel a median of more than 40 miles, whilst travel distance for the radiotherapy group was unchanged. In the post centralisation cohort, there was a 63% decline in the number of patients undergoing radical prostatectomy per month from a mean of 5.1 to 1.9. The radical radiotherapy group had a concurrent 41% increase in patient numbers with a mean increase from 13.3 to 18.8 patients per month. Conclusion: Choice of radical treatment in localised prostate cancer is based on multiple factors. This study infers that local availability can influence choice of radical treatment. It is imperative that efforts are made to maintain accessibility to all viable options for prostate cancer patients, so that patient choice is not compromised.

Keywords: prostate, prostatectomy, radiotherapy, centralisation

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Authors: M. J. Pourvaghar, Sh. Khoshemehry

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

Keywords: kyphosis, exercise-rehabilitation, addict, addiction

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Authors: Harshadkumar Rajgor, Jeff Butterworth

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Background: Barretts oesophagus increases the risk of developing oesophageal adenocarcinoma. Over the last 40 years, there has been a 6 fold increase in the incidence of oesophageal adenocarcinoma in the western world and the incidence rates are increasing at a greater rate than cancers of the colon, breast and lung. Endoscopic mucosal resection (EMR) is a relatively new technique being used by 2 centres in the greater midlands cancer network. EMR can be used for curative or staging purposes, for high-grade dysplasia’s and T1 tumours of the oesophagus. EMR is also suitable for those who are deemed high risk for oesophagectomy. EMR has a recurrence rate of 21% according to the Wiesbaden data. Method: A retrospective study of prospectively collected data was carried out involving 24 patients who had EMR for curative or staging purposes. Complications of residual or recurrent disease following EMR that required further treatment were investigated. Results: In 54% of cases residual or recurrent disease was suspected. 96% of patients were given clear and concise information regarding their diagnosis of high-grade dysplasia or T1 tumours. All 24 patients consulted the same specialist healthcare team. Conclusion: EMR is a safe and effective treatment for patients who have high-grade dysplasia and T1NO tumours. In 54% of cases residual or recurrent disease was suspected. Initially, only single resections were undertaken. Multiple resections are now being carried out to reduce the risk of recurrence. Complications from EMR remain low in this series and consisted of a single episode of post procedural bleeding.

Keywords: endoscopic mucosal resection, oesophageal dysplasia, T1 tumours, cancer network

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Authors: John Bosco Ngendakurio

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The key question this paper asks is, ‘how does the refugee encampment policy undermine refugees’ potentials and fail local economy in East African countries?’ It is important to develop a full understanding of the legacies of the encampment policy for refugees’ performances economically, socially, and politically. The negative impacts of the encampment policy include the lack of participation or access to opportunities outside the refugee camps such as employment, education, and local integration, unfair imprisonments and constant alienation of refugees, mental and physical health issues, just to name a few. Evidence suggests that refugee camps in East Africa have progressively become open detention centres due to their designs, their locations, and movement restrictions imposed on refugees. Such restrictions in a region that hosts millions of refugees do not only undermine refugees’ potentials, but it also hurts the local economy- host countries miss out in many ways. Outlining the negative impacts of the encampment policy will enable governments and relevant non-governmental actors, including policymakers, to re-consider this policy with the aim to improve refugees’ participation and contributions in the broader society, promote socially cohesive practices, and help millions of refugees gain independence and reach their potentials financially, socially and politically, finally and truly giving the voice to the voiceless. The encampment policy undermines the general human security in East Africa, and it is one of the migration practices showcasing East African governments’ lack of will to protect human rights, especially within the most vulnerable population groups such as refugees.

Keywords: migration policy, immigration, refugees, encampment, migration, integration, social cohesion

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Authors: Skander Ben Mami

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Despite its particular patterns and historical importance, the remote region of the Pamir Hindu Kush still lacks public recognition, as well as scientific substance, because of the abundance of classical state-centred geopolitical studies, the resilience of (inter)national narratives, and the political utility of the concepts of 'Central Asia' and 'South Asia'. However, this specific region of about 100 million inhabitants and located at the criss-cross of four geopolitical areas (Indian, Iranian, Chinese and Russian) over a territory of half a million square kilometres features a string of patterns that set it apart from the neighbouring areas of the Fergana, the Gansu and Punjab. Moreover, the Pamir Hindu Kush undergoes a series of parallel social and economic transformations that deserve scrutiny for their strong effect on the people’s lifestyle, particularly in three major urban centres (Aksu in China, Bukhara in Uzbekistan and Islamabad in Pakistan) and their immediate rural surroundings. While the involvement of various public and private stakeholders (States, NGOs, civil movements, private firms…) has undeniably resulted in positive elements (economic growth, connectivity, higher school attendance), it has in the same time generated a collection of negative effects (radicalizing, inequalities, pollution, territorial divide) that need to be addressed to strengthen regional and international security. This paper underscores the region’s strategical importance as the major hotbed and engine of insecurity and violence in Asia, notably in the context of Afghanistan’s enduring violence. It introduces the inner structures of the region, the different sources of violence as well as the governments’ responses to address it.

Keywords: geography, security, terrorism, urbanisation

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Authors: A. O. Osabo

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Polytechnic education is often described as the only sustainable academic institution that can propel massive industrial and technological growth and development in all sectors of the Nigerian economy. Because of its emphasis on science and technology, practical demonstration of skills and pivotal role in the training of low-and-high-cadre technologists and technocrats to man critical sectors of the economy, the administration of polytechnics needs to be run according to global best standards and practices in order to achieve their goals and objectives. Besides, the polytechnics need to be headed by seasoned and academically sound professionals to pursue the goals and objectives of the schools as centres of technology, learning and academic excellence. Over the years, however, polytechnics in Nigeria have suffered a wide myriad of administrative problems and challenges which have prevented them from achieving their basic goals and objectives. Apart from regulatory problems and challenges, some heads of polytechnics do not demonstrate leadership and management skills in bringing the desired innovations in the management of the polytechnics under them. These have resulted, in most cases, to the polytechnics not performing optimally in its mandate. This paper examines the administrative problems, challenges and prospects of polytechnics education in north-central Nigeria. Using a total of 97 questionnaires consisting of semi-structured interviews of yes-or-no questions shared among staff and students of the selected polytechnics and a descriptive statistical method of analysis, the study found that the inability of the polytechnics to meet their goals and objectives is caused by administrative and organizational problems and challenges, bordering on funding, accreditation, manpower, corruption and maladministration, among others. The paper thus suggests that the leadership of the polytechnics must rise up to the demands of the time in order to deal with the administrative problems and challenges affecting them and fulfill the goals and objectives for which the schools were established.

Keywords: education, administration, polytechnic, accreditation, Nigerian

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Authors: Devadrita Dey Sarkar

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Oxidosqualene cyclase is a membrane bound enzyme in which helps in the formation of steroid scaffold in higher organisms. In a highly selective cyclization reaction oxidosqualene cyclase forms LANOSTEROL with seven chiral centres starting from the linear substrate 2,3-oxidosqualene. In humans OSC in cholesterol biosynthesis it represents a target for the discovery of novel anticholesteraemic drugs that could complement the widely used statins. The enzyme oxidosqualene: lanosterol cyclase (OSC) represents a novel target for the treatment of hypercholesterolemia. OSC catalyzes the cyclization of the linear 2,3-monoepoxysqualene to lanosterol, the initial four-ringed sterol intermediate in the cholesterol biosynthetic pathway. OSC also catalyzes the formation of 24(S), 25-epoxycholesterol, a ligand activator of the liver X receptor. Inhibition of OSC reduces cholesterol biosynthesis and selectively enhances 24(S),25-epoxycholesterol synthesis. Through this dual mechanism, OSC inhibition decreases plasma levels of low-density lipoprotein (LDL)-cholesterol and prevents cholesterol deposition within macrophages. The recent crystallization of OSC identifies the mechanism of action for this complex enzyme, setting the stage for the design of OSC inhibitors with improved pharmacological properties for cholesterol lowering and treatment of atherosclerosis. While studying and designing the inhibitor of oxidosqulene cyclase, I worked on the pdb id of 1w6k which was the most worked on pdb id and I used several methods, techniques and softwares to identify and validate the top most molecules which could be acting as an inhibitor for oxidosqualene cyclase. Thus, by partial blockage of this enzyme, both an inhibition of lanosterol and subsequently cholesterol formation as well as a concomitant effect on HMG-CoA reductase can be achieved. Both effects complement each other and lead to an effective control of cholesterol biosynthesis. It is therefore concluded that 2,3-oxidosqualene cyclase plays a crucial role in the regulation of intracellular cholesterol homeostasis. 2,3-Oxidosqualene cyclase inhibitors offer an attractive approach for novel lipid-lowering agents.

Keywords: anticholesteraemic, crystallization, statins, homeostasis

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Authors: Mengwei Li

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Since the 1990s, biennials, and large-scale transnational art exhibitions, have proliferated exponentially across the globe, particularly in Asia, Africa, and Latin America. It has spurred debates regarding the inclusion of "new art cultures" and the deconstruction of the mechanism of exclusion embedded in the Western monopoly on art. Hans Belting introduced the concept of "global art" in 2013 to denounce the West's privileged canons in art by emphasising the inclusion of art practices from alleged non-Western regions. Arguably, the rise of new biennial networks developed by these locations has contributed to the asserted "inclusion of new art worlds." However, phrases such as "non-Western" and "beyond Euro-American" attached to these discussions raise the question of non- or beyond- in relation to whom. In this narrative, to become "integrated" and "equal" implies entry into the "core," a universal system in which preexisting authoritative voices define "newcomers" by what they are not. Possibly, if there is a global biennial system that symbolises a "universal language" of the contemporary art world, it is centered on the inherently dynamic yet asymmetrical interaction and negotiation between the "core" and the rest of the world's "periphery." Engaging with theories of "minor literature" developed by Deleuze and Guattari, this research proposes an epistemological framework to comprehend the global biennial discourse since the 1990s. Using this framework, this research looks at two biennial models in China: the 13th Shanghai Biennale, which was organised in the country's metropolitan art centre, and the 2nd Yinchuan Biennale, which was inaugurated in a geographically and economically marginalised city compared to domestic centres. By analysing how these two biennials from different locations in China positioned themselves and conveyed their local profiles through the universal language of the biennial, this research identifies a potential "minor" positionality within the global biennial discourse from China's perspective.

Keywords: biennials, China, contemporary, global art, minor literature

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Authors: A. Miškinytė, A. Dėdelė

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Road traffic is one of the main sources of air pollution in urban areas associated with adverse effects on human health and environment. Nitrogen dioxide (NO2) is considered as traffic-related air pollutant, which concentrations tend to be higher near highways, along busy roads and in city centres and exceedances are mainly observed in air quality monitoring stations located close to traffic. Atmospheric dispersion models can be used to examine emissions from many various sources and to predict the concentration of pollutants emitted from these sources into the atmosphere. The study aim was to compare modelled concentrations of nitrogen dioxide using ADMS-Urban dispersion model with air quality monitoring network in cold and warm seasons in Kaunas city. Modelled average seasonal concentrations of nitrogen dioxide for 2011 year have been verified with automatic air quality monitoring data from two stations in the city. Traffic station is located near high traffic street in industrial district and background station far away from the main sources of nitrogen dioxide pollution. The modelling results showed that the highest nitrogen dioxide concentration was modelled and measured in station located near intensive traffic street, both in cold and warm seasons. Modelled and measured nitrogen dioxide concentration was respectively 25.7 and 25.2 µg/m3 in cold season and 15.5 and 17.7 µg/m3 in warm season. While the lowest modelled and measured NO2 concentration was determined in background monitoring station, respectively 12.2 and 13.3 µg/m3 in cold season and 6.1 and 7.6 µg/m3 in warm season. The difference between monitoring station located near high traffic street and background monitoring station showed that better agreement between modelled and measured NO2 concentration was observed at traffic monitoring station.

Keywords: air pollution, nitrogen dioxide, modelling, ADMS-Urban model

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Authors: Lucy Adesomon Okukpon, Margaret Omolara Akerele

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Higher Education in Nigeria is sought after by women, they believe that the economic power and growth lies in the attainment and pursuit of higher Education. No nation in the world can boast of developmental growth when the women are not fully empowered educationally. The attainment of higher education spurs women to contribute meaningfully towards the growth and development of the Nigerian workforce. Recent innovations and trends reveal that over fifty per cent of Nigerian women have attained higher education within and outside the country. Women in Nigeria have expressed their growing concern of what becomes of the remaining 50 per cent who are unable to attain basic education. This concern has brought about the issue of funding which is a practical challenge towards the attainment of education for these vulnerable women. Another challenging factor is that most women often seek the permission of their husbands, brothers, fathers and uncles to enable them attain educational pursuit, especially when the institution is miles away from their place of abode. The solution to this problems from research findings reveal that the umbrella body which co-ordinates education for women in Nigeria (The National Council of Women Societies, NCWS) have taken it upon itself to provide educational learning centres in all the states of the Federation including Abuja the Nations capital city. This is to stem the ugly trend and enable women gain access to educational facilities provided for their growth and development. This positive stride has brought succour to women who hitherto have no hope of attaining any form of education. Moreover, awareness creation concerning higher education is translated into different Nigerian languages so that the women at the grassroots can benefit immensely and contribute towards the growth and development of the Nation. Their educational progress attest to the fact that Nigerian Women are happy for the educational opportunities provided and have vowed to attain greater heights particularly where higher education is concerned.

Keywords: developmental growth, educational attainment, higher education, women in higher education, Nigeria

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Authors: Lim Poh Im

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This paper examines the current strategic and planning issues in the provision of affordable housing in urban centres in Malaysia from the perspective of sustainability. Sustainability here refers to social sustainability such as the need to address urban poverty and ensure better quality of life; economic sustainability in ensuring that the financial mechanisms are healthy and stable in the long-run, and to a lesser extent, environmental sustainability in reducing pollution related problems and building footprint. The Malaysian affordable housing sector has undergone tremendous transformations since the sixties, transcending from the earlier social housing catering to the poorer strata of the society, to the current state of housing woes plaguing the young urban middle class. The increase in urban land prices and construction costs, coupled with rampant property speculative and manipulative activities have resulted in situations of housing that are largely unaffordable even to the middle income sector of the urban populations. To overcome such scenario, the public as well as private sectors in the recent years, have came up with various intermediate, as well as medium-term policies aimed to curb the burning housing needs of the urban populations. Key strategies include financial intervention in regulating the interests rates, imposing property gain taxes; loosening the requirement for density and other planning requirements, faster approval of projects, compulsory contribution from developers, etc. Some of the policies are commendable, while others are ad-hoc by nature, and are not able to resolve the long-term socio-economic challenges. This paper discusses and examines the issues from the ‘sustainability’ perspective, focusing on key fiscal, land use and planning policies, as well as the more subtle (but important) political and institutional factors shaping the provision of mass housing for the urban populations in Malaysia.

Keywords: affordable housing, urban housing, sustainable housing, planning for urban housing

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Authors: Diptiman Dinda, Shyamal Kumar Saha

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In the 21st century, sensitive and selective detection of trace amounts of explosives has become a serious problem. Generally, nitro compound and its derivatives are being used worldwide to prepare different explosives. Recently, TNP (2, 4, 6 trinitrophenol) is the most commonly used constituent to prepare powerful explosives all over the world. It is even powerful than TNT or RDX. As explosives are electron deficient in nature, it is very difficult to detect one separately from a mixture. Again, due to its tremendous water solubility, detection of TNP in presence of other explosives from water is very challenging. Simple instrumentation, cost-effective, fast and high sensitivity make fluorescence based optical sensing a grand success compared to other techniques. Graphene oxide (GO), with large no of epoxy grps, incorporate localized nonradiative electron-hole centres on its surface to give very weak fluorescence. In this work, GO is functionalized with 2, 6-diamino pyridine to remove those epoxy grps. through SN2 reaction. This makes GO into a bright blue luminescent fluorophore (DAP/rGO) which shows an intense PL spectrum at ∼384 nm when excited at 309 nm wavelength. We have also characterized the material by FTIR, XPS, UV, XRD and Raman measurements. Using this as fluorophore, a large fluorescence quenching (96%) is observed after addition of only 200 µL of 1 mM TNP in water solution. Other nitro explosives give very moderate PL quenching compared to TNP. Such high selectivity is related to the operation of FRET mechanism from fluorophore to TNP during this PL quenching experiment. TCSPC measurement also reveals that the lifetime of DAP/rGO drastically decreases from 3.7 to 1.9 ns after addition of TNP. Our material is also quite sensitive to 125 ppb level of TNP. Finally, we believe that this graphene based luminescent material will emerge a new class of sensing materials to detect trace amounts of explosives from aqueous solution.

Keywords: graphene, functionalization, fluorescence quenching, FRET, nitroexplosive detection

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Authors: El Hadji Mamadou Sonko, Ndiogou Sankhare, Maïmouna Lo, Jean Birane Gning, Cheikh Diop

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In Senegal, access to water, hygiene, and sanitation in small island towns is a particular problem, which is still poorly understood by the public authorities and development aid actors. The main objective of this study carried out in the Municipality of Foundiougne is to contribute to the knowledge of the problems related to the supply of drinking water, access to sanitation, and hygiene in small island towns in Senegal. The methodology adopted consisted of a literature review and quantitative surveys of a sample of 100 households in the Municipality. Semi-structured interviews using interview guides and informal interviews were also conducted with mechanical and manual emptiers, municipal authorities, public toilet managers, and neighbourhood leaders. Direct observation with photography was also used. The results show that, with regard to access to drinking water, 35% of households have unimproved water services, 46% have a limited level of service, and 19% have a basic level of service. Regarding sanitation, 77% of households are considered to have access to basic sanitation services, compared to 23% with limited sanitation services. However, these figures hide the dysfunctions of the sanitation system. Indeed, manual emptying is practiced exclusively by 4% of households, while 17% of households combine it with mechanical emptying. In addition, domestic wastewater is mainly evacuated outside the sanitation facilities, and all the sludge extracted from the pits is discharged directly into the environment without treatment. As a matter of fact, the surveys showed that 52% of households do not have access to a basic level of hygiene-related to handwashing when leaving the toilet. These results show that there is real work to be done at the level of small urban centres if we want to achieve MDG 6.

Keywords: Foundiougne, Senegal, small island, small town, water-sanitation, hygiene

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Authors: Jegede Kehinde Jacob, Ola Akeem Bayonle, Adewale Yemi Yekeen

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The rapid rate of urban growth in most developing countries of the world in recent times is alarming. Mass movement of people from rural areas to the urban centres, the consequence of the uncontrolled rapid urbanisation resulting to many un-conforming environmental challenges such as inadequate infrastructure, land, water and air pollution, poor environmental sanitation, poor and inadequate housing, urban degradation, sprawl and slums, urban violence, crime, robbery and prostitution as well as many other social vices that make the cities unsustainable. The resultant effects of all these are abysmal failure in the management of cities on the part of the governing authorities and other relevant stakeholders as well as unconducive and unwholesome condition of living of the people. This paper attempts to examine holistically the issue of environmental planning management (EPM) process development and management concept with a view for dynamic and interactive approach for various stakeholders as partners in achieving sustainable cities of our dream. The areas of discussion including conceptual and contextual issues, sustainable cities concept, good urban governance including literature review. The paper goes further to examine opportunities and challenges of built environment generally, the nature and context of environmental problems in particular, the role and duties of environmental planning and management (EPM) process in sustainable urban development. The paper further reviewed briefly the various levels of institutionalisation of EPM process with a typical case study of sustainable Ibadan project (SIP). The paper concludes with a list of recommendations to ensure effective and lasting solutions to cities problems through initiation of EPM process achievable in a sustainable manner.

Keywords: built environment, environmental planning, sustainable cities, sustainable development, urbanization

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Authors: Daniel Afolayan, Christina Olawepo, Francis Olowookanga, Nguhemen Tingir, Olawale Fadare, John Oko

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In Nigeria, traditional birth attendants (TBAs) can play an important role in the prevention of mother-to-child transmission of HIV. However, their role in improving access to antiretroviral therapy (ART) is unclear. Catholic Caritas Foundation of Nigeria (Caritas Nigeria) is an implementing agency supporting increased access to HIV testing and treatment services in Lagos state through health facilities including Mother Theresa Hospital. Despite intra-facility testing and community outreaches, ART uptake at Mother Theresa Hospital, Lagos was low with 6 individuals on antiretroviral drugs 3 months post-activation. This study explored improving access to ART through linkages with TBAs for ART uptake at the facility. Plan-Do-Study-Act model was used. The goal was to improve uptake of ART from 6 to 80 in 5 months (end of project year). Scanning revealed a network of 15 TBAs with potential as satellites for HIV testing. Caritas Nigeria linked the facility with 15 TBAs who were provided with HIV test kits and trained on HIV testing services for provider-initiated testing and outreaches. Weekly reports and referrals of positives were received, tracked and feedback given on testing yield. These TBAs serve individuals of various age and gender at their trado-medical centres. At the end of 5 months, HIV testing increased by 10,575 (78% from TBAs) and HIV positives obtained improved by 77 (44.2% from TBAs). 55 new individuals were enrolled and commenced on ART (61.8% from TBAs). There was a successful linkage of all clients with escort services due to incentives. Total uptake of ART was 61 (76.3% of target). Structured partnerships between TBAs and HIV care and treatment centers should be strengthened to improve access to ART.

Keywords: access improvement, antiretroviral therapy, traditional birth attendants, uptake

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